bluuebunny/crossref_metadata_2025 huggingface dataset:
Aplikasi Pengenalan Pola Citra Logo Obat Medis Menggunakan K-Means Clustering
Authors: Andreansyah Agus
Published: October 2022

Trends in drug abuse have occurred since 2014 such as ATS abuse or chemicals such as over-the-counter PCC. People no longer follow the rules of using drugs according to applicable regulations, but many who buy and consume drugs without a doctor's prescription. These behaviors and actions can endanger health, so people need to know the use of drugs to be more safe for consumption, one of them by paying attention to the type of logo on the drug packaging. To make it easier to find out the name of the logo type on drug packaging, it is necessary to develop an application using digital image processing. The study began with taking a drug pattern image using a smartphone camera and the results were carried out cropping the logo image in detail. Furthermore, cropping (RGB) images are converted into binary images and grayscale images to be performed a feature extraction process that is metric, eccentricity, and GLCM. The results of testing the test image data, a percentage of 91.5% with an accuracy rate of 100% types of over-the-counter drugs, hard drugs, and narcotics, while over-the-counter drug images are limited to 66%.
The Relationship Between Patient Characteristics Diabetes Self-Care Management with Diabetic Peripheral Neuropathy in Type 2 DM Patients in Regional General Hospital in Indonesia
Authors: Aulia Akmal  , Hilman Syarif  , Cut Husna
Published: October 2022

One of the microvascular complications is loss of sensation in the leg area (peripheral neuropathy) which causesfoot ulcers and the risk of amputation. The purpose of this study was to determine the relationship betweenpatient characteristics and Diabetes Self-Care Management (DSCM) with Diabetic Peripheral Neuropathy (DPN)in type 2 diabetes mellitus patients in a regional public hospital in one of the provinces in Indonesia. This studyused a correlative design with a cross-sectional approach to 154 patients with type 2 diabetes mellitus who wereselected using a proportionate stratified random sampling technique. The data were obtained using a Summaryof Diabetes Self-Care Activities and the Michigan Diabetic Neuropathy Score and analyzed using the Chi-squaretest and logistic regression. The results showed that age and duration of diabetes were the sub-variables ofpatient characteristics that were most associated with neuropathy in diabetic patients. Patients are expectedto be able to do diabetes management regularly so that no more diabetes patients are injured due to a lack ofself-management. Hospitals are expected to routinely carry out training and counseling for diabetic patients toprevent serious complications caused by peripheral neuropathy.
Meningkatkan Ketahanan Ekonomi Masyarakat Melalui Pelatihan Kewirausahaan di Kelurahan Pangkalan Lesung
Authors: Nur DP Emrinaldi , Tambunan Raja Jhuand Mulia , Pratama M. Anggi , Pratami Chanti Anjelica , Putri Yolanda Eka
Published: October 2022

Indonesia merupakan negara berkembang yang mengalami penurunan ketahanan ekonomi akibat meningkatnya jumlah tenaga kerja namun tidak diiringi oleh penambahan lapangan kerja. Salah satu upaya dalam mencegah hal itu yaitu dengan melakukan pelatihan, penyuluhan, dan pendampingan dalam berwirausaha terkhususnya daerah Pangkalan Lesung. Pangkalan lesung merupakan daerah yang memiliki potensi objek wisata dan sumber daya alam yang tinggi. Tujuan dilakukan pengabdian masyarakat ini adalah untuk meningkatkan ketahanan ekonomi dengan pelatihan kewirausahaan. Metode yang digunakan yaitu survei, sosialisasi, dan pelatihan. Hasil yang diperoleh yaitu masyarakat antusias dalam mengikuti kegiatan yang dilakukan dan keinginan masyarakat untuk membuka usaha atau berwirausaha sangat tinggi.

Kata Kunci : Kewirausahaan, Pangkalan Lesun, Ketahanan Ekonomi, Pelatihan
Myoclonus as an unusual presentation of progressive multifocal leukoencephalopathy in a HIV positive patient
Authors:   Department of Neurology II, Clinical Emergency County Hospital Timisoara, Romania, Chicea Lucian , Rosca Elena Cecilia ,   Department of Neurology II, Clinical Emergency County Hospital Timisoara, Romania,   Department of Neurology II, “Victor Babes” University of Medicine and Pharmacy Timisoara, Timisoara, Romania, Rosca Ovidiu ,   Department of Infectious Diseases I, “Victor Babes” Clinical Hospital of Infectious Diseases and Pneumophtisiology, Timisoara, Romania,   Department of Infectious Diseases I, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania, Ciolan M. ,   Department of Neurology II, Clinical Emergency County Hospital Timisoara, Romania, Simu Mihaela ,   Department of Neurology II, Clinical Emergency County Hospital Timisoara, Romania
Published: October 2022

From mild muscular contractions to gross jerks affecting the whole body, myoclonus is an involuntary movement caused by an excessive discharge from a group of neurons located in one or multiple sites from cortical to peripheral level. Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating disease of the CNS caused by oligodendroglial destruction due to JC virus. Usually it manifests with focal neurological deficits such as motor weakness, sensory abnormalities, visual disturbances, cognitive impairments, movement disorders having a low incidence in these patients. We report a rare case of myoclonus as a neurological complication of PML in AIDS, analyzing the link between the stage of HIV infection, the MRI lesions and the type of myoclonus, being also aware of potential interactions between the antiepileptic drugs and the antiretroviral therapy.
As mulheres na ciência: contribuições da produção científica feminista do campo CTS
Authors: Rocha Etiene Siqueira , Alves Pedro Wilson José
Published: October 2022

