bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the reflections of pandemic (COVID-19) on university education from the perspective of faculty
Authors: ALTIPARMAK İpek Beyza , CEBECİOĞLU Gülçin
Published: April 2022

COVID-19 pandemic has caused dramatic and rapid changes along with some problems in education. Analysing the situation in question and making suggestions on the subject are important for the ongoing process. It is aimed to evaluate the changes in the education system during COVID-19 pandemic process from the perspective of academicians. In-depth reviews were conducted with 20 academicians working in Faculty of Sciences and Arts in Kirsehir Ahi Evran University. The data obtained from the interviews were analysed with computer based program, Maxqda 2020.4. The analysis indicated that the motivation of the academicians was negatively affected by the pandemic process. Not being able to get feedback on distance learning or communicate with the students and students’ being inactive during the courses have been put forward as problematic areas. Academicians also emphasized that the measurement and evaluation process did not work well, but they made attempts to improve it. It was also observed that there exists the idea that distance education and technological elements would be more involved in education even after the pandemic is over. This study helps us to understand how technology has become a fundamental part of our lives. It also unearthed how we could fight against the problems, including educational ones, which a worldwide pandemic caused. Firstly, with the distance education system we were able to continue to carry out educational activities. Later on, we have come to realise that distance education has so many advantages that it should be integrated with face-to-face education and used more often even after the pandemic.
Views of School Counselors on Dating Violence
Authors: TERZI ILHAN Sare , IŞIK Şerife
Published: April 2022

Dating violence is a common problem with severe effects in the short and long term. It is known that dating violence occurs mostly among young people aged between of 16-24. The purpose of this study was to explore and describe the views, awareness, and experiences about dating violence of school counselors who work at the high schools in the central district of Amasya, Turkey. The research design is qualitative descriptive research. The study group consists of 14 school counselors. As one of the data collection methods of qualitative research, interviews were held throughout the study. In the collection of data, “Personal Information Form (PIM)” and “Interview Form (IF)” were employed. The IF consists of 7 open-ended questions about the concept of dating violence. For data analysis, content analysis was used. Almost half of the school counselors have not heard of the concept of dating violence before, they do not know the concept and do not work on dating violence or healthy romantic relationships. Participants think that studies related to dating violence and healthy romantic relationships should be done and these studies will have positive effects on an individual level and on social contexts. However, they think that if they do these studies with teachers and administrators, or with parents, they will get negative reactions. Similar studies can be done in different regions, different provinces, with different people, and larger samples. Studies can also be conducted to examine the opinions and experiences of students, teachers, and parents on this issue and to raise their awareness. Especially in high schools, preventive studies aimed at avoiding dating violence and studies to protect students who are exposed to dating violence can be conducted.
An Examination of Curiosity and Academic Self-Concept among Students of Category “A” Senior High Schools in the Central Region of Ghana
Authors: AMPONSAH Mark , MAHAMA Inuusah , TAKYİ-WADİEH Ebenezer
Published: April 2022

Curiosity and academic self-concept as psychological constructs are often mentioned in education and psychology. These constructs are elusive in terms of how they are exhibited or portrayed and measured. Despite their elusive nature, they are highly significant to the success or otherwise of learners. Therefore, the current study explored curiosity and academic self-concept among students of category “A” Senior High schools in the Central Region of Ghana. Using a descriptive-quantitative method, a sample of 400 students was selected through proportionate-stratified and systematic sampling techniques. Adapted curiosity (Kashdan et al., 2018) and academic self-concept (Liu & Wang, 2005) scales were used for the data collection. The data collected were analysed using frequencies, percentages, and structural equation modelling (SEM). The study revealed that the majority of the students possessed low curious abilities and low academic self-concepts. The study further revealed that curiosity of deprivation sensitivity (b=.577, p<.001), the curiosity of stress tolerance (b=.248, p=.007), and curiosity of thrill-seeking (b=.544, p<.001) positively and significantly predicted academic self-concept of students but the curiosity of joyful exploration and social curiosity did not predict academic self-concept of students. It was concluded that students’ curious abilities were precursors to their academic self-concept. Thereupon, teachers need to devise new approaches by allowing students to engage in other learning opportunities without much restrictions so that they could hone their natural potentials.
How usable is Coursera? A usability analysis through eye-tracking and authentic tasks
Authors: TANIŞ Hasan , AKÇAY Arif , YILMAZ Nursel , YİĞİT Mehmet Fatih , TÜZÜN Hakan
Published: April 2022

