bluuebunny/crossref_metadata_2025 huggingface dataset:
More Than a Thousand Words!
Authors: Koçak Bahri Baran
Published: June 2022

Consumer engagement (CE) has become one of the marketing problems that many airlines strive to solve. In this sense, emojis implemented to increase CE on social media have gained a stronger popularity as a form of communication among brands. This chapter will provide readers with a deeper understanding of how emoji usage and emoji types affect CE using the highly standardized Unicode classification based on emoji semiotics. Therefore, the author concludes with a case study that investigates the relationship between emoji usage and CE in the official Instagram pages of Turkish airline companies. Also, the author discusses the state of the art in semiotics and concludes by suggesting that the use of emojis by brands may change activism on social media through consumer behavior.
Communication Skills Training in Workplaces
Authors: Ruão Teresa , Lopes Ana Isabel
Published: June 2022

Communication processes in business environments are crucial for organizations to survive. However, these processes must be highly professional, which is difficult within structures with various academic and cultural backgrounds. Thus, many organizations often develop educational programs that help employees to increase their communicative performance, following literature recommendations on the positive effect of communication skills training in workplace environments. Nevertheless, the body of knowledge on these learning settings has not evolved within the communication sciences literature. Taking this into account, a program of workshops on communication skills was implemented in a factory of the multinational Bosch company in Portugal. Afterwards, a study was developed to answer a research question: What is the most suitable training model for the acquisition of communication skills in a workplace environment? The authors point out that the most appropriate model implies human communication knowledge and motivation for change, but also practical strategic communication skills.
Contributions to Research in Literary Reading Mediation
Authors: Pereira Cláudia Sousa
Published: June 2022

The author proposes a text with two approaches: a reflection on experiences of observation and participation in activities of cultural dynamization in libraries and the presentation of contributions to a possible research path in literary studies, particularly taking children's literature studies as a possible model, applied to the training of professionals in communication and information science. The courses in the higher education of these professionals should always consider that in addition to the creativity of the proposals of mediation and animation of reading activities, the aesthetic-literary value of books is an unavoidable driver of attractiveness and enrichment of the reader who fully enjoys it.
Electronic Administration and Transparency as an Object of Research in Librarianship and Information Science Studies in Spain
Authors: Muñoz-Cañavate Antonio , Rodríguez-Torrado Esteban
Published: June 2022

Public administrations around the world have experienced notable advances thanks to the application of information and communication technologies to their different processes. Not only has this enabled them to better manage their internal processes (back-office) but also their external processes (front-office), including information and communication with citizens, thanks, among other applications, to the use of the world wide web. This study presents the results of research carried out on a sample of Spanish municipalities that have populations between 3001 and 5000 inhabitants – a total of 81 municipalities. The questionnaires of the six areas that Transparency International Spain had previously applied to large Spanish municipalities were used. The results show huge differences between municipalities of similar size and budget. It is argued that these differences may be due to a lack of political will and a resistance to change in a culture of public management that has traditionally moved in opacity.
Global Research Trajectories of Hereditary Non-Rare Thrombophilia in a Scientometrics Analysis
Authors: Corera-Álvarez Elena , Turrini Mauro , Faba-Pérez Cristina
Published: June 2022

The method of scientometrics can be extremely useful when combined with the qualitative study of technoscience widely practiced by science and technology studies. This chapter intends to integrate a qualitative study of the regulation of testing of two genetic variants (called nonrandom thrombophilias [NRT]), associated with susceptibility to generate blood clots in the venous system, or venous thromboembolism (VTE). NRTs are of particular interest because they were identified in the mid-1990s and have nurtured and participated in the promise of predictive medicine based on individualized risk profiles. The integration of qualitative and quantitative methods occurs at two levels. In the first, the qualitative survey previously conducted provides the tools to orient the scientometric analysis and direct its results. In the second, the maps obtained will be compared and integrated through interviews with several key figures from different European countries.
Corporate Strategies in the Airline Industry
Authors: Sengur Ferhan K. , Kılıç Doğan , Erdoğan Burak
Published: June 2022

The air transport industry is a highly regulated, dynamic industry dominated by international rules and highly competitive. In this environment, airline companies need to determine both the type and scale of their activities. In this chapter, corporate strategies, which are an essential element for airline businesses, will be explained, and their applications will be discussed, particularly for airline companies. Corporate strategies mainly consist of growth and retrenchment strategies. The first part will explain growth strategies and related and unrelated diversification strategies. Next, the second part will explain savings and liquidation strategies as retrenchment strategies and sub-strategies. The third part will explain the applications of diversification and retrenchment strategies in airline companies. In the last section, airline alliances will be explained.
Air Transport Safety and Security
Authors: Lakshmanan Ravi
Published: June 2022