A perspectiva feminista da ciência é fundamental para a promoção da igualdade de gênero na C&T, uma vez que denuncia os valores sexistas e preconceituosos que historicamente permeia a ciência. Neste sentido, realizou-se um estudo bibliográfico a fim de identificar a produção feminista sobre mulheres nos estudos Ciência, Tecnologia e Sociedade (CTS). Para tanto, elaborou-se um levantamento em periódicos de referência no âmbito nacional e internacional com enfoque CTS sobre as mulheres nas ciências, bem como realizou-se buscas sobre a temática no Google Trends. Observou-se, assim, que os estudos feministas no campo CTS problematizam, principalmente, os inúmeros mecanismos sexistas que afetam as cientistas e retratam os avanços alcançados pelas mulheres. Tais estudos feministas tem potencial para fomentar o debate necessário para a ruptura das estruturas vigentes, conforme os dados observados no Google Trends que corroboram com as inquietações expressas nos estudos da revisão em análise.
Análise da presença feminina no curso de licenciatura em Física da UFT
Authors: De Carvalho Sheyse Martins , Da Silva Cláudia Adriana , Rodrigues Jannyny Oliveira Fogaça
Published: October 2022

Estudos recentes mostram que a presença feminina ainda é bastante reduzida nas carreiras científicas. As mulheres continuam segregadas em cursos feminizados, e as poucas que optam pelas ciências exatas, como a Física, encontram inúmeras barreiras para permanecer e avançar na carreira científica. Este trabalho tem como objetivo dar início a um estudo voltado para a participação feminina no curso de licenciatura em Física da Universidade Federal do Tocantins (UFT), e assim contribuir para o debate de questões de gênero dentro do meio acadêmico, principalmente na busca de políticas públicas que favoreçam a permanência das mulheres nessa área. Através de dados fornecidos pela secretaria acadêmica, foi realizada uma análise quantitativa acerca da trajetória das mulheres dentro do curso. Os resultados obtidos apontaram um curso com predominância masculina, mas com a participação de mulheres que tendem a desistir menos que os homens e resistir mais.
A experiência de jovens professoras feministas e a rede social como lócus de militância
Authors: Dorotéio Patrícia Karla Soares Santos
Published: October 2022

Esse artigo se detém sobre o discurso feminista que constitui a experiência de militância de três jovens professoras, a partir de suas práticas discursivas na rede social Facebook. A rede social é aqui entendida como lócus de militâncias de múltiplas pautas, múltiplos focos, múltiplos movimentos. O conceito de experiência, em Michel Foucault, fundamenta as análises. Procuramos apreender traços da correlação entre os saberes, poderes e as formas de subjetividade que estão em jogo nos discursos de militância feminista das professoras pesquisadas. Para responder as questões de pesquisa, foi feita uma netnografia no perfil da rede social Facebook, seguida por entrevista a cada uma delas. A partir do que publicam na rede social, é possível afirmar que elas fazem um movimento que mobiliza fragmentos, rastros, pedaços de discursos feministas historicamente construídos, de modo a realizar a luta, a denúncia e a resistência.
Os efeitos de poder produzidos pelo projeto Escola sem Partido na docência
Authors: Santos Dayana Brunetto Carlin dos , Mottin Karina Veiga
Published: October 2022

Este texto se propõe a investigar os efeitos de poder produzidos pelos regimes de saber-poder (FOUCAULT, 2010) sobre corpo, gênero e sexualidade na educação, instituídos por discursos conservadores, como o do Projeto Escola Sem Partido, sobre a docência. Fundamentada nas teorizações pós-estruturalistas, foucaultianas e estudos de gênero, suspeito que tais efeitos estejam forjando subjetividades docentes que se produzem como sujeitadas e as que se constituem como resistências (FOUCAULT, 1988) às investidas do poder. Essa nova configuração da docência tem produzido também práticas docentes governadas por um pânico moral (COHEN, 1972) que se instala na educação brasileira como uma espécie de reação as conquistas dos movimentos sociais LGBTI e feministas. Interroga ainda sobre possíveis estratégias de produção da docência como cuidado de si (FOUCAULT, 1985; 1995) e prática de liberdade contribuindo para se (re)pensar as práticas para uma vida não fascista no cotidiano das escolas.
Etiology model for many vaccination adverse reactions, including SARS-CoV-2 spike vaccines
Authors: Ricke Darrell O.
Published: October 2022

Objective

Vaccinated individuals (vaccinees) experience no adverse events, mild adverse events, multiple adverse events, or serious adverse events post vaccination. Many of these vaccine adverse events occur with different vaccines with different occurrence frequencies. Many of these adverse events are generally considered as associated with immune responses to the active vaccine components (antigens) and/or to possibly one or more of the vaccine excipients. Most of these vaccine adverse events are self-limiting and resolve within days. The number of vaccine adverse reactions is higher for SARS-CoV-2 spike vaccines than all other vaccines. Can data analysis of vaccine adverse reactions responses provide etiology insights for high reactogenicity vaccines?

Methods

The Vaccine Adverse Event Reporting System (VAERS) database was data mined for all vaccine adverse events data by vaccine, age, gender, dose, and day of onset post vaccination. Results for vaccines with the highest number of adverse events were compared.