Massive Open Online Courses (MOOCs) are considered learning environments that eliminate many learning barriers. Online courses in MOOCs have become an opportunity for everyone during the lockdown of the COVID-19 outbreak. However, usability issues may cause problems such as high dropout rates and lack of learner's motivation. Therefore, in this study, the usability of Coursera, one of the most known MOOCs in the world, was evaluated. The evaluation was performed with ISO 9241-11 standard. The environment's effectiveness, efficiency, and satisfaction were evaluated with the authentic tasks requested to be done in Coursera. Additionally, the findings were supported by eye-tracking metrics such as fixation duration, fixation counts, heat maps, and gaze plots. Twelve individuals (six females, six males) participated in the authentic tasks, and three individuals (two females, one male) participated in the eye-tracking phase. Results of the study revealed that most participants successfully performed the authentic tasks and are generally satisfied with the usability of the environment. However, considering eye-tracking findings and Coursera Usage Satisfaction Survey, some usability problems such as inadequate language support and the difficulty of using the search feature emerged. In the end, possible reasons were discussed, and the suggestions were presented for usability improvements.
China and the International System: The Formation of a Chinese Model of World Order
Authors:   Peoples' Friendship University of Russia, Grachikov Evgeny , Xu Haiyan ,   Institute of Political Science, Beijing
Published: April 2022

During its 72-year history, China has gone through a difficult path of changing the diplomatic strategies of relations with the outside world. The first period, thirty years from 1949 to 1978, was ideological, directed by Mao Zedong and completely ignored international organizations (IOs). The second, the next 30 years (1978-2008) - economic, which was determined by Deng Xiaoping's policy of reforms and opening up, and the gradual embedding of the PRC in the IOs. Now China is implementing the third, political stage under the leadership of Xi Jinping, who set the country with the tasks of great power diplomacy and the formation of new / alternative international structures in which it plays a leading role and has a real impact on the future model of the system of international relations. The formation of the PRC in 1949 and the Korean War (1950-1953) that followed soon after, where Chinese "volunteer" soldiers fought with the united UN forces, blocked the possibility of contacts between the PRC and this universal international organization for two decades. The country's internal problems in the form of a "cultural revolution" also did not contribute to the solution of this problem. Even the restoration of the PRC's rights in the UN in 1971, the establishment of diplomatic relations with the United States in 1979, and Deng Xiaoping's reforms could not significantly accelerate the PRC's accession to other international organizations. This process took about twenty more years and, on the whole, ended only in 2001 with the entry into the WTO. In the 21st century, especially after the 2008 global financial crisis, China began to actively use existing and create new international organizations with partner countries. The purpose of the article is to analyze the Chinese academic discourse on the problem of relations between the PRC and international organizations and international system, where Western countries, headed by the United States, dominate to this day, and China does not see a prospect for itself to take a place worthy of its complex power. The article examines the history of the formation of relations between the PRC and international system, identifies the reasons for the dissatisfaction of the PRC with its status in its structures and traces the process of creating international organizations in which China occupies a dominant position and in global competition with the United States can influence the future model of the world.
Human Pregnant Uterine Myometrium Tissue Collection and Preservation Methods - UCSD Female Reproductive TMC v1
Authors: Stanley Valentina , Lindsay-Hewett Scott , Parast Mana , Laurent Louise
Published: April 2022

