bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of mitotane in patients with ectopic adrenocorticotropic hormone syndrome caused by advanced pancreatic neuroendocrine tumors: a case series and review of the literature
Authors: Hu Shaobo , Wang Xianhua , Su Fei , Zhou Qiong , Li Zhaoqing , Luo Jie , Tan Huangying
Published: January 2024

Ectopic adrenocorticotropic hormone syndrome (EAS) is a rare condition caused by pancreatic neuroendocrine tumors (p-NETs). The severe hypercortisolemia that characterizes EAS is associated with a poor prognosis and survival. Mitotane is the only adrenolytic drug approved by the Food and Drug Administration and is often used to treat adrenocortical carcinoma. Combination therapy with mitotane and other adrenal steroidogenesis inhibitors is common for patients with Cushing’s syndrome (CS). Here, we describe three patients who developed EAS secondary to the liver metastasis of p-NETs. All three rapidly developed hypercortisolemia but no typical features of CS. They underwent anti-tumor and mitotane therapy, which rapidly reduced their blood cortisol concentrations and ameliorated their symptoms. Their hypercortisolemia was controlled long term using a low dose of mitotane. The principal adverse effects were a slight loss of appetite and occasional dizziness, and there were no severe adverse effects. Importantly, even when the tumor progressed, the patients’ circulating cortisol concentrations remained within the normal range. In summary, the present case series suggests that mitotane could be used to treat hypercortisolemia in patients with EAS caused by advanced p-NETs, in the absence of significant adverse effects.
Resolving the Theseus Paradox at the Cusp of Independence: The Battle to Become the Legal Successor of British India
Authors: Rai Sanchi
Published: January 2024

This paper attempts to answer important questions about the extents to which newly decolonised nations wish to maintain colonial legacies – or jettison them. More viscerally, how are post-colonial identities defined? These questions are particularly intricate in the context of British India’s partition. Before independence, stakeholders debated whether India and Pakistan should be regarded as two new states, or was India a continuation of British India, with Pakistan seceding from it? In the former scenario, the earlier ‘India’ would have ceased to exist. These points are brought out through extensive archival research into the negotiations governing the transfer of power, and furnish a crucial jigsaw piece in the state formation puzzle. The paper focuses on two clear lines of inquiry. Firstly, and perhaps counterintuitively, India’s keenness to become the legal successor to British India and accept the consequent treaty obligations. Archival research shows that Indian National Congress, especially Nehru, fought uncompromisingly for this legal status. It was a matter of ‘prestige’ that the India they had fought hard to free legally continue to exist; that its enduring identity and essence align with its new legal personality. Secondly, the relatively unexplored story of how London sought to saddle the new states with its own commitments in South Asia, and the complicated legal jugglery that ensued. The aforementioned treaty obligations became an important aspect of Independent India’s foreign policy, especially on the eastern border, with ramifications for Tibet and Sino-Indian relations, underlining the continuity of British Indian foreign policy post-independence.

Résoudre le paradoxe de Thésée à l’aube de l’indépendance : la lutte pour la succession légale de l’Inde britannique
Shape memory polymer composite supports for reinforcement binding: Design, manufacturing, and validation
Authors: Yang Yawen , Chen Xi , Liu Bei , Li Yufeng , Yin Haibin
Published: January 2024

The reinforcement binding in the construction field has recently been moving from manual to automation. However, the current binding device powered by electrical motors is complex and unwieldy. This paper proposes a method for reinforcement binding under thermal driving utilizing the thermally induced shape memory characteristic of shape memory polymer composite support with integrated structure and function. The method involves manufacturing support memory binding shape, programming to temporary shape, and reheating to complete binding. Supports reinforced with ceramic powder and glass fiber are manufactured using molds. The tensile test shows a positive correlation between the maximum tensile force of support and the weight fraction of reinforcing materials. The 6.93% weight fraction glass fiber reinforced support achieves the highest tensile force among all supports, at least 39% higher than the maximum tensile force of existing wire binding. All supports require 9 s to complete binding at 60°C, while it only takes 6 s to increase the heating temperature to 80°C. This article presents the potential of thermally driven shape memory polymer composite support for reinforcement binding for the first time.
Evaluating the Adaptive Fitness of Circadian Clocks and their Evolution
Authors: Jabbur Maria Luísa , Dani Chitrang , Spoelstra Kamiel , Dodd Antony N. , Johnson Carl Hirschie
Published: January 2024

Surely most chronobiologists believe circadian clocks are an adaptation of organisms that enhances fitness, but are we certain that this focus of our research effort really confers a fitness advantage? What is the evidence, and how do we evaluate it? What are the best criteria? These questions are the topic of this review. In addition, we will discuss selective pressures that might have led to the historical evolution of circadian systems while considering the intriguing question of whether the ongoing climate change is modulating these selective pressures so that the clock is still evolving.
Status Quo or Innovation? Transforming Teacher Education in Hostile Times
Authors: Brown Cory T.
Published: January 2024

