bluuebunny/crossref_metadata_2025 huggingface dataset:
La cúpula de mayólica de Santa Maria della Sanità en Nápoles. Configuración geométrica y estudios de estabilidad
Authors: Zerlenga Ornella , Cirillo Vincenzo , Cennamo Claudia , Cusano Concetta
Published: June 2021

This article deals with the survey and representation of the dome of Santa Maria della Sanità in Naples (Italy). The survey led to a geometric analysis of the spatial configuration of the dome, the drawing of its majolica decoration and its structural behavior. The overall objectives of this research can be briefly outlined as follows. First, the study focuses on defining the correct geometry of the dome obtained through accurate surveys. Finally, the study performs a simplified structural analysis of the compound dome-buttress system set within the theoretical framework of the Limit Analysis through the graphical statics.
Problem-Based Geometry in Seventh Grade: Examining the Effect of Path-Based Vs. Conventional Instruction on Learning Outcomes
Authors: Klančar Andreja , Istenič Starčič Andreja , Cotič Mara , Žakelj Amalija
Published: June 2021

This experimental study examined the impact of learning and teaching ge-ometry in seventh-grade geometry education comparing learning-path and conventional instruction. According to constructivism, a learning path with the use of learning objects should enhance learner autonomy and self-directedness by providing differentiated instruction. We designed a model of path-based geometry learning in a learning management system–based learning environment with the use of dynamic geometry programs and applets, which fosters visualisation and the exploration of geometric concepts through the manipulation of interactive virtual representations. The results show that the experimental group (EG) achieved higher scores on all levels of knowledge and statistically significantly better results in taxonomy level-III tasks (problem-solving knowledge) and overall score than the control group (CG). There was initial equivalence between the EG and CG in prior knowledge. The authors concluded that path-based geometry learning empirically develops knowledge at higher cognitive levels.
Machine Learning-Based Student Emotion Recognition for Business English Class
Authors: Cui Yuxin , Wang Sheng , Zhao Ran
Published: June 2021

Traditional English teaching model neglects student emotions, making many tired of learning. Machine learning supports end-to-end recognition of learning emotions, such that the recognition system can adaptively adjust the learning difficulty in English classroom. With the help of machine learning, this paper presents a method to extract the facial expression features of students in business English class, and establishes a student emotion recognition model, which consists of such modules as emotion mechanism, signal acquisition, analysis and recognition, emotion understanding, emotion expression, and wearable equipment. The results show that the proposed emotion recognition model monitors the real-time emotional states of each student during English learning; upon detecting frustration or boredom, machine learning will timely switch to the contents that interest the student or easier to learn, keeping the student active in learning. The research provides an end-to-end student emotion recognition system to assist with classroom teaching, and enhance the positive emotions of students in English learning.
MODEL-Based Performance Quality Assessment for IoT Applications
Authors: Kh. Teeba Ismail , Hamarash Ibrahim I.
Published: June 2021

The number of applications incorporating Internet of Things (IoT) concepts increases extraordinarily. This increase cannot continue without high-quality assurance. There are some difficulties in testing IoT applications; the system heterogeneity, test cost and time are taken to test the system, and the precision percentage of test results.

A well-known and possibly the best solution to overcoming these difficulties is to model the system for evaluation purposes, known as model-based testing (MBT). This paper aims to design a model-based testing approach to assess IoT applications performance quality attributes. The ISO 25000 quality model is used as a standard for software quality assurance applications. IoTMaaS is used as a case study to implement the methodological approach. The possible test cases were generated using the ACTS combinatorial test generation tool. The performance metrics of each test case were monitored until the optimum test case was identified, with the shortest response time and the least amount of resources used. The proposed testing method appears to be successful, according to the results.
JKRW Link Prediction – A New Ensemble Technique Based on Merging Other Known Techniques in The Social Network Analysis
Authors: Taleb Aya , Al-Sayyed Rizik M. H. , Al-Bdour Hamed S.
Published: June 2021

In this research, a new technique to improve the accuracy of the link prediction for most of the networks is proposed; it is based on the prediction ensemble approach using the voting merging technique. The new proposed ensemble called Jaccard, Katz, and Random models Wrapper (JKRW), it scales up the prediction accuracy and provides better predictions for different sizes of populations including small, medium, and large data. The proposed model has been tested and evaluated based on the area under curve (AUC) and accuracy (ACC) measures. These measures applied to the other models used in this study that has been built based on the Jaccard Coefficient, Katz, Adamic/Adar, and Preferential attachment. Results from applying the evaluation matrices verify the improvement of JKRW effectiveness and stability in comparison to the other tested models.  The results from applying the Wilcoxon signed-rank method (one of the non-parametric paired tests) indicate that JKRW has significant differences compared to the other models in the different populations at 0.95 confident interval.
Rhodes
Authors: Maglio Emma
Published: June 2021

