bluuebunny/crossref_metadata_2025 huggingface dataset:
The Nomic Likelihood Account of Laws
Authors: Meacham Christopher J.
Published: March 2023

An adequate account of laws should satisfy at least five desiderata: it should provide a unified account of laws and chances, it should yield plausible relations between laws and chances, it should vindicate numerical chance assignments, it should accommodate dynamical and non-dynamical chances, and it should accommodate a plausible range of nomic possibilities. No extant account of laws satisfies these desiderata. This paper presents a non-Humean account of laws, the Nomic Likelihood Account, that does.
The Governing Conception of Laws
Authors: Emery Nina
Published: March 2023

In her paper, “The Non-Governing Conception of Laws,” Helen Beebee argues that it is not a conceptual truth that laws of nature govern, and thus that one need not insist on a metaphysical account of laws that makes sense of their governing role. I agree with the first point but not the second. Although it is not a conceptual truth, the fact that laws govern follows straightforwardly from an important (though under-appreciated) principle of scientific theory choice combined with a highly plausible claim about the connection between scientific theory choice and theory choice in metaphysics. I present and defend this argument and then show how the resulting understanding of governance gives rise to an especially strong version of recent explanatory circularity arguments against Humeanism about laws of nature. Finally, I present three options for a further understanding of the governance relation that are compatible with my argument.
Robespierre, monstre ou héros ?
Authors: Pouffary Marion
Published: March 2023

L’image de Robespierre n’est pas un bloc, comme le montre l’étude du discours public du xixe siècle, et notamment celle de la parole politique. Ce discours n’a pas jusqu’ici retenu l’attention des historiens, qui se sont concentrés sur l’historiographie, la littérature et les beaux-arts. Il révèle que la légende noire de Robespierre se scinde entre la Révolution et le milieu du xixe siècle en quatre légendes, qui peuvent être rapprochées de quatre courants politiques distincts : conservateur/contre-révolutionnaire, libéral, communiste et anarchiste. De plus, une légende dorée, peu analysée jusqu’ici, émerge dans les années 1830 chez les militants républicains les plus radicaux. Ce schéma interprétatif, présenté dans les deux premières parties de l’ouvrage, est confirmé par l’étude de l’image de Robespierre dans les débats parlementaires au xixe siècle, objet de la troisième partie. Il permet de comprendre pourquoi, plus de deux siècles après sa mort, Robespierre reste au cœur des débats sur l’héritage républicain.
Managing Stress and Enhancing Employee Wellness and Performance in Times of Crisis
Authors: Sokro Evans , Obuobisa-Darko Theresa
Published: March 2023

Employee stress has been explored extensively. However, there remain a dearth of scholarship on how leadership, specifically authentic leadership, helps to reduce employee stress levels in crises, such as the COVID-19 pandemic, in emerging economies, and to ensure employee wellness and performance using the social exchange theory. Using exploratory qualitative design and thematic analysis, data from 32 interviews with public sector employees in Ghana were analysed. Findings demonstrate that authentic leaders exhibit such characteristics as honesty, accountability, self-regulation, relational transparency, objective analysis of information, and valuing followers' contributions to arrive at decisions. These characteristics relate positively to employee job performance, wellness, and stress management.
Managing Stress and Overcoming Traumatic Workplace Betrayals
Authors: Gates Denise
Published: March 2023

The purpose of this chapter was to explore the lived experiences of a middle-aged Caucasian production supervisor who worked in the manufacturing industry within the United States. The chapter emphasized the stress and trauma she endured, which primarily stemmed from repetitive, prolonged, and cumulative sexual harassment. It offered the salient themes that emerged as the participant discussed traumatic institutional betrayal as well as the stress that resulted from working in a culture that condoned sexual harassment and ignored pay disparities. Strategies to overcome stress and marginalization were discussed.
Stress in a Crisis Context
Authors: Ferreira Diana Contente , Casquilho-Martins Inês
Published: March 2023

The emergence of COVID-19 led to a global pandemic framework, decreed in March 2020 by the World Health Organization. This phenomenon led to several changes and restrictions in people's lives, which subsequently questioned many professional practices, namely in social work. This chapter aims to analyze the factors and consequences of stress in the professional activity of social workers, as well as the changes in the health area caused by the pandemic crisis context in Portugal. Social workers' stress levels were affected during the COVID-19 pandemic, while recognizing that there were already present and identified causes of stress before the crisis. Work overload, multiple duties, fatigue, and even a decrease in the quality of professional care were aspects mentioned that need addressing, and since social workers intervene with a vulnerable population in different dimensions, greater attention is required. Therefore, the specificity of stress in social workers is correlated to the responsibility and demands of the professional practice itself.
Work and Life Balance Post COVID-19
Authors: Sharma Aditi Singh
Published: March 2023