Over the last 20 years, the reduction in aircraft accident rates has been due to proactive and predictive safety measures implemented through state safety program and safety management system. Likewise, gradual enhancement of security measures is achieved using advanced screening technology, threat assessment, and behaviour detection through analytics and the security management system. The pandemic had a significant impact on the aviation industry, with decreased operations, revenue loss, and idle aircraft, among other things, which brought many challenges to the industry. The reactivation of the human resources and assets, especially inoperative aircraft, will be a huge task when the traffic accelerates. This chapter is a simplified form of safety and security management with processes/models to assess and mitigate the risks to ensure safety and security performance. In addition, this chapter highlights broader issues foreseen due to pandemics and describes models to evaluate additional risks comprehensively and mitigate them.
Do Ultra Long Haul Flights Attract More Premium Class Passengers?
Authors: Law Colin C. H. , Lin Eliver
Published: June 2022

Improved aircraft technologies have allowed aircraft to fly faster and farther, which offered more flexibility to the airlines to operate ultra long haul flights. This chapter reviews the development of and examines the changes in traveler demand after the introduction of ultra long haul flights. Five ultra long haul routes including Singapore/New York, Perth/London, Singapore/Los Angeles, Manila/New York, and Sydney/Houston were examined. The result has demonstrated that airlines offering ultra long haul flights are obtaining a larger market share between city pairs as passengers were attracted away from direct flights and connecting flights. There was evidence that passengers were willing to purchase premium services for more comfort on most ultra long haul markets where the origin and destination cities are large business centers.
Ethnopolitical Conflicts and the Problem of Regional Security in the Caucasus
Authors: Kotsotsashvili Madlein
Published: June 2022

The aim of the chapter is to determine the security risk factors in the region, assess the existing risks, and analyze the vision and security strategies of the countries in the region. This will allow the authors to find how realistically the states of the region perceive the threats and risks that may be a problem for the security of the Caucasus region, the degree of coherence in the perception and assessment of these risks and challenges by the states, and the foreign policy course. They create a framework to ensure peace and development in the Caucasus.
The Challenge of Democratization in Africa
Authors: Akinyetun Tope Shola , Ebonine Victor Chukwugekwu
Published: June 2022

The spread of democracy in Africa in the 1990s, often dubbed the third wave of democracy, was a period of democratic optimism on the continent. This revolution, which led to an increase in democratic activities, was given impetus by the fourth industrial revolution, occasioned by the internet to engender a digital democratic space characterized by increased political communication and easy access to information. Despite the optimism of liberation that digital democracy promises, it has been reversed by African leaders to promote authoritarianism: digital authoritarianism. Digital tools are increasingly being used to promote mass surveillance of citizens, internet shutdown, electoral manipulation, corporate espionage, censorship, etc. The chapter further posits that the incidence of digital authoritarianism pervades Africa and has been further entrenched by the incidence of the COVID-19 pandemic, which provided autocratic leaders with the opportunity to restrict expression and free speech with the pretext of combating disinformation and cybercrime.
In Crisis Risk Management Across Nations
Authors: Read Colin
Published: June 2022

COVID-19 has inflicted tremendous damage across countries and economies. Some of the world's most populous nations suffered high death rates as their political leaders publicly expressed skepticism of the advice of their public health leaders and sowed distrust in the public's mind. Many political leaders failed to understand its implications and attributed blame rather than identified public health solutions, which diluted public health messaging. In addition, central and state government leaders undermined attempts by local leaders to mount effective public health campaigns. Meanwhile, leaders most closely aligned themselves with the advice of public health experts fared better both in the measures of disease mitigation and economic displacement. The author compares results in various countries based on their response pattern, explores the literature on effective contingent and risk management that helps explain the divergence in success in battling COVID-19, and demonstrates that collective citizen trust in government is a significant predictor of effective crisis risk management.
Terrorism, Automated Hosts, and COVID-19
Authors: Korstanje Maximiliano Emanuel
Published: June 2022

The reign of terror ignited by 9/11 and the resulting War on Terror has accelerated the effects on social imaginary. Beyond the economic aftermaths, 9/11 recreated the conditions towards a monopoly of radicalized discourse, which was mainly oriented toward demonizing the “Non-Western Other.” Terrorism allowed the introduction of a conspiracy plot that marked some minority ethnicities as an enemy living within. At the bottom, these narratives punctuated that Muslim communities hate the society they inhabit. Such discourse changed forever the ways the “Other” is imagined. The chapter deals with HBO Saga Westworld, a futurist and dystopian world where robots (hosts) are subjected to torture, violence, and even sadist practices at the hands of wealthy tourists (guests). The formula in “Robots We Must Trust” is placed under the critical lens of scrutiny.
A Machine Learning Approach to Classify the Telecommunication Customers Based on Their Profitability
Authors: Mishoba Selvaratnam , Banujan Kuhaneswaran , Prasanth Senthan , Kumara B. T. G. S.
Published: June 2022

