bluuebunny/crossref_metadata_2025 huggingface dataset:
La geo-alfabetización sobre la división territorial española de los futuros maestros de Educación Primaria en la Universidad de Salamanca
Authors: Gómez-Gonçalves Alejandro , Binimelis Sebastián Jaume , García-González Juan Antonio , Gómez-Trigueros Isabel María
Published: June 2021

Existe un creciente interés por medir el conocimiento previo y la adquisición de competencias y contenidos por parte del alumnado y del futuro profesorado, algo que, en los últimos años, también se ha extendido al ámbito de la geografía. El objetivo de esta investigación es analizar la alfabetización en geografía de una muestra de estudiantes universitarios del grado en Maestro de Educación Primaria por su posible efecto multiplicador, ya que serán ellos quienes enseñen geografía a las generaciones futuras. Para alcanzar el objetivo formulado se contó con la participación de 168 estudiantes de la Universidad de Salamanca, que respondieron un cuestionario compuesto por preguntas de carácter sociodemográfico y por una pregunta en la que debían dibujar un mapa mental sobre la división político-administrativa de España. Los resultados indican que los encuestados tienen ciertas dificultades para situar las provincias de nuestro país, especialmente aquellas más alejadas de su lugar de procedencia.
3D PRINTING FOR SUSTAINABLE LOW-INCOME HOUSING IN SOUTH AFRICA: A CASE FOR THE URBAN POOR
Authors: Aghimien Douglas , Aigbavboa Clinton , Aghimien Lerato , Thwala Wellington , Ndlovu Lebu
Published: June 2021

This paper presents the findings of an assessment of the possible measures needed for the adoption of three-dimensional (3D) printing for sustainable low-income houses that can be beneficial to the urban poor. The study adopted a quantitative approach and answers were sought from construction professionals actively involved in a construction project in the country. The study revealed through factor analysis that 3D printing for sustainable low-income housing delivery in South Africa could be encouraged through effective promotion and training, government support, improvement of 3D printing technology, and affordability of the technology. The study contributes significantly to the body of knowledge as it reveals the possible measures for improving the adoption of 3D printing in housing delivery in South Africa—an aspect that has not gained significant attention in the fourth industrial revolution and housing delivery discourse in the country.
REGENERATION OF A DECAYING URBAN INDUSTRIAL AREA DRIVEN BY ENDOGENOUS HOME INDUSTRIES: A CASE STUDY OF MARÉ FAVELA, RIO DE JANEIRO
Authors: Wu Shanshan , Li Hao
Published: June 2021

Favelas are low-income urban communities in Brazil, and Maré in Rio de Janeiro has the largest cluster of favelas in the country. The prevailing view of a unique, regulated, and normative city conflicts with the reality of the continued expansion of the favelas, posing challenges for architects and urban planners in developing new strategies for integrating informal areas with the main city. This study focused on a decaying industrial area adjacent to the Maré favelas and explored a sustainable path for improving both the quality of the built environment and the quality of life of the residents. Effective infrastructure and socioeconomic links between the favelas and the city were proposed. The home production model that emerged from the favelas inspired the use of the abandoned industrial area as a home-industry incubator. The study proposed an urban regeneration strategy involving a bottom-up industry-space process evolving from home industries to group industries, and finally to larger community industries. This strategy can accelerate Maré’s development and integration with the city of Rio de Janeiro.
DELTA WINGLETS FOR ENHANCING SOLAR ENERGY: TURBULENT STRAIN RATE-HEAT CONVECTION RELATIONSHIP
Authors: Yang Yang , Mohanakrishnan Siddharth Koushik , Ting David S-K. , Ray Steve
Published: June 2021

Delta winglets are an effective means for enhancing heat exchange and thus the performance of renewable energy technologies, including solar energy. A pair of 0.1 mm thick, 15 mm high (h) and 30 mm long aluminum winglets separated with transversal spacing, s, of 2h, h and 0 were scrutinized in a closed-loop wind tunnel at a Reynolds number based on h of 6300. The turbulent flow was characterized using a 3D hotwire probe, and the heat convection augmentation was quantified in terms of the normalized Nusselt number (Nu/Nu0), indicating the heat transfer improvement compared to the reference case without the winglets. The interaction of the organized counter-rotational vortices intensifies and they become indiscernible at s = 0. The peak strain rate at 10h downstream increased from 390 s–1, to 478 s–1, to 514 s–1, when the spacing decreased from 2h to h to 0, respectively. The zero-spaced winglet pair provided the largest Nu/Nu0, of around 1.21, at X/h = 10 and Y/h = 0, approximately 21% higher than that of 2h-spaced winglet pair, due to the strongest strain rate and the absence of upwash flow. On the other hand, the 2h-spaced winglet pair provided the largest span-averaged Nu/Nu0, which is of practical significance.
D’argent, de verre et de plomb : maximisation de la production et économie de pénurie dans les mines de Melle au haut Moyen Âge
Authors: Téreygeol Florian , Sarah Guillaume , Gratuze Bernard
Published: June 2021