The chapter explores the issue of work-life balance and its importance to the individual and the organization. The work-life balance issue is defined and looked at from all perspectives. The chapter will study the major components that affect work-life balance. The chapter will make an evaluative study of the way individuals and organizations have tried to approach the issue of work and life balance post COVID-19. Next, the chapter will explore the emerging challenge for people to balance work and home post COVID-19 after working from home for over two years. The emergence of digital technology and how it has impacted the global work and life balance will be discussed. Further, it elaborates how the COVID-19 pandemic has impacted the global workplace and why striking the right work and life balance is a challenge for humankind like never before. Finally, the chapter will conclude by looking into how people and organizations achieve the right balance in the new post-COVID-19 paradigm.
Does Voluntary Simplicity Lifestyle Support Psychological Resilience During Crises?
Authors: Yürüyen Kılıç Hediye , Dursun Inci , Tumer Kabadayi Ebru
Published: March 2023

This study aims to investigate the contribution of voluntary simplicity to psychological resilience during the Covid-19 pandemic. Distinctively, the study investigates (1) how a voluntary simplicity lifestyle (VSL) supports psychological well-being in terms of the valuation of life, mental health, and boredom experienced during the pandemic crisis and (2) whether pandemic-induced psychological states encourage the intention for a future VSL. Data were collected in Turkey through an online survey of 541 participants in the Covid-19 period. Analysis results revealed that not all but certain VSL aspects supported psychological resilience by promoting the valuation of life, mental health, and alleviating boredom during the pandemic. Material independency appeared as the most prominent VSL value contributing to psychological resilience. Findings revealed that a high valuation of life and high mental stress during the pandemic motivates individuals for future simple lives. The present study enhances the current knowledge about voluntary simplicity during highly stressful periods.
3D Reconstruction of Ancient Building Structure Scene Based on Computer Image Recognition
Authors: Zhu Yueyun
Published: March 2023

With the extensive application of computer image recognition (CIR), the high cost of three-dimensional (3D) models, long construction cycles, poor data visualization, and other problems have become the main bottlenecks in further development of CIR. Artificial intelligence (AI) is an important branch of computer science and has a wide range of application prospects and high practical value, especially in the field of medical and health applications of intelligent machines. This article introduces the background of 3D reconstruction of ancient architectural structure scenes, and then presents academic research and a summary on two key applications of CIR. It then summarizes 3D reconstruction and media technology in combination with AI used for medical diagnoses. In this article, the algorithm model is established, and various algorithms are proposed to provide a theoretical basis for the research of 3D reconstruction of ancient building structure scenes based on CIR.
Executive Coaching
Authors: Bhatia Divya , Naik Asha , Damle Pramod
Published: March 2023

Executive coaching has acquired a significant position in the world of developmental interventions in human resources development. Similarly, another trend spotted over the past two decades is reduction in the age group of senior and top executives. As the managers reach the top slots at young ages, it is imperative that their coaching needs must be re-assessed on the backdrop of the traditional needs of their relatively elder counterparts. Hence, the study was undertaken to understand the coaching needs expectations of young executives below 40 years of age. This paper presents the findings based on these young executives' responses on the related parameters (e.g., firm and faster decision making, acquisition of new knowledge, certifications, refining the presentation skills, better time management, strict financial controls and planning, technological updates, wider reading, better communication, listening skills, empathy, and career opportunities). The paper concludes with a few pointers for coaching for young executives and paves the way for further research in this area.
Examining Toxic Leadership Nexus With Employee Cyberloafing Behavior via Mediating Role of Emotional Exhaustion
Authors: Fan Tianyu , Khan Jawad , Khassawneh Osama , Mohammad Tamara
Published: March 2023

From the perspective of social exchange and the conservation of resources theories, the current study investigated the effect of toxic leadership on employee cyberloafing behaviour via the mediating role of emotional exhaustion and the moderating role of organisational commitment. SPSS models 1:moderation, 4: mediation, and 14: moderation mediation of PROCESS Hayes were used to evaluate the data from 357 employees of the Chinese corporate sector. The results show a positive relation between toxic leadership and cyberloafing, and emotional exhaustion mediates this relationship. Further, organisation commitment moderates the indirect, interactive effect of toxic leadership and emotional exhaustion on cyberloafing. The model was tested using 3-wave data; however, since the data were attained from a single source, the problem of common method bias cannot be ruled out. To avoid or lessen instances of cyberloafing behaviour and encourage good working attitudes, organisations must also take action and develop regulations governing internet use in the workplace.
Research of Moisture Sorption by Laminated Composite Materials
Authors: Kychkin A.A. , Vasilyeva E.D. , Vasilyeva A.A. , Kychkin A.K.
Published: March 2023

This article focuses on the moister sorption by laminated composites. Moisture sorption was carried out on layered polymer composite materials consisting of layers of basalt fabric and fiberglass based on epoxy-diane resin. It is shown that the process of moisture absorption for glass fiber-reinforced polymers is more intense and with a higher concentration of moisture in comparison with basalt fiber-reinforced polymer. Curves of the sorption processes of moisture absorption and water absorption are obtained. The diffusion coefficients for the corresponding processes are calculated. Alteration in the surface structure of polymer composite materials were recorded using surface topography and REM images before and after exposure in the climate of Yakutsk (Russia).
Mechanical Properties of Sand-Cement Mortar with Different Water/Cement Ratio under Thermal Gradient Conditions
Authors: Korobkov S.V. , Gnyrya A.I.
Published: March 2023