Results

For vaccines and adverse events with the highest numbers of reports, the day of onset approximates a power of two decay pattern for the first three days. The consistency of this pattern for multiple unrelated vaccines narrows possible etiology mechanisms. Many of these adverse event symptoms overlap symptoms associated with elevated histamine levels. Herein, innate immune responses and specifically elevated histamine levels are proposed to be causative for the majority of these adverse events. This hypothesis is based on a model of innate immune responses releasing a surge of inflammatory molecules, including histamine; this surge is hypothesized to exceed the normal histamine tolerance level for vaccinees causing reactogenicity adverse events. Further, these symptoms resolve as histamine levels fall below the vaccinee's tolerance threshold. This model can be evaluated by the detection of elevated histamine levels in vaccinees corresponding to timing of symptoms onset. If confirmed, a direct consequence of this model predicts that specific antihistamine treatments, mast cell stabilizers, and possibly diamine oxidase enzyme may reduce the incidence or severity of adverse events experienced by vaccinees post vaccinations for most or all high reactogenicity vaccines including coronavirus disease 2019 (COVID-19) spike vaccines.

Conclusions

The reported onset occurrences of the majority of reported adverse events are consistent with the likely etiology of innate immune responses to vaccinations for vaccines with higher reactogenicity levels. Herein, the hypothesis is proposed that the majority of these adverse events result from a histamine surge that temporarily exceeds the vaccinee's tolerance level.
New stability criteria for systems with an interval time-varying delay
Authors: Tian Junkang , Ren Zerong , Liu Yanmin
Published: October 2022

This paper studies the stability analysis of systems with an interval time-varying delay. First, some new integral inequalities are introduced. Second, based on these new integral inequalities, some less conservative stability criteria are introduced in terms of the linear matrix inequalities. Finally, the merits of the stability criteria are shown via two numerical examples.
Mit o Antigoni in francoska revolucija
Authors: Kocijančič Matic
Published: October 2022

Recepcija mita o Antigoni v času francoske revolucije je za slovensko literarnokritiško tematizacijo tega mita relevantna iz dveh razlogov: prvič, George Steiner je v svoji znameniti študiji Antigones, ki velja za temeljno delo o moderni recepciji Antigone, francosko revolucijo označil za ključno spodbudo pri modernem preporodu zanimanja za ta mit; in drugič, v času francoske revolucije se oblikuje povezava med antigonsko tematiko ter vprašanji revolucionarnega konflikta in nasilja – povezava, ki je bila na svojevrsten način središčna tudi za povojno recepcijo Sofoklove Antigone v slovenski literaturi, literarnem kritištvu, filologiji, filozofiji in političnem diskurzu. Članek se kritično sooči s Steinerjevimi tezami o vplivu francoske revolucije na moderno popularizacijo Antigone in pokaže, da je bil ta mit v tem času v večji meri povezan s protirevolucionarnimi in rojalističnimi tokovi. Članek ob tem osvetli tudi pomenljive zgodovinske paralele med francosko in slovensko recepcijo antigonskega mita.
O prizmatičnem prevajanju
Authors: Nikolaš Leona
Published: October 2022

Kritika:

Matthew Reynolds, ur.: Prismatic Translation. Cambridge: Legenda, 2019. 381 str.
The Traditional Restorative Justice Practices That Have Influenced Southern Africa
Authors: Brown Angelo Kevin
Published: October 2022

The indigenous peoples of Southern Africa have a tradition of using restorative justice practices. The region has used restorative justice practices primarily until European colonization had enforced a Western criminal justice and legal system. During and after colonization, Southern Africa has continued to use traditional methods for public safety and resolving conflicts in communities. This led to governments having a dual system in which nonserious violations are usually handled in the traditional courts, and the more serious crimes are handled in the formal criminal courts.
Looking at Community-Based ADRS in India Through a Restorative Justice Perspective
Authors: Lama Swikar
Published: October 2022

Restorative justice is a type of alternative dispute resolution, but not all ADR (Alternative Dispute Resolution) procedures constitute restorative justice. This chapter examines community-based alternative dispute resolution systems, attempting to distinguish the similarities and differences between ADRS (Alternative Dispute Resolution Systems) and restorative justice procedures. It examines whether these community-based ADRs adhere to restorative justice principles such as victim empowerment, deliberate effort by those involved in decision-making to reduce stigmatization and punishment of the offender, emphasis on strengthening or repairing interpersonal relationships, and so on. It also looks into whether formal restorative justice processes could imbibe some of the good features of these community-based ADRs.
Tourism and Women
Authors: Deliormanli Ayse
Published: October 2022

Gender-related issues have not lost their importance from the past to the present and are being carefully emphasized. As one of the important subjects of sociology, gender and gender discrimination continues to exist in the tourism sector as well. There are basic predispositions for both employment in tourism and the participation of women as consumers in tourism activities. The roles socially determined for women can create an obstacle for women to participate in working life. The same attitude is observed at the stage of women's participation in tourism activities. In particular, the risks and concerns faced by women traveling as a group or alone indicate the perspective on women has not changed. Based on this point of view, this study aims to present the relationship between gender and tourism, the experiences of women both in working life and in tourism activities as a tourist in a theoretical framework.
Emotion Detection and Classification Using Machine Learning Techniques
Authors: Dessai Amita Umesh , Virani Hassanali G.
Published: October 2022