Le gisement d’argent de Melle a été ouvert au cours du VIe siècle de notre ère. L’exploitation prend son essor dans la seconde moitié du VIIe siècle pour décliner et s’éteindre au Xe siècle. Ainsi, durant près de 4 siècles, Melle aura été un haut lieu de la production d’argent en Europe, et sûrement le premier de l’Empire carolingien. Mais il n’est plus possible de réduire au seul métal blanc la production minière melloise du haut Moyen Âge. Le plomb, sous-produit évident de cette métallurgie basée sur la transformation de la galène argentifère, doit être pris en considération. Plus inattendu, le verre est également inclus dans ce schéma technique et économique. Les travaux engagés portant sur la diffusion des produits de cette mine à travers l’Europe associés aux fouilles des sites archéologiques mellois mettent en lumière la logique productive qui sous-tend cette exploitation minière de premier plan et dont la première victime a été le couvert forestier voisin.
Circulation, transport et commerce de la chaux en Provence au travers des sources écrites (XIIIe-XVIIe siècles)
Authors: Vaschalde Christophe
Published: June 2021

Le transport de la chaux est possible moyennant une adaptation à l’instabilité chimique de cette matière première indispensable à l’économie médiévale. Les archives provençales médiévales montrent qu’elle fait l’objet d’échanges micro-régionaux. Si les techniques de transport employées ne se distinguent en rien des autres denrées échangées, l’intégration de la chaux dans des réseaux marchands régionaux repose sur la capacité des artisans à stabiliser la chaux dans des structures de stockage adaptées, et à la faire circuler rapidement sur de longues distances. De ce point de vue, la basse vallée du Rhône se distingue du reste de la Provence, avec un transport sur de longues distances favorisé par de véritables entreprises.
Lo zolfo in Sicilia in età romana. Dalle miniere ai mercati
Authors: Zambito Luca
Published: June 2021

Tra le materie prime che viaggiavano sulle onerarie romane c’era senza dubbio lo zolfo siciliano. L’area solfifera agrigentina, dunque, per un lungo periodo di tempo, si caratterizza come il centro di un intenso scambio commerciale che aveva nello zolfo, utilizzato in agricoltura, medicina, purificazione delle lane, in guerra, per la preparazione di alcune armi, e in altri, molteplici, usi domestici. A differenza di altre merci, ma analogamente a diverse materie prime (piombo, ferro, legname, marmi) l’archeologia dello zolfo e delle sue aree produttive non può contare, come nel caso di vino e olio, sullo studio dei contenitori in cui viaggiava. In questo contributo si fa il punto della situazione e si espongono alcuni importanti reperti, le tegulae sulphuris, che sono l’unico fossile guida, in attesa di approfondite indagini stratigrafiche nelle zolfare antiche (che ho individuato sul terreno) per lo studio di questo ramo importante dell’economia romana. Particolare attenzione, infine, viene posta alle associazioni commerciali, in particolare a quelle degli Annii e degli Atinii, documentate anche nell’industria solfifera.
L’approvisionnement en matières premières des grands chantiers gothiques catalans selon l’exemple géronais
Authors: Victor Sandrine
Published: June 2021

Derrière le commerce des matériaux utilisés sur les chantiers géronais de la fin du Moyen Âge, pouvons-nous voir les fournisseurs ? Malgré une documentation riche et abondante, ces hommes échappent assez rapidement à au regard du chercheur. Les archives ne nous offrent que de rares exemples de mise en relation directe entre un commanditaire et un fournisseur de matière première. L’enjeu est donc d’humaniser le matériau, et, tout en entrant dans le sujet par cette même matière première, de s’interroger sur les hommes qui la produisent et la commercialisent. Peut-être par distorsion des sources, ce dont nous nous méfierons par conséquent, il semblerait qu’en fonction du matériau concerné, le profil des acteurs tenant ce marché change. C’est donc ce que nous allons essayer de voir pour trois familles de matériaux : la pierre, le bois, la chaux.
Faire flotter du bois (comté du Roussillon, Vallespir et Conflent, XIVe et XVe siècles)
Authors: Verna Catherine
Published: June 2021

Le flottage du bois si commun dans les Pyrénées au Moyen Âge n’en est pas moins méconnu, faute de sources. Les registres notariés et les documents de gestion du patrimoine royal dans le comté du Roussillon, en Conflent et en Vallespir, aux XIVe et XVe siècles, permettent de répondre à certaines interrogations : cours d’eau concernés et étapes, techniques employées, qualités et formes des bois flottés, commanditaires du flottage (les « fusters » de Perpignan, les teinturiers de la capitale et des bourgs de montagne), modalités des contrats et prix du flottage. Quelques informations ont été également rassemblées sur ceux qui procèdent au flottage : les « manadors ».
I negotiatores nell’Italia longobarda e carolingia
Authors: Gasparri Stefano
Published: June 2021