The paper studies the strength properties of sand-cement rod with the water-cement ratios of 0.4, 0.44, 0.49 and 0.54 under thermal gradient conditions. Experimental research concerns the influence of the temperature gradient within 60 to –20 оС on the mechanical properties of the sand-cement mortar with the different water-cement ratio. It is shown that the strength gain rate of sand-cement specimens varies in different periods of curing. The strength index of the sand-cement rod also varies in the conditions of heat and mass transfer that is supported by the theoretical background. The indicated temperature gradient significantly affects the curing process of the sand-cement specimens. Lower intensity of the strength gain is observed in specimens after 4-hour curing. The increase in the curing time from 8 to 12 hours leads to more intensive strength gain starting from the third specimen, when positive temperature begins. After 8-hour curing, the strength gain rate grows starting from the fifth specimen. At last, 12-hour curing results in the higher rate of the strength gain. Further increase in the curing time can lead to the highest strength gain rate. The rupture point drops with increasing water-cement ratio for all the specimens, independently of their position in the rod. Investigation of these processes will provide a better understanding of the negative effect of thermal gradient on the concrete structures and allow finding ways to increase their service life.
MWCNT Filled Banana-Rice Husk Epoxy Hybrid Natural Fiber Polymer Composites
Authors: Ramu S. , Senthilkumar N. , Rajendran Saravanan
Published: March 2023

Natural fiber composites are prepared by combining two varying fiber/filler contents with a single matrix material. Hybrid polymer composite material made with synthetic agents (Thermosetting polymer) and natural fiber/filler contents. The current study focuses on hybrid polymer composite Multi Walled Carbon nanotubes (MWCNT)-filled Banana fiber/Rice husk filler-reinforced composites that have been assessed for mechanical responses. The banana fiber mat has been in the constant piling mode and altering the MWCNT and rice husk percentage in volume. Vacuum lay-up technique was used to construct the hybrid polymer composite and MWCNT was included with the help of ultrasonic probe sonicator instrument. Mechanical testing is performed accordance to the ASTM standards. The integration of MWCNT, as well as the constant piling order of banana fiber layers, has a stronger impact on mechanical properties. The three samples are prepared at the extremities 5% Banana fiber mat uniform loading and rice husk proportions are 10%, and 15% along with MWCNT filler (0.5% and 1%) for BRME2 and BRME3. The exhibited mechanical testing of the hybrid polymer composite to identify the conventional enhancement of hardness, tensile, impact, flexural, and compressive properties. Scanning Electron Microscope (SEM) is used to examine the fractograph of the tensile sample prepared with BRME3. BRME2 polymer composite with 1% weight of MWCNT was identified higher mechanical properties compare to BRME3 and BRME1 (Tensile, Flexural Strength, and Shore-D Hardness: 46.5 MPa, 59.7 MPa, and 88.5). Furthermore, the impact strength of BRME3 was significantly higher than BRME2 and BRME1.
Impetus Yield of Acrylic Top Cover Pyramid Solar still due to Furthered Thermal Conductivity of MnO2 and PANI-MnO2 Nanocomposite Materials
Authors: Selvakumar B. , Palanisamy Periasamy , Vijayalakshmi S. , Arunachalam S.
Published: March 2023

Attempts to study the effect of blend MnO2 and PANI-MnO2 nanocomposites in enhancing the productivity of an acrylic Pyramid Solar Still (PSS) is carried out. Synthesized nanocomposites assorted with black paint to improve the absorption efficiency. Size of the synthesized MnO2 is found to be 35nm. SEM image infers particles are aggregates with random shape. Thermal analysis if distillate yield confirms the formation of nanocomposite with improved thermal stability of the PANI. Distillate yield is observed around 0.484 litre/0.25m2, 0.568 litre/0.25m2 and 0.615 litre/0.25m2 still without and with MnO2 and PANI-MnO2 nanocomposites. Average efficiency is found to be 23.05%, 26.63% and 28.52% under three modes. Efficiency of the combined performance is amended due to the absorption properties of MnO2 and PANI-MnO2. Performance ratio under three modes are found to be 5.52 %, 6.44 % and 6.93 %. Results concluded that saturation vapour pressure and latent heat also plays a major hole in production of distillate yield.
Extramammary paget’s disease of the axilla
Authors: Balawardena J. , Liyanage S. , Rasnayake S. , Senanayake A. N. , Thilakarathne U. , Perera N. R. P.
Published: March 2023

No abstract available
Penetrating abdominal trauma: an experience at tertiary care centres
Authors: Rampal K. , Prajapati D. K. , Kaur H. , Sandhu P. S. , Singh H. , Sharma M.
Published: March 2023

No abstract available
Death due to retroperitoneal haemorrhage following ureteroscopic intervention: Two case reports
Authors: Gunawardena S. A. , Senadhipathi H. , Abeyratne P. K. , Ewaduge V. , Sriwardhana D. , Peiris D. , Samaranayake R.
Published: March 2023