Customer profitability is one of the most critical problems faced by businesses today. Keeping an existing customer is more valuable than gaining a new subscriber in the telecommunication industry. As a result, anticipating customer attrition behavior in advance is challenging. This behavior has prompted most researchers to establish a model for categorizing clients based on their profitability levels in various businesses. This study was carried out with the assistance of a local telecommunication service provider. Approximately 10,000 pre-paid subscriber details with 12 attributes were acquired. Furthermore, the classification technique was used to reduce the dimensionality between features and classify the high profitable customers, low profitable customers, and average profitable customers. The data was then fed into various supervised learning algorithms to choose the optimum algorithm by considering certain evaluation metrics for developing the final prediction model. The proposed approach revealed that the SVM outperformed all other techniques with greater accuracy of 80.00%.
Defining and Measuring the Perceived Quality of a Virtual Community
Authors: Othmani Leila , Bouslama Neji , Sfaxi Jouda
Published: June 2022

Despite the development of social networks and virtual communities, there is no specific scale measuring the perceived quality of a virtual community. This research is part of this perspective and attempts to propose a scale to measure the perceived quality of a virtual community. To achieve the objective, a qualitative study was carried out with the technique of “brain writing” for the generation of items and a quantitative study with 343 members of virtual communities was conducted. The results show that the perceived quality of a virtual community is a multidimensional concept and confirms validity and reliability.
Customer Journey Redefined
Authors: Çakıcı N. Meltem
Published: June 2022

The rising popularity of social media has added a new challenge that companies are facing today since they can hardly manage the information that is shared about their products and brands among the members of these social platforms. Customer relationship management strategy, in this respect, has transformed into social-CRM through which the social media channels are integrated with the CRM tools. This significant change in companies' interactions with customers demands not only different ways of doing business but also managerial commitment, participatory human resources, and technological infrastructure. The are multiple objectives of this chapter. Firstly, the aim is to provide detailed information about social-CRM and its differences from the traditional CRM. Secondly, how social-CRM affects consumers' changing roles during their purchase journeys and helps firms in creating personalized experiences for customers will be explained. Finally, what social-CRM demands from managers and how they can develop strategies based on this new CRM orientation will be discussed.
Social Network Customer Relationship Management for Orchestras
Authors: Wang Jiaming , Deng Suming , Chiu Dickson K. W. , Chan Cheuk Ting
Published: June 2022

The COVID-19 pandemic and quarantine policies have caused the Hong Kong Philharmonic Orchestra (HKPhil) to significantly reduce offline concerts and ticket revenue, while increasing reliance on government funding. With the advancement of internet and mobile technologies, social media greatly help disseminate information and connect to customers. Thus, this study investigates HKPhil's social customer relationship management (CRM) by surveying its website and social media. Quesenbery's 5Es usability model was used to analyze the orchestra's social media usability and the 7Ps marketing mix model to explore the current opportunities and risks faced by HKPhil. The findings indicate the limitations of HKPhil's current approach to social CRM and suggest changing concert formats, enhancing social network promotions, and providing online education resources to help HKPhil attract a wider audience of different age groups. Scant studies focus on orchestras in East Asia, and this study offers some social CRM development strategies and actionable recommendations.
Supply Chain and Digital Transformation in Japan
Authors: Shaposhnikov Sergei , Veselova Anna
Published: June 2022

Geopolitical risks, business globalization, increasing complexity of transactions have required companies to adapt to changes. This chapter examines the digital transformation of supply chains and digitalization challenges in Japan. Many companies seem to realize the importance of digital transformation; however, on their way to digitalization companies face numerous challenges like a shortage of human and financial resources, a lack of awareness and understanding of digital transformation processes, etc. Moreover, Japanese culture does not easily fit digital transformation which also slows down the pace of transformation. As a result, the supply chain processes in the Japanese manufacturing companies remain old-fashioned, fragmented, siloed, with a lack of global vision and proper understanding of potential risks. To meet the needs of diverse customers, ensure global supply, and compete in uncertain environment, the SCM of Japanese companies has to be digitally upgraded and become more complex to achieve end-to-end supply chain optimization and an advanced decision-making.
Analysis of Technology as a Factor of Resilience in the Agri-Food Supply Chain
Authors: Vilalta Oriol Montanyà , Serrat Núria Arimany
Published: June 2022

Distribution companies in the Spanish agri-food sector have shown a high level of resilience during the COVID-19 crisis, as they have always guaranteed a high availability of product in stores (more than 90%) despite the changes in demand themselves from such an uncertain context. The scientific literature already identifies some specific factors that can positively influence the robustness of their logistics processes, such as proximity supply models, collaboration between value chain actors, and customer-oriented strategies. But this chapter seeks to delve into the relevance that technology can have as an element of supply chain resilience, concluding that it is an important but not yet determining factor. The companies that took part in the study, which represent more than 50% of the Spanish agri-food distribution, have shown that the technological capacity of their companies does not have a direct correlation with their current level of resilience, although in at the same time, they consider it a binomial that has a lot of potential and needs to be developed.
Efficacy of Supply Chain Collaboration on Resilience in the Fast-Moving Consumer Goods Retail Industry
Authors: Neboh Nkechi Dorothy , Mbhele Thokozani Patmond , Shakantu Winston
Published: June 2022