Au cours de leur installation à Rhodes pendant environ deux siècles, les Chevaliers Hospitaliers ont superposé une forteresse-monastère à la ville byzantine. La conquête ottomane a entraîné ensuite dans la ville un processus d’islamisation qui s’est traduit par une large réutilisation du bâti existant. Les modalités de ces opérations demeurent peu connues. Cet ouvrage propose un voyage dans l’histoire de Rhodes entre le Moyen Âge et le début de l’époque moderne, afin de retracer les phases de son accroissement urbain et les interactions entre l’architecture religieuse et la forma urbis. Cette étude s’appuie sur les outils de l’analyse spatiale et morphologique, qui a une partie importante dans les études d’archéologie urbaine, ainsi que sur un corpus de sources variées : les manuscrits de l’Ordre, les récits de voyage, l’iconographie et les données archéologiques. Une partie de l’ouvrage est consacrée enfin au recensement et à une analyse comparative des églises et des mosquées urbaines : bien que souvent limitée à une dimension régionale, la production architecturale et artistique à Rhodes est étroitement liée à des réalisations plus prestigieuses d’inspiration byzantine et gothique, ainsi que du monde ottoman. Dans un contexte actuel où l’urbanisation contemporaine côtoie tant le patrimoine bâti le plus connu que les vestiges archéologiques mineurs, Rhodes s’avère être un véritable « laboratoire urbain » dont l’histoire demeure un champ en construction.
Leadership distribué, leadership partagé : coopération et pouvoir
Authors: Bihan Serge Le
Published: June 2021

En France, de nombreuses recherches ont été consacrées à la fonction de direction dans le second degré. Dans le cadre d’un travail réalisé au sein du Laboratoire Cultures Education Société (LACES), l’auteur a étudié les mécanismes du travail collectif au sein de six écoles élémentaires, à travers des questionnaires et des entretiens avec les directeurs. Le modèle théorique utilisé a été le leadership distribué (Spillane, Halverson, Diamond, 2008). Cette recherche montre que pour les tâches qui impliquent des personnes extérieures à l’école, le directeur constitue l’interface et qu’il peut exercer un réel leadership distribué. Pour les tâches plus pédagogiques, le leadership semble moins affirmé. Enfin les dimensions relationnelles et les relations à l’autorité entre le directeur et les adjoints sont présentes dans l’exercice du leadership.
Le leadership des chefs d’établissement : un exercice en tensions et balances
Authors: De Ketele Jean-Marie
Published: June 2021

Sur la base des analyses effectuées dans cet ouvrage par des chercheurs français et chiliens, ce chapitre conclusif tente une synthèse sous forme de modélisation du leadership distribué. Cette modélisation repose sur huit dimensions qui tantôt sont croisées entre elles, tantôt mises en parallèle. Elle aboutit à dégager quatre conceptions princeps du leadership que l’auteur tente de caractériser et de symboliser par l’une ou l’autre métaphore. Les conclusions ouvrent le débat pour une réflexion plus approfondie et des recherches complémentaires.
L’idée de pédagogie scientifique chez Freinet
Authors: Jacomino Baptiste
Published: June 2021

Il y a chez Freinet une critique radicale de la science. Mais le pédagogue propose aussi une pédagogie scientifique. Il présente cette pédagogie scientifique idéale comme délivrée de toutes les illusions dans lesquelles la science était enfermée. Il imagine une science intuitive capable de saisir le mouvement de la vie et orientant parfaitement l’action du pédagogue. Freinet voile ainsi la carence de savoir constitutive de toute situation pédagogique. Mais, même s’il masque cette spécificité épistémologique de la pédagogie, Freinet propose des techniques pédagogiques qui permettent d’affronter cette carence de savoir et qui sont une des alternatives possibles à l’impasse dans laquelle l’idée de pédagogie scientifique nous conduit.
La qualité de l’éducation de base au Bénin : la voix des acteurs locaux
Authors: Lauwerier Thibaut , Brüning Marie , Akkari Abdeljalil
Published: June 2021

L’article aborde la question de la qualité de l’éducation de base en Afrique de l’Ouest, en adoptant une approche qui valorise les perceptions des acteurs éducatifs locaux. Nous avons choisi de nous concentrer sur le cas du Bénin, et plus particulièrement de la commune de Comé située au sud du pays. Après avoir présenté le contexte général de la recherche ainsi que des cadres conceptuels et théoriques pertinents pour étudier la qualité, cet article met en avant les nombreux défis dans l’éducation de base tout en proposant des pistes de réflexion pour l’amélioration de la qualité.
Field hospitals to face COVID-19: Requirements and lessons learned in the design and construction of the Lagoa Barra Hospital - Brazil
Authors: Ribeiro Alexandre Passos , Ferreira Kemmylle Sanny de Matos , Chinelli Christine Kowal , Soares Carlos Alberto Pereira
Published: June 2021

The construction of field hospitals has been a strategy adopted worldwide to face the consequences of the pandemic impacts caused by COVID-19 on healthcare systems. Specific characteristics of this pandemic, such as different ways and speeds of the disease transmission, and the implications at the population health and the productive system, has made the project, management, and construction of field hospitals for the patients with COVID-19 present specific features. In this work, for each phase of the FHLB  implantation, we present the main concepts, premises, restrictions, and challenges, focusing mainly on the needs programs of the project that guided the configuration of the environments, the definition of the circulation flows,  the typology of the beds, the main management tools used during the project's planning and control process, and in the lessons learned.
Confronting COVID-19 - The case of PPE and Medical Devices production using Digital Fabrication at PUC-Rio
Authors: Dos Santos Jorge Roberto Lopes , Correia de Melo João Victor , Frajhof Leonardo , Kauffmann Aline Reis
Published: June 2021