No abstract available
Rainfall and Streamflow Trends in the Upper Maduru Oya Sub-watershed in Sri Lanka: A Comparative Study Using Different Statistical Methods
Authors: Ranasinghe R. D. U. A. , Dayawansa N. D. K. , De Silva R. P.
Published: March 2023

Analysis of historical data on rainfall and streamflow provides useful information for water resources management in a river basin. The objective of this study was to assess the variations and trend analysis of rainfall and streamflow data in the upper Maduru Oya sub watershed in Sri Lanka during a 30 year period (1989 October to 2019 September) using daily rainfall data from two gauging locations (Padiyathalawa and Bibile) and daily average streamflow data from one gauging location (Padiyathalawa). Descriptive statistics were used to assess the variations. The Mann Kendal Trend Test (MK test) and Innovative Trend Analysis method (ITA) were used to analyze the trend, and Sen’s Slope Estimator was used to assess the magnitude of the trend. Based on the MK test, most of the rainfall trends obtained are in an increasing direction, and streamflow trends are in a decreasing direction. Rainfall trends found in Padiyathalawa are not statistically significant. Annual, First Inter Monsoon, March, and May time scales of rainfall showed significant upward trends at Bibile (p<0.1) while streamflow in January, April, and September showed significant negative trends (p<0.1) at Padiyathalawa. The results displayed by all three tests were in very good agreement for rainfall. ITA results showed similar trend types of 77%, 95% and 41% at Padiyathalawa and Bibile rainfall and streamflow, respectively. A significant positive (ρ<0.01) strong and lower correlation between the trend value of the ITA and the Z value of the MK test were found for rainfall and streamflow, respectively. Changes in rainfall are not sufficient to explain the observed trends in streamflow. Therefore, future research should be directed at the causal aspects of streamflow change in this watershed.
Tumor Suppressor Adenomatous Polyposis Coli Sustains Dendritic Cell Tolerance through IL-10 in a β-Catenin–Dependent Manner
Authors: Cao Wei , Liu Jiamin , Jiang Zhenyan , Tao Yuexiao , Wang Huizi , Li Jia , Ni Jun , Wu Xuefeng
Published: March 2023

Dendritic cells (DC) play important roles in balancing immunity and tolerance, in which β-catenin signaling plays an important role, yet the underlying mechanisms remain elusive. In this study, we investigated the functions of the tumor suppressor adenomatous polyposis coli (APC), also a key component of the β-catenin upstream destruction complex in DC. APC depletion in DC does not alter DC and T cell homeostasis under resting conditions. However, APC deficiency in DC leads to attenuated antitumor immunity in mice, which exhibit fewer CD8+ T cells and more Foxp3+ regulatory T cells in tumor and draining lymph nodes. Loss of APC in DC does not affect the expression levels of costimulatory molecules. However, APC-deficient DC produce more IL-10 and exhibit a higher ability of inducing regulatory T cells but a lower ability of priming CD8+ T cells, both of which can be reversed by IL-10 inhibition. Lastly, β-catenin depletion in APC-deficient DC rescues their antitumor immunity and reverses elevated IL-10 production. Taken together, our results identify that APC drives DC tolerance via the β-catenin/IL-10 axis.
Analysis of online parenting community posts on expanded newborn screening for metabolic disorders using topic modeling: a quantitative content analysis
Authors: Lee Myeong Seon , Chung Hyun-Sook , Kim Jin Sun
Published: March 2023

Purpose: As more newborns have received expanded newborn screening (NBS) for metabolic disorders, the overall number of false-positive results has increased. The purpose of this study was to explore the nature of the psychological impacts experienced by mothers related to the NBS process. Methods: An online parenting community in Korea was selected, and questions regarding NBS were collected using web crawling for the period from October 2018 to August 2021. In total, 634 posts were analyzed. The collected unstructured text data were preprocessed, and keyword analysis, topic modeling, and visualization were performed. Results: Of 1,057 words extracted from posts, the top keyword based on ‘term frequency-inverse document frequency’ values was “hypothyroidism,” followed by “discharge,” “close examination,” “thyroid-stimulating hormone levels,” and “jaundice.” The top keyword based on the simple frequency of appearance was “XXX hospital,” followed by “close examination,” “discharge,” “breastfeeding,” “hypothyroidism,” and “professor.” As a result of LDA topic modeling, posts related to inborn errors of metabolism (IEMs) were classified into four main themes: “confirmatory tests of IEMs,” “mother and newborn with thyroid function problems,” “retests of IEMs,” and “feeding related to IEMs.” Mothers experienced substantial frustration, stress, and anxiety when they received positive NBS results. Conclusion: The online parenting community played an important role in acquiring and sharing information, as well as psychological support related to NBS in newborn mothers. Nurses can use this study’s findings to develop timely and evidence-based information for parents whose children receive positive NBS results to reduce the negative psychological impact.
Impact of the COVID-19 pandemic on depression during pregnancy: a cross-sectional study
Authors: Seok Da-bin , Ju Hyeon Ok
Published: March 2023