Teacher education is at a critical crossroads as colleges and schools of education contend with decreased student enrollment, legislative strategizing to limit what is taught, and general pushback regarding what teachers should learn about teaching and their students. As such, the field of teacher education must examine how to collectively rebuff the current movement by policy makers and elected officials who have formalized their desire to maintain the status quo in education. They continue to lobby against social justice in education, critical race theory, multicultural perspectives in teaching, and culturally responsive and relevant pedagogical approaches to classroom instruction, among others. This paper examines the current moment in educational history and highlights opportunities that may transform teacher education policy to become more justice centered.
Europe: Passages or reflections
Authors: Palenzuela Nilo
Published: January 2024

This text reflects on identities from an African archipelago in the Atlantic that is part of the Spanish state. The Canary Islands were the first place colonized by Europeans in their expansion toward America. The text focuses on identity formation throughout the twentieth century. Reference is made to Canarian artists and poets such as Tomás Morales and Alonso Quesada, and more recent artists of international stature such as Manolo Millares, Martín Chirino, and César Manrique. The international context and the destruction of the idea of Europe are reflected from various perspectives. Reference is made to travelers who drew analogies between Canary Islanders and Native Americans, and the notion of “displacement” at every level is addressed. The article also discusses “foreigners” traveling back and forth in the era of advanced technology, globalization, and mass tourism. As Stefan Zweig and Franz Rosenzweig have observed since the 1920s, in the age of border control, anyone can become a “foreigner.” “Europe: Passage and Reflections” was born within the context of the exhibition “Europe, that Exotic Place” (2019–2020) and expands upon the reflection on insularities undertaken in the exhibition “Island Horizons” (2009–2010), which featured artists and writers from Cuba, the Dominican Republic, Puerto Rico, Martinique, Guadeloupe, French Guiana, the Canary Islands, the Azores, Madeira, Cape Verde, and Réunion. The article also arose from the “Islands, Images, Imaginaries” discussion series held at Duke University in 2011.
Conflict Expression Types: Introducing a New Experiential Exercise
Authors: Todorova Gergana , Barbuto John E.
Published: January 2024

Conflict expression describes the way people convey opposition across six types (debate, argue, tease, dismiss, complain, and disguise). The concept has garnered increased attention among management scholars, but experiential exercises to guide instruction are needed. This paper presents an engaging activity that encourages participants to experience the six conflict expression types. We provide guidelines for implementing the exercise and assess its effectiveness for in-person and online courses.
Achieving Carbon-Neutrality in MENA Countries: Does Financial Inclusion Matter?
Authors: Said Rabie , Acheampong Alex O.
Published: January 2024

This study examines the relationship between financial inclusion, renewable energy, and CO2 emissions using data from 11 Middle East and North Africa (MENA) countries from 2004 to 2019. Evidence from fixed effects-ordinary least squares (FE-OLS), dynamic ordinary least squares (DOLS), fully modified ordinary least squares (FMOLS), and canonical correlation regression (CRR) showed that financial inclusion contributes significantly to decarbonization. Country-specific analysis indicated that financial inclusion is associated with mitigating CO2 emissions in Egypt, Israel, Qatar, and Tunisia while significantly spurring CO2 emissions in Algeria, Lebanon, and Saudi Arabia. In addition, renewable energy contributes significantly to decarbonization in MENA, especially in Algeria, Lebanon, Tunisia, and Turkey. We recommend that policies promoting financial inclusion and renewable energy usage would contribute to the attainment of the carbon-neutrality goal by MENA countries.
Growth-induced delamination of an elastic film adhered to a cylinder
Authors: Bevilacqua Giuseppe , Napoli Gaetano , Turzi Stefano
Published: January 2024

We study the delamination induced by the growth of a thin adhesive sheet from a cylindrical, rigid substrate. Neglecting the deformations along the axis of the cylinder, we treat the sheet as a one-dimensional flexible and compressible ring, which adheres to the substrate by capillary adhesion. Using the calculus of variations, we obtain the equilibrium equations and in particular arrive at a transversality condition involving in a non-trivial way the curvature of the substrate, the extensibility of the ring and capillary adhesion. By numerically solving the equilibrium equations, we show that delamination by growth occurs through a discontinuous transition from the fully adherent solution to the partially delaminated one. The shape of the delaminated part can take the form either of a ruck, with a small slope, or a fold, with a large slope. Furthermore, in the weak adhesion regime, complete delamination may occur. We construct the phase diagram between the different solutions in the parameter space. In the quasi-incompressible limit, numerical results are also supported by asymptotic calculations both in the strong and weak adhesion regimes.
Systematic review and meta-analysis comparing Manta device and Perclose device for closure of large bore arterial access
Authors: Cheema Tayyab , Venero Carmelo , Champaneria Shivam , Younas Sundas , Hadeed Khan Muhammad Adil , Anjum Ibrar , Ijaz Unaiza , Haider Sajjad , Akbar Muhammad Shoaib , Abdul-Waheed Mohammad , Saleem Sameer
Published: January 2024