This chapter analyzes 57 articles published from 2012 on emotion classification using bio signals such as ECG and GSR. This study would be valuable for future researchers to gain an insight into the emotion model, emotion elicitation and self-assessment techniques, physiological signals, pre-processing methods, feature extraction, and machine learning techniques utilized by the different researchers. Most investigators have used openly available databases, and some have created their datasets. The studies have considered the participants from the healthy age group and of similar cultural backgrounds. Fusion of the ECG and GSR parameters can help to improve classification accuracy. Additionally, handcrafted features fused with automatically extracted deep machine learning features can increase classification accuracy. Deep learning techniques and feature fusion techniques have improved classification accuracy.
Optimization of Formulation Variables Using Central Composite Design to Enhance Andrographolide Release from Andrographis paniculata Extract-Chitosan Solid Dispersion
Authors: Nontasirichayakul Chanicha , Wiranidchapong Chutima , Sithithaworn Worapan , Shuwisitkul Duangratana
Published: October 2022

Andrographolide (AGP), a major component of Andrographis paniculata (Burm.f.) Nees (AP), has several biological activities. Nevertheless, poorly water solubility and low bioavailability of AGP lead to decrease clinical benefits. Therefore, this study aims to develop of AP extract-chitosan solid dispersion using central composite design (CCD) to enhance AGP release. AP crude extract was obtained by Soxhlet extractor using 85%v/v ethanol as a solvent extraction. Then, AP extract, chitosan, and poloxamer 188 in the concentrations provided by CCD was spray dried. The in-vitro release of AP extract-chitosan spray dried powder was studied by dissolution equipped with enhancer cell in 200 ml of 50%v/v methanol at 37°C and 50 rpm of paddle speed. Samples were withdrawn at 0.25-96 hours and then determined AGP by UV spectrophotometer at 224 nm. The results of CCD indicated that %ethanol and %AGP from concentrated AP extract had significant (P < 0.05) effect on the concentration of AGP released at 5 hours. The optimum formulation composed of %ethanol of 18.25, %AGP in extract of 0.38, and %poloxamer 188 of 0.17 resulted in more AGP concentration at 5 hours than 50 μg/mL. Release kinetic study revealed that %release of the optimal formulation was best fitted to first order kinetic. In powder X-ray diffraction, intensity of AGP characteristic peaks in the optimal formulation decreased by 7.17-25.69 times compared with AGP standard. It was concluded that the optimal formulation of AP extract-chitosan solid dispersion could improve AGP release due to changing crystalline AGP to amorphous state.
Comparative Analysis of Stationary and Rotary Electrode on Dry EDM in Machining of Hastelloy C276
Authors: Dongre Ganesh , Raut Ravi Abhiman , Kulkarni Apurva , Nikalje Sudhanshu , Nehul Sayali , Mokashi Madhav , Nevlikar Rutuja , Nikam Sanket
Published: October 2022

Dry EDM is a variation of the standard EDM method in which the liquid dielectric is replaced with a gaseous medium during the machining process. This paper presents comparative analysis of stationary and rotary electrode on Dry EDM in machining of Hastelloy C276 using copper EC grade rod as electrode and air as dielectric medium. Solid cylindrical (stationary and rotary) tool electrodes are used, and high-velocity gas is fed between the electrode and the workpiece through it into the discharge gap. The high-velocity gas flow into the gap assists debris clearance and reduces tool and workpiece overheating at the discharge areas. The dry EDM technique is currently known to have reduced tool wear, a smaller discharge gap, fewer residual stresses, a smaller white layer, and a smaller heat-affected zone, in addition to being ecologically friendly. To improve response factors such as material removal rate (MRR), surface roughness (Ra), and tool wear rate (TWR), Taguchi's L9 orthogonal array approach is utilised to design the trials and study the effects of different process parameters. Discharge current (I), pulse on time (Ton), Voltage (V), pressure (P), and tool rotational speed (N) were the varied input parameters. It is observed that the rotary electrode gives better MRR compared to stationary. The analysis of results show that current (I), pulse on time (Ton) and pulse off time (Toff) are the dominant factors that influence MRR and EWR.
Development of a Validated RP-HPLC Method for Quantification of Four Bioactive Phenolic Compounds from Mulberry Leaf Infusion
Authors: Ruttanakorn Kanong , Detpan Apipawat , Thongkham Mongkol , Mahavijitr Detchkorn , Pangpun Denpon , Thida Aye , Satiraphan Malai
Published: October 2022

The aim of this work was to develop and validate RP-HPLC method for quantification of 4 major polyphenolic compounds of mulberry leaf infusion. The mulberry leaf samples were extracted by simulation of tea infusion beverage preparation. HPLC-DAD analysis combined with column C-18 150 mm x 4.6 mm, 2.7 μm was used to determine bioactive polyphenols such as chlorogenic acid, caffeic acid, rutin, and quercetin. The optimal conditions involved the flow rate of mobile phase at 0.3 ml/min with gradient elution of 0.1% formic acid in water and methanol, column temperature at 35 °C, 2 μl injection volume, and the detection wavelength at 320 nm (chlorogenic acid and caffeic acid) and 360 nm (rutin and quercetin). The retention times of chlorogenic acid, caffeic acid, rutin, and quercetin were 25.68, 28.03, 33.97 and 39.11 minutes, respectively. Analysis of four bioactive compounds was found to be linear with a correlation coefficient > 0.99 each at the tested concentration. All other validation parameters that represented accuracy and precision met the AOAC requirements. The developed analytical method was specific, robust, and accurate for simultaneous determining the stated compounds in mulberry leaf extracted with hot water. Moreover, this method could provide the chromatographic profiles of specific cultivar from specific source that could be used to control the quality of mulberry leaf tea products. Different cultivars and different origins of mulberry leaf in this study were also found to present different content of chlorogenic acid, caffeic acid, and rutin. No quercetin was found in the studied samples.
The Study of Betulin Particles Containing Hydrogels Prepared by Antisolvent Precipitation
Authors: Paze Aigars , Vitolina Sanita , Berzins Rudolfs , Rizhikovs Janis , Makars Raimonds , Godina Daniela , Teresko Arturs
Published: October 2022