Purpose: Uncertainty and restrictions on daily life have increased fear, stress, and depression during the coronavirus disease 2019 (COVID-19) pandemic. Depression is the most common mental health problem in pregnant women. The purpose of this study was to evaluate the levels of fear and stress related to COVID-19 experienced by pregnant women, as well as their levels of depression, and to examine the factors associated with depression during pregnancy.Methods: This was a cross-sectional, correlational study conducted among 153 pregnant women who visited a maternity hospital in Busan, South Korea. A self-reported questionnaire was used for data collection from December 18, 2021 to March 8, 2022. Data were analyzed using descriptive statistics, the independent t-test, one-way analysis of variance, Pearson correlation coefficients, and multiple regression. Results: Pregnant women experienced a moderate level of fear related to COVID-19, with an average score of 21.55±4.90. The average score for depression during pregnancy was 14.86±11.10, with 50.3% of the participants experiencing depression (13). The factors associated with depression during pregnancy were fear of COVID-19, contact with a confirmed case of COVID-19, being in the third trimester of pregnancy, high stress levels due to difficulties experienced from social distancing measures, and unintended pregnancy. These five statistically significant factors explained 35.0% of variance in depression during pregnancy.Conclusion: Considering the prevalence of depression in pregnant women during the COVID-19 pandemic, it is necessary to develop interventions to reduce anxiety by providing correct information and alleviating the stress of social distancing.
Preconception care knowledge and information delivery modes among adolescent girls and women: a scoping review
Authors: Kurniawati Wiwit , Afiyanti Yati , Nasution Lina Anisa , Juliastuti Dyah
Published: March 2023

Purpose: The aim of this study was to conduct a scoping review of knowledge and information delivery modes related to preconception care (PCC) among adolescent girls and women Methods: A scoping review was performed on studies selected from five electronic databases (Cochrane Library, PubMed, Science Direct, CINAHL/EBSCO, and ProQuest), published between 2012 and 2022, with predetermined keywords and criteria. We included English-language research articles available in full text and excluded irrelevant articles.Results: This study included eight articles, comprising seven quantitative studies and one qualitative study conducted among adolescent girls and women. Five were from low- and middle-income countries and three were from high-income countries. The synthesized themes generated from the data were PCC knowledge and PCC information delivery modes and effectiveness. In general, adolescent girls and women were found to have basic PCC knowledge, including risk prevention and management and a healthy lifestyle, although more extensive knowledge was found in higher-income countries than in lower-income countries. The delivery modes of PCC information have grown from individual face-to-face conventional methods, which are used predominantly in lower-income countries, to more effective digital mass media.Conclusion: Globally, many women still have insufficient knowledge regarding PCC, as not all of them receive access to PCC information and support. PCC promotion efforts should be initiated earlier by involving a wider group of reproductive-age women and combining individual, in-group, face-to-face, and electronic delivery modes.
Procedure for water analysis of hydraulic fluids using the Karl Fischer apparatus
Authors: Mintz K J
Published: March 2023

A Metrohm automatic Karl Fischer titrator has been used successfully for about three years in the Canadian Explosive Atmospheres Laboratory for measuring the water content of fire-resistant hydraulic fluids. The water content is critical for maintaining the
fire-resistance of these fluids. The report describes the. method, apparatus and procedure to be followed. A detailed analysis of possible errors is provided.
Extracorporeal life support as a lifesaving procedure in palliative surgery of stenosing upper tracheal tumor
Authors: Sawadogo Adama , D’Ostrevy Nicolas , Belem Farid Pengwinde , Camilleri Lionel
Published: March 2023

In the patients with stenotic upper respiratory airways tumor, the tracheal intubation during the surgical resection is sometimes impossible. In these situations, Extracorporeal Membrane Oxygenation appears to be an interesting temporarily alternative to ventilation to allow tumor removal. In this report the authors describe a case of successful resection of tracheal tumor in an 80-year-old female patient in which tracheal intubation was impossible. A circulatory assistance was used to perform the operation. Afterwards, tracheal intubation was easily performed for the rest of the operation.
An unusual cause of heparin resistance - A case report
Authors: Raja Javid , Baruah Sudip D , Santhosh V , Menon Sabarinath , Dharan Baiju S
Published: March 2023

Primary intestinal lymphangiectasia (PIL) is a rare disorder characterized by dilated intestinal lacteals that result in leakage of excessive serum proteins and lymphocytes into the gastrointestinal (GI) tract culminating in protein-losing enteropathy. The GI loss of protein and possible antithrombin III (AT-III) loss creates a prothrombotic environment. The surgical management of congenital heart disease (CHD) in presence of PIL can present with altered heparin response and can impose problems in instituting cardiopulmonary bypass (CPB). We report a case of surgical closure of ventricular septal defect with PIL with altered heparin response. Such an association of PIL with altered heparin response in CHD has not been reported in literature.
Supraglottic airway versus endotracheal tube for transesophageal echocardiography guided watchman procedures
Authors: Musuku Sridhar Reddy , Doshi Isha , Yukhvid Dmitriy , Di Capua Christopher A. , Shapeton Alexander D.
Published: March 2023

Context:

Atrial fibrillation (AF) is the most common arrhythmia in adults. For over 90% of non-valvular AF patients, the left atrial appendage is the primary site of thrombus formation. Left atrial appendage occlusion using the FDA-approved Watchman™ device has been shown to have better clinical outcomes with minimal post-procedural complications when compared to warfarin therapy for patients with contraindications to anticoagulation. Traditionally, this procedure requires an endotracheal tube (ETT) to facilitate transesophageal echocardiography (TEE) guidance. However, recently supraglottic airway (SGA) has emerged as a feasible, non-inferior alternative to ETT for procedures requiring TEE.