At the end of 2019, the first cases of COVID-19 were registered. As the disease spread across continents culminating in a pandemic, countries suffered from a shortage of personal protective equipment. In Brazil, the first case was recorded on February 2020. This study aims to describe the experience of creating an interinstitutional network to meet the pandemic’s demands and the experience of transforming an academic design laboratory into space for the production of personal protective equipment using 3D printing and laser cutting techniques. The actions described in this study, made it possible to meet the high emergency demand for PPE in the city of Rio de Janeiro, as well as the construction of knowledge both within the scope of building networks to solve complex social problems and about the possibilities of production in an academic environment. The work addresses and reflexes this action on society's perception of Design professionals.
Makers against Covid-19: Face shields as the international solidarity KPI
Authors: García Sáez César , Cuartielles David
Published: June 2021

At the first signs of the Covid-19 pandemic, the uncertainty around the global stock of medical supplies sparked a response in the DIY communities around the world. In the case of Spain, a community called Coronavirus Makers (CVM) emerged to supply ventilators and personal protection equipment (PPE) to hospitals and people in need. This paper explores the evolution of this community-driven development, detailing the patterns proposed by members of the group acting as design experts to tackle different problems. More specifically the paper uses face shields, the most produced PPE in Spain, as a boundary object to highlight the relationships amongst individuals, institutions, and companies. The objects of design, since they fall in the specific category of devices for medical use, have to overcome validation at the technical level. Authors will also explore some of the controversies surrounding the transfer of these products from horizontal innovation networks to traditional production companies.
Mexico City’s Quarantine Narratives and Underlying Values for Future Urban and Domestic Design
Authors: Delgado Marcela , Sattele Vanessa
Published: June 2021

This paper explores the construction of quarantine narratives as they relate to the design of everyday public spaces and domestic artifacts in Mexico City. The interdisciplinary research studies the government-led health campaign and exposes pre-existing urban design problems further accentuated by the crisis. In parallel, the paper presents an online survey in which photographs and texts of domestic objects are analyzed alongside artistic exhibitions and events that uncover individual needs and aspirations. Finally, the paper identifies a set of collective and distributed values for Mexico City’s new normal to be materialized locally at the urban and product design scale and discusses the potential of narratives as a design tool
Design as a positive stimulus in a Brazilian hospital environment
Authors: Berger Ana von Frankenberg , Capra Andrea , De Rocco Aline , Oliveira Manuela
Published: June 2021

The new coronavirus pandemic has put healthcare professionals, patients and family members under pressure and stress, causing mental health issues especially in the healthcare community. Studies show that a positive environment plays an important role in the well-being of individuals, impacting physical and psychological security of people. This article presents a project developed for the Hospital de Clínicas de Porto Alegre, that through graphic interventions softened the effects of combating COVID-19 for the healthcare staff and patients throughout the pandemic. The project is detailed and the discussion presents the main points considered in the process of decision making. Results show how design can play an important role in helping, not only the Covid-2019 pandemic, but also in making hospitals more hospitable places.
Comparative Systematic Analysis of Milankovitch Cycles to Identify Variations of Glaciers and Interglacial Periods of Late Pleistocene in South Asia
Authors: Ravibhanu Aravinda , Katupotha Jinadasa , Aouititen Majda
Published: June 2021

Variations in the first Euler angle known as Earth precession phenomenon which is described as a change in the Earth’s orbit; found to have strong impact on the climate of Earth. These observations of climate changes were connected with the behavior of the global ice sheets, including their advancing and retreating movements which have been recorded. In fact, Earth’s climate depends essentially on the cycle of glaciers' growth and reduction. The alternative glacial periods and the interglacial periods coincide with the variations in Earth’s orbit known as “Milankovitch cycles”, which affect the insolation, and the sunlight exposure of different regions of the world and thus ultimately the behavior of ice formation. This paper aims to document the variations of the Earth’s axis orientation and to discuss how these changes have affected to the sea-level fluctuation of the South Asian Region during late Pleistocene. Experiment methodology consists of compelling a standardized dataset of the sea-level index (Data SET 01-Radiocarbon Journal, Katupotha. J, Data SET 02- SEAMIS database and selected 35 number of carbon dating values recorded and published in the literature of the South Asian Region) and then compare it with the data of Milankovitch Cycles. The discussed results show that the sea-level variations occurred mainly between 12,500 ± 1,500 YBP to 11,000± 1,500 YBP, indicating that 25m ± 5m recorded to be the lower sea level documented than the current sea level found around the South Asian region. This has been resulted by a quick glacier transition that happened in the Late Pleistocene.
Reviewing the Paleo- Biological Remains of Rajagala Mahalena Cave in The Eastern Province of Sri Lanka
Authors: Alexander K.M. , Ranasinghe G. , Abeynayake M.D.I.K. , Suranga E.G.J. , Satish S.
Published: June 2021