Lo studio dei mercanti nei primi secoli del medioevo italiano non è facile, perché le fonti sono poche e ci consentono soprattutto di seguire il commercio dei prodotti di lusso. Tuttavia le notizie che abbiamo, grazie anche al contributo fornito negli ultimi anni dall’archeologia (si veda ad esempio il caso di Comacchio), sono sufficienti per affermare che il ceto dei mercanti rivestiva un ruolo non marginale nella società. Questo è dimostrato dalle leggi longobarde – in particolare dalle leggi di Astolfo del 750 – e dai capitolari carolingi e, in maniera purtroppo sporadica, anche dalle carte private. Le notizie più importanti arrivano soprattutto dalla costa del mare Adriatico, dove i mercanti di Comacchio e Venezia, sfruttando il sistema dei fiumi padani, portavano sale e prodotti orientali fino nel cuore del regno longobardo e poi italico. I Veneziani, che erano destinati ad un grande avvenire, stipularono il loro primo importante accordo con l’impero occidentale proprio in questo periodo, con il patto di Lotario dell’840.
‘E por do suele e debe andar la sal de las dichas salinas de Atienza’. El comercio de la sal del nordeste de Guadalajara en época médieval
Authors: García-Contreras Ruiz Guillermo
Published: June 2021

Abordamos el tema del comercio y la distribución de la sal producida en el nordeste de la provincia de Guadalajara, las conocidas como salinas de Atienza. No pretendemos realizar una compilación de todos los datos existentes, sino ofrecer una aproximación que sintetice su evolución histórica. Para ello, adoptaremos una doble perspectiva. En primer lugar, abordaremos lo concerniente a la legislación, los impuestos y las prebendas en lo que a la adquisición, compra y venta de las salinas de Atienza se refiere. En segundo lugar, atenderemos a los destinos a los que se dirigió la sal del nordeste de Guadalajara, dando cuenta de algunas de las localidades donde se distribuyó, así como la información que tenemos sobre los caminos salineros.
Design for Sustainability Transformations: A Deep Leverage Points Research Agenda for the (Post-)Pandemic Context
Authors: Gaziulusoy Idil , Veselova Emilija , Hodson Elise , Berglund Eeva , Erdogan Öztekin Elif , Houtbeckers Eeva , Hernberg Hella , Jalas Mikko , Fodor Kata , Ferreira Litowtschenko Maria
Published: June 2021

This position paper presents a prototype research agenda for design for sustainability transformations (DfST) in the (post-)pandemic context. COVID-19 has made visible vulnerabilities, structural dysfunctions, inequalities and injustices across health, environmental, social, economic, provisional and political systems. In response to the crisis, rapid, adaptive, technological and social innovations have started to emerge across all levels of society, opening up a multiplicity of alternative futures. This is an opportune time to address long-standing and urgent sustainability challenges in ways that move beyond the ineffective and business-as-usual approaches of ecological modernism. The authors used a co-creative process to identify weak signals relevant to sustainability transformations. In alignment with the deep leverage points framework, the identified weak signals are presented under two main headings: first, social structures and institutions; and second, values, goals and worldviews. The deep leverage points form the basis of a research agenda on how DfST could contribute to sustainability transformations right now and in the longer-term.
From Emergency to Emergence: re-think design approach in a transition age.
Authors: Marotta Fabiana , Block Marina , Perriccioli Massimo
Published: June 2021

This position paper look at the COVID-19 pandemic human condition that arises with fundamental conversations about design as a fluid social, cultural, and political artifact. The aim of our position comes from the necessity of consider some concepts to analyse epistemic and ontological consequences of the pandemia in the field of design research. There is no question about the huge impact of pandemic disease on the planet. On the other hand, terms as environment, digital, hyperobjects have already deeply changed our perception of the reality, our daily life, our behaviours. Rather than an emergency to be responded to quickly, the virus is here intended as an opportunity to let problems and solutions already in place for some time, aware that it is not life that has changed after the pandemic, but the most accurate perception we have of it.
Rationalizing Inquiry Paths for Responsible Design in the Context of a Global Pandemic
Authors: Salamanca Juan , Briggs Molly
Published: June 2021

The systemic disruptions caused by the Covid-19 pandemic amplified the effects of some social inequalities and revealed positive environmental effects associated with slowing the economy. In order to explore the repercussions of contagion prevention and community engagement initiatives such as deploying face masks and visualizing Covid-19 statistics, we resorted to an ethical model of Design for Responsible Innovation (DRI). This interactive model is useful for identifying, exploring, and describing analytical and generative paths of inquiry departing from, or arriving at, diverse matters of concern such as the impact of commodification and manufacturing in society and nature, the relativism of truth, the segregation of identities, and the reduction of agency. In this paper we argue that the human-centered perspective on design relies on a biased value system that either disfavors some social groups or disregards nonhuman living agencies, and we emphasize the analytical capacity of the model to chart and rationalize alternative inquiry paths. In consequence, future responsible design interventions would benefit from positioning life at center stage and embracing the relational and dependent nature of human beings from a posthuman perspective. To achieve this, research methods capable of handling human-nonhuman units of analysis and allowing the examination of systemic impact in complex systems are needed.
Prospecting a systemic design space for pandemic responses
Authors: Van Amstel Frederick M.C. , Guimarães Cayley , Botter Fernanda
Published: June 2021

