bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence and Outcome of Acute Kidney Injury in Hospitalised Children
Authors: Paudel Rajan , Shah Gauri Shankar , Chaudhary Shipra , Dharel Dinesh , Timilsina Anuradha
Published: May 2021

Introduction: Acute kidney injury (AKI) is common in hospitalised children with adverse short and long term outcomes. Detection of the incidence, etiological profile and outcome of AKI is important for starting preventive and therapeutic modalities. This study aimed to determine the incidence, etiology and short term outcome of AKI at a tertiary centre in Eastern Nepal.

Methods: A prospective observational study was conducted in children from two months to 14 years of age admitted in paediatric wards and paediatric intensive care unit (PICU) of a tertiary centre of Eastern Nepal. AKI was defined according to pRIFLE criteria.

Results: From May 2015 to March 2016, 942 patients enrolled in Paediatric wards and PICU were evaluated. The overall incidence of AKI was found to be 5.9% and 18.23% in patients admitted in PICU. AKI was commonest among cases having infectious etiology compromising 73.2% (n = 41), 17.85% (n = 10) due to primary renal disease, 5.35% (n = 3) secondary to congenital heart disease, and 3.57% due to other causes. Among AKI patients, 55.4% (n = 31) required inotropic support, 33.9% (n = 19) required mechanical ventilation while 5.36% (n = 3) underwent dialysis. Out of 56 AKI patients 71.4% (n = 40) had improved clinical outcome and 28.6% (n = 16) expired. Patient with AKI had significant longer duration of hospital stay as compared to non AKI (Seven days vs. three days, p < 0.001). Mortality was high among AKI patients on injury and failure stage (p = 0.003) and those requiring mechanical ventilation and inotropic support (p < 0.001).

Conclusions: The incidence of AKI was found to be high in paediatric patients. Presence of AKI increased the duration of hospital stay and mortality in hospitalised children often requiring mechanical ventilation and inotropic support.
Clinical and Demographic Profiles of Children Presenting with Acetaminophen Induced Acute Liver Failure in a Tertiary Paediatric Intensive Care Unit of South India
Authors: Amatya Puja , Kapalavai Sudeep Kumar , Krupanandan Ravi Kumar , Sadasivam Kalaimaran , Sankaranarayanan Srinivas , Ramachandran Bala
Published: May 2021

Introduction: Acetaminophen (APAP) is the most widely used over-the-counter antipyretic and analgesic medicine in children. Although hepatic failure and death is rare in paediatric population, it is one of the most important and dangerous presentation of acetaminophen induced toxicity in children. There is very sparse data regarding APAP induced paediatric acute liver failure in our settings, hence this study was done to know the clinical and demographic profiles as well as outcome of children with APAP induced acute liver failure.

Methods: This was a retrospective study done in children aged 0 - 18 years admitted with the diagnosis of acetaminophen induced acute liver failure in a tertiary paediatric intensive care unit of South India from January 2014 to December 2018. The clinical, demographic profiles and outcome of these patients were reviewed and analysed.

Results: A total of 26 children had acetaminophen induced acute liver failure. Out of 26 patients, 53.8% were males and 46.1% were females. Among these, 24 (92.3%) survived and two (7.7%) died. The average dose of acetaminophen ingested was 168.5 mg/ kg/d. The mean serum acetaminophen level was 52.3 mg/dl. The presence of low pH, hypotension and international normalised ratio (INR) value of > 4 showed bad outcome in children with acetaminophen induced acute liver failure.

Conclusion: Paracetamol induced acute liver failure is rare but fatal presentation in children. Children with acidosis, shock and INR value of > 4 had poor prognosis. Hence, judicious use of different preparations as well as counselling to parents regarding use of appropriate doses in children should be done while prescribing this medicine.
Efficacy of Heel Warming on Pain Response to Heel Stick in Neonates
Authors: Sharma Sapkota Pratima , Bhandari Sunita Shah , Karn Basanta Kumar , Yadhav Upendra
Published: May 2021

Introduction: Heel prick is one of the commonest procedures carried out in the hospitalised newborns. Pain is a subjective experience for which the neonates, infants and children respond with behavioural reactions. Applying hot pack to the skin surface causes proximal blood vessels to dilate due to the raised temperature which may decrease the pain perception in neonates. We intended to study the effect of heel warming during heel prick in perception of pain in neonates.

Method: An experimental study was conducted among neonates admitted in paediatric wards of BPKIHS. Total 92 participants undergoing heel prick/stick were selected by consecutive sampling technique and allocated randomly to experimental group and control group. Warmer was applied to the heel of the baby for three to five minutes which provided the baby’s heel with the warmth of 38°C to 40°C prior to heel stick in experimental group only. Newborn’s pain level was assessed in both experimental and control group through The Neonatal Infant Pain Scale (NIPS). Mann Whitney test was used to compare means of pain score between experimental and control groups.

Results: The mean pain score among experimental group was 1.39 and in control group was 2.20. Experimental group showed significantly lower pain (p < 0.001) compared to the control group. Application of warmth before heel stick caused reduction in pain.