The Rajagala is the dry lowland of the island, which lies at or below 900m asl, is confined to the north-central and southeastern parts of Sri Lanka. The zone comprises a plain rarely rising above c.40 m asl, but which contains isolated eroded remnants or monadnocks. The site of Rajagala is spread over 1025 acres consisting of more than 700 archaeological remains of prehistoric and historic periods. Preliminary investigations revealed that prehistoric human activity took place in the natural cave of the area before the third century BC. Accordingly, from 2016 to 2019, a selected cave called Maha Lena (ML) was excavated for further investigation. This cave was excavated jointly by Deccan College and the University of Sri Jayawardanepura. Excavations in 2018 and 2019 revealed a large number of prehistoric evidences. Among them are stone tools, bone tools, animal bones, and botanical remains. The main focus of this research paper is to analyze the biological remains found during the excavation of the ML Cave and to assess what the past environment was like through it. We have very limited knowledge of prehistoric research and information in the Eastern Province compared to the Low land Wet Zone of Sri Lanka. Accordingly, the focus was on research questions on the subsistence of prehistoric humans living in the caves of the Eastern Province and how environmental conditions have changed concerning the wet zone. Faunal and botanical remains have been recorded from ML, denoting the prevalence of climatic conditions similar to those of the present.
Bamboo Crafts and Associated Knowledge System of The Karbi Tribe of Assam Plains, North-Eastern India: A Cultural Heritage
Authors: Das Pritam , Bain Worrel Kumar , Gogoi Bitupan
Published: June 2021

Bamboo, one of the precious plant resources of the earth, plays a cardinal role in influencing civilised life patterns in Southern and Eastern Asian countries, where they are found in abundance. It has a long history in people's lives as cultural material. India is the second richest country in the generic bamboo resources after China. In India, bamboo is one of the most important forest species and has a wide distribution throughout the country and contributes to the rural economy. The North-Eastern region of India has a rich diversity of bamboo. It is integral to the life and culture of the ethnic communities of this region. In this area, the usage of bamboo made it an indispensable commodity for the rural people. The Karbi tribe of the Assam State of India has a rich cultural heritage of arts and crafts. They are masters in the skilful tradition of bamboo craft. Bamboo is an indispensable part of their livelihood mostly in food, shelter, household items, basketry, fishing gear, musical instrument, medicine, furniture and other various ethno-religious purposes. Various bamboo craft traditions of the community get the most creative expression through skill and the traditional knowledge of craftsmanship. This knowledge is essentially community-specific and restricted to the community and is accumulated through long interaction with the environment. Nowadays, this craft tradition is on the verge of extinction due to many reasons. Therefore, it is a timely requirement to document this craft tradition associated with the traditional knowledge system and wisdom. The present study has been designed in this context. During the study, standard anthropological methods have been applied. The present paper is based on the authors' empirical findings, and it probes into the cultural heritage of bamboo crafts of the Karbi community, which is governed by traditional knowledge and skills through empiricism. The paper also focuses on the importance and cultural significance of bamboo within the said community. The study also highlights this craft tradition's present scenario and provides recommendations to revive this heritage tradition.
Evaluate the Therapeutic Effect of Allicin (L-cysteine) on Clinical Presentation and Prognosis in Patients with COVID-19
Authors: Yaghoubian Hosein , Niktale Hossein , Yazdi Arash Peivandi , Ghorani Vahideh , Rashed Masoud Mahdavi , Hashemian Amir Masoud
Published: June 2021

The antiviral effectiveness of allicin (L-cysteine) has been shown by numerous studies in both levels of clinical and animals. The aim of this study was to evaluate the therapeutic effect of allicin (L-cysteine) on clinical presentation and prognosis. In the current study, 66 patients with COVID-19 based on clinical, radiological presentations and RT-PCR results, were enrolled in two groups of placebo and allicin. In the both allicin (L-cysteine) and placebo groups (n=33 in each group), the capsules were prescribed two times a day for two weeks. Clinical signs and symptoms, blood parameters and chest CT scan were evaluated before and two weeks after treatment. The results showed that allicin (L-cysteine) could significantly impact on improvement of signs and symptoms of COVID-19 after two weeks of treatment in comparison to placebo. Allicin (L-cysteine) not only improve the clinical signs, but also ameliorate the lab and radiological data, which suggest a therapeutic effect for this agent in COVID-19. Our data suggest the therapeutic effect of allicin (L-cysteine) on COVID-19 through improvement of clinical symptoms and acceleration of the healing process.
IL RILANCIO DEL PROGETTO EUROPEO A 60 ANNI DAI TRATTATI DI ROMA
Authors: Martinelli Alberto
Published: June 2021

Written on the occasion of the sixtieth anniversary of 1957 Treaties of Rome, the essay reviews the main stages of Europeâ€™s integration process, its achievements and failures, its crises and strategies for a necessary revival. The essay argues that the evolution toward an ever greater and diversified union was made possible by a compromise between the supranational-communitarian and the intergovernmental method of governance. The essay criticizes the fact that the transfer of quotas of national sovereignty to the supranational level has not be accompanied by an equivalent transfer of loyalty and commitment by member statesâ€™ citizens, who are at the same time EU citizens. The main cleavages within the EU are then analysed, which can be traced to different goals, interest and expectations of member states: the cleavage between those who view the union just as a single market and those who conceive it also as a supranational politiical project; and the cleavage between Northern creditor countries who hold fiscal austerity as a policy priority and Southern indebted countries who are mostly concerned with economic stagnation and unemployment. And it is argued that these cleavages have deepened because of three interconnected challenges: the economicfinancial crisis and its social implications (growth of inequalities, unemployment and underemployment), the migration pressure, and the threat of fundamentalist terrorism. The essay then analyses the upsurge of national-populism and euroscepticism and traces these phenomena to the democratic deficit of EU institutions and the inadequate development of a common European identity. Finally, the alternative strategies for the EU renewal, ougtlined in the Commissionâ€™ s White Paper are discussed, arguing that the one oriented toward a federal union to be achieved through the method of reinforced cooperation is to be preferred.
Â«SCRISI IN FAMAGOSA ... IN MILE TRESENTO CINQUANTAÂ». COSA PUÃ’ DIRCI UNâ€™ANTICA NOTA DI POSSESSO
Authors: Meneghetti Maria Luisa
Published: June 2021