Design literature describes an expansion of design activity towards systemic relations, which requires dealing with controversies among multiple actors. These controversies have a sociotechnical nature, given the inextricably of social and technical relations. This research looks at the sociotechnical controversy in COVID-19 design responses to assess the extent of said expansion. A controversial design space mapping was conducted based on a set of web pages found in the international design community which describes design responses for the pandemic. Considered as a representation of a socially-produced design space, the mapping reveals that systemic relations are still overlooked by the design community. A possible explanation for that is the lack of depth in problematizing the COVID-19 pandemic. The research offers, thus, prospective recommendations for a systemic design space for pandemics and other systemic crisis.
The Effect of Remote Collaborative Work on Design Processes During the Pandemic
Authors: Ozturk Pelin , Avci Cem , Kaya Cigdem
Published: June 2021

At the beginning of 2020, the virus called "COVID-19" spread rapidly all over the world. One of the measures taken to prevent the spread of the virus was social distance rules. Hence, employees and students had to work remotely using communication tools. In the design field, professionals and students working remotely during the pandemic, were limited to the possibilities of the communication tools they used while developing the design process, and they found ways to use these facilities in line with their practice routines in the physical environment. In this article, the tools used during the collaborative design processes conducted remotely during the pandemic were examined with a questionnaire study. Even though designers worked digitally due to the necessity to continue their work in this period, it was observed that they had positive experiences with the special tools they used. However, the transfer of tacit knowledge to design projects in the collaborative design process has been restricted in the collaborative design process due to limited spatial communication. While many designers were discovering the tailored tools for this purpose they could already use, many improvements were suggested through the unaware needs became explicit ones.
COVID-19 and the emergency of new economies for the design of a new world
Authors: Barauna Debora , Stafford Fernanda do Nascimento , Farina Marina Zambonato , Aleixo Amanda Cassia Oliveira
Published: June 2021

The COVID-19 pandemic situation has proven the fragilities of the current lifestyles of humanity. The previously established patterns, as they were, a predominately linear type of economy, and the manners for generating work and income, were based on production and consumption. However, that proved to be unsustainable due to the necessity of social isolation. In this context, the aim of this article is to resume the emergency for finding new ways of thinking and acting in the economy and to explore emerging views. A documental research and narrative literature review were performed to foster this discussion. A comparative framework based on four models of new economies that have arisen in the literature between the end of the XX century and the beginning of the XXI was constructed. Design evolution is related to circular, distributed, creative, and regenerative economy as an agent for change. Then, in conclusion, the authors reported on strategies and actions that have been created during the pandemic to corroborate on views posed by the new economies and design culture that are constantly being transformed in the eminence of contributing to a new material and immaterial world.
Design and Covid-19: Monitoring Urban Data
Authors: Do Val da Fonseca Maria , Souza de Carvalho Borges Kistmann Virgínia
Published: June 2021

This article discusses the use of population monitoring within urban space by designers. It considers its use to define design strategies aiming at mitigating the Covid-19. Some governments have used identified citizens data as well as stored population data through telephone companies. In search to establish new strategies to mitigate the pandemic consolidation, data collected are used for communication, considering among other aspects statistical surveys of the population. With this, new services are offering digital applications in the pandemic context, having designers as part of the group of people involved in this new process. On population monitoring activity, issues such as data privacy, surveillance capitalism and doubts about the use of these data and activities after the pandemic are points to be considered. In this context, how and what should designers consider in this scenario is a question that arises. This work presents a discussion about the theme based upon a systematic research on the related literature. Literature was analysed resulting in a set of points that shows the importance of design strategy in the use of these projects.
The impact of COVID-19 on perceptions of home and house design in Saudi Arabia
Authors: AlKhateeb Maryam , Peterson Helen
Published: June 2021

This research explored the changes that may have occurred in attitudes of people in Saudi Arabia toward their dwellings due to the mandatory quarantine from COVID-19.  Two online surveys, one from before the lockdown and one after the lockdown assessed residents’ space requirements.  A follow up in-person survey asked about specific aspects of their homes and how their impression of home had changed during the lockdown.  It was found that based on their lockdown experiences, residents were moving away from traditional cultural activities such as hospitality and trending toward spaces that would function for family activities such as studying, work from home and entertainment.  Further research should examine if these trends remain after former outside pursuits resume.
Rethinking post-Covid-19 school design in Brazil: adaptation strategies for public schools PEE-12 FNDE
Authors: Furlani Sinara , Tibério Cardoso Grace
Published: June 2021

In 2020, the World Health Organization (WHO) declared the disease COVID-19, whose causative virus is SARS-CoV-2, a pandemic. An important measure was the closure of schools in several countries to try to reduce the contagion levels, so that students were not exposed to risk, nor their families. The question that arises within this context is: In school architecture, what are the appropriate design methods to deal with challenges during and after a pandemic? In this scope, the article aimed to propose an adaptive design scenario in the post-pandemic moment for a standard school in Brazil. The methodology was built through a literature review and multidisciplinary research, to later present strategies based on the recommendations of competent bodies and studies focused on the school architecture, design patterns for 21st-century schools, technology and security. The focus was on design challenges in the education field in the post-pandemic moment, and on the adaptation of the school built spaces for the return of activities. The results can help the school community and public agencies in making decisions to face this challenge, recreating safer, user-centered schools.
Interiorism as a Means to Go Forward in Designing for the Adaptable City
Authors: Snyder Alison B.
Published: June 2021