Data comparing MANTA device with Perclose device for large bore arterial access closure is limited. We performed meta-analysis to compare safety and efficacy of the two devices in large (⩾14 Fr sheath) arteriotomy closure post-TAVR. Relevant studies were identified via PubMed, Cochrane, and EMBASE databases until June, 2022. Data was analyzed using random effect model to calculate relative odds of VARC-2 defined access-site complications and short-term (in-hospital or 30-day) mortality. A total of 12 studies (2 RCT and 10 observational studies) comprising 2339 patients were included. The odds of major vascular complications (OR 0.99, 95% CI 0.51–1.92; p = 0.98); life threatening and major bleeding (OR 0.77, 95% CI 0.45–1.33; p = 0.35); minor vascular complications (OR 1.37, 95% CI 0.63–2.99; p = 0.43); minor bleeding (OR 0.94, 95% CI 0.57–1.56; p = 0.82); device failure (OR 0.74, 95% CI 0.49–1.11; p = 0.14); hematoma formation (OR 0.76, 95% CI 0.33–1.75; p = 0.52); dissection, stenosis, occlusion, or pseudoaneurysm (OR 1.08, 95% CI 0.71–1.62; p = 0.73) and short-term mortality (OR 1.01, 95% CI 0.55–1.84; p = 0.98) between both devices were similar. MANTA device has a similar efficacy and safety profile compared to Perclose device.
Internationalisation and digital transformation in HEIs: The impact of education 4.0 on teaching, learning and assessment
Authors: Koseda Ellie , Cohen Ivan K. , McIntosh Bryan , Cooper Jasmine
Published: January 2024

There is a particular emphasis on embracing digital transformation to re-define how Higher Education Institutions (HEIs) impact the lives of individuals through educational means. This includes the ability to adapt and respond according to outlined graduate attributes, staff, and the wider community for continual success in 21st century learning and work. Ideally, HEI development ultimately inculcates transformation as a university vision and post-covid catalyst for digital innovation. Lastly, the pathway to transformation assumes futuristic, pre-conceived scenarios through pre-planning to inform proposed developmental change by foreseeing digital competition for target year 2030. This entails utilising effective change agents, and key stakeholders to meet and sustain objectives accordingly.
Randomized Pilot Study of a Keratin-based Topical Cream for Radiation Dermatitis in Breast Cancer Patients
Authors: Winkfield Karen M. , Hughes Ryan T. , Brown Doris R. , Clohessy Ryan M. , Holder Robert C. , Russell Gregory B. , Rejeski Alexis F. , Burnett Luke R.
Published: January 2024

Purpose: Radiotherapy (RT) is commonly used in the treatment of breast cancer and often, despite advances in fractionated dosing schedules, produces undesirable skin toxicity. The purpose of this study was to evaluate the feasibility of using a keratin-based topical cream, KeraStat® Cream (KC; KeraNetics, Inc., Winston Salem, NC, USA) to manage the symptoms of radiation dermatitis (RD) in breast cancer patients undergoing RT. Materials and Methods: A total of 24 subjects were enrolled on this single-center, randomized, open-label study. Participants were randomly assigned to KC or standard of care (SOC, patient's choice of a variety of readily available creams or moisturizers). Patients were asked to apply the assigned treatment to the irradiated area twice daily, beginning with day 1 of RT, through 30 days post-RT. The primary outcome was compliance of use. Secondary outcomes included safety and tolerability of KC, as well as RD severity assessed using the Radiation Therapy Oncology Group (RTOG) scale and the patient-reported Dermatology Life Quality Index (DLQI). Results: All subjects in the KC group were assessed as compliant with no adverse events. The rate of RTOG Grade 2 RD was lower in the KC group (30.8%) compared to the SOC group (54.5%, P = .408). At the final RT visit, the mean RTOG RD score was lower in the KC group (1.0) versus the SOC group (1.4). Similarly, patient-reported quality of life measured by the DLQI at the end of RT was improved in the KC group (mean 4.25, small effect) versus the SOC group (mean 6.18, moderate effect, P = .412). Conclusions: KC was safe and well tolerated with no adverse events. Though efficacy measures were not powered to draw definitive conclusions, trends and clinical assessments suggest that there is a benefit of using KC compared to SOC for breast cancer patients treated with RT, and a larger powered study for efficacy is warranted. Trial Registry: This clinical trial is registered as NCT03374995 titled KeraStat(R) Cream for Radiation Dermatitis.
Renormalization theory and wargaming: multi-layered wargames
Authors: Dobias Peter
Published: January 2024

Generally speaking, wargames are tools for exploring human decision-making in an environment with incomplete and imperfect information. They can provide important insights into the complexity of military operations or can be used to generate novel ideas. However, if an analyst desired to conduct analyses spanning multiple warfare levels, the only feasible approach would be to select the largest domain and the highest resolution to accommodate even the smallest scales involved. This paper develops a theoretical framework based on the renormalization theory for a multi-layered approach to wargaming. This approach would enable representing variety of warfare scales within a single wargame, while avoiding the overhead that would have arisen from trying to represent desired scenarios at the highest required temporary and spatial scales. The proposal of a conceptual framework for multi-scale wargaming is demonstrated on a simplest possible example of hybrid wargames used in support of NATO concept development.
Between Proclamations of Friendship and Concealed Distrust: The Turkish-Soviet Border Commission, 1925–1926
Authors: Rindlisbacher Stephan
Published: January 2024