Fast-moving consumer goods (FMCG) are driven by threats and nascent challenges that range from logistical issues to disruptions in the environment. The chapter aimed to determine the efficacy of supply chain collaboration on resilience in the industry. Scholars have constantly highlighted the need for supply chain collaboration by building supply chain resilience, necessitated against sporadic, disruptive, and unforeseen events in the business environment. The argument for businesses to desist from working in silos within their supply chain provokes this study. There seems to be a mismatch between the supply chain members in terms of integrating or collaborating efforts and their capabilities to be resilient when faced with disruptions. Organisations need to identify the variables that exist inside and outside of their environment to ensure alignment, collaboration, and integration. Centralisation of stocks, foreign exchange fluctuation, joint business plans, and longstanding collaboration with vendors could help promote supply chain resilience.
Tribological Properties of Different 3D Printed PLA Filaments
Authors: Muntean Roxana , Ambruș Sebastian , Sîrbu Nicuşor Alin , Uţu Ion Dragoş
Published: June 2022

Fused Deposition Modeling (FDM) is generally used to fabricate complex geometry structures and it has found applicability in various industries, such as the biomedical, aerospace, automotive, and building industries. As the mechanical properties and tribological behaviour of the 3D printing components are critical during operation, it is necessary to study the influence of process parameters and chemical composition on these specific characteristics. The paper aims to determine the coefficient of friction and wear behaviour of three different 3D-printed polylactic acid (PLA) materials in contact with a metallic counterbody. 3D printing process of the proposed PLA filaments was achieved by applying the FDM technique, using same deposition parameters for all three types of materials. Tribological characteristics of the 3D printed polymers were evaluated using pin-on-disk method and a comparison among the obtained frictional features of the specimens has been analyzed. The printed PLA samples show significant differences in sliding wear behaviour, the material loss of Co-reinforced PLA specimen is much more substantial than that obtained for PLA and tough PLA samples, due to the presence of metallic particles, hence for this specimen, an inferior wear resistance is attributed.
Experimental Study on Truss-Column Pinned Connections in Large-Span Steel Structures
Authors: Ma Jianwei , Evangelista Ana , Haddad Assed Naked , Siddhpura Milind , Hao Huifen
Published: June 2022

A pin-connected joint, which was intended to accommodate a certain in-plane rotation and resist the shear forces, was introduced in this paper. Pinned-connections were applied on Truss-Column joints to support the heavy-loaded floors and roofs in a long-span steel structure. The Pinned-connection was designed in accordance with European code, and compared with other standards such as America standard and Australia standard. To better understand the behavior of materials and structure of this pin-connection structural system, four specimens, including two full-scale pin-connections and two truss connections, were tested to investigate the performance under both monotonic and cyclic loads. The load–displacement curves, hysteretic curve and ultimate loads were obtained, and the failure mode, capacity and ductility were discussed. The experimental and numerical results indicated that the pin-connection behaved good ductility, load transfer ability and capacity.
Considerations Regarding the Extension of the Service Life of Metal Wear Components from Urban Means of Rail Transport
Authors: Cojocaru Radu , Botila Lia-Nicoleta , Perianu Ion Aurel , Geana Alexandru Adrian
Published: June 2022

The paper presents proposals for technical solutions based on the interest shown by transport companies in the country to reduce the cost of maintenance of means of transport by increasing the service life of metal components that, in traffic, are subject to a severe process of wear degradation. Specifically, the paper proposes solutions to solve these problems in the case of urban public transport by rail (tram). The results obtained by ISIM Timisoara (implemented at public transport companies in the country) in the field of reintroduction into operation of used metal components from trams are presented. It also presents new, innovative and efficient technical ideas and solutions, from the point of view of the cost / performance ratio and in compliance with the conditions for guaranteeing traffic safety. It is proposed to design and implement a flexible, complex and high-performance automated system for the reconditioning of tram wear components.The implementation of the proposed automated solutions will ensure: significantly increasing the service life of parts subject to wear, reducing the costs of loading with functional layers by increasing productivity, improving part quality due to automation of the loading process, use of constant process parameters, established, controllable during process. Innovative solutions are also proposed for: mobile automated inspection system for determining the degree of wear of tram wheel bandages; method of real-time monitoring of the welding loading process; technical solution to protect the rubber damping elements against overheating and degradation (the solution allows the tires to be reconditioned without removing them from the wheels).Accurate and efficient uses of automated systems, process programming units are specific approaches to the development and modernization of welding and reconditioning technologies by welding.
Acne exacerbation after tofacitinib treatment for alopecia areata
Authors: Alharthi Sawsan , Turkmani Mohammed , AlJasser Mohammed I.
Published: June 2022