Conclusions: The findings suggest that heat application prior to heel stick is effective in reducing pain in newborns.
Referrals from Paediatric Department with Respiratory Symptoms having Skin Lesions
Authors: Jha Sagar Mani , Budhathoki Lee , Shakya Nabin Bhakta , Shakya Sunil , Roka Kumar
Published: May 2021

Introduction: Paediatric patients with respiratory symptoms having skin lesions are often referred from Paediatric to Dermatology Department. Knowledge about skin and respiratory manifestations will lead to early diagnosis and proper management by the doctors of both the specialties. These dermatological conditions may or may not be related to respiratory illness or may hence be part of total disease process or may be completely separate entity. The aim of this study was to find out skin manifestations of various respiratory diseases and analyse dermatological disorders in children referred from Paediatric Department having respiratory symptoms.

Methods: An observational cross sectional hospital based study involving inpatients and outpatients referred from Paediatrics to Dermatology Department having respiratory illness and skin lesions was undertaken between January 2019 to December 2020. Details of skin disease were recorded. The descriptive statistical analysis was expressed in frequency and percentage and Chi square test was applied to determine significance among variables.

Results: Total 437 patients were included in the study. The most common diagnosis made by Paediatric {160 (36.6%)} and Dermatology Departments {246 (56.2%) was viral exanthema followed by atopic dermatitis {77 (17.6%)}. Out of total 65 patients who suffered from bronchial asthma, 59 (90.7%) patients had atopic dermatitis.

Conclusions: Significant paediatric patients with respiratory illnesses have concomitant skin lesions. There is very high percentage of patients having atopic dermatitis among those who had asthma and hence clearly depicts relation between the two diseases.
Modeling the Electronic structure and stability of three aluminum nitride phases
Authors: Ruiz-González Joselyn
Published: May 2021

Phase transitions in aluminum nitride (AlN) were investigated by first principles total energy calculations. Three AlN crystal structures were considered: rock salt (NaCl), zinc blende and wurtzite. The cohesion energy was calculated within both GGA and LDA formalisms. According to the cohesion energy results, the ground state corresponds to the hexagonal wurtzite phase, in agreement with experimental evidence. However, the zinc blende and NaCl phases may be formed as metastable structures. To determine the energy gap the modified Becke-Johnson pseudopotential was applied, with results showing good agreement with the experimental data. The ground state structure exhibits direct electronic transitions. However, the zinc blende and NaCl phases show indirect band gap. Provided that external pressures may induce transitions from wurtzite to zinc blende or rock salt, these transitions were also investigated. Estimation of the pressure at the phase transition indicates that small pressures are needed to achieve such transitions.
An Arduous Ascension for Black Masculinity: Toward Subject Status in Austin Clarke’s “The Man”
Authors: Anderson Janice
Published: May 2021

Austin Clarke’s extensive body of work introduces characters whose contested subject status and representation serve to critique the ways in which Blackness is figured in Canada. In the short story “The Man,” Clarke interrogates the recognition and subject status afforded his protagonist, William Jefferson, by various entities in the course of his rather mundane and unremarkable life. What unfolds is Jefferson’s ascension toward a self-possessed and self-actualized subjectivity that is more reflective of the multiple expressions of Black masculinity in Canada. In this story, Clarke offers a vivid portrayal of both the absented and perceived brutish presence of Black masculinity. Despite the attention to reason and the cultivation of his mind, the corporeal in which the subjectivity of Jefferson rests—that is, his racialized, masculine, aging, ailing body—figures prominently. At the seat of contention in this article is how that body is received and regulated by external social forces that maintain rigid hierarchies of race, gender and class that work to exclude, harass and vilify Jefferson, the owner of this body. Clarke’s “The Man” thus skillfully and subtly tracks the trajectory of Othering through Jefferson’s negotiation of his subject status in Canada, illuminating the arduous task of asserting subjectivity in the process of claiming the nation as home.
Austin Clarke’s Funereal Fiction: From the Almshouse to the Cathedral
Authors: Ballantyne Darcy
Published: May 2021

Analyzing several prose works by Austin Clarke, this article reads the author’s longstanding literary attention to the rituals associated with death, dying and the Black funeral as both a redemptive strategy and an exercise in agency. I argue that Clarke’s funereal fiction suggests a pathway to restitution and Black caring in and beyond death.
Dyskeratosis Congenita: Squamous Cell Carcinoma of the Buccal Mucosa on a Background of Lichen Planus – A Case Report During COVID-19 Pandemic
Authors: Ben Salah Khaled Saleh , Ben Salah Khaled Saleh , M. Emaetig Fatma , El Mahjoubi Ebrahim H. , O. Jebriel Abdalla , A. Oshah Nada , K. Abdulmalik Firas , A. Elfagieh Mohamed , A. Baba Wafa , O. Altaweel Mohamed , Zoubia Naji , Shoaoba Alla , Abdelmollah Monir , O. Howayw Yaser , Ukwas Abdouldaim , Zaggut Abdulhakim W
Published: May 2021

Dyskeratosis Congenita is a severe disorder that involves several systems in the human body and is well-known for its transmission hereditarily through generations. The triad of a) reticular atrophy of the skin with pigmentation b) dystrophy of the nails c) leukoplakia of the oral mucosa characterises this uncommon disorder, which most commonly affects men. One of the key reasons for premature death in this disease is malignant transformation within areas of mucosal hyperkeratosis. In Dyskeratosis Congenita, the simultaneous existence of squamous cell carcinoma (SCC) with lichen planus and or lichenoid reactions in the mucosa of the oral cavity is a rare, stated condition. This report discusses a case of a Libyan male patient affected by Dyskeratosis Congenita that ended with buccal mucosal squamous cell carcinoma developed on a lichen planus background after thirty years of suffering at the age of 64.
RANCANG BANGUN PROTOTIPE KULKAS BERBASIS INTERNET OF THINGS (IoT)
Authors: Surya Agung , Winardi Slamet
Published: May 2021