Opposing the treaties signed after the Paris Peace Conference, the Soviet state and the nascent Turkish Republic saw themselves as potential allies. The Treaties of Moscow and Kars in 1921 were the legal expressions of this. Among other things, both signatory powers agreed that a bilateral commission would demarcate their newly established mutual border in the South Caucasus. This article provides insights into the daily work of the Joint Turkish-Soviet Border Commission that met, after repeated delays, from March 1925 to September 1926. Based on the minutes of this commission stored in the National Archive of Armenia, it explores the following questions: Who were its members? What was its daily business? What sort of challenges occurred and how were they dealt with? This allows us to place this commission in context. Even though the Commission members stuck publicly to the terms of friendship and cooperation, they had conflicting geopolitical interests. Potential conflicts were deliberately silenced. Furthermore, regional representatives from the Transcaucasian Federation (on the Soviet side) or from the Kurdish minority (on the Turkish side) were marginalised in the decision-making processes. After one and a half years, the Commission was able to demarcate the bilateral border. From this perspective, its work was a success. The boundaries established in 1925/26 still exist today, separating Turkey from the three South Caucasian republics.
A simple and efficient clinical prediction scoring system to identify malignant pleural effusion
Authors: Wang Shuyan , An Jing , Hu Xueru , Zeng Tingting , Li Ping , Qin Jiangyue , Shen Yongchun , Wang Tao , Wen Fuqiang
Published: January 2024

Background:

Early diagnosis of malignant pleural effusion (MPE) is of great significance. Current prediction models are not simple enough to be widely used in heavy clinical work.

Objectives:

We aimed to develop a simple and efficient clinical prediction scoring system to distinguish MPE from benign pleural effusion (BPE).

Design:

This retrospective study involved patients with MPE or BPE who were admitted in West China Hospital from December 2010 to September 2016.

Methods:

Patients were divided into training, testing, and validation set. Prediction model was developed from training set and modified to a scoring system. The diagnostic efficacy and clinical benefits of the scoring system were estimated in all three sets.

Results:

Finally, 598 cases of MPE and 1094 cases of BPE were included. Serum neuron-specific enolase, serum cytokeratin 19 fragment (CYFRA21-1), pleural carcinoembryonic antigen (CEA), and ratio of pleural CEA to serum CEA were selected to establish the prediction models in training set, which were modified to the scoring system with scores of 6, 8, 10, and 9 points, respectively. Patients with scores >12 points have high MPE risk while ⩽12 points have low MPE risk. The scoring system has a high predictive value and good clinical benefits to differentiate MPE from BPE or lung-specific MPE from BPE.

Conclusion:

This study developed a simple clinical prediction scoring system and was proven to have good clinical benefits, and it may help clinicians to separate MPE from BPE.
Comparison of Point Accuracy Between Two Widely Used Continuous Glucose Monitoring Systems
Authors: Hanson Kevin , Kipnes Mark , Tran Hien
Published: January 2024

Background:

Safe and effective self-management of glucose levels requires immediate access to accurate data. We assessed the point accuracy of the Dexcom G7 Continuous Glucose Monitoring System (Dexcom, Inc., San Diego, CA, USA) and FreeStyle Libre 3 (Abbott Diabetes Care, Alameda, CA, USA) sensors in a head-to-head comparison.

Method:

Multicenter, single-arm, prospective, nonsignificant risk evaluation enrolled adults (≥ 18 years) with diagnosed type 1 diabetes (T1D) or type 2 diabetes (T2D). Accuracy was assessed by comparing sensor data to laboratory reference values Yellow Springs Instrument [YSI] and capillary blood glucose values. Outcome measures were differences in mean absolute relative difference (MARD), number and percentage of matched glucose pairs within ±20 mg/dL/±20 of reference values within glucose ranges: < 54, 54 to 69, 70 to 180, 181 to 250, > 250 mg/dL, and combined.

Results:

Data from 55 adults were included in the analysis. Analysis showed significantly lower MARD with the FreeStyle Libre 3 sensor vs the Dexcom G7 sensor (8.9% vs 13.6%, respectively, P < .0001) with a higher percentage of glucose values within ±20 mg/dL/±20 of reference (91.4% vs 78.6%). The MARD values for both continuous glucose monitoring (CGM) sensors were similar during the first 12 hours; however, the FreeStyle Libre 3 MARD was notably lower than the Dexcom G7 MARD during the next 12 hours (10.0% vs 15.1%, respectively, P < .0001) and throughout the study period.

Conclusions:

The FreeStyle Libre 3 sensor was more accurate than the Dexcom G7 sensor in all metrics evaluated throughout the study period. This is the first head-to-head study to our knowledge that compares the flagship products currently in widespread use of the two largest CGM manufacturers.
Magic for the mind's eye: A promising avenue for more universal design in the art of magic
Authors: Ekroll Vebjørn , Wünsch Lara , van Lier Rob
Published: January 2024