The aim of the study was to investigate the effect of process parameters on the production of hydrogels with antisolvent precipitation using unpurified (UB) and purified (PB) birch outer bark betulin powder samples. Experimental activities are focused on the production of hydrogels using concentration of colloidal dispersions with filtration of UB or PB sample particles obtained by antisolvent precipitation method varying the dilution of saturated (at boiling temperature) ethanol solutions with different water content. During the study the maximum solubility in ethanol at boiling point of PB (22.0 g/L) and UB (55.0 g/L) was determined. For obtaining gel with the highest liquid content (absorption capacity 37.45 g per 1 g of dry matter) from PB by antisolvent precipitation the optimal saturated ethanol solution dilution with water was 12.5 vol%. In the case of UB hydrogel, by dilution of ethanol from 25 to 10 vol%, a gradual decrease of hydrogel dry matter yield and a simultaneous increase of the filtrate dry matter yield can be observed, which is related with leaching of the particles through the filter paper together with a solution and form a colloidal suspension of particles. For obtaining gels with high liquid content from UB the optimal saturated ethanol solution dilution with water was in the range from 20.0 to 12.5 vol% (absorption capacity in average 18 g per 1 g of dry matter). Comparing the chemical compositions of the raw materials and dry matter of hydrogels in the case of PB composition remains quite similar while in UB dry matter composition the betulin content increased from 52 to even 69 wt%. PB at the optimal dilution of 12.5 vol% of ethanol managed to achieve average particle size - 231.7 nm and with UB in the optimal dilution range from 20 to 12.5 vol% the range of average particle size was from 304.7 to 189.8 nm.
Athletic Training Preceptors' Levels of Cultural Competence: A Cross-Sectional Study
Authors: León Zaragoza Elizabeth , Lough Nancy , Samuel Michelle , Girouard Tedd
Published: October 2022

Context

The field of athletic training promotes cultural competence education to prevent negative consequences in health care that can result from a lack of cultural awareness. While prior studies have assessed cultural competence among faculty, students, and athletic trainers, no study has specifically focused on preceptors.

Objective

The objective of this study was to assess cultural competence among a subsection of athletic training preceptors.

Design and Setting

Cross-sectional online survey.

Patients or Other Participants

Active preceptors from Commission on Accreditation of Athletic Training Education (CAATE) accredited programs in good standing from two districts of the National Athletic Trainer's Association.

Measurements

The Cultural Competency Assessment (CCA) consists of 27 Likert-type response items split into the Culture Awareness and Sensitivity (CAS) subscale and the Cultural Competence Behaviors (CCB) subscale. Higher scores indicate higher cultural competence. Descriptive statistics were used to analyze the data.

Results

Sixty-five preceptors of the estimated 260 were included in the analysis. The combined average score on the CCA was 89.72 ± 11.46 out of 135 (67.9%). A paired-samples t- test revealed that preceptors scored significantly better in the CAS compared to the CCB [t(64) = 12.47, P < .001], with averages of 37.27 ± 3.47 out of 55 (67.77%) and 52.44 ± 10.08 out of 80 (65.5%), respectively.

Conclusions

This study provides data on athletic training preceptor's awareness and behaviors relative to cultural competence. Results demonstrate a need to further develop cultural competence among preceptors. The role of a preceptor has been shown to have a great influence on student development and retention in the profession. Preceptors should be considered as another source of knowledge of cultural competence.
Comparison of postoperative nausea and vomiting between remimazolam and propofol: a propensity score-matched, retrospective, observational, single-center cohort study
Authors: Suzuki Yuji , Kawashima Shingo , Makino Hiroshi , Doi Matsuyuki , Nakajima Yoshiki
Published: October 2022

Background: Remimazolam is a novel ultrashort-acting benzodiazepine that has recently become available for general anesthesia. However, the incidence of postoperative nausea and vomiting (PONV) associated with remimazolam remains unknown. In this propensity score-matched, retrospective, observational study, we compared the rates of PONV between remimazolam and propofol.Methods: In this retrospective observational study, propensity score-matching was performed to minimize selection bias. Patients who received total intravenous anesthesia with remimazolam or propofol at the Hamamatsu University Hospital between August 2020 and July 2021 were enrolled in the study. Data on patient demographics, anesthetic agents, and PONV within the first 24 h were collected and analyzed.Results: Of the 1,239 patients who met the study selection criteria, 585 received remimazolam and 684 received propofol. After propensity score matching, 333 matched pairs were further analyzed. Patient demographics and the anesthetic agents used were comparable between the matched cohorts. The incidence of PONV was significantly higher in the remimazolam group than in the propofol group (35% vs. 21%, P < 0.001).Conclusions: The incidence of PONV is higher with remimazolam anesthesia than with propofol anesthesia. The findings of this study require confirmation in larger prospective randomized controlled trials.
Challenges faced by ethics committee members in India during COVID-19 pandemic: A mixed-methods exploration
Authors: Kadam Abhijit Vasantrao , Patil Sandip , Sane Suvarna , Shahabuddin S.M. , Panda Samiran
Published: October 2022

Background & objectives:

The COVID-19 pandemic had a distinct impact on scientific research and Ethics Committees (ECs). We conducted a mixed-methods investigation to understand the issues faced and solutions identified by ECs during this pandemic in India.