In the context of the city, we must—especially today—study the types of spaces cities present as public, free and open.  With a notion of interiorism, the goals are to explain how urban spaces act as interiors, and why it is important to expose the qualities and characters that compose and define them.  The pedagogy mixed with theory and reseach presented in this essay is intended for practitioners and students to gaine new awareness.  We worked through a series of local and global urban interior field work research scenarios, a multi-disciplinary reading list of urbanists, sociologists, designers, practitioners, journalists and other critics’ writings that culminated with Sketch Problem/Charrette exercise focusing on a global urban locale. These designs express an forward thinking positive attitude concerning the pandemic and the global spaces that are to be re-adapted.
Designing a “New Normality”, Distributed and Sustainable for All
Authors: Vezzoli (LeNS) Carlo
Published: June 2021

The Covid-19 pandemic crisis is increasing poverty and inequalities on a global scale. The UN Secretary-General António Guterres said that “The recovery from the covid-19 crisis must lead to a different economy.  Everything we do during and after this crisis must be with a strong focus on building more equal, inclusive and sustainable economies and societies that are more resilient in the face of pandemics, climate change and the many other global challenges we face.” Sharing this approach, the recovery cannot be a return to the “old normality”: it should lead to a radically better society and economy, a “new normality”.
LLC Converter Based PV Water Pumping System With Enhanced User Safety Approach
Authors: Tomar Anuradha
Published: June 2021

In this paper, LLC resonant converter based Photovoltaic (PV) water pumping is proposed. Commercially, the available PV based water pumping system consists of a non-isolated DC-DC converter, which is suitable for low power applications but results in a less safe operating environment for human. In the case of PV based water pumping systems, the safety of humans should be the main concern, as these systems are normally being operated by farmers, their families and it may possible that they are not that much aware of operational hazards. Therefore, this paper attempts to present an LLC converter based PV water pumping system, considering human safety as a major concern. The proposed system is simulated in MATLABenvironment and results shows that proposed system configuration has no adverse impact on system efficiency and it enhances safety for operating personals. Presented results can be further exploited for hardware verification as the future scope of this work.
Tuberculosis Control within Indonesia's Hospital Accreditation
Authors: Oktamianti Puput , Bachtiar Adang , Sutoto Sutoto , Trihandini Indang , Prasetyo Sabarinah , Achadi Anhari , Efendi Ferry
Published: June 2021

Background

Tuberculosis (TB) is an infectious disease that is a major problem in Indonesia, placing Indonesia among the three major countries with the highest TB cases in the world. In addition, reporting of TB data from health service facilities, especially hospitals, is still weak. Since the implementation of Directly Observed Treatment Shortcourse (DOTS) in hospitals in 1995, the number of new TB case reports from hospitals is still low. In order to increase hospital participation in TB control, the government has made a breakthrough strategy, which is the integration of the DOTS strategy in hospital accreditation.

Design and methods

This study conducted a literature review and document analysis related TB control standards in hospital accreditation and the implication for the involvement of hospitals in national TB program. This study analyzed regulations, policies, and procedures, including hospital accreditation instruments and annual reports of TB.

Results

Accreditation standards related to TB control include: i) Hospital must implement a tuberculosis control program in the hospital, including monitoring and evaluation through activities such as health promotion, tuberculosis surveillance, controlling risk factors, detection and treatment of tuberculosis cases, providing immunity and preventive drugs; ii) Hospital prepares resources for service delivery and tuberculosis control; iii) hospital provides facilities and infrastructures for tuberculosis services in accordance with regulations; and iv) hospital conducts tuberculosis services and efforts to control tuberculosis risk factors in accordance with regulations.

Conclusions

Standards and elements of the assessment of TB control components in accreditation are adjusted to the national TB control guidelines.
Teleneurorehabilitation Among Person with Parkinson's Disease in India
Authors: Garg Divyani , Majumdar Ritu , Chauhan Sonal , Preenja Ravi , Parihar Jasmine , Saluja Alvee , Dhamija Rajinder K.
Published: June 2021

Objective:

We aimed to assess the feasibility of teleneurorehabilitation (TNR) among persons with Parkinson's disease (PD), considering difficulties imposed by the COVID-19 pandemic in access to healthcare, particularly in low-resource settings. The feasibility of TNR in India has not been formally assessed so far.

Methods:

We conducted a single-center, prospective cohort study at a tertiary center in India. Persons with PD with Hoehn & Yahr (H&Y) stages 1-2.5, who were not enrolled into any formal exercise program, were offered TNR as per a predesigned program for 12 weeks. Baseline and post-intervention assessment included Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), part II and III, Parkinson's Disease Questionnaire (PDQ)-8 and Non-Motor Symptoms Scale (NMSS). We assessed adherence to TNR and problems expressed by patients/caregivers by means of open-ended surveys addressing barriers to rehabilitation.

Results:

We recruited 22 for TNR. Median age (interquartile range [IQR]) was 66.0 (44.0-71.0) years; 66.7% were H&Y stage 2.0. One patient died of COVID-19-related complications. Of the remaining 21, 14 (66.7%) had adherence of ≥75%; 16/21 (76.2%) patients had problems with attending TNR sessions as the family shared a single phone. Slow Internet speed was an issue among 13/21 (61.9%) of the patients. Other issues included lack of rapport, migration to distant hometowns and motor-hand impairment.