In the art of conjuring, as well as in cognitive science, possibilities for designing magic tricks that are suitable for people who are blind or visually impaired have only rarely been considered. In this article, we argue that many magic tricks which are normally presented in a visual way, are not inherently based on visual processes, but instead on systematic illusions and limitations in visual imagery and mental simulations. Accordingly, it should be possible to adapt these tricks for presentation in a non-visual format, which should be suitable for people who are blind or visually impaired. As an initial test of this general approach, we adapted three magic tricks for non-visual presentation and presented them for blindfolded participants. Standard versions of the tricks were also presented to seeing participants. The participants in both groups were asked to indicate how magical they felt the tricks were, as well as whether they had any idea about the secrets behind them. The results suggest that the non-visual versions of the tricks are roughly comparable to the regular visual versions. We conclude that adapting magic tricks based on illusions of imagery for non-visual presentation appears to be a promising avenue for more universal design in the art of magic. We also argue that the illusions of imagery responsible for the experiences of magic evoked presents interesting challenges for basic cognitive science.
Glycogen storage disease type III: a mixed-methods study to assess the burden of disease
Authors: Evins Ayla , Mayhew Jill , Cimms Tricia , Whyte Julie , Vong Kathy , Hribal Elizabeth , Evans Christopher J. , Grimm Andrew
Published: January 2024

Background:

Glycogen storage disease type III (GSD III) is a rare inherited disorder that results from a glycogen debranching enzyme deficiency.

Objectives:

The purpose of this research was to collect data on the signs, symptoms, and impacts of GSD III from the perspective of adult patients and caregivers of individuals with GSD III.

Design:

Online survey and qualitative interviews.

Methods:

Following institutional review board approval, adult patients and caregivers of children with GSD III were recruited through advocacy networks and clinical sites. If eligible, participants were consented, screened, and sent a survey and/or participated in a 60-min interview. The survey and interview included questions about family history, diagnosis, signs and symptoms, impacts, and management of GSD III. Conceptual models were developed following the analysis of results.

Results:

In all, 29 adults and 46 caregivers completed the online survey and/or the interviews with 73 survey and 19 interview respondents. Adults and caregivers reported digestive, musculoskeletal, growth and physical appearance, and cardiac signs and symptoms. Liver conditions were reported by most respondents (83%). Adults and caregivers frequently reported impacts such as difficulty keeping up with peers (77%) and difficulty exercising/difficulty with physical activity (53%). Hypoglycemia was frequently reported in both adults and children, with more than half reporting hospitalizations due to hypoglycemia. Caregivers focused on hypoglycemia when reporting signs/symptoms that most interfere with their child’s life and prevention of hypoglycemia as a desired outcome for an effective therapy. Adults most often reported muscle weakness as a top interfering symptom and the most important goal of a potential therapy. Impacts were also reported in activities of daily living, cognitive, emotional, work/school, and sleep domains.

Conclusion:

Individuals with GSD III experience a broad spectrum of symptoms and disease impacts. There is an unmet need for therapies that improve metabolic control, reduce the burden of dietary management, reduce fatigue and liver problems, and improve muscle strength and function.
The Geography of Principal Internships in North Carolina
Authors: Drake Timothy A. , Bastian Kevin C.
Published: January 2024

Principal preparation programs play an important role in developing future school leaders’ skills and practices. Internships, or structured opportunities for future leaders to engage in the work of school leadership in hands-on, authentic ways, are among the most essential components of principal preparation. Using longitudinal data from 12 programs in North Carolina, this study extends research on internships by examining the pathways of interns from prior- to post-internship employment. We find that internships are highly localized around interns’ prior- and post-employment schools but not their preparation program, with wide variability in placements between programs. Interns’ demographics do not play a large role in shaping the geography of internship placements. However, we find that preparation program type is strongly related to the geography of internship placements, suggesting that differences in program structure may shape internship placements. We conclude by highlighting the limitations and discussing implications for future research.
Caste and Gender Politics: An Understanding of Dalit Consciousness in the Poems of Contemporary Dalit Writers
Authors: Patni Gunja , Khan Sheehan S.
Published: January 2024

Dalit women face endemic gender and caste discrimination and violence as a result of extreme unequal social, economic, and political power equations because of their vulnerability at the bottom of India’s caste, class, and gender hierarchies. Their socio-economic weakness and lack of political power, combined with the main risk factors of being Dalit and female, heighten their exposure to potentially violent Circumstances, hindering their rights to live with dignity and reach their full potential. The poems of three contemporary Dalit feminist writers, namely, Meena Kandasamy (1984–), Aruna Gogulamanda (1970–) and Sukirtharani (1973–) appear to be an encyclopaedia of painful catalogues, some heard and some experienced. Their witty arguments and unbashful and uncompromising writing style not only unleash the power/caste/sexual politics at hand but also suggest ways of emancipation for women and an era of liberation for them. The article aims to uncover the intersectionality of caste and gender—through a reading of select poets’ works—exposing the exploitation, oppression, violence and marginalization that reflects on the Dalit female body inhibiting from and affecting the physical, psychological, economic and social dimensions. It will do so by employing various post-modern critical scholarships on caste/gender politics, politics of the body, identity, self, subjectivity, agency, and its attendant issues. Thus, by using the female body as an ingress the article through critical analysis of the select poems will showcase a paradigm shift in understanding the self via body hence suggesting ways for Dalit women’s agency/emancipation. By highlighting the experiences of marginalized female voices, this research contributes to a deeper understanding of gender dynamics, caste politics within Indian society, ultimately prompting discussions on the need for caste and gender equity and inclusivity in contemporary India.
Caste Prejudice, Colonial Education in Kumaon: Dynamics of Depressed Class Education, 1881–1947
Authors: Tamta Isha
Published: January 2024