The major discovery of the novel therapeutic Janus kinase (JAK) inhibitors has been implicated in several dermatological diseases. Recently, studies have shown the efficacy and encouraging results of oral JAK inhibitors as a treatment for alopecia areata (AA). Due to the novelty of this treatment, potential side effects are not fully explored. In this paper, we present a case of a 28-year-old male with a 10-year history of alopecia totalis (AT) treated successfully with tofacitinib with encouraging effects on hair regrowth; however, a significant worsening of the patient’s facial acne was observed four months after AT treatment initiation. JAK inhibitors have promising results in the management of different dermatological conditions including moderatesevere forms of AA with few reported adverse events. Acne exacerbation is a unique observed adverse effect of this therapy. More thorough larger sized studies are needed to further characterize the association between acne exacerbation and the use of JAK inhibitors.
Health determinants in the pediatric population: health education project on the correct use of digital technologies in adolescents
Authors: Di Matteo Roberta , Bolgeo Tatiana , Bertolotti Marinella , Gatti Denise , Gardalini Menada , Maconi Antonio
Published: June 2022

Contesto: Internet è un mondo di comunicazione in gran parte libera e di condivisione reciproca, ma rappresenta anche un rischio per la tutela della privacy e della riservatezza. È importante che gli operatori sanitari forniscano istruzione sull'uso corretto della tecnologia, creino programmi di supporto e stabiliscano la correlazione tra uso della tecnologia e dipendenza. L'obiettivo del progetto di educazione sanitaria è educare i bambini delle scuole secondarie all'uso responsabile delle tecnologie digitali.

Materiali e metodi: La formazione segue un programma di apprendimento misto, che combina diversi strumenti: e-learning; attività in aula con il docente di classe e il formatore del progetto; l'utilizzo di scenari, sia online che offline; e discussioni sui forum online.

Risultati: Lo sviluppo di un programma di formazione di sei moduli della durata di un anno scolastico.

Conclusioni: Un metodo di insegnamento innovativo che utilizza le tecnologie digitali può garantire un apprendimento personalizzato, autonomo e collaborativo: ogni allievo diventa il principale contributore della propria formazione.
The Nursing and Allied Health Professions Research Unit within the Department of Integrated Activities of the Azienda Ospedaliera of Alessandria; an opportunity for the improvement of assistance: analysis of the results obtained in the years 2019-2021.
Authors: Bolgeo Tatiana , Di Matteo Roberta , Gatti Denise , Gardalini Menada , Maconi Antonio
Published: June 2022

Background. In Italy, to date, there are six Nursing and Allied Health Professions Research Centres; in Piedmont, the Nursing and Allied Health Professions Research Unit is located at the Public Hospital SS. Antonio e Biagio e Cesare Arrigo of Alessandria, within the Department of Integrated Activities, Research and Innovation.

Aim. To build and establish a network of nurse and allied health professional research, within Departments and facilities, to increase scientific production, to promote partnerships with scientific communities for improving the quality of clinical healthcare activities.

Materials and methods. Specific result indicators were defined, on the basis of which to estimate the trend of annual activities. A corporate network of Departments and Facilities has been established, as well as a collaboration with the Local Health Authority of Alessandria, the University of Eastern Piedmont and the other areas of the Integrated Activities, Research and Innovation Department.

Results. The selection of 11 Departments and 67 Facilities referents. The activation of 13 collaborations with national organizations and 5 international institutions. Sixteen clinical studies activated, 10 articles published in impacted/indexed journals, 10 publications in grey literature and the participation in 3 funded calls.

Conclusions. The organizational model established has achieved its objectives and can be reproduced in other national and international settings.
Delays in HIV-1 infant polymerase chain reaction testing may leave children without confirmed diagnoses in the Western Cape province, South Africa
Authors: Mahlakwane Kamela L. , Preiser Wolfgang , Nkosi Nokwazi , Naidoo Nasheen , Van Zyl Gert
Published: June 2022