One of the most important and precious manuscripts of ancient Italian literature â€“ the thirteenth-century Saibante-Hamilton 390, now preserved at the Staatsbibliothek zu Berlin â€“ has a hardly readable ownership note. This paper provides its interpretation, allowing to get relevant informations concerning the place of execution, the recipients and the target of the codex.
Commemorazioni â€“ RICORDO DEL m.e. GIAMPIERO LANDENNA
Authors: Dall'Aglio Giorgio
Published: June 2021

Non disponibile.
Critical Appraisal of a Machine Learning Paper
Authors: Vinny Pulikottil W. , Garg Rahul , Padma Srivastava MV , Lal Vivek , Vishnu Venugoapalan Y.
Published: June 2021

Machine learning (ML), a form of artificial intelligence (AI), is being increasingly employed in neurology. Reported performance metrics often match or exceed the efficiency of average clinicians. The neurologist is easily baffled by the underlying concepts and terminologies associated with ML studies. The superlative performance metrics of ML algorithms often hide the opaque nature of its inner workings. Questions regarding ML model's interpretability and reproducibility of its results in real-world scenarios, need emphasis. Given an abundance of time and information, the expert clinician should be able to deliver comparable predictions to ML models, a useful benchmark while evaluating its performance. Predictive performance metrics of ML models should not be confused with causal inference between its input and output. ML and clinical gestalt should compete in a randomized controlled trial before they can complement each other for screening, triaging, providing second opinions and modifying treatment.
Idiosyncratic Reaction to Single 7.5 mg Dose of Methotrexate
Authors: Kumari Pallavi , Jain Sonia , Sonkusale Pratiksha
Published: June 2021

Methotrexate (MTX) is one of the most common systemic immunosuppressive agents prescribed in dermatology. MTX toxicity targets skin, gastrointestinal mucosa, kidney, liver, and bone marrow. Toxic effects of MTX presenting as hepatic, renal, pulmonary, and bone marrow disorders occur less frequently than the minor effects but may be life-threatening. Characteristic signs and symptoms of acute MTX toxicity are based on extent and severity of organ involvement. Here, we report a 55-year-old married male, known case of chronic plaque-type psoriasis presenting with reaction to single dose of tablet MTX 7.5 mg as advised by the dermatologist for his disease. On history and clinical examination, diagnosis of idiosyncratic reaction to single dose of tablet MTX 7.5 mg was made.
Ultrasound-guided transrectal implantation of fiducial markers for image-guided radiotherapy of prostate cancer without local anesthesia
Authors: Sen Cenk Ahmet
Published: June 2021

Purpose:

The present study evaluates procedure-associated pain and side effects in the gastrointestinal–genitourinary system in patients with early-stage prostate cancer who were treated with image-guided radiotherapy (IGRT), accompanied by an ultrasound-guided transrectal implantation of fiducial markers, without local anesthesia.

Materials and Methods:

A total of 46 patients who referred to our clinics between 2012 and 2017 with a diagnosis of early-stage prostate cancer were included in the study. Before undergoing radiotherapy, all patients were implanted with three intraprostatic fiducial markers through the ultrasound-guided transrectal approach without local anesthesia. The patients underwent radiotherapy after the clinical target volumes were established, in accordance with the respective risk groups, and localization of the markers was confirmed before each therapy session. The levels of procedure-associated pain and side effects were graded immediately after the procedure through the use of a patient-based scoring system.

Results:

The faces pain scale – revised version was used for the measurement of the severity of procedure-associated pain. Of the total study sample, the facial expressions of 38 patients (35%) corresponded to level 0 in the study, seven (15%) to level 2, and a single patient (2%) to level 4. None of the facial expressions of the patients corresponded to levels 6, 8, or 10. The evaluation of procedure-related genitourinary and gastrointestinal system side effects indicated that nine patients (20%) experienced side effects, while no side effects were reported in 37 patients (80%). The reported side effects included rectal bleeding in two patients (4%), dysuria in three patients (6%), hematuria in five patients (11%), and frequent urination in five patients (11%). None of the patients experienced fever or hematospermia. All side effects were reported by the respondents as “a little,” while only one patient answered positively to the question on the frequency of urination. Among the patients who answered “yes” and “a little” to the questions evaluating genitourinary and gastrointestinal system side effects, the severity of these events was reported as Grade 1, corresponding to mild adverse, in only 9 (20%) patients. None of the patients experienced a Grade 2 or higher severe adverse event. In the comparison of the severity of pain of the patients during the fiducial marker procedure without local anesthesia with the severity of pain during the biopsy, 24 patients (80%) reported “lower” levels of pain, while five patients (20%) reported “equal” levels of pain. None of the patients stated that they had experienced “more” pain.