Aims:

Compare outcomes between TEE guided Watchman™ procedures performed with a SGA versus ETT.

Settings and Design:

A single tertiary care academic medical center.

Methods and Materials:

Retrospective Observational Study comparing SGA and ETT patients.

Statistical Analysis Used:

1:4 propensity score matching of SGA and ETT patients.

Results:

42 SGA patients were matched with 155 ETT patients. All patients underwent procedure with TEE. SGA patients had shorter operating room time (11 min difference, P = 0.00001) and considerably shorter PACU length of stays (45 min difference, P = 0.024). Statistically significant, but clinically trivial differences were seen in procedure times (P = 0.015) and fluoroscopy times (P = 0.017). Patients in the SGA group received lower fentanyl (P < 0.00001) dosages. No significant differences were observed in postoperative complications, organ-specific morbidity or 30-day mortality.

Conclusions:

General anesthesia with SGA is likely a safe, feasible alternative to ETT in Watchman™ procedures requiring TEE guidance. Use of SGA was associated with significant reductions in operating room time and PACU length of stay, potentially offering advantages in terms of resource utilization.
A Descriptive Cross-sectional Study to Assess Knowledge Regarding Brain Death among Health Professionals in India
Authors: Bharambe Vaishaly Kishore , Vijayakumar K , Arunprasad V K , Methepatil Supriya , Jadhav Sunit , Ambike Mandar
Published: March 2023

Context:

Brain-dead donors are one of the largest sources of organs for transplant. However, lack of knowledge about brain death may lead to delayed declaration of brain death.

Aims:

This study aimed to evaluate the knowledge about brain death among health professionals in Maharashtra state of India.

Settings and Design:

This was a descriptive, cross-sectional study.

Subjects and Methods:

The study assessed the knowledge of health professionals in Maharashtra state of India regarding brain death.

Statistical Analysis Used:

The data obtained were fed into Microsoft Excel 2010 and subsequently analyzed on SPSS.

Results:

Four hundred health professionals participated in the study between 2015 and 2017. The study found that the knowledge of brain death increased with age while no correlation with gender was observed (Pearson’s “r” = 0.7677). Seventy percent of the participants were found to have knowledge about the brain-dead category of organ donor, the highest knowledge being among the doctor category of participants and lowest among the nurse participants. Twenty-six percent of the respondents were aware of the legality of brain death. A positive correlation was found between medical college as source of knowledge and correctness of knowledge of brain death (Pearson’s “r” = 0.9789, Spearman’s rho “rs
” = 0.94286, P (two-tailed) = 0.0048, statistically significant).

Conclusions:

Medical curricula should include details of brain death-related organ donation. A health professional aware of brain death will be able to counsel the family of brain-dead donor for organ donation leading to increased availability of organs for transplantation.
Kidney Health for All: Bridging the Gap in Kidney Health Education and Literacy
Authors: Langham Robyn G. , Kalantar-Zadeh Kamyar , Bonner Ann , Balducci Alessandro , Hsiao Li-Li , Kumaraswami Latha A. , Laffin Paul , Liakopoulos Vassilios , Saadi Gamal , Tantisattamo Ekamol , Ulasi Ifeoma , Lui Siu-Fai ,   World Kidney Day Joint Steering Committee
Published: March 2023

The high burden of kidney disease, global disparities in kidney care, and poor outcomes of kidney failure bring a concomitant growing burden to persons affected, their families, and carers, and the community at large. Health literacy is the degree to which persons and organizations have or equitably enable individuals to have the ability to find, understand, and use information and services to make informed health-related decisions and actions for themselves and others. Rather than viewing health literacy as a patient deficit, improving health literacy largely rests with health-care providers communicating and educating effectively in codesigned partnership with those with kidney disease. For kidney policy makers, health literacy provides the imperative to shift organizations to a culture that places the person at the center of health care. The growing capability of and access to technology provides new opportunities to enhance education and awareness of kidney disease for all stakeholders. Advances in telecommunication, including social media platforms, can be leveraged to enhance persons’ and providers’ education; The World Kidney Day declares 2022 as the year of “Kidney Health for All” to promote global teamwork in advancing strategies in bridging the gap in kidney health education and literacy. Kidney organizations should work toward shifting the patient-deficit health literacy narrative to that of being the responsibility of health-care providers and health policy makers. By engaging in and supporting kidney health-centered policy making, community health planning, and health literacy approaches for all, the kidney communities strive to prevent kidney diseases and enable living well with kidney disease.
Knowledge and Attitude Regarding Organ Donation among Medical and Nonmedical Students: A Comparative Study
Authors: Puri Somya , Razdan Nazuk
Published: March 2023

Background and Objective:

Organ transplant is the treatment of choice for end-stage organ failure but there is a shortage of donor organs worldwide. Situation in India is even worse. There is a worldwide shortage of donor organs in comparison to the need for transplantation. The present study was designed with the aim to assess knowledge and attitude regarding organ donation among medical students and students pursuing courses other than medical and compare among both groups.