Conclusion:

Multiple challenges were faced in implementing a telerehabilitation program among persons with PD, exacerbated by the COVID-19 pandemic. These barriers were present at various levels: recruitment, adherence issues and maintenance. Future TNR programs must address these concerns.
Neurosyphilis, A True Chameleon of Neurology
Authors: Pujari Shripad S , Kulkarni Rahul V , Duberkar Dhananjay , Nirhale Satish , Nadgir Dattatraya , Dhonde Pramod , Sakale Tejas , Shembalkar Prafulla , Meshram Chandrashekhar
Published: June 2021

Background:

Neurosyphilis (NS) is a rarely encountered scenario today. Manifestations are heterogeneous, and their characteristics have changed in the antibiotic era. A differential diagnosis of NS is not commonly thought of even with relevant clinical-radiological features, as it mimics many common neurological syndromes.

Objectives:

To study the manifestations of NS in the present era and the process of diagnosis.

Method:

The data of ten patients with NS was collected and analyzed. Their background data, clinical features, investigations, the process of reaching the diagnosis, management and outcomes were recorded.

Observations and Results:

The manifestations of NS in our cohort included six patients with cognitive decline/encephalopathy and one each with meningitis with cranial nerve palsies, cerebellar ataxia, myelitis and asymptomatic NS. The presence of Argyll Robertson pupil helped to clinch diagnosis in one patient. Treponemal tests were ordered in two patients only after alternative etiologies were looked at, to begin with, whereas in six patients treponemal test was requested as a part of standard workup for dementia/ataxia.

Conclusions:

NS dementia and behavior changes are mistaken for degenerative, vascular, nutritional causes, autoimmune encephalitis or prion disease. Meningitis has similarities with infective (tubercular), granulomatous (sarcoidosis, Wegener's), collagen vascular disease and neoplastic meningitis, and myelitis simulates demyelination or nutritional myelopathy (B12 deficiency). Rarely, NS can also present with cerebellar ataxia. Contemplate NS as one of the rare causes for such syndromes, and its early treatment produces good outcomes.
Feasibility and Determinants of Deprescription of Proton Pump Inhibitors in Patients with Typical Reflux Symptoms
Authors: Jain Mayank
Published: June 2021

Background and Aims:

Proton pump inhibitors (PPIs) are commonly used drugs in the management of reflux symptoms. These drugs are frequently overused and have side effects on long term use. The present study was undertaken to determine the feasibility and determinants of deprescription of PPI in patients with typical reflux symptoms.

Materials and Methods:

This retrospective study recruited all patients, >18 years, with heartburn and/or regurgitation of more than 3-month duration. The severity of reflux was assessed with white light endoscopy and graded as per Los Angeles classification. All patients were advised lifestyle changes, aerobic exercises for >30 min/day, and dietary modifications. Follow-up details, including symptom resolution and drug requirement, were noted at 3 months after the initial visit.

Results:

A total of 106 patients formed the study cohort (males 60, median age 43 years [range 18–72 years]). Reflux esophagitis was noted in 32 cases (30%). Of these patients, 8 (25%) had Grade A esophagitis and the remaining had Grade B or beyond. Three-fourths of the patients were prescribed once a day PPI. On follow-up at 3 months, PPI therapy was stopped completely in 58 (54.7%) cases. Thirty-two (30.2%) and 16 (15.1%) patients were on on-demand PPI and continuous low dose therapy, respectively. A significantly higher proportion of patients with reflux esophagitis (30/32, 93.75%) could stop PPI at the end of 3 months. The need for on-demand PPI and continuous low dose therapy was higher in patients with nonerosive reflux disease (14 cases, 19%). In univariate analysis, use of alcohol (P = 0.04), smoking (P = 0.0006), presence of diabetes mellitus (P = 0.01), and presence of hiatus on endoscopy (P = 0.03) were the factors significantly associated with continued use of PPI at the end of 3 months. In multivariate analysis, smoking was the only factor independently associated with the continuation of PPI use after 3 months.

Conclusion:

Deprescription of PPI was achieved in 90 cases (84.9%) at 3 months. In univariate analysis, use of alcohol, smoking, presence of diabetes mellitus, and presence of hiatus are associated with continued PPI use at 3 months. In multivariate analysis, smoking was the only factor independently associated with the continuation of PPI use after 3 months.
Evaluation of Psychological Impact of COVID-19 on Health-Care Workers
Authors: Grover Sandeep , Mehra Aseem , Sahoo Swapnajeet , Avasthi Ajit , Rao T. S. Sathyanarayana , Vaishnav Mrugesh , Dalal P. K. , Saha Gautam , Singh Om Prakash , Chakraborty Kaustav , Janardran Reddy Y. C. , Rao Naren P. , Tripathi Adarsh , Chadda Rakesh K. , Mishra K. K. , Rao G. Prasad , Kumar Vinay , Gautam Shiv , Sarkar Siddharth , Krishnan Vijay , Subramanyam Alka
Published: June 2021

Background:

Little information is available from India about the psychological impact of COVID-19 on helath-care workers.