Methods:

A quantitative online survey form (30 members) and qualitative in-depth interviews (10 members) from various ECs were conducted. Thematic content analysis for qualitative and proportion analysis for quantitative data was carried out.

Results:

During the online survey, an average difficulty score, which was measured using the Visual Analogue Scale, was 5.3 (SD 2.1). Pressure for expedited approvals was felt by EC members with a drastic increase in the number of submission of research projects. The scarcity of information on investigational products (IPs) and requisite consent process posed major hurdles. Ongoing non-COVID studies and post-graduate dissertations were badly hit due to the shift in attention towards COVID-related research. Non-familiarity with virtual technology and lack of face-to-face interactions were highlighted as demerits. However, a few of the EC members welcomed newer methods, being time-saving, convenient and reducing travel hassles. Site monitoring and severe adverse event-related analyses were also negatively impacted upon. Solutions included the alternate methods of consenting (virtual, abbreviated), a detailed explanation of the protocol and IPs and benefits versus risk assessment.

Interpretation & conclusions:

Despite various challenges posed by the COVID-19 pandemic, the ECs in India steered well through the hurdles. Moreover, adapting a hybrid mode, technical training and updating guidelines were perceived as urgent by EC members.
Assessing engagement of scheduled tribe communities in the functioning of Village Health Sanitation & Nutrition Committees in India
Authors: Pandey Apoorva , Kaur Harpreet , Karra Vijay Kumar , Mutatkar R. K. , Khan A. M.
Published: October 2022

India is home to the largest population of indigenous tribes in the world. Despite initiative of the National Rural Health Mission, now National Health Mission (NHM) and various tribal development programmes since India’s Independence, disparity in healthcare for Scheduled Tribes (STs) prevails. The constitution of Village Health Sanitation and Nutrition Committees (VHSNCs) in 2007 by the NHM is a step towards decentralized planning and community engagement to improve health, nutrition and sanitation services. VHSNCs are now present in almost all States of the country. However, several reports including the 12th Common Review Mission report have highlighted that these committees are not uniformly following guidelines and lack clarity about their mandates, with no clear visibility of their functioning in tribal areas. Therefore, this review was conducted to assess the participation of the VHSNCs in tribal dominated States in order to know in detail about their functioning and gaps if any that require intervention. Several deviations from the existing guidelines of NHM were identified and we concluded that in order to sustain and perform well, VHSNCs not only require, mobilization and strict monitoring but also motivation and willingness of its members to bring in a radical change at the grassroot level. With continuous supervision and support from both the Government and various non-governmental organizations, handholding, strategic deployment of workforce, community participation and sustained financial support, VHSNCs would be able to facilitate delivery of better healthcare to the indigenous population.
Large Cell Neuroendocrine Carcinoma of the Lung in Posttuberculosis Cavity
Authors: Abdulla Mansoor C.
Published: October 2022

A 73-year-old male was admitted with hemoptysis for 2 months. He was diagnosed to have sputum-positive pulmonary tuberculosis 4 years back and was treated with antitubercular drugs for 6 months. Contrast-enhanced computed tomography (CT) of the thorax at that time revealed a cavitary lesion with surrounding consolidation in the right lower lobe of the lung. Contrast-enhanced CT of the chest during present admission showed a mass lesion in the lower lobe of the right lung, which was diagnosed as large cell neuroendocrine carcinoma of the lung on histopathological examination. We describe a patient who developed large cell neuroendocrine carcinoma of the lung in a posttuberculosis cavity which, to our knowledge, is the first such report.
NOTCH and Tumor Necrosis Factor-Alpha Converting Enzyme Levels Could be used in COVID-19 for Risk Stratification
Authors: Karabulut Dilay , Erdal Gülçin Şahingöz , Yildiz Cennet , Hergünsel Gülsüm O , Karabulut Umut , Binboğa Elif , Isiksacan Nilgun
Published: October 2022

Background:

Novel coronavirus disease-2019 (COVID-19) has become a public emergency that is characterized by a dysregulated immune response and hypercoagulable state. The purpose of the present study was to evaluate NOTCH and tumor necrosis factor-alpha converting enzyme (TACE) levels in COVID-19-infected patients and assess their predictive value on the severity of the disease.

Methods:

A total of 116 severe-critical COVID-19 patients who were interned intensive care were included in the study. The severity of the disease was evaluated according to the WHO classification system. Patients were divided into two groups according to their cTroponin T (cTnT) levels. Patients who had cTnT levels at least five times the upper limit of normal constituted Group 1 (n = 58); patients who had normal cTnT levels constituted Group 2 (n = 58). Besides, 62 age- and sex-matched healthy controls, who applied to cardiology outward clinic were taken as a control group (Group 3). All patients underwent echocardiographic examination. NOTCH and TACE levels were assessed using enzyme-linked immunosorbent assay.