Materials and Methods:

The study included 200 medical students and 200 students pursuing courses other than medical. After taking informed consent, the students were given a prevalidated self-designed questionnaire having three sections to assess knowledge and attitude regarding organ donation. Data were collected, compiled, and analyzed.

Results:

On average, 98.75% of students were aware that organ donation can save life but a significantly higher number of medical students (P < 0.0001) knew brain death and that organ donation can be done during life and after death. However, willingness to donate their own organs or organs of the relative was seen among a greater number of students pursuing other courses (P < 0.001). To save someone’s life was the reason to will for organ donation among 70% of medical students.

Conclusion:

It was observed that the medical students had better awareness regarding organ donation but students pursuing other courses had a better attitude toward organ donation.
BK Virus Nephropathy in Renal Transplantation and the Effect of Intravenous Immunoglobulin: A Prospective Longitudinal Single-Center Study in South Asia
Authors: Ganesh Kartik , Abraham M. Abi , Thomas Renu Mariam , Kumar Jithin S. , Simon Sunita
Published: March 2023

Aims and Objectives:

The aim was to assess the prevalence and treatment of BK virus nephropathy (BKVN) in patients who underwent renal transplantation at a single center in South India with a 1-year follow-up analysis. To assess the efficacy of treatment with intravenous immunoglobulin (IvIg) in cases of proven BKVN.

Materials and Methods:

Three hundred and seventy-one patients underwent renal transplantation from 2018 to 2020. All were screened for BKVN with quantitative serum polymerase chain reaction (PCR) every 3 months for 1 year after transplant. Patients with positive tests underwent renal allograft biopsy. In all patients, antimetabolite was stopped, tacrolimus dose was reduced, and leflunomide was started. All patients with biopsy-proven BKVN were administered IvIg 2 grams/kg over 5 days and had a 1-year follow-up.

Results:

Fourteen patients had BK viremia; 12 had biopsy-proven BKVN. All were male with a mean age of mean age: 45.3 years ± 14.8 standard deviation (SD). Induction: basiliximab (7) and antithymocyte globulin (ATG) (7). Maintenance immunosuppression: tacrolimus, enteric-coated mycophenolate mofetil, and prednisolone. The median presentation time was 12 months. Mean graft function: baseline S. Creatinine of 1.32 mg/dL changed to 2.01 mg/dL at diagnosis. The mean presenting BKV PCR (copies/ml) was 44912 ± 56285 SD. No significant differences were observed in time of presentation, severity, mean tacrolimus level, and graft failure between patients receiving basiliximab or ATG. There were two relapses; two grafts failed. Class I BKVN had a better prognosis. Graft survival at 1 year was 85.71%.

Conclusions:

This is the first South Asian follow-up study of BKVN in kidney transplant recipients treated with IvIg. BKVN was documented in the first 15 months after transplant. There was no increased prevalence of BKVN in patients with ATG. Histopathological class has prognostic relevance with Class I having a better prognosis. Multipronged treatment, including IvIg, leads to 1-year graft survival of 85.71%. Long-term outcomes need follow-up.
Synchronous Urological Malignancies in a Renal Allograft Recipient
Authors: Chandran Nivedita , Kannan Muthuvel Seral , Kurien Abraham , Veeramani Muthu
Published: March 2023

Malignancy risk in transplant recipients is higher than in the general population. We present synchronous urological malignancies – papillary carcinoma of the native kidney and ductal adenocarcinoma of the prostate in a renal transplant recipient. Clear-cell carcinoma and papillary carcinoma are common renal tumors in transplant recipients. Contrast-enhanced computed tomography helped in the diagnosis of tumor in the native kidney. To the best of our knowledge, ductal adenocarcinoma of the prostate in renal transplant recipients has not been reported. Ductal adenocarcinoma is an aggressive subtype of prostatic carcinomas with lesser prostate-specific acid elevation which has a bearing on diagnosis and management.
A Child with VACTERL Association for Deceased Donor Renal Transplantation: Perioperative Anesthetic Management Concerns
Authors: Trivedi Viral , Vaniya Nilesh , Vora Kalpana , Singh Amrita
Published: March 2023

Each letter of the mnemonic VACTERL stands for one or more types of malformation. It is defined by the presence of at least 3 of the following congenital malformations: vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal anomalies, and limb abnormalities. In addition to these core component features, patients may also have other congenital anomalies. It is an association rather than a syndrome. Due to multiple congenital anomalies of different systems, anesthesia management of these patients can be challenging. Here, we present a case of a 14-year-old patient with VACTERL association posted for deceased donor renal transplantation under general anesthesia. Our article describes the uneventful perioperative course of the patient and highlights the concerns and complications in anesthesia management of a patient with VACTERL association.
Parental awareness regarding the use of fluoride products in their children
Authors: Vijai S. , Kumar R. Krishna , Peter Joby , Anaswara M. S. , Vrinda M. P.
Published: March 2023

Introduction:

Oral health is an integral part of general health and has an impact on the quality of life of children. Proper oral hygiene along with nutrition, regular dental visits, and fluoride (F) prophylaxis has got a significant impact on the oral health of children. Mostly, the family provides background for the development of knowledge regarding the use of F products among children. Hence, the aim of this study is to evaluate parental knowledge about the use of F products in children. The study included 356 correctly filled-in questionnaires from randomly chosen parents of children which were circulated through social platforms.