Aim:

The current study aimed to evaluate the psychological issues among the health-care workers (HCW) during the COVID-19 pandemic.

Materials and Methods:

An online survey using Survey Monkey® platform was carried out to evaluate depression (using Patient Health Questionnaire-9), anxiety (using Generalized Anxiety Disorder Questionnaire-7), and other psychological issues (using a self-designed questionnaire).

Results:

The study sample comprised 303 participants with a mean age of 41.2 (standard deviation: 11.1) years. A majority of them were male (69%) and married (79.9%). Nearly half (46.2%) of the participants had either anxiety disorder or depression or both and 12.9% of HCW had suicidal behavior. Higher level of anxiety and depression scores were associated with being female, having undergone quarantine, directly involved in the care of COVID-19 patients, and younger age (<30 years). Higher prevalence of depression and anxiety disorder was seen in younger (<30 years) age group, being a doctor (compared to paramedics). In addition, higher prevalence of depression was seen in those who were directly involved in the care of patients with COVID-19 infection.

Conclusion:

About half of the HCWs are suffering from psychiatric morbidity, specifically anxiety, in the wake of the COVID-19 pandemic. There is a need to assess all the HCWs for psychiatric morbidity and provide them with psychological support.
Coping with COVID
Authors: Singh Virendra Vikram , Patra Priyadarshee , Singal Ankit
Published: June 2021

Introduction:

The sudden and extended lockdown imposed by the government as an attempt to break the transmission chain of COVID disrupted the lives and plans of many. The impact on mental health of people is variable depending on the appraisal of the situation and the resources and coping strategies.

Aim and Objectives:

The aim of the study was to know the impact on mental health and coping strategies used by internet users dealing with the COVID-19 pandemic and involved difficulties in India.

Materials and Methods:

The survey was conducted using Google doc application. Tools included Generalized Anxiety Disorder-7 (GAD-7) questionnaire, Patient Health Questionnaire (PHQ), and brief COPE questionnaire.

Statistical Analysis:

Descriptive statistics were used to assess the sociodemographic characteristics, GAD-7, PHQ-2, and brief COPE scales. The group differences were analyzed using appropriate parametric or nonparametric tests for the quantitative variable and Chi-square/Mc-Nemar's test for categorical variables. The data were analyzed using SPSS software.

Results:

Three hundred and twenty six responses were analyzed. Nearly 35.3% screened positive for anxiety disorder and 12% for major depression. Respondents who were screened positive for anxiety disorder used active coping, denial, substance use, behavioral disengagement, planning, and self-blame more often than those screened negative. Those screened positive for major depression used all the coping strategies similar to anxiety disorder except for active coping more often than those who screened negative. While females used adaptive coping more frequently than males, respondents those engaged in essential services employed maladaptive coping less often.

Conclusions:

Acceptance, positive reframing, and positive coping were the most often employed strategies, while denial, self-blame, and substance use were least often employed.
Safety and feasibility of laparoscopic left hepatectomy for the treatment of hepatolithiasis in patients with previous abdominal surgery
Authors: Liu Lingpeng , Huang Yong , Ding Zigang , Xu Bangran , Luo Dilai , Xiong Hu , Liu Hongliang , Huang Mingwen
Published: June 2021

Background:

The aim of the study was to compare the benefits and drawbacks of laparoscopic left hepatectomy (LLH) in patients with previous abdominal surgery (PAS) with those in patients without PAS and confirm the safety and feasibility of LLH as a treatment for patients with hepatolithiasis and PAS.

Materials and Methods:

This retrospective comparative study included 111 patients who underwent LLH for hepatolithiasis (with PAS, n = 41; without PAS, n = 70) from August 2017 to August 2019. Patients’ general information, surgical outcomes, hospital stay duration, hospitalisation cost, post-operative laboratory data and post-operative complications were evaluated.

Results:

No statistically significant difference was noted in the post-operative laboratory data between patients with and without PAS (P > 0.05). Longer operative times were required for patients with PAS than for those without PAS (P = 0.025). Hospitalisation cost, hospital stay duration, blood loss, open conversion and post-operative complications were not significantly different between patients with and without PAS (P > 0.05). No cases of mortality were noted.

Conclusions:

LLH is a safe and feasible treatment for patients with hepatolithiasis and PAS.
Ocular Rosacea and Corneal Perforation
Authors: Das Sujit , Pradeep B , Mandal Chhanda
Published: June 2021

Acne rosacea is a chronic skin condition with exacerbations and remissions, which requires long-term therapy to maintain symptomatic control. Etiology of rosacea is not fully understood and more than 50% of patients with rosacea have ocular manifestations such as blepharitis, conjunctival hyperemia, and rosacea-associated keratitis. Sight-threatening disease is rare with rosacea; however, keratitis can result in corneal ulceration and eventual perforation if not treated aggressively. Here, in my case, there is acne rosacea associated with blepharitis, dryness, peripheral keratitis, and eventually landed up with corneal perforation which then managed with corneal grafting.
Socioeconomic and Demographic Profile of Autism Spectrum Disorder
Authors: Marella Shivaji , Sahu Samiksha , Mujawar Swaleha , Saldanha Daniel , Chaudhury Suprakash
Published: June 2021

Background:

Autism spectrum disorder (ASD) is a multifactorial disorder resulting from genetic and nongenetic risk factors and their interaction. There is a paucity of data on the socioeconomic and demographic factors underlying ASD from India.