Various innovations have been developed in various sectors in industry, especially in the field of technology, one of which is the IoT (Internet of things) technology. The working principle of IOT is to control and monitor object equipped with sensors and connected to network that can later send data and even be able to communicate with other objects. One example is built prototype IOT-based refrigerator. The purpose of this study is to control the use of food ingredients (in the form of eggs and yakult) remotely. During this time users such as egg shops and yakult only receive the results sales and purchases of goods that have been made by employees, often the results of reports that are made are not in accordance with reality in the field. With these problems the authors make design of  controller using the refrigerator (eggs and yakult) using the ESP8266 microcontroller, DHT11 to measure temperature, Limit Switch is used for the process of opening and closing the valve. From the results of this research, the results are able to provide information to users in real-time, where users can find out how many items (eggs and yakult) are available in the refrigerator through an application.
RANCANGAN DATA WAREHOUSE AKADEMIK POLITEKNIK PARIWISATA BALI BERBASIS LINUX OPENSUSE
Authors: Wirautama I Gusti Agung Made , Candiasa I Made , Dantes Gede Rasben , Pratama I Putu Agus Eka
Published: May 2021

This study aims to design an academic data warehouse at Politeknik Pariwisata Bali because there are several information systems that require a system capable of handling databases of several existing information system applications and perform analysis. A data warehouse is the right solution for handling databases of several information systems that are not yet integrated. The research method begins with literature study, identification of problems, determining research objectives, designing solutions, namely designing an academic data warehouse, determining the hardware and software specifications needed, and ending with discussions and drawing conclusions. The result of this research is an academic data warehouse design that can be implemented properly. Besides, the results of this study are also accompanied by specifications for open-source hardware and software to save costs. The data warehouse design produced in this study uses a database of 3 information systems which is the main business process of a college, namely: Academic Information System, Information System for New Student Admissions, Research Information System. The three databases of the information system are internal data sources using the MySQL DBMS. The resulting academic data warehouse design uses open source software, namely: openSUSE, Pentaho Data Integration, MySQL DBMS.
IMPLEMENTASI ZONING DAN FITUR ARAH SEBAGAI EKSTRAKSI FITUR PADA PENGENALAN TULISAN TANGAN AKSARA BALI
Authors: Wiguna I Komang Arya Ganda , Asana I Made Dwi Putra
Published: May 2021

Character recognition is one of the most researched fields in computer science. Combining the field of digital image processing and pattern recognition is a challenge in determining the most optimal method combination to complete character recognition. Balinese script is one of the regional scripts used in Balinese literary. The challenge with Balinese script is that some of its characters have a degree of similarity. So far, several methods of feature extraction that have been studied for Balinese script are modified direction feature, template matching, image centroid zone and zone centroid zone, local binary pattern. In this research, we combine methods based on zoning and directional features. The methods used are ICZ, ZCZ and freeman chain code to find the characteristics of Balinese script handwriting. The addition of chain code method aims to determine the value around the foreground point. The results of feature extraction will be used as input in the Support Vector Machine for the classification process. The test result shows that the combination of the ICZ, ZCZ and freeman chain code methods produces an accuracy of 89.09%, while the combination of ICZ and ZCZ produces 88.06% of accuracy. The SVM kernels compared use linear kernels.
Cross-Cultural Adaptation and Validation of the Persian Version of the 24-Item Early-Onset Scoliosis Questionnaire
Authors: Esfandiari Mahmood , Babaee Taher , Kamyab Mojtaba , Kamali Mohammad , Matsumoto Hiroko , Ghandhari Hassan , Vitale Michael G.
Published: May 2021

Study Design: Cross-sectional study.Purpose: To translate and culturally adapt the original English version of the 24-item Early-Onset Scoliosis Questionnaire (EOSQ-24) to the Persian language as well as assess its reliability and validity.Overview of Literature: Early-onset scoliosis (EOS) patients with progressive curves require active treatments, such as serial elongation– derotation–flexion casting, bracing, and surgery, which are stressful and expensive. In order to evaluate the impact of EOS and its treatment strategies, it is important to consider the patients and their parents’ quality of life as the clinical and radiological parameters. The EOSQ-24 is a parent-based measure that evaluates the health-related quality of life of patients with EOS and their caregivers/parents. Similar to other widely used questionnaires, EOSQ-24 needs to be translated into other languages to make it usable in populations from different cultures and societies.Methods: We evaluated the translation and back translation of the EOSQ-24 and made the required revisions as per the analysis performed by the expert committee and an international guideline to adapt it for use in this study. Thereafter, we recruited 100 EOS patients in order to evaluate its reliability and validity. The reliability was assessed with internal consistency. Convergent validity was assessed by comparing the scores of the EOSQ-24 and the 22-item Scoliosis Research Society Questionnaire (SRS-22r). Finally, the known groups validity was assessed as per patient’s sex, curve magnitude, and treatment type.Results: The Persian EOSQ-24 demonstrated very good internal consistency (Cronbach’s α=0.88). All the items had an acceptable corrected item-total correlation (>0.3). Further, the EOSQ-24 and the SRS-22r scores (p <0.001) were significantly correlated. The EOSQ-24 could discriminate patients with different curve magnitudes.Conclusions: The Persian EOSQ-24 can serve as a disease-specific instrument with strong validity and reliability in the evaluation of EOS patients. Its applicability in other Persian-speaking countries and regions of the world needs to be investigated further.
POLICE POWER OF THE BRAZILIAN ARMY
Authors: Souza ARLEN JOSE Silva de , TEIXEIRA SERGIO WILLIAM DOMINGUES , NANTES ROSALINA ALVES , Soares Maria Grima da Silva
Published: May 2021