Materials and Methods:

The questionnaire contained 21 questions relating to F products used by children, as well as their benefits and usage limitations. For statistical analysis, descriptive statistics were performed.

Results:

More than 80% of parents have heard of F, and the main source of information was television/newspaper. Out of the parents, 59% of them believe that F can reverse early-stage tooth decay, whereas the other half do not agree with this. A very less number of parents are aware of the professional F treatments available in dental clinics. As per this study, 28.7% of school-going children had participated in school-based F preventive treatment. Among the mothers, 76% of them have not used any F-containing medications during pregnancy. Most of the respondents have not heard of the term fluorosis and are unaware of its symptoms.

Conclusion:

There is an association between the female gender and knowledge about the benefits of F prevention. The parental knowledge about oral hygiene and anticaries prevention with the use of F in children is insufficient. Most parents are neither familiar with the type of toothpaste their children should use nor aware of the proper amount of dentifrice to apply on a toothbrush. Dentists would be able to guide them by providing proper knowledge regarding F use. Care must be taken to ensure that a balance is maintained between maximizing the protective F effect against dental caries and minimizing the risk of dental fluorosis.
Prevalence and Heritability of Dental Caries and Malocclusion in Haryana: A Family-Based Study
Authors: Tariq S , Thakur P , Gupta N , Gupta P , Sharma A
Published: March 2023

Background:

Genetics could be one of the factors in determining oral health and disease in families and the interplay of genetics with environmental factors can affect the prevalence of oral diseases.

Aim:

To evaluate the genetic influence on dental caries and malocclusion.

Objective:

To assess the prevalence of dental caries and malocclusion in the family tree.

Materials and Methods:

A descriptive study was conducted among 26 families of Barwala, District Panchkula, Haryana, India. Clinical examination was conducted to assess dental caries [Decayed Filled Surface Index (DFS/dfs)] and malocclusion (Dental Aesthetic Index). Heritability within the study population was assessed within the pairs: grandparent–grandchildren pair and parent–children pair. Data were analyzed in IBM SPSS Statistics version-24.

Results:

Dental caries prevalence in grandfather–grandchildren pairs was 35.29% as compared to grandmother–grandchildren pair (36.36%), whereas father–children pair had 38% and mother–children pair had 42.59%. Statistically significant results were obtained for caries in grandmother–grandchildren pairs, father–children pair, and mother–children pair but not for grandfather–grandchildren. The prevalence of malocclusion in grandfather–grandchildren pairs was 70.58% as compared to grandmother–grandchildren pairs (13.63%), whereas the father–children pair had 52% and mother-children pair had 20.37%. Statistically, a significant result was obtained for a malocclusion among grandparent–grandchildren pair and parent–children pair.

Conclusion:

This study attempts at defining genetic implications in dental caries and malocclusion process. Caries prevalence was higher in mother–children pairs than in the father-children pair. The grandfather–grandchildren pairs had a higher prevalence of malocclusion than grandmother-grandchildren pairs. Thus, the study leads to improved understanding and prevention of the factors leading to them.
Implementation and Evaluation of Community Participatory Oral Health Program in School Children from Select Rural Population in Deshmukhwadi, Pune District
Authors: Shinde P , Shetiya SH , Agarwal D
Published: March 2023

Introduction:

In order to reduce the oral health disparities among school children in rural areas and provide a sustainable program, a pilot project using community health workers was planned.

Aim and Objectives:

The objectives of the study were to implement and evaluate community participatory oral health promotion and prevention program in school children from select rural population in Deshmukhwadi, Pune district, and also carry out knowledge, attitude and practice survey among health workers and school teachers about oral health.

Materials and Methods:

One hundred and thirty-nine students, aged 6–13 years, constituted the sample size. The program consisted of oral health education, atraumatic restorative treatment, scaling of teeth with hand scalers, and fortnightly fluoride mouth rinsing. The health workers who were commissioned into medical department by Tata Motors from the same village, after proper training and calibration performed the above-mentioned preventive procedures on children.

Results:

There was a significant improvement in gingival status (P
< 0.001), caries status (P = 0.003), and incipient lesion (P = 0.01) after the program. In the present study, the health workers were successfully trained to provide basic oral care services in rural areas. Furthermore, the knowledge, attitude, and practice regarding oral health which was assessed among the health workers and school teachers improved after 16 months of the program.

Conclusions:

The community participatory oral health promotion and prevention program showed a significant improvement in the filled and initial lesion surfaces in the primary and permanent dentition and the bleeding sextants. Health workers and school teachers showed improvement in knowledge and practice after the program.