Background: Early diagnosis and confirmation of HIV infection in newborns is crucial for expedited initiation of antiretroviral therapy. Confirmatory testing must be done for all children with a reactive HIV PCR result. There is no comprehensive data on confirmatory testing and HIV PCR test request rejections at National Health Laboratory Service laboratories in South Africa.Objective: This study assessed the metrics of routine infant HIV PCR testing at the Tygerberg Hospital Virology Laboratory, Cape Town, Western Cape, South Africa, including the proportion of rejected test requests, turn-around time (TAT), and rate of confirmatory testing.Methods: We retrospectively reviewed laboratory-based data on all HIV PCR tests performed on children ≤ 24 months old (n = 43 346) and data on rejected HIV PCR requests (n = 1479) at the Tygerberg virology laboratory over two years (2017–2019). Data from sample collection to release of results were analysed to assess the TAT and follow-up patterns.Results: The proportion of rejected HIV PCR requests was 3.3%; 83.9% of these were rejected for various pre-analytical reasons. Most of the test results (89.2%) met the required 96-h TAT. Of the reactive initial test results, 53.5% had a follow-up sample tested, of which 93.1% were positive. Of the initial indeterminate results, 74.7% were negative on follow-up testing.Conclusion: A high proportion of HIV PCR requests were rejected for pre-analytical reasons. The high number of initial reactive tests without evidence of follow-up suggests that a shorter TAT is required to allow confirmatory testing before children are discharged.
The Togo national proficiency test pilot programme for basic clinical chemistry tests
Authors: Kouassi Kafui C. , Dorkenoo Améyo M. , Gbada Komivi , Afanyibo Yaovi-Gameli , Têko Minogblon , Koura Adjane
Published: June 2022

Background: A national proficiency test (PT) programme is not currently implemented in most low-income countries. However, participation in such PT programmes assists improves test performance and result accuracy.Objective: This study assessed how well 11 government hospital laboratories performed 18 basic clinical chemistry tests and identified areas needing improvement.Methods: A cross-sectional study was carried out by the Division of Laboratories of the Ministry of Health of Togo from 01 July 2016 to 31 December 2016. The test performance was evaluated using panels provided by One World Accuracy, Canada (Vancouver). The Clinical Laboratory Improvement Amendments criteria were used in evaluating the laboratories, and their success rates were compared with the World Health Organization Regional Office for Africa’s target of 80%.Results: The overall rate of acceptable results at the laboratories was over 80% for glucose, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase, alkaline phosphatase and triglycerides tests. The laboratories using fully automated spectrophotometers had an acceptable results rate of 89% (p = 0.001). The overall performance of the laboratories by cycles varied from 71% to 82%.Conclusion: This national PT programme identified the tests, which laboratories must improve their performance (urea, creatinine, uric acid, bilirubin, cholesterol, total protein, calcium, magnesium, phosphorus). It demonstrated the need for the use of routine appropriate internal quality control in all laboratories. The proficiency test programme should be extended to all clinical laboratories and target all biology disciplines.
Practical tips to using formalin-fixed paraffin-embedded tissue archives for molecular diagnostics in a South African setting
Authors: Van Deventer Barbara S. , Du Toit-Prinsloo Lorraine , Van Niekerk Chantal
Published: June 2022

Background: Formalin-fixed paraffin-embedded (FFPE) tissue archives in hospitals, biobanks, and others offer a vast collection of extensive, readily available specimens for molecular testing. Unfortunately, the use of tissue samples for molecular diagnostic applications is challenging; thus, the forensic pathology FFPE tissue archives in Africa have been a largely unexploited genetic resource, with the usability of DNA obtainable from these samples being unknown.Intervention: The study, conducted from January 2015 to August 2016, determined the usefulness of FFPE tissue as a reliable source of genetic material for successful post-mortem molecular applications and diagnostics. Formalin-fixed paraffin-embedded tissue samples were collected and archived from autopsies conducted over 13 years in the forensic medicine department of the University of Pretoria (Pretoria, South Africa). Deoxyribonucleic acid from FFPE tissue samples and control blood samples was amplified by high-resolution melt real-time polymerase chain reaction before sequencing. The procurement parameters and fixation times were compared with the quantity and quality of the extracted DNA and the efficiency of its subsequent molecular applications.Lessons learnt: This study has shown that FFPE samples are still usable in molecular forensics, despite inadequate sample preparation, and offer immense value to forensic molecular diagnostics.Recommendations: FFPE samples fixed in formalin for more than 24 h should still be used in molecular diagnostics or research, as long as the primer design targets amplicons not exceeding 300 base pairs.
Module 2
Authors: Reebye Rajiv , Balbert Alexander , Bensmail Djamel , Walker Heather , Wissel Jörg , Deltombe Thierry , Francisco Gerard E.
Published: June 2022

Spasticity management should be part of a well-coordinated and comprehensive rehabilitation program that is patient-centric and goal-specific. There are a variety of options available for the treatment of spasticity. A usual approach is starting with the least invasive treatment modalities initially and gradually increasing to more complex interventions as this is required. This curriculum considers oral antispasticity drugs in terms of mechanism of action, clinical use, efficacy, and adverse events. It also presents other treatment options, such as chemical neurolysis using phenol and alcohol and chemodenervation using botulinum toxin A (BoNT-A). Therapeutic intramuscular injections of BoNT-A require sound patient selection, accurate muscle selection, and precise localization. The common methods for achieving these are described. The importance of physiotherapy is explained, along with the necessity to combine treatment modalities to address spasticity and the various components of the upper motor neuron syndrome. Recognizing differences in various health-care systems across countries and regions, the authors aim to present various treatment options. While this section of the curriculum highlights the importance of an interdisciplinary effort in managing spasticity, it is understandable that not all treatment options are available uniformly. The challenge to clinicians is to make the most of the management options on hand to optimize outcomes.
Module 4
Authors: Ketchum Nicholas , Carda Stefano , O'Dell Michael W , Säterö Patrik , Jacinto Jorge , Deltombe Thierry , Francisco Gerard E.
Published: June 2022