This work deals with the legal frameworks that manage the exercise of the police power granted to the Armed Forces, addressing the attributions and situations in which they can be employed. The legal provisions are found in the legal system in force, among the precursors the complementary laws of n. 97/1999, n. 117/2004 and n. 136/2010, which brought significant changes in the general rules for the organization, preparation and employment of the Armed Forces. The basis of this work is the study of the use of the Brazilian Army in law and order guarantee operations, as well as ensuring Brazilian territorial sovereignty. The activities called patrolling and policing operations in the border area of the Brazilian territory are exposed throughout the work. Such activities are subsidiary duties conferred by the Armed Forces. At first, a brief exposition will be made of the legal and doctrinal foundations that deal with the power of police, distinguishing it in what is the "administrative police power" and "the power of security police", although coming from state power, both have different purposes.
Organizational Diagnosis in a Brazilian Food Industry - Londrina / PR. / Brazil
Authors: Ceccato Maicon Silvio , Mello Cleverson Molinari
Published: May 2021

The study made an organizational diagnosis in a Brazilian industry in the food segment. The research was submitted to the company's management taking into account the organization's assessment from six perspectives: structure, marketing, production, people, finances and society. Despite the analysis, using the Averange Ranking method, reaching a general neutral index (n = 3.0), the study warns that a company must urgently consider the areas of production, marketing and people; considering that several items in the areas were identified as defined points.
POWER OF INNOVATION ON PERFORMANCE AND SOCIO-ENVIRONMENTAL SUSTAINABILITY
Authors: Mazzioni Sady , Magro Cristian Baú Dal , Picolo Jaime Dagostim , Johann Gabriela Bertoletti
Published: May 2021

Purpose: This study has analyzed the relationship between process and organizational innovation, performance in product, market and technical innovation and social environmental sustainability.

Design/methodology/approach: The data was collected in industrial companies using a questionnaire with a Likert scale and a structural equation model was used to estimate the parameters.

Findings: The results indicated that process and organizational innovation mediated by performance in product, market and technical innovation, influence social and environmental sustainability.

Practical implications: According to the investigated managers, the practical contributions point to the need of considering innovation elements to achieve a good performance.  Subsequently points out that better performing organizations favor practices to seek the global sustainability of the enterprises.

Originality/value: The model used in this study, is broader than that applied in previous studies when considering the dimensions of innovation, performance and sustainability concurrently. Thus, it suggests the understanding, by the interested parties, about organizational performance as an influence of good socio-environmental sustainability practices.
PHYSIOLOGY AND MORPHOLOGY OF RICE PLANTS WITH SILICON SUPPLEMENTATION AND DIETHOLATE SEED TREATMENT UNDER WATER DEFICIT
Authors: Cezar Cassol Jéssica , Lopes Sidinei José , Bidel Dornelles Sylvio Henrique , Peripolli Mariane , Tabaldi Luciane Almeri
Published: May 2021

Silicon is an enzyme stimulator that promotes signaling for the production of antioxidant, osmoprotective compounds and attenuates interference in photosynthesis in rice plants subjected to water deficit. The aim of this study was to evaluate the possible effects of silicon as a stress reliever in rice plants grown from seeds treated with dietholate under of water deficit conditions. The experimental design was fully randomized with three replicates, 144 experimental units consisting of pots containing 4.4 pounds soil, and a 3x2x2x4 factorial arrangement: three soil water conditions (50% and 100% of soil water retention capacity and water blade of 5.0 cm); two cultivars (IRGA 424 RI and Guri INTA CL); two sources of Si (sodium and potassium metasilicate); and four Si rates (0; 4.0; 8.0 and 16 g L-1). Silicon boosted stomatal density; induced an increase in the maximum photochemical efficiency of photosystem II (PSII) under both water deficit and optimal conditions, boosting photosynthesis; and increased effective quantum yield of PSII and levels of total dry mass. Thus, silicon attenuated the effects of water deficit in plants grown from seeds treated with dietholate.
E-learning in a pandemic era
Authors: Olanrewaju Gideon Seun , Omotosho Abiodun Yetunde , Falajiki Olajide Charles , Osama Godwin
Published: May 2021