From the last quarter of the eighteenth century, the East India Company slowly acquired the area which is now called Uttar Pradesh. Territories were acquired from different powers by the company were initially kept under Bengal Province. However, in 1833 these, areas were separated and a new province called North-Western Provinces was created. Again, after the annexation of Oudh, this province came to be called in 1877 as North-Western Provinces. The United Provinces of Agra and Oudh was changed to United Provinces in 1902 which later became present Uttar Pradesh. Colonial rule wanted to control the knowledge systems of the colonized. The epistemology and knowledge systems produced by the colonial state sought to create the feeling of interiority among the colonized people. Education is one such area through which the colonial state wanted to justify their rule. The British argued that Indians were inferior and justified their monopoly of all higher posts. They, further, pointed out that untouchability, rigid caste system are some of the reasons for inferiority. In this article, I would like to discuss the colonial state policy towards education of lower castes and depressed classes in Kumaon division of United Provinces of British India. I argue that although the British professed that it wanted to educate all people, yet in practice the colonial state gave in to the caste prejudices of the society and also because of its own ambivalent policy towards depressed classes. Doms constitute majority of Dalit community in Kumaon division of United Provinces from whom Shilpakar community emerged gradually.
Aesthetic Chin Lines: A Novel Clinical Assessment for Diagnosis and Treatment of Chin Deformities
Authors: Emmanuel Guerrero Soto , Miguel Angel Morales Pérez
Published: January 2024

The chin represents an important component in facial aesthetics. A wide range of facial deformities may alter the chin’s position and may bring along aesthetic and functional implications. It is imperative to consider the current aesthetic ideals, while diagnosing and creating a patient’s treatment plan, instead of using the usual cephalometric analysis. The principal objective of this study was to evaluate the chin’s position in a group of male individuals considered to be facially attractive. Material and methods: This is an observational, longitudinal, and descriptive study, in which 100 high quality photographs of male individuals were collected. Images included a lateral facial view of the subject with the head oriented in a natural position and smiling until exposing at least the upper central incisive teeth. The models were described as facially attractive on specialized web site. Exclusion criteria included excessive facial hair and the presence of jewelry or accessories that made it difficult to identify facial landmarks. Two true vertical lines were traced in each photo, the first one passed through the Subnasale and the other one passed through the vestibular aspect of the upper central incisor, these lines were named “Aesthetic Chin Lines,” subsequently the position of the Pogonion was determined in relation to both lines. Results: In 84 cases (84%) the Pogonion was found between the Aesthetic Chin Lines. In 15 cases (15%) it was found behind the Upper Central Incisor line, and in 1 case (1%) it was found in front of the Subnasal line. Conclusion: With the results obtained in this study, we can determine that the “Aesthetic Chin Lines” described in this manuscript are a diagnostic resource than may help with the treatment plan of dentofacial and chin deformities in male patients.
Craniofacial Surgery in a Low-Resource Setting: The Successes, Challenges, and Prospects
Authors: Obiri-Yeboah Solomon , Boakye Frank Nketia , Nii Lamy Larmie Robert , Gowans Lord Jephthah Jojo , Sam-Awortwi Wilfred , Ampem Gyimah Tuffour , Olesu Jonathan , Frimpong Paul , Atuwo Ampoh Richard , Adabie Appiah John , Johnston James , Grant John H. , Donkor Peter
Published: January 2024

Background:Craniofacial Trauma and Anomalies affect a substantial proportion of the global society, especially those in the low-and middle-income countries (LMICs). The literature stresses the concept of a team approach for craniofacial surgery and the need for the interaction of many specialists to provide optimal care for the patient. Craniofacial surgery is practiced mainly in the advanced countries of Europe and America. This report describes the establishment of craniofacial care in an African country. It reports on 6-year early outcomes of craniofacial surgery in a low-resourced country, counting the successes, challenges, and prospects. Methods: The establishment of an international collaboration that facilitated the training in craniofacial surgery is described. A 6-year retrospective review of craniofacial surgery cases managed by the Multidisciplinary Cleft and Craniofacial team at the Komfo Anokye Teaching Hospital (KATH) was done from January 2016 to December 2022. Results: Two Ghanaian surgeons were trained in Alabama, USA (a maxillofacial surgeon and a neurosurgeon), then returned to Kumasi to begin a Craniofacial practice with the help of the craniofacial team in Children of Alabama Birmingham Al, USA. A total of 646 procedures were performed (616 cases of orofacial cleft, 20 cases of craniofacial anomalies, and 10 cases of craniofacial trauma involving the cranial vault or base of the skull). Ninety percent of the cases were cleft lip and palate, with the remainder being a mixture of isolated and syndromic craniosynostosis, craniofacial trauma, encephalocele, and craniofacial fibrous dysplasia. Conclusion: The Commonest craniofacial procedure performed was cleft lip and palate repair. Other surgeries were for the repair of velopharyngeal incompetence (VPI) and atypical facial clefts. Complex craniosynostosis and encephaloceles are also now being repaired at KATH. The foundation for a sub-regional center of excellence in cleft and craniofacial surgery is being laid in Ghana at KATH.
Development and Evaluation of Messages to Facilitate Secure Storage and Disposal of Prescribed Opioid Medication
Authors: Egan Kathleen L , Cox Melissa J , Helme Donald W , Jackson Jeffrey Todd , Sesay Mahdi , Valliani Inara , Richman Alice R
Published: January 2024

Background:

Secure storage and disposal is a critical strategy to reduce prescription opioid misuse. We sought to develop effective messages to promote secure storage and disposal of unused opioid medications that can be used in interventions designed to reduce diversion of opioid medications for nonmedical use.