With many recent advancements in spasticity treatment, more patients are surviving critical illness and injury but are left with ongoing disability that needs constant treatment. Such treatment will change as the patient's condition evolves. Constant appraisal of treatment efficacy and patient progress is therefore an important component of spasticity management, and physicians need to be familiar with how to troubleshoot treatment regimens when outcomes of that regimen become suboptimal. This module considers how to optimize the use and outcomes of major treatment modalities and provides drug and device maintenance algorithms to guide the treating team.
Comparison of Airtraq DL™ and Macintosh laryngoscope for double-lumen tube placement in simulated difficult airway: A randomised study
Authors: Mounika K , Kar Prachi , Padhy Shibani , Pathy Archana , Durga Padmaja
Published: June 2022

Background and Aims:

The Airtraq DL ™ is a prototype channeled video laryngoscope, designed specifically for endobronchial intubation with a double-lumen tube (DLT). Evidence on its superiority over Macintosh laryngoscope for DLT placement in the difficult airway is limited. This study compared the efficacy of both these laryngoscopes in the simulated difficult airway.

Methods:

A prospective randomised controlled study was conducted on 52 patients undergoing elective thoracic surgery with lung isolation using a left-sided DLT. The patients were randomised into Airtraq DL ™ group (group A) and Macintosh group (group M). The primary objective was to compare the time required for intubation, and the secondary objectives were to evaluate time to best glottic view, Cormack–Lehane (CL) grading, intubation difficulty score (IDS), manoeuvres, attempts at intubation, haemodynamic response and complications. Operating anaesthesiologists were also asked to grade the ease of laryngoscopy and intubation for both devices on a 4-point Likert scale.

Results:

The mean time to intubation was found to be lesser in group A than in group M (18 ± 6.91 s vs 25.48 ± 9.47 s, P = 0.003). Group A showed better CL grading (P ≤ 0.001), lesser requirement of manoeuvres (P = 0.02) and lower IDS (P = 0.003). Also, group A had significantly better Likert scale results as compared to group M.

Conclusion:

The Airtraq DL ™ is superior to Macintosh laryngoscope as it requires lesser time for intubation and provides favourable intubating conditions (better CL grading, lesser manoeuvres, lower IDS and improved Likert scales) for double-lumen placement in the simulated difficult airway.
Ketodex for MRI sedation in syndromic children with congenital cardiac anomalies – A case series
Authors: Magoon Rohan , Choudhary Nitin , Wadhawan Sonia
Published: June 2022

Safe paediatric sedation in a magnetic resonance imaging (MRI) suite can be challenging. The challenges intensify in uncooperative syndromic children compounded by an accentuated risk of periprocedural cardio-respiratory complications with anaesthetic sedation in this peculiarly predisposed subset. Amidst ardent debates on the ideal sedative agent for paediatric MRI, we report an encouraging application of ketamine-dexmedetomidine combination (ketodex) sedation for MRI in our case-series including syndromic children with coexistent congenital cardiac anomalies.
Nonalcoholic Fatty Liver Disease from an Ayurvedic Perspective
Authors: Ranade Manjiri Anil
Published: June 2022

Nonalcoholic fatty liver disease (NAFLD) is a metabolic dysfunction. If left untreated, it can proceed to cirrhosis of the liver and hepatocellular carcinoma. This condition can further lead to other metabolic problems, such as diabetes and eventually, coronary artery disease. Modern medicine can only provide limited assistance with a basic treatment plan that includes lifestyle and dietary adjustments. Ayurveda, with its comprehensive range of medicines, can cure the disease at an early stage and prevent serious complications. We present a case of stage 3 NAFLD, which was treated with Arogyavardhinivati, Panchakolachurna, and Mahatiktaghrita. The patient's condition improved, and ultrasound evidence of pathology remission was seen. The purpose of this case study is to explore the mechanism of action of the medications indicated above, as well as the Ayurvedic approach to treatment. Effective approach to disease care could make a world of difference in the early stages of disease.
Efficacy of Piccha Basti and immune enhancer medicines in the management of ulcerative colitis
Authors: Sharma Pooja , Kajaria Divya
Published: June 2022