The COVID-19 pandemic contributed to a digital economy transition by emphasizing the importance of digital infrastructure while exposing the digital gaps between countries and communities. Inequalities in digital access has impeded educational gains made towards achieving the sustainable development goals. While major studies have been carried out on digital learning there is currently a dearth of knowledge on the digital gaps and needs of students in remote communities in Nigeria. To this end, this study explored the digital gaps and needs of rural secondary schools in remote communities and its implications on e-learning across 6 Nigerian states during the COVID-19 era. The study adopted a concurrent embedded mixed method design approach to collect data from rural secondary schools from 6 Nigerian states. Findings from the study identified lack of ICT strategies and policies in Nigeria, socio-economic status, poor internet connectivity, electricity, and a high poverty level as the major drivers of digital gaps in remote communities.
Overview of Student Enrolment, Teaching Faculty and Student-Teacher Ratio of Private and Public Universities in Pakistan
Authors: Hanafi Munazza Rahim , Abuzar Wajidi
Published: May 2021

Growth and social wellbeing of a country largely depends on all the activities that require knowledge, expertise and highly qualified individuals to fill the gape between new avenues and job demand. Higher education institutions, number of enrolments in universities and availability of qualified teachers is important for fostering quality of education with a smooth flow of academic activities. This study is an attempt to gauge the situation of public and private universities in Pakistan by focusing on the number of universities, number of teachers and student-teacher ratio in public and private universities of Pakistan. Secondary data has been reviewed and examined from the available source (Pakistan Education Statistic). It has been identified that there is an increase in the number of universities but with a prominent decrease in teaching staff particularly in public sector universities, whereas student-teacher ratio has also been witnessed higher in public sector than the private universities in Pakistan.
POPULARIZAÇÃO DA CIÊNCIA, SENSO COMUM E O PAPEL DO PROFESSOR NO ENSINO DE CIÊNCIAS
Authors: FERREIRA JOAO PEDRO GOMES ALVES
Published: May 2021

Este trabalho apresenta uma discussão sobre a aproximação entre o conhecimento elaborado cientificamente e os saberes do senso comum na perspectiva daqueles esforços comumente denominados de Popularização da Ciência. Para tanto, defende-se a consideração da leitura e visão do mundo dos sujeitos integrantes dos processos educativos, aliada a uma apresentação diferenciada do conhecimento científico, isto é, a apresentação da ciência como produto, mas sobretudo, como um processo que pode se adequar as realidades local e regional do educando. Dessa forma se dará o estabelecimento de um diálogo que seja capaz de desvelar as singularidades do real. Objetivando atingir as características de um ensino de ciências dialógico-democrático, cabe ao professor como responsável pela apresentação da atividade científica, assumir a postura do educador-educando que se coloca como um constante aprendiz ao procurar continuamente apreender os saberes de experiências feitos dos educandos e iniciar um processo de colaboração, entre ele, o intelectual compromissado com seu conhecimento científico, e o povo com as suas percepções primeiras sobre a realidade. Dessa forma, apresenta-se as justificativas para a promoção da Popularização da Ciência nos espaços educativos, refletindo os desafios e as limitações impostas pela realidade a cada uma delas. Nesse sentido, a pedagogia da pergunta é considerada como princípio pedagógico norteador da prática educativa, contrapondo-se a hegemônica educação de respostas, exímia especialista em depositar conhecimentos. Criadas e estabelecidas as condições para o diálogo entre o conhecimento científico e os saberes de senso comum, inaugura-se a possibilidade de um ensino de ciências capaz de auxiliar os sujeitos das classes populares a atuarem na sociedade a partir de conhecimentos científicos básicos, permitindo-lhes, homens e mulheres, a seguirem a sua ontológica vocação: de ser mais.
Systematic review of charged-particle therapy for chordomas and sarcomas of the mobile spine and sacrum
Authors: Pennington Zach , Ehresman Jeff , Elsamadicy Aladine A. , Shin John H. , Goodwin C. Rory , Schwab Joseph H. , Sciubba Daniel M.
Published: May 2021

OBJECTIVE

Long-term local control in patients with primary chordoma and sarcoma of the spine and sacrum is increasingly reliant upon en bloc resection with negative margins. At many institutions, adjuvant radiation is recommended; definitive radiation is also recommended for the treatment of unresectable tumors. Because of the high off-target radiation toxicities associated with conventional radiotherapy, there has been growing interest in the use of proton and heavy-ion therapies. The aim of this study was to systematically review the literature regarding these therapies.

METHODS

The PubMed, OVID, Embase, and Web of Science databases were queried for articles describing the use of proton, combined proton/photon, or heavy-ion therapies for adjuvant or definitive radiotherapy in patients with primary sarcoma or chordoma of the mobile spine and sacrum. A qualitative synthesis of the results was performed, focusing on overall survival (OS), progression-free survival (PFS), disease-free survival (DFS), and disease-specific survival (DSS); local control; and postradiation toxicities.

RESULTS

Of 595 unique articles, 64 underwent full-text screening and 38 were included in the final synthesis. All studies were level III or IV evidence with a high risk of bias; there was also significant overlap in the reported populations, with six centers accounting for roughly three-fourths of all reports. Five-year therapy outcomes were as follows: proton-only therapies, OS 67%–82%, PFS 31%–57%, and DFS 52%–62%; metastases occurred in 17%–18% and acute toxicities in 3%–100% of cases; combined proton/photon therapy, local control 62%–85%, OS 78%–87%, PFS 90%, and DFS 61%–72%; metastases occurred in 12%–14% and acute toxicities in 84%–100% of cases; and carbon ion therapy, local control 53%–100%, OS 52%–86%, PFS (only reported for 3 years) 48%–76%, and DFS 50%–53%; metastases occurred in 2%–39% and acute toxicities in 26%–48%. There were no studies directly comparing outcomes between photon and charged-particle therapies or comparing outcomes between radiation and surgical groups.