Human pregnant uterine myometrium tissue collection and storage protocol for HuBMAP's UCSD Female Reproductive TMC.
[RETRACTED] Sports Illustrated Intensi-T Reviews 2022: Dietary Supplement To Male Enhancement v1
Authors: not provided officialjoanna
Published: April 2022

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[RETRACTED] Best Natures Only CBD Gummies – Shocking Top Check Out 2022? v1
Authors: cbd Gummies Natures
Published: April 2022

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[RETRACTED] Tiger Woods CBD Gummies Shark Tank - Reviews, Price, Benefits v1
Authors: CBD Gummies Uly
Published: April 2022

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Tiger Woods CBD Gummies Shark Tank - Reviews, Price, Benefits
[RETRACTED] OcuRenew v1
Authors: H H
Published: April 2022

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Enabling enhanced query for patient care 5) Fostering distributed population-level analytics.
SPARC_CWRU_Shoffstall_OT2-OD025340_VagusNerveOsmiumTetroxideStaining V.1 v1
Authors: R. Upadhye Aniruddha , A Pelot Nicole , A. Ludwig Kip , J. Gustafson Kenneth , Shoffstall Andrew
Published: April 2022

In this protocol, we describe our steps to stain nerve fibers with Osmium Tetroxide for further visualization wtih microCT, 3D MUSE (Microscopy with Ultraviolet Surface Excitation), and electron microscopy.
[RETRACTED] ://healthcare24hrs.com/keto-advanced-fat-burner/ v1
Authors: not provided healthshead
Published: April 2022

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[RETRACTED] Natures Only CBD Gummies Reviews v1
Authors: cbd Gummies Natures
Published: April 2022

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Natures Only CBD Gummies Reviews
[RETRACTED] Purify 247 Keto Gummies [IS LEGIT 2022] Customer Dangers or Effective Ingredients? v1
Authors: Shi H
Published: April 2022

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And then the last one is that health care reform is going to reduce the costs of healthcare.
[RETRACTED] Igenics (Truth Revealed) Results and Opinion!*OVERVIEWS* v1
Authors: not provided iGenics
Published: April 2022

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iGenics eye supplement are 100% natural & proved to be effective in solving eye-related issues permanently! These ingredients include lutein zeaxanthin), bilberry extract, vitamin C!
[RETRACTED] Sports Illustrated Intensi-T [Testosterone Booster],(Shark Tank)Most Promising Male Health Pill v1
Authors: Test Test
Published: April 2022

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Sports Illustrated Intensi-T Test Booster
[RETRACTED] Xcellerate 35 Is A Hair Serum Invented For The Prevention Of Hair Loss! v1
Authors: not provided larasousa
Published: April 2022

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Xcellerate 35
[RETRACTED] Green Roads Full Spectrum CBD Oil US - Reviews - Green Roads Full Spectrum CBD Oil US SCAM ALERT! Read Real Critical Reports v1
Authors: not provided health
Published: April 2022

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Inducing gemmulation in the freshwater spongeEphydatia muelleriin culture using theophylline v1
Authors: Sogabe Shunsuke , Cornish Taitum , Hill April , Riesgo Ana , P Leys Sally
Published: April 2022