Conclusion:

IGRT accompanied by an ultrasound-guided implantation of fiducial markers without local anesthesia can be considered a safe method, given the associated acceptable levels of pain, low side effect profiles, and high prostate-specific antigen control rates.
Effectiveness of rectal displacement devices during prostate external-beam radiation therapy
Authors: Sanei Mastaneh , Ghaffari Hamed , Ardekani Mahdieh Afkhami , Mahdavi Seied Rabi , Mofid Bahram , Abdollahi Hamid , Rostami Aram
Published: June 2021

Dose-escalated prostate radiotherapy (RT) can improve treatment outcomes, but rectal toxicity is the main limiting factor for introducing dose-escalated RT. Pushing rectal wall away from the prostate reduces the volume of the rectum in high-dose region, which can decrease both short- and long-term rectal toxicities after RT. This review focuses on the literature using different rectal displacement devices such as endorectal balloons, tissue spacers, rectal retractor, and ProSpare during prostate External beam radiotherapy, with regard to dosimetric effects, clinical benefits, prostate motion, and postoperative RT setting.
Recurrence of renal cell carcinoma after three decades in an octogenarian
Authors: Philip Arun , Jojo Annie , Keechilat Pavithran
Published: June 2021

Renal cell carcinoma (RCC) is the most common primary renal neoplasm. About a half of our patients relapse after primary treatment. We present here a case of RCC with solitary metastasis to the pleura which occurred 32 years after nephrectomy. Our patient is an 86-year-old male who presented to us with a cough of 2 months and a history of having undergone a right nephrectomy 32 years back. Imaging of the chest showed left pleural effusion with a left pleural nodule. Computed tomography-guided fine-needle aspiration cytology from the pleural nodule was suggestive of malignancy with a clear cell morphology, suggestive of clear cell RCC. The patient was started on sunitinib 25 mg once daily. After the 1st month, the patient's performance status improved markedly, with no cough and improved appetite. He had developed Grade II hand–foot syndrome, which was managed conservatively, and the dose was deescalated to 25 mg once daily – 5 days on and 2 days off. An X-ray of the chest taken 6 weeks after the start of therapy showed complete resolution of the pleural fluid and regression of the pleural nodule. The patient is alive and well 5 years into therapy. The case highlights the unusual propensity for very late metastasis in RCC. Metastasis after 30 years is extremely rare. Another highlight of the case is the good tolerability of the dose-modified schedule of sunitinib. Wise patient selection and dose modification can certainly add “life to the years” in our very elderly patients.
Expression of the autophagic markers, light chain 3-I, light chain 3-II, and beclin 1, in vitiligo
Authors: El-Hanafy Ghada M. , Nada Hanan R. , Rashed Laila A. , Mousa Marwa F. , Elmasry Maha F.
Published: June 2021

Background

Autophagy is a lysosomal degradative process that is essential for the cell viability, homeostasis, and maintenance.

Objective

To measure microtubule-associated protein 1 light chain 3 (LC3)-I, LC3-II, and beclin 1 as indicators of autophagy and superoxide dismutase (SOD) and malondialdehyde (MDA) as indicators of oxidative stress in patients with vitiligo.

Patients and methods

This comparative case–control study was conducted on 20 patients with nonsegmental vitiligo as well as 20 controls. LC3-I, LC3-II, and beclin 1 tissue expressions were detected by western blot analysis, whereas MDA and SOD were measured by the colorimetry method in the tissue homogenate.

Results

The LC3-I, LC3-II, beclin 1, and SOD levels were significantly lower in lesional skin than nonlesional skin of patients as well as both lesional and nonlesional skin of patients than controls (P<0.001). On the contrary, the level of MDA was significantly higher in lesional skin than nonlesional skin of patients as well as both lesional and nonlesional skin of patients than controls (P<0.001).

Conclusion

Downregulated autophagy as evident by downregulated levels of autophagic markers together with dysregulated oxidative stress species could play a role in the pathogenesis of vitiligo, and optimizing autophagy could open a new era in vitiligo treatment.
Novel subcision technique combined with either microneedling or trichloroacetic acid 35% peeling for acne scars
Authors: Zayed Amira A. , Abelghafar Rasha A. , Hehazy Ahmed I. , Orabi Sarah , El-Mesidy Marwa S.
Published: June 2021

Background

Challenging treatment of acne scars makes it a must to have a plan for each case specifically. Subcision breaks the fibrous strands tethering the scar but is followed by recurrence. Chemical peeling and microneedling are other treatment options.

Objectives

To evaluate a new subcision technique combined with either microneedling or peeling in the treatment of acne scars.

Patients and methods

A total of 20 patients with bilateral rolling and boxcar acne scars were enrolled. Subcision using microkeratomes was done followed by either peeling using 35% trichloroacetic acid on one side or microneedling on the other side. Evaluation of response was done by Echelle d'Evaluation clinique des Cicatrices d'acné grading scale and optical coherence tomography imaging.