CONCLUSIONS

The current evidence for charged-particle therapies in the management of sarcomas of the spine and sacrum is limited. Preliminary evidence suggests that with these therapies local control and OS at 5 years are comparable among various charged-particle options and may be similar between those treated with definitive charged-particle therapy and historical surgical cohorts. Further research directly comparing charged-particle and photon-based therapies is necessary.
Surgical management of spinal metastases involving the cervicothoracic junction: results of a multicenter, European observational study
Authors: Hubertus Vanessa , Gempt Jens , Mariño Michelle , Sommer Björn , Eicker Sven O. , Stangenberg Martin , Dreimann Marc , Janssen Insa , Wipplinger Christoph , Wagner Arthur , Lange Nicole , Jörger Ann-Kathrin , Czabanka Marcus , Rohde Veit , Schaller Karl , Thomé Claudius , Vajkoczy Peter , Onken Julia S. , Meyer Bernhard
Published: May 2021

OBJECTIVE

Surgical management of spinal metastases at the cervicothoracic junction (CTJ) is highly complex and relies on case-based decision-making. The aim of this multicentric study was to describe surgical procedures for metastases at the CTJ and provide guidance for clinical and surgical management.

METHODS

Patients eligible for this study were those with metastases at the CTJ (C7–T2) who had been consecutively treated in 2005–2019 at 7 academic institutions across Europe. The Spine Instability Neoplastic Score, neurological function, clinical status, medical history, and surgical data for each patient were retrospectively assessed. Patients were divided into four surgical groups: 1) posterior decompression only, 2) posterior decompression and fusion, 3) anterior corpectomy and fusion, and 4) anterior corpectomy and 360° fusion. Endpoints were complications, surgical revision rate, and survival.

RESULTS

Among the 238 patients eligible for inclusion this study, 37 were included in group 1 (15%), 127 in group 2 (53%), 18 in group 3 (8%), and 56 in group 4 (24%). Mechanical pain was the predominant symptom (79%, 189 patients). Surgical complications occurred in 16% (group 1), 20% (group 2), 11% (group 3), and 18% (group 4). Of these, hardware failure (HwF) occurred in 18% and led to surgical revision in 7 of 8 cases. The overall complication rate was 34%. In-hospital mortality was 5%.

CONCLUSIONS

Posterior fusion and decompression was the most frequently used technique. Care should be taken to choose instrumentation techniques that offer the highest possible biomechanical load-bearing capacity to avoid HwF. Since the overall complication rate is high, the prevention of in-hospital complications seems crucial to reduce in-hospital mortality.
Delayed variations in the diagnostic accuracy of intraoperative neuromonitoring in the resection of intramedullary spinal cord tumors
Authors: Kimchi Gil , Knoller Nachshon , Korn Akiva , Eyal-Mazuz Yahel , Sapir Yechiam , Peled Anton , Harel Ran
Published: May 2021

OBJECTIVE

The use of intraoperative neuromonitoring (IONM) has become an imperative adjunct to the resection of intramedullary spinal cord tumors (IMSCTs). While the diagnostic utility of IONM during the immediate postoperative period has been previously studied, its long-term diagnostic accuracy has seldom been thoroughly assessed. The aim of this study was to evaluate long-term variations in the diagnostic accuracy of transcranial motor evoked potentials (tcMEPs), somatosensory evoked potentials (SSEPs), and D-wave recordings during IMSCT excision.

METHODS

The authors performed a retrospective evaluation of imaging studies, patient charts, operative reports, and IONM recordings of patients who were operated on for gross-total or subtotal resection of IMSCTs at a single institution between 2012 and 2018. Variations in the specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV) for postoperative functional outcome (McCormick Scale) were analyzed at postoperative day 1 (POD1), 6 weeks postoperatively (PO-6 weeks), and at the latest follow-up.

RESULTS

Overall, 28 patients were included. The mean length of follow-up was 19 ± 23.4 months. Persistent motor attenuations occurred in 71.4% of the cohort. MEP was the most sensitive modality (78.6%, 87.5%, and 85.7% sensitivity at POD1, PO-6 weeks, and last follow-up, respectively). The specificity of the D-wave was the most consistent over time (100%, 83.35%, and 90% specificity at the aforementioned time points). The PPV of motor recordings decreased over time (58% vs 33% and 100% vs 0 for tcMEP and D-wave at POD1 and last follow-up, respectively), while their NPV consistently increased (67% vs 89% and 70% vs 100% for tcMEP and D-wave at POD1 and last follow-up, respectively).