Methods:

We used a mixed-method design to develop and evaluate messages. First, we pretested 34 messages in focus group discussions (FGDs; n = 12 FGDs, n = 2-5 participants per FGD; 37 total participants). Then, we tested the 12 most salient messages in an online survey with a nationally representative Qualtrics® panel (n = 1520 participants). A pretest–posttest design was conducted to assess change in beliefs about storage and disposal of opioid medication following message exposure.

Results:

All 12 messages favorably influenced participants’ perceptions related to concerns and risks of retaining unused opioid medications and the importance of and self-efficacy in securely storing and disposing of unused opioid medications. Storage and disposal messages that included the sentence—“Your prescription can become someone else’s addiction.”—outperformed other messages in encouraging people to safely store or dispose of opioid medication.

Conclusions:

This study informs the development of a universal text message intervention using multimodal feedback from the target population that the intervention seeks to serve. The next step is to conduct a randomized controlled trial to assess efficacy of the intervention.
Distal and Proximal Minority Stressors on Patterns of Tobacco and Cannabis Use Among Young Bisexual Women
Authors: Ehlke Sarah J. , Fitzer Samantha A. , Stamates Amy L. , Kelley Michelle L.
Published: January 2024

Background:

Bisexual women have high rates of tobacco and cannabis use, but few studies have examined co-use behavior in this population. Although the role of distal minority stressors (eg, discrimination) on substance use has been examined, fewer studies have examined proximal minority stressors (eg, negative sexual identity self-schemas). The current study was a secondary data analysis that examined patterns of tobacco and cannabis use, and the role of distal (instability of bisexuality, sexual irresponsibility of bisexual people, and hostility toward bisexual people) and proximal (illegitimacy of bisexuality, anticipated binegativity, internalized binegativity, and identity affirmation) bisexual-specific minority stressors among bisexual women.

Methods:

Participants were 224 young (aged 18-30 years old) self-identified bisexual women who reported on their past 30-day tobacco and cannabis use and completed measures of distal and proximal bisexual-specific minority stressors. Participants were categorized into one of 4 patterns: no use, tobacco use only, cannabis use only, and tobacco and cannabis co-use.

Results:

The most common pattern of past 30-day use was tobacco and cannabis co-use (39.1%). Results from a multinomial logistic regression revealed that bisexual women who reported higher illegitimacy of bisexuality, a proximal minority stressor, were significantly more likely to engage in tobacco and cannabis co-use, relative to no use.

Discussion:

Bisexual women have particularly high rates of substance use, with tobacco and cannabis co-use as the most common pattern. Incorporating the role of proximal minority stressors, and specifically, beliefs about the legitimacy of bisexuality, may be an important target of substance use interventions for bisexual women.
Pyramiding of Low Chalkiness QTLs Is an Effective Way to Reduce Rice Chalkiness
Authors: Yang Weifeng , Chen Songliang , Hao Qingwen , Zhu Haitao , Tan Quanya , Lin Shaojun , Chen Guodong , Li Zhan , Bu Suhong , Liu Zupei , Liu Guifu , Wang Shaokui , Zhang Guiquan
Published: January 2024

Rice chalkiness is a key limiting factor of high-quality rice. The breeding of low chalkiness varieties has always been a challenging task due to the complexity of chalkiness and its susceptibility to environmental factors. In previous studies, we identified six QTLs for the percentage of grain chalkiness (PGC), named qPGC5, qPGC6, qPGC8.1, qPGC8.2, qPGC9 and qPGC11, using single-segment substitution lines (SSSLs) with genetic background of Huajingxian 74 (HJX74). In this study, we utilized the six low chalkiness QTLs to develop 17 pyramiding lines with 2–4 QTLs. The results showed that the PGC decreased with the increase of QTLs in the pyramiding lines. The pyramiding lines with 4 QTLs significantly reduced the chalkiness of rice and reached the best quality level. Among the six QTLs, qPGC5 and qPGC6 showed greater additive effects and were classified as Group A, while the other four QTLs showed smaller additive effects and were classified as Group B. In pyramiding lines, although the presence of epistasis, additivity remained the main component of QTL effects. qPGC5 and qPGC6 showed stronger ability to reduce rice chalkiness, particularly in the environment of high temperature (HT) in the first cropping season (FCS). Our research demonstrates that by pyramiding low chalkiness QTLs, it is feasible to develop the high-quality rice varieties with low chalkiness at the best quality level even in the HT environment of FCS.
Human health and ecology at risk: a case study of metal pollution in Lahore, Pakistan
Authors: Iqbal Hafiza Hira , Siddique Ayesha , Qadir Abdul , Ahmad Sajid Rashid , Liess Matthias , Shahid Naeem
Published: January 2024

Background

With rapid industrial development, heavy metal contamination has become a major public health and ecological concern worldwide. Although knowledge about metal pollution in European water resources is increasing, monitoring data and assessments in developing countries are rare. In order to protect human health and aquatic ecosystems, it is necessary to investigate heavy metal content and its consequences to human health and ecology. Accordingly, we collected 200 water samples from different water resources including groundwater, canals, river and drains, and investigated metal contamination and its implications for human and ecological health. This is the first comprehensive study in the region that considered all the water resources for metal contamination and associated human health and ecological risks together.