Ulcerative colitis (UC) is an immune-mediated disease; the intestine contains an enormous colitis antigenic load derived from the food and microbial flora. There appear to be four main factors which influence the disease: host genetic susceptibility, a dysregulated immune response, impairment of intestinal epithelial barrier function, and environmental factors. According to Ayurveda, it may be correlated with Raktatisara, which is mentioned as advanced stages of Pittatisara with similar signs and symptoms. A 19-year-old female patient was diagnosed with UC in May 2018, with the complaints of frequent defecation of stool mixed with blood and pain in the abdomen. She consulted allopathic physician and where the patient was diagnosed with UC through sigmoidoscopy, colonoscopy, and biopsy. The patient was on conservative treatment for 2 months. The patient gradually developed the following symptoms like bilateral pain in all major and minor joints, hair loss, reddish discoloration on both medial aspect of thigh and hips. After getting no relief, the patient visited outpatient department of AllA, Sarita Vihar, New Delhi. The patient was admitted to the inpatient department of AIIA hospital. After the 41 days of treatment, stool examination shows no occult blood in stool, followed by 2 months follow-up and the patient got 80% relief in all the signs and symptoms. Piccha Basti along with oral medicines is highly effective in the management of Raktatisara. This case report highlights the efficacy of Piccha basti and immune enhancer medicines in the management of UC and provide a better pathway for this disease.
Awareness, perception, and acceptance of coronavirus vaccines by health-care workers approved for restricted emergency use in India
Authors: Srivastava Amit , Bala Renu , Bhaskar Ravi
Published: June 2022

Introduction:

Health-care workers (HCWs) have been designated as the highest priority group to receive the coronavirus (CoV) vaccine. The study aimed to assess the awareness and perception about the CoV vaccine and the factors associated with the acceptance or rejection of vaccines among HCWs in India.

Materials and Methods:

An online cross-sectional study using a convenience sampling method was conducted between January 5 and January 14, 2021, just before the initiation of CoV vaccination among HCWs in India. Questions to assess awareness and perception were developed based on the information available on the public health websites. HCWs' willingness to accept the vaccines was also studied along with the factors associated with acceptance or rejection of CoV vaccination.

Results:

The study received responses from 496 HCWs. Awareness about the CoV vaccine was low, with a mean score of 5.44 (standard deviation = 2.91). Willingness to accept CoV vaccination was found in 63.51% of HCWs with the main reason to protect their family and colleagues (43.73%). The majority of HCWs agreed with the emergency authorization of CoV vaccines (65.93%) and agreed that vaccines will break the chain of transmission of infection (65.73%). Perception of vaccine effectiveness (odds ratio [OR] = 8.52, P = 0.000) and higher awareness (OR = 2.86, P = 0.000) were significantly associated with willingness to accept CoV vaccination.

Conclusion:

HCWs have the responsibility to disseminate correct information and risks about vaccinations among the public. Health authorities should continue encouraging the increase of the knowledge and awareness of the utility of vaccines among HCWs.

The following core competencies are addressed in this article:

Medical knowledge, Professionalism, Patient care and procedural skills, and Systems-based practice.
Reliability and Reproducibility of a Conversion Factor for Grayscale Values Obtained from CBCTS Assessed at Various Anatomical Regions- A Retrospective Study
Authors: Prasanna Arvind T.R. , Jain Ravindra K
Published: June 2022

Background:

Bone density assessment in dental practice is required for dental implant planning and placement, Orthodontic tooth movement, and establishing mid palatal suture maturation. Establishing a linear relationship between grayscale values and Hounsfield units (HUs) in softwares can improve the ease of diagnosis and treatment planning.

Aim:

To determine a conversion factor and test its reliability and reproducibility for grayscales values to HUs obtained in Cone-beam computed tomography (CBCT) s at various anatomical regions using Galileos Sirona CBCT Viewer Software and Philips DICOM Viewer.

Methods:

Eighty-seven (87) CBCTs were included in this retrospective study and 343 sites were assessed across different anatomical regions. Sites assessed were isolated in both softwares at identical locations. Grids were used for standardizing reference planes at different anatomical sites. Reference landmarks were isolated 1) between anterior interdental regions 2) between posterior interdental regions, and 3) at radio-opaque regions. Grayscale value was divided with HU to obtain conversion factors at different sites, which was the primary outcome of the study. The reproducibility of the factor obtained was also assessed to improve its clinical correlation.

Results:

In anterior interdental regions, grayscale values were 7.6 times greater than HUs. In posterior interdental regions, gray scale values were 4.5 times greater than HUs. The reliability of values obtained was verified using Kappa's correlation test. In radio-opaque regions, grayscale values were 1.4 times greater than HUs and highly reliable (r = 0.972).

Conclusion:

In well-exposed regions, a defined conversion factor can be established between grayscale values and HUs in Galileos Software. This factor determined is highly reproducible and reliable in radio-opaque regions, and adequately reliable in anterior and posterior interdental regions.