CONCLUSIONS

The diagnostic accuracy of IONM in the resection of IMSCTs varies during the postoperative period. The decrease in the PPV of motor recordings over time suggests that this method is more predictive of short-term rather than long-term neurological deficits. The increasing NPV of motor recordings indicates a higher diagnostic accuracy in the identification of patients who preserve neurological function, albeit with an increased proportion of false-negative alarms for the immediate postoperative period. These variations should be considered in the surgical decision-making process when weighing the risk of resection-associated neurological injury against the implications of incomplete tumor resection.
Feasibility of achieving planned surgical margins in primary spine tumor: a PTRON study
Authors: Dandurand Charlotte , Fisher Charles G. , Rhines Laurence D. , Boriani Stefano , Charest-Morin Raphaële , Gasbarrini Alessandro , Luzzati Alessandro , Reynolds Jeremy J. , Wei Feng , Gokaslan Ziya L. , Bettegowda Chetan , Sciubba Daniel M. , Lazary Aron , Kawahara Norio , Clarke Michelle J. , Rampersaud Y. Raja , Disch Alexander C. , Chou Dean , Shin John H. , Hornicek Francis J. , Laufer IIya , Sahgal Arjun , Dea Nicolas
Published: May 2021

OBJECTIVE

Oncological resection of primary spine tumors is associated with lower recurrence rates. However, even in the most experienced hands, the execution of a meticulously drafted plan sometimes fails. The objectives of this study were to determine how successful surgical teams are at achieving planned surgical margins and how successful surgeons are in intraoperatively assessing tumor margins. The secondary objective was to identify factors associated with successful execution of planned resection.

METHODS

The Primary Tumor Research and Outcomes Network (PTRON) is a multicenter international prospective registry for the management of primary tumors of the spine. Using this registry, the authors compared 1) the planned surgical margin and 2) the intraoperative assessment of the margin by the surgeon with the postoperative assessment of the margin by the pathologist. Univariate analysis was used to assess whether factors such as histology, size, location, previous radiotherapy, and revision surgery were associated with successful execution of the planned margins.

RESULTS

Three hundred patients were included. The surgical plan was successfully achieved in 224 (74.7%) patients. The surgeon correctly assessed the intraoperative margins, as reported in the final assessment by the pathologist, in 239 (79.7%) patients. On univariate analysis, no factor had a statistically significant influence on successful achievement of planned margins.

CONCLUSIONS

In high-volume cancer centers around the world, planned surgical margins can be achieved in approximately 75% of cases. The morbidity of the proposed intervention must be balanced with the expected success rate in order to optimize patient management and surgical decision-making.
Prevalence of COVID-19 Positive Cases Diagnosed by Real time Polymerase Chain Reaction in a Tertiary Care Hospital of Nepal
Authors: Pokharel Khilasa , Mishra Bhavesh , Karki Anup
Published: May 2021

Introduction: The virus that causes COVID-19 is known as severe acute respiratory syndrome Coronavirus-2. This new variant of Corona Virus introduced in China has urged the massive health system resources to focus on its screening and management of sick patients worldwide. We aimed to find the prevalence of COVID-19 positive cases diagnosed by Real-time polymerase chain reaction in a tertiary care hospital of Nepal.

Methods: This is a descriptive cross-sectional study that was conducted from 11th of November to 15th December 2020. Nasopharyngeal and Oropharyngeal swabs were collected, and confirmation of cases of COVID-19 was done based on the detection of viral ribonucleic acid by nucleic acid amplification tests such as real-time reverse transcriptase-polymerase chain reactions. The viral genes targeted include the E, N, and ORF.

Results: A total of 15247 samples have been processed, of which s (14.81%) positive cases were included in this study. There were 1427 (63.19%) male and 831 (36.68%) females. The majority of the cases were asymptomatic 1386 (61.38%). The most common age group infected was between 15 to 40 years, 841 (58.93%) male and 542 (65.22%) females. The most common presenting symptoms were cough 315 (13.95%) and fever 306 (13.55%).

Conclusions: Most of the individuals reported for real-time polymerase chain reaction were asymptomatic patients who might be contagious and have the potential to transmit infection. Among symptomatic cases, common symptoms were cough and fever.
Irritable Bowel Syndrome and Me: A Sworn Rivalry
Authors: Shakya Selika
Published: May 2021

â€œThree more hoursâ€, I tell myself as I find my way to the exam hall. I see a bunch of my classmates cramming for the last minute, and here I am, in a corner, reminding myself that itâ€™s just three more hours till I get away from this horror. Irritable Bowel Syndrome is a gastrointestinal disorder in which there is dull achy lower abdominal pain associated with either diarrhea or constipation. Though it has high prevalence, it is still an underrated disease which can be easily missed in clinical settings.
What people drink and where they drink informs us about their personality
Authors: K. Jonason Peter , Talbot Daniel , Anderson Joel
Published: May 2021

Folk wisdom and research on personality inferences suggest one should be able to judge a person's personality based on their behaviour related to alcohol consumption. In a sample of Australians (N = 1,232), we compared the utility of knowing where and what people prefer to consume alcohol to understand people's personality (broadly construed). Where people drank had limited utility; predicting hopelessness in those who drank at home more than at a licensed venue and the consumption of spirits for those high in extraversion at a licensed venue. In contrast, there were several differences in people's personality across drink preferences. For example, neuroticism was higher in cider and spirit drinkers than beer and wine drinkers. Results are framed within the personality inference literature and qualified by (1) the traditional beer-drinking culture of our sample and (2) the complex relationships between personality and any behaviour, including habits surrounding alcohol consumption.
PELATIHAN JOURNALISME WARGA: PENGEMBANGAN MEDIA SOSIAL BAGI MASYARAKAT
Authors: Wedyawati Nelly , Dharma Yokie Prasetya , Susanti Yudita
Published: May 2021