Results

Here we show that the water resources of Lahore (Pakistan) are highly contaminated with metals, posing human and ecological health risks. Approximately 26% of the groundwater samples are unsuitable for drinking and carry the risk of cancer. Regarding dermal health risks, groundwater, canal, river, and drain water respectively showed 40%, 74%, 80%, and 90% of samples exceeding the threshold limit of the health risk index (HRI > 1). Regarding ecological risks, almost all the water samples exceeded the chronic and acute threshold limits for algae, fish, and crustaceans. Only 42% of groundwater samples were below the acute threshold limits. In the case of pollution index, 72%, 56%, and 100% of samples collected from canals, river Ravi, and drains were highly contaminated.

Conclusions

In conclusion, this comprehensive study shows high metal pollution in water resources and elucidates that human health and aquatic ecosystems are at high risk. Therefore, urgent and comprehensive measures are imperative to mitigate the escalating risks to human health and ecosystems.
Convolutional neural network for brachial plexus segmentation at the interscalene level
Authors: Xi Yang , Chong Hao , Zhou Yan , Zhu Feng , Yao Yuhang , Wang Geng
Published: January 2024

Background

Regional anesthesia with ultrasound-guided brachial plexus block is widely used for patients undergoing shoulder and upper limb surgery, but needle misplacement can result in complications. The purpose of this study was to develop and validate a convolutional neural network (CNN) model for segmentation of the brachial plexus at the interscalene level.

Methods

This prospective study included patients who underwent ultrasound-guided brachial plexus block in the Anesthesiology Department of Beijing Jishuitan Hospital between October 2019 and June 2022. A Unet semantic segmentation model was developed to train the CNN to identify the brachial plexus features in the ultrasound images. The degree of overlap between the predicted segmentation and ground truth segmentation (manually drawn by experienced clinicians) was evaluated by calculation of the Dice index and Jaccard index.

Results

The final analysis included 502 images from 127 patients aged 41 ± 14 years-old (72 men, 56.7%). The mean Dice index was 0.748 ± 0.190, which was extremely close to the threshold level of 0.75 for good overlap between the predicted and ground truth segregations. The Jaccard index was 0.630 ± 0.213, which exceeded the threshold value of 0.5 for a good overlap.

Conclusion

The CNN performed well at segregating the brachial plexus at the interscalene level. Further development could allow the CNN to be used to facilitate real-time identification of the brachial plexus during interscalene block administration.

Clinical trial registration

The trial was registered prior to patient enrollment at the Chinese Clinical Trial Registry (ChiCTR2200055591), the site url is https://www.chictr.org.cn/. The date of trial registration and patient enrollment is 14/01/2022.
Transition of patients with recently diagnosed Dementia from inpatient to outpatient setting– a scoping review
Authors: Hegerath Flora-Marie , Giehl Chantal , Pentzek Michael , Vollmar Horst Christian , Otte Ina Carola
Published: January 2024

Introduction

After being diagnosed with dementia, patients need a medical professional to empathetically address their fears and get initial questions answered. This scoping review therefore addresses how patients newly diagnosed with dementia are cared for in the general practitioner (GP) setting and how the communication between different healthcare professionals and the GP is handled.

Methods

The scoping review was conducted based on the PRISMA Extension for Scoping Reviews checklist. After developing a search algorithm, literature searches were performed in PubMed, Scopus, Web of Science, Cochrane Library, PsychInfo, GeroLit and Cinahl using defined search criteria, such as a focus on qualitative study designs. After the removal of duplicates, title/abstract and full text screening was carried out.

Results

Final data extraction included 10 articles out of 12,633 records. Strategies regarding the post-acute care of newly diagnosed patients included providing clarity and comfort to the patients and giving support and information both pre- and post-diagnosis. Care efforts were focused on advanced care planning and deprescribing. Involving people with dementia and their caregivers in further care was seen as crucial to provide them with the support needed. GPs emphasised the importance of listening to concerns, as well as ensuring wishes are respected, and autonomy is maintained. All studies found communication between the GP setting and other healthcare professionals regarding post-acute care to be inadequate. Lack of information sharing, clinical notes and recommendations for the GP setting resulted in inefficient provision of support, as GPs feel limited in their ability to act.

Discussion

Sharing necessary information with the GP setting could promote patient-centred care for people living with dementia and facilitate appropriate and timely resource allocation and effective healthcare collaboration between the settings, for example, by defining clear care pathways and clarifying roles and expectations.