Results

Both therapeutic modalities yielded statistically significant improvement of acne scars and statistically significant decrease in acne scar depth. There was neither a statistically significant difference between the two sides regarding Echelle d'Evaluation clinique des Cicatrices d'acné scoring after treatment (P=0.968) nor regarding optical coherence tomography acne scar depth after treatment (P=0.583).

Conclusion

This novel technique of subcision is a safe and effective method for rolling and boxcar scar treatment, with almost no adverse effects and no downtime. In addition, trichloroacetic acid 35% peel is cheaper, as well as does not need any extensive special training or expensive instruments, as compared with microneedling, but microneedling shows better skin tightness and improvement of skin elastolysis especially in older patients.
Serum interleukin 15 as a marker of activity in patients with vitiligo
Authors: Hamza Ashraf , Aiad Mona , Abdel-Bary Ahmed , Gouda Eman
Published: June 2021

Background

Interleukin 15 (IL15) is a proinflammatory cytokine that is involved in the pathogenesis of several autoimmune and inflammatory diseases. The stability of vitiligo represents the periods of no activity of the disease, and it is crucial in determining the line of treatment of the patient.

Objective

To assess serum IL15 in patients with vitiligo and to evaluate its predictive capacity as a marker of vitiligo activity.

Patients and methods

A total of 40 patients with nonsegmental vitiligo were included, in addition to 30 age-matched and sex-matched healthy individuals as a control. The severity of vitiligo was assessed using vitiligo area severity index score, whereas the activity of disease in patients was assessed using vitiligo disease activity score. Serum levels of IL15 were measured using the ELISA technique.

Results

The mean serum level of IL15 was significantly higher in patients with vitiligo (201.14±115.41 ng/l) than in control (136.13±22.57 ng/l). Moreover, the mean serum level of IL15 was significantly higher in patients with unstable/active vitiligo (243.12±136.64 ng/l) than in patients with stable vitiligo (144.35±28.82 ng/l). Patients with serum level of less than or equal to 150.90 ng/l can be diagnosed as stable vitiligo, with 76.47% sensitivity and 73.91% specificity.

Conclusion

IL15 is a good and reliable marker for the detection of activity in patients with vitiligo, but further studies are needed to follow the progression of disease and to correlate this with the serum level of IL15. Targeting IL15 could be a novel treatment approach for patients with vitiligo.
Prevalence of dental anomalies among the school children
Authors: Jahan Nasrin , Iqbal Md. Ashif
Published: June 2021

Purpose:

This study was conducted on a randomly selected group of secondary school adolescents in the Sadar Upazila under Cox's Bazar to assess the incidence of developmental dental (Deciduous, permanent and Mixed Dentition) anomalies concerning age, gender, and the relationship between jaws and teeth.

Methodology:

A sample survey by an oral examination of 198 school students, 11–16 years of age, was drawn from a Kalatali, Cox's Bazar District school Bangladesh who were available on October 19, 2019. Our participants were limited to students whose parents were agreed to participate in the survey and provided informed consent. Clinical examination was performed to identify the prevalence of developmental dental anomaly using portable light, dental mirror, and oral explorer. Dental abnormalities were discovered after examining the complete maxillary and mandibular arch.

Results:

Of the total respondents under the study, 56.6% were female, and 43.4% were male. Among the diagnosed disturbances, developmental anomalies in upper lateral incisors prevailed in 34.3% of cases. The cusp of Carabelli appeared to be the most dominant one covering almost 73.9% of the existing coverage of anomalies. However, the presence of the cusp of Carabelli in the permanent dentition was found in 76.2% of cases.

Conclusion:

Out of several dental anomalies, cups of Carabelli came out as the most prevalent dental anomaly among the sample shows 11.15 Chi-square value of the study subjects.
Dental considerations in obstructive sleep apnea – Retrieving current status
Authors: Shaukari Sarita , Nandan Raghu K. , Gajavalli Meghana , George Subi
Published: June 2021

Obstructive sleep apnea (OSA) is a sleep disorder caused by partial or complete upper airway collapse with hallmark features of repetitive breathing cessation resulting in reduced oxygen saturation. India ranks third among countries worst hit by OSA. OSA is linked with elevated morbidity and mortality with various modifiable/nonmodifiable predisposing factors. Different medical approaches such as polysomnography, home sleep testing, dynamic magnetic resonance imaging, drug-induced sleep endoscopy, and neutrophil-to-lymphocyte ratio assist in diagnosis. Depending on disease severity, various treatment lines have been advocated, including behavioral modifications, continuous positive airway pressure, oral appliances (OAs), and surgical intervention. The role of pharmacotherapy in OSA remains controversial and demands extensive study. OA case selection and titration need to be done with utmost care. Definite protocols for the selection of suitable candidates for OA therapy need to be established. Various invasive and non-invasive surgical interventions such as bariatric surgeries, uvulopalatopharyngoplasty and Mandibular advancement appliances (MAA) have been advocated for OSA treatment. However, MMA requires a detailed diagnosis, including hard and soft tissue examination and an adequate recovery strategy to avoid any resulting adverse facial aesthetics. Implantable upper airway neurostimulators serve as a hope for newer therapeutic approaches. The need for the hour is a multidisciplinary solution to OSA.
SARS-CoV-2-Specific Antibody and T Cell Response Kinetics According to Symptom Severity
Authors: Kim Ji Yeun , Kwon Ji-Soo , Bae Seongman , Cha Hye Hee , Lim Joon Seo , Kim Min-Chul , Chung Jin-Won , Park Se Yoon , Lee Myung Jin , Kim Baek-Nam , Jung Jiwon , Kim Min-Jae , Shin Eui-Cheol , Kim Sung-Han
Published: June 2021