Results:

The average age of the patients was 59.96 ± 15.46 years, 92 (51.7%) were female and 86 (48.3%) were male. The mean length of hospital stay was 16.35 ± 10.97 days. NOTCH levels were significantly higher in Group 1 patients compared to Group 2 and control group of patients P = 0.001). NOTCH levels of Group 2 were significantly higher compared to the control group (P = 0.002). Similarly, the TACE levels of Group 1 were significantly higher than that of Group 2 and the control group (P = 0.001). Mortality and length of hospital stay were significantly higher in Group 1 patients compared to Group 2 patients (P = 0.002 and P = 0.004, respectively). TACE levels of deceased patients were significantly higher than that of live patients (P = 0.004). There was a positive relationship between the length of hospital stay and NOTCH levels in Group 1 patients (r = 0.527, P = 0.003). TACE and NOTCH levels were positively correlated with troponin levels (r = 0.627 and r = 0.671, respectively P < 0.001 for both). NOTCH value of 0.34 nmol/L and TACE value of 6.53 μg/mL predicted inhospital mortality with a sensitivity of 90.30% and 63.6% and specificity of 91.5% and 78.6%, respectively.

Conclusion:

Measurement of NOTCH and TACE levels during severe acute respiratory syndrome coronavirus infection could be helpful for risk stratification.
Exudative Retinal Detachment
Authors: Soukaina Belfaiza , Taoufiq Abdellaoui , Issam Fiqhi , Yassine Mouzari , Karim Reda , Bar Oubaaz Abdel
Published: October 2022

Ocular syphilis is a disease known as a great simulator. It can affect the structures of the eye. It often manifests by an anterior uveitis. Posterior segment involvement is very rare and it is exceptionally complicated by exudative retinal detachment. We report the case of a patient with bilateral bullous retinal detachment in the context of ocular syphilis with a good evolution after treatment by penicillin G and corticotherapy.
Hemophagocytic Lymphohistiocytosis after ChAdOx1 nCoV-19 Coronavirus Vaccination in a Patient with no Known Comorbidities
Authors: Rai Nitin , Misra Saumitra , Prajapati Shashank , Roy Shubhajeet , Yadav Geeta
Published: October 2022

Hemophagocytic lymphohistiocytosis (HLH) is an inflammatory condition where there is marked cytopenia and large-scale activation of macrophages and CD8+ cytotoxic T cells. HLH may be of two types – primary HLH caused by genetic abnormalities and secondary HLH due to infections, malignancies, autoimmune disorders, rheumatologic disorders, and metabolic dysfunctions. We describe a case of HLH following the first dose of the ChAdOx1 nCoV-19 Corona Virus vaccine. In this patient, there was no clear precipitant of HLH. The most probable explanation could be intense immune activation by vaccine constituents producing aberrant activation of inflammatory cytokines. There were no signs of infection or malignancy. Since our patient was clinically stable, his symptoms had resolved and HLH parameters had improved, no HLH-specific therapy was given.
What Heterogeneities in Individual-level Mobility Are Lost During Aggregation? Leveraging GPS Logger Data to Understand Fine-scale and Aggregated Patterns of Mobility
Authors: Schaber Kathryn L. , Kobayashi Tamaki , Hast Marisa , Searle Kelly M. , Shields Timothy M. , Hamapumbu Harry , Lubinda Jailos , Thuma Philip E. , Lupiya James , Chaponda Mike , Munyati Shungu , Gwanzura Lovemore , Mharakurwa Sungano , Moss William J. , Wesolowski Amy , _ _
Published: October 2022

Human movement drives spatial transmission patterns of infectious diseases. Population-level mobility patterns are often quantified using aggregated data sets, such as census migration surveys or mobile phone data. These data are often unable to quantify individual-level travel patterns and lack the information needed to discern how mobility varies by demographic groups. Individual-level datasets can capture additional, more precise, aspects of mobility that may impact disease risk or transmission patterns and determine how mobility differs across cohorts; however, these data are rare, particularly in locations such as sub-Saharan Africa. Using detailed GPS logger data collected from three sites in southern Africa, we explore metrics of mobility such as percent time spent outside home, number of locations visited, distance of locations, and time spent at locations to determine whether they vary by demographic, geographic, or temporal factors. We further create a composite mobility score to identify how well aggregated summary measures would capture the full extent of mobility patterns. Although sites had significant differences in all mobility metrics, no site had the highest mobility for every metric, a distinction that was not captured by the composite mobility score. Further, the effects of sex, age, and season on mobility were all dependent on site. No factor significantly influenced the number of trips to locations, a common way to aggregate datasets. When collecting and analyzing human mobility data, it is difficult to account for all the nuances; however, these analyses can help determine which metrics are most helpful and what underlying differences may be present.
Performance Evaluation of the Schistoscope 5.0 for (Semi-)automated Digital Detection and Quantification of Schistosoma haematobium Eggs in Urine: A Field-based Study in Nigeria
Authors: Meulah Brice , Oyibo Prosper , Bengtson Michel , Agbana Temitope , Lontchi Roméo Aimé Laclong , Adegnika Ayola Akim , Oyibo Wellington , Hokke Cornelis Hendrik , Diehl Jan Carel , van Lieshout Lisette
Published: October 2022