ABSTRAKPengabdian bertujuan untuk media penyampaian informasi terkait tentang literasi teknologi bagi masyarakat. Hal ini sangat penting selain untuk meningkatkan pemahaman masyarakat terhadap internet sehat, kegiatan ini juga berupaya untuk meningkatkan kepekaan dan antusiasme masyarakat terhadap masalah-masalah yang kerap muncul pada pelayanan publik. Kegiatan dilaksanakan  di Desa Nanga Tikan, Kecamatan Kayan Hilir, Kabupaten Sintang, Kalimantan Barat. Sasaran kegiatan PkM ini adalah para perangkat desa dan anggota Karang Taruna (pemuda) yang ada di Desa. Penentuan kriteria khalayak tersebut berdasarkan pengamatan bahwa generasi muda rentang dari umur 17 hingga 35 tahun adalah mereka yang gemar atau secara intensif memanfatkan internet atau sosial media. Bentuk PkM ini penyuluhan dan pelatihan kepada masyarakat tentang pengembangan media sosial. Penyuluhan dan pelatihan dilaksanakan pada tanggal 23 Oktober 2020 di Balai Desa Nanga Tikan dengan model ceramah dan demonstrasi pemanfaatan media sosial (internet). Hasil wawancara dengan kepala desa dan beberapa pemuda desa diperoleh respon sangat baik terhadap kegiatan ini. Hasil angket respon diperoleh hasil 95% dengan kategori sangat senang. Kesimpulan dari kegiatan yaitu sasaran kegiatan sangat puas terhadap pelatihan Journalis warga.Kata Kunci: Pelatihan, Journalis, Literasi, Teknologi, Media. ABSTRACTThe community service aimed to delivering information media related to technology literacy for the community. This is very important in addition to increasing public understanding of a good internet usage, this activity also seeks to increase the sensitivity and enthusiasm of the community towards problems that often arise in public services. The activity was carried out in Nanga Tikan Village, Kayan Hilir District, Sintang District, West Kalimantan. The targets of this PkM activity are village officials and members of the Karang Taruna (youth) in the village.The determination of the audience criteria is based on the observation that the younger generation, ranging from 17 to 35 year old, are those who like or intensively use the internet or social media. This form of PkM provides counseling and training to the community on social media development. Counseling and training was carried out on October 23, 2020 at the Nanga Tikan Village Hall with a lecture and demonstration model of the use of social media (internet). The results of interviews with the village head and several village youth received very good responses to this activity. The results of the response questionnaire were 95% with the very enthusiastic. The conclusion of the activity is that the target of the activity is very satisfied with the citizen journalism training.Keywords: Training, Journalists, Literacy, Technology, Media.
EDUKASI PENGGUNAAN PROBIOTIK YANG TEPAT SEBAGAI IMUNOSTIMULAN DI ERA PANDEMI COVID-19
Authors: Mawardika Herlinda , Oktavia Ira
Published: May 2021

ABSTRAKPandemi COVID-19 adalah salah satu masalah utama yang sedang dihadapi masyarakat karena memberikan dampak yang besar di bidang kesehatan maupun perekonomian. Dalam mengatasi infeksi COVID-19, masyarakat dianjurkan untuk menerapkan protokol kesehatan seperti memakai masker, menjaga jarak, cuci tangan dengan sabun, serta menjaga imunitas tubuh melalui olahraga dan konsumsi makanan atau minuman yang baik untuk kesehatan. Selain jamu, probiotik dapat menjadi pilihan yang tepat untuk dikonsumsi selama pandemi COVID-19. Probiotik adalah kultur mikroba hidup yang baik untuk sistem pencernaan dan diketahui berperan dalam mempengaruhi sistem imun tubuh. Probiotik dapat diperoleh dari produk-produk fermentasi. Kegiatan pengabdian masyarakat ini bertujuan memberikan informasi kepaa masyarakat tentang penggunaan probiotik yang tepat untuk peningkatan imunitas tubuh di era pandemi COVID-19. Kegiatan ini dilakukan melalui sosialisasi di Desa Duwet Kabupaten Malang. Keberhasilan pengabdian masyarakat ditentukan dari penilaian kuesioner yang diberikan ke peserta. Hasil evaluasi kegiatan menunjukkan bahwa pengabdian kepada masyarakat ini berlangsung dengan baik dan dapat mencapai tujuan yang diharapkan, yaitu sosialisasi dapat meningkatan pemahaman dan kesadaran peserta untuk mengkonsumsi probiotik.Kata Kunci: Probiotik, Imune system, COVID-19 ABSTRACTPandemic COVID-19 is one of the main problems faced by society because it causes a huge impact in the field of health and economy. In overcoming the infection of COVID-19, people are encouraged to apply health protocols such as wearing mask, keeping a distance, washing hands with soap, as well as maintaining the immunity of the body through exercise and the consumption of foods or drinks that are good for health. In addition to herbs, probiotics can be the right choice to be consumed during the pandemic COVID-19. Probiotics are cultures of live microbes that are good for digestive system and have been found to influence the immune system. Probiotics can be obtained from the fermentation products. The objective of this community service was to provide information for the public about the proper use of probiotic to increase the body's immunity in the era of pandemic COVID-19. This activity was carried out by socialization in Duwet Village Malang Regency. The success of the community is determined based on the assessment of participants’questionnaire. The results showed that this community service was going well and achieved the expected goal, socialization increased participants’ awareness and understanding of probiotic consumption. Keywords: Probiotics, Immune system, COVID-19