Data on the longevity of humoral and cell-mediated immune responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients with coronavirus disease 2019 (COVID-19) are limited. We evaluated the detailed kinetics of antibody and T-cell responses at the acute, convalescent, and post-convalescent phases in COVID-19 patients with a wide range of severity. We enrolled patients with COVID-19 prospectively from four hospitals and one community treatment center between February 2020 and January 2021. symptom severity was classified as mild, moderate, or severe/critical. Patient blood samples were collected at 1 week (acute), 1 month (convalescent), and 2 months after symptom onset (post-convalescent). Human SARS-CoV-2 IgG and IgM antibodies were measured using in-house-developed ELISA. The SARS-CoV-2-specific T-cell responses against overlapping peptides of spike proteins and nucleoprotein were measured by interferon-γ enzyme-linked immunospot assays. Twenty-five COVID-19 patients were analyzed (mild, n = 5; moderate, n = 9; severe/critical, n = 11). IgM and IgG antibody responses peaked at 1 month after symptom onset and decreased at 2 months. IgG response levels were significantly greater in the severe/critical group compared with other groups. Interferon-γ-producing T-cell responses increased between 1 week and 1 month after symptom onset, and had a trend toward decreasing at 2 months, but did not show significant differences according to severity. Our data indicate that SARS-CoV-2-specific antibody responses were greater in those with severe symptoms and waned after reaching a peak around 1 month after symptom onset. However, SARS-CoV-2-specific T-cell responses were not significantly different according to symptom severity, and decreased slowly during the post-convalescent phase.
Editorial - Covid-19: A Global Challenge – Misinformation, Misconceptions And Myths
Authors: Osuagwu Uchechukwu Levi
Published: June 2021

No Abstract.
Viewpoint: Prospect of Military Educational Roles during Public Health Crises - Lessons from the COVID-19 Pandemic in South Africa
Authors: Agbedahin Adesuwa Vanessa , Agbedahin Komlan
Published: June 2021

This viewpoint paper examines the prospect of an effective educational role for the military during public health crises. Reflecting a broad understanding of environmental education as education to protect the public space, the authors argue that the military could provide this during times of crises. The response to the COVID-19 pandemic in South Africa included the South African National Defence Force (SANDF), thus offering a unique opportunity to inquire into this contentious possibility. At the outset of the outbreak, some scholars deemed the SANDF unfit to make any meaningful contribution to the fight against the novel coronavirus. Leadership and coordination hurdles, a longstanding legitimacy crisis and inadequate training, may justify this pessimistic view. Based on available literature and document analysis, the authors propose the viewpoint that the military can play a progressive environmental educational role during crises if (1) its educational programmes such as green soldiering are intensified, widened and adequately informed by training; (2) if more is made of the experience, cultural insights and personnel gain during peacekeeping missions; (3) if healthy civil-military relations are prioritised, along with (4) military professionalism, supported by a deeper understanding in society of the diversity of roles and skills the military could offer. The military itself needs to recognise this and not train all personnel as if they are about to enter combat with an enemy. Should these elements be present, the security forces could indeed be a force for good during times of public health crises.Keywords: COVID-19, civil-military relations, environmental education, pandemics, SANDF
Occurrence of haemoparasites in cattle slaughtered at Jalingo abattoir, north-eastern Nigeria
Authors: Bitrus I. , Musa H.I. , Hambali I.U. , Konto M. , Shittu I. , Balami P.U.
Published: June 2021

Livestock plays a significant role in the economy of a nation but its productivity can be hampered by numerous haemoparasites thereby leading to economic losses to the livestock industry. The prevalence of haemoparasite in cattle slaughtered at Jalingo abattoir was investigated. A total of four hundred blood samples were collected at the point of slaughter, processed, and screened for haemoparasites by examining Giemsa-stained thin blood smears. An overall prevalence of 12.25% was recorded. Four haemoparasites of cattle with prevalence rates of 5.0%, 6.75%, 0.25%, and 0.25% for Anaplasma, Babesia, Microfilaria and Trypanosoma respectively were observed. The prevalence of haemoparasite in relation to sex, revealed higher infection in females (13.75%) than in males (10.0%) which were not found statistically different (P > 0.05). All breeds encountered during the study were infected with haemoparasites with the highest prevalence of 13.91 % recorded in White Fulani, Red Bororo (10.94%), and Sokoto Gudali (10.00 %), while Adamawa Gudali had the least prevalence of 0.5%. There was no statistically significant difference in the prevalence of haemoparasite in relation to breeds (P > 0.05). High prevalence was observed in the young (14.29%) more than the adult (11.59%) and older (12.14%). The current study has revealed the haemoparasites status in cattle slaughtered at Jalingo abattoir. Therefore, there is a need for effective preventive and control policy of these haemoparasites to enhance livestock productivity.

Keywords: Abattoir, cattle, haemoparasite, prevalence, slaughter