Aim:

The aim of this study was to evaluate the socioeconomic and demographic profile of ASD.

Materials and Methods:

Six hundred patients with behavioral complaints reporting to either psychiatric or pediatric outpatient departments were screened and validated as per Autism questionnaire (Childhood Autism Rating Scale [CARS]). Included patients were evaluated on socioeconomic and demographic scale the appropriate Child Behavior Checklist (CBCL).

Results:

Twenty-eight children out of 600 (4.66%) were found to have ASD. The average age at which parents first noticed symptoms was 16 months (range: 9–24 months). The mean age at first consultation for ASD symptoms was delayed for girls. A highly significant association between intelligence quotient (IQ) and a diagnosis of ASD was seen. The mean IQ of ASD patients (93.2 n = 28) was significantly lesser than either psychiatric diagnoses or no diagnosis. Even though all patients had an IQ >70, there were still 9/28 patients with a level 3 severity of ASD. A highly significant association between ASD diagnosis and CARS scores was seen. Out of the documented 26 presenting complaints, 17 were social impairment related and 9 related to repetitive patterns of behaviors. The clinical findings from the CBCL conform to a previously developed autism profile for CBCL.

Conclusion:

Children are taking longer than recommended for optimal outcome to receive a diagnosis. Girls were brought for consultation with the pediatrician later than the boys. Male preponderance in ASD with M: F ratio of 6:1 was highly significant. ASD was found higher in MSES and HSES families. Living in urban areas predicted higher severity. IQ was lesser than for other conditions in ASD.
Psychological distress among survivors of moderate-to-critical COVID-19 illness
Authors: Imran Javaria , Nasa Prashant , Alexander Leny , Upadhyay Surjya , Alanduru Veena
Published: June 2021

Purpose:

Coronavirus disease-2019 (COVID-19) is predicted to have long-term sequelae on the physical and mental health of survivors. We aim to calculate the prevalence of psychological distress in moderate-to-critical survivors of COVID-19.

Materials and Methods:

The patients discharged from the hospital after moderate-to-critical COVID-19 were interviewed using e-mail at 30 and 60 days for anxiety, depression, and posttraumatic stress disorder (PTSD) using Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and PTSD Check List-5 questionnaire, respectively.

Results:

In 103 patients (96% were immigrant workers), the prevalence rate of clinically significant anxiety, depression, and PTSD was 21.4%, 12.7%, and 8.7% at day 30 and 9.5%, 7.1%, and 4.7% at day 60, respectively. There was significantly higher anxiety in patients of Indian nationality and depression with preexisting chronic illness.

Conclusion:

There is a high prevalence rate of clinically significant psychological distress among COVID-19 survivors, and we propose a formal psychiatric assessment and long-term follow-up.
Free groups as end homogeneity groups of 3-manifolds
Authors: Garity Dennis J. , Repovš Dušan D.
Published: June 2021

For every finitely generated free group

F

, we construct an irreducible open 3-manifold

M_F

whose end set is homeomorphic to a Cantor set, and with the end homogeneity group of

M_F

isomorphic to

F

. The end homogeneity group is the group of all self-homeomorphisms of the end set that extend to homeomorphisms of the entire 3-manifold. This extends an earlier result that constructs, for each finitely generated abelian group

G

, an irreducible open 3-manifold

M_G

with end homogeneity group

G

. The method used in the proof of our main result also shows that if

G

is a group with a Cayley graph in

\mathbb{R}^3

such that the graph automorphisms have certain nice extension properties, then there is an irreducible open 3-manifold

M_G

with end homogeneity group

G

.
Influence of cigarette smoking on endoscopic sinus surgery long-term outcomes
Authors: Krzeski Anton , Galewicz Anna , Chmielewski Rafal , Kisiel Marta
Published: June 2021

Objective: The purpose of this study was to explore the influence of smoking on long-term outcomes of endoscopic sinus surgery for chronic rhinosinusitis. Methods: The study prospectively enrolled 274 patients at the Department of Otolaryngology of the Warsaw Medical University from 1993 to 2000. All patients were diagnosed with chronic rhinosinusitis and scheduled for the endoscopic sinus surgery. We evaluated subgroups of patients with respect to bronchial asthma, allergy, aspirin triad, gastro-esophageal reflux disease and nasal septal deviation. Patients were divided into smokers and non-smokers. Patient CT scan results were recorded according to the four-grade classification system by Kennedy. Patients were observed over a period between 2 to 9 years following the surgical intervention and had their surgery revised if the severity of symptoms were at the same level or worsened. Results: Prior to endoscopic sinus surgery, 23% of smokers and 20% of non-smokers scored III or IV on the Kennedy Scale. The revision ESS was carried out in 27 patients. In this group there were 20% smokers and 7% non-smokers, with the difference being significant. There was no significant difference in the postoperative quality of life scale scores. Conclusions: The study shows that while smoking did not influence preoperative symptoms, smokers had worse postoperative outcomes.