Conventional microscopy is the standard procedure for the diagnosis of schistosomiasis, despite its limited sensitivity, reliance on skilled personnel, and the fact that it is error prone. Here, we report the performance of the innovative (semi-)automated Schistoscope 5.0 for optical digital detection and quantification of Schistosoma haematobium eggs in urine, using conventional microscopy as the reference standard. At baseline, 487 participants in a rural setting in Nigeria were assessed, of which 166 (34.1%) tested S. haematobium positive by conventional microscopy. Captured images from the Schistoscope 5.0 were analyzed manually (semiautomation) and by an artificial intelligence (AI) algorithm (full automation). Semi- and fully automated digital microscopy showed comparable sensitivities of 80.1% (95% confidence interval [CI]: 73.2–86.0) and 87.3% (95% CI: 81.3–92.0), but a significant difference in specificity of 95.3% (95% CI: 92.4–97.4) and 48.9% (95% CI: 43.3–55.0), respectively. Overall, estimated egg counts of semi- and fully automated digital microscopy correlated significantly with the egg counts of conventional microscopy (r = 0.90 and r = 0.80, respectively, P < 0.001), although the fully automated procedure generally underestimated the higher egg counts. In 38 egg positive cases, an additional urine sample was examined 10 days after praziquantel treatment, showing a similar cure rate and egg reduction rate when comparing conventional microscopy with semiautomated digital microscopy. In this first extensive field evaluation, we found the semiautomated Schistoscope 5.0 to be a promising tool for the detection and monitoring of S. haematobium infection, although further improvement of the AI algorithm for full automation is required.
Prevalence, Risk Factors, and Prognosis of Liver Involvement in Adult Patients with Chikungunya in Thailand
Authors: Srikirin Punyavee , Siripoon Tanaya , Charoenpong Lantharita , Soonthornworasiri Ngamphol , Matsee Wasin , Kittitrakul Chatporn , Tangkijvanich Pisit , Charunwatthana Prakaykaew , Poovorawan Kittiyod
Published: October 2022

Chikungunya is a mosquito-borne disease mainly characterized by fever with polyarthralgia. Currently, liver complications of chikungunya remain rarely described. This study assesses the prevalence, severity, and risk factors of liver involvement, and the association between liver involvement severity and prognosis. We conducted a retrospective cohort study at two referral centers for tropical infectious diseases—the Hospital for Tropical Diseases and Bamrasnaradura Infectious Diseases Institute in Thailand—from January 2016 to April 2021. The study included 400 patients diagnosed with chikungunya. Of them, 254 (63.5%) were female with a mean age of 41.5 ± 14.1 years, and 98.5% of them presented with fever with arthralgia. Gastrointestinal presentations included nausea or vomiting (n = 62, 15.5%), diarrhea (n = 33, 8.3%), and abdominal pain (n = 4, 1%). Of 88 patients with available liver function tests, 39.8% had hepatitis (abnormal alanine aminotransferase levels), of whom 5.7% had moderate hepatitis. Nausea or vomiting is a clinical risk factor associated with liver involvement (adjusted odds ratio, 5.17; 95% CI, 1.20–22.34). Liver involvement was usually observed during the first 2 weeks of illness and resolved eventually. None of the patients experienced severe hepatitis, liver failure, or death caused by a liver problem. In conclusion, most of the patients with chikungunya did not have significant liver involvement. In those patients with severe liver injury, coexisting causes should be considered.
Repeated Rapid Active Sampling Surveys Demonstrated a Rapidly Changing Zika Seroprevalence among Children in a Rural Dengue-endemic Region in Southwest Guatemala during the Zika Epidemic (2015–2016)
Authors: Lamb Molly M. , Paniagua-Avila Alejandra , Zacarias Alma , Rojop Neudy , Chacon Andrea , Natrajan Muktha S. , Waggoner Jesse J. , Lopez Maria Renee , Cordon-Rosales Celia , Huleatt James W. , Bonaparte Matthew I. , Asturias Edwin J. , Olson Daniel
Published: October 2022

Although Central America is largely dengue virus (DENV)-endemic, the 2015–2016 Zika virus (ZIKV) pandemic brought new urgency to develop surveillance approaches capable of characterizing the rapidly changing disease burden in resource-limited settings. We conducted a pediatric DENV surveillance study in rural Guatemala, including serial cross-sectional surveys from April through September 2015 (Survey 1), in October–November 2015 (Survey 2), and January–February 2016 (Survey 3). Serum underwent DENV IgM MAC ELISA and polymerase chain reaction testing. Using banked specimens from Surveys 2 and 3, we expanded testing to include DENV 1–4 and ZIKV microneutralization (MN50), DENV NS1 IgG ELISA, and ZIKV anti-NS1 antibody Blockage of Binding (BoB) ELISA testing. Demographic risk factors for ZIKV BoB positivity were explored using multivariable generalized linear regression models. Of Survey 2 and 3 samples available (N = 382), DENV seroprevalence slightly increased (+1%–10% depending on the assay) during the surveillance period and increased with age. In contrast, ZIKV seroprevalence consistently increased over the 3-month period, including from 6% to 34% (P < 0.0001) and 10%–37% (P < 0.0001) using the MN50 ≥100 and BoB ELISA assays, respectively. Independent risk factors for ZIKV seropositivity included older age (prevalence ratio (PR)/year = 1.12, 95% confidence interval (CI) = 1.07–1.17) and primary caregiver literacy (PR = 2.80, CI = 1.30–6.06). Rapid active surveillance (RAS) surveys demonstrated a nearly 30% increase in ZIKV prevalence and a slight (≤ 10%) increase in DENV seroprevalence from October to November 2015 to January to February 2016 in rural southwest Guatemala, regardless of serologic assay used. RAS surveys may be a useful “off-the-shelf” tool to characterize arboviruses and other emerging pathogens rapidly in resource-limited settings.