Freshwater sponges produce overwintering cysts called gemmules that are full of stem cells, allowing them to survive harsh winter months. The gemmules of Ephydatia muelleri can be kept in 3°C for months, and in -80°C for years, while still remaining viable to hatch and develop into a functional sponge, as outlined in the protocol: "Hatching and freezing gemmules from the freshwater sponge Ephydatia muelleri" (https://dx.doi.org/10.17504/protocols.io.863hzgn). With a recently published chromosome-level assembly of the genome (Kenny et al., 2020), along with multiple transcriptomes, this makes Ephydatia muelleri an ideal sponge species to establish as a model sponge species that can be used in labs world-wide. While the gemmules used in the lab are usually collected from rivers and lakes every season for practical reasons, there have been studies showing the gemmulation process can be induced. A classic study looking at this process was conducted by Rasmont in 1974, who used theophylline to induce gemmulation in the freshwater sponge Ephydatia fluviatilis. Using up to 400uM of theophylline, this study showed that gemmulation can be induced in 100% of the sponges used in the experiments, and can occur as fast as 4 days after treatment with theophylline. While this is an interesting and important process to understand the biology of freshwater sponges, the ease and practicality of collecting masses of gemmules from wild populations most likely led to this process being rarely revisited in the lab. Here, we outline a protocol for inducing gemmulation in the freshwater sponge Ephydatia muelleri using theophylline, establishedby revisiting the study done by Rasmont (1974). In E. muelleri, the gemmulation process takes longer than in E. fluviatilis, with the fastest documented gemmulation detected at 8 days after treatment with theophylline, and taking up to 12+ days in some cases. The gemmulation process usually completes within 4-5 days once the gemmulation process can be detected, and results in a smaller gemmule size than the ones obtained from wild populations. The newly formed gemmules take roughly 6-7 weeks to mature in the 3°C incubator before they can be plated to hatch. While this is a lengthy process, being able to induce gemmulation in the lab increases the potential for using E. muelleri in transfection studies. References Kenny, N.J., Francis, W.R., Rivera-Vicéns, R.E. et al. Tracing animal genomic evolution with the chromosomal-level assembly of the freshwater sponge Ephydatia muelleri. Nature Communications. 2020. 11, 3676. https://doi.org/10.1038/s41467-020-17397-w. Rasmont R. Stimulation of cell aggregation by theophylline in the asexual reproduction of fresh-water sponges (Ephydatia fluviatilis). Experientia. 1974. Jul 15;30(7):792-4. doi: 10.1007/BF01924190. PMID: 4367998.
[RETRACTED] Refine365 Keto Gummies (FAT BURNING DIET) A Natural Solution For Eliminating Body! v1
Authors: Shi H
Published: April 2022

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Illumina MiSeq Dual-barcoded Two-step PCR Amplicon Sequencing Protocol v1
Authors: M. U'Ren Jana , A. Elizabeth Arnold not provided
Published: April 2022

Background Information High throughput amplicon sequencing is an extremely sensitive technique. The lab environment is full of airborne bacterial and fungal cells as well as bacterial and fungal genomic DNA from cultures, and so extreme care must be taken to keep reactions uncontaminated and in preventing cross-contamination. This protocol was modified from the IBEST Geomics Core at University of Idaho. It utilizes a 2-step PCR, where the first PCR amplifies the specific region of interest (e.g., ITS or 16S V4), and the second PCR adds adapters and barcodes to these amplicons. The target specific primers include (in addition to the standard primer sequence) the universal sequences CS1 and CS2, which provide the bases used in the second PCR to extend the amplicons with Illumina adapters and sample-identification barcodes. Illumina adapters and sample-identification barcodes are not included in the region-specific primers used in PCR1. This allows for maximum flexibility in choosing which primers to use and provides the ability to swap out targets, or include multiple targets in the same sequencing reaction, without needing to purchase a large number of barcoded target specific primers. Barcodes are included in both adapters, therefor a pair of barcodes is used to uniquely identify each sample during bioinformatic processing. This allows us to use 32 barcode pairs to uniquely identify 1024 samples (32 x 32). Phase-shifted primers are used to introduce 1, 2, and/or 3 additional bases to allow for the maximum amount of “sequence diversity” in the first 4 bases. This is important because of how the Illumina sequencers detect clusters on the flowcell during sequencing. If sequences are too similar (as is often the case with amplicons), then sequencing yields will be much lower than expected. 2-bp linkers and phase-shifting bases were chosen to have low identity between primers and the target sequence. Tagged primers were ordered from IDT (standard desalting; not HPLC-purified), re-suspended at 100 μM using a new bottle of molecular grade water in the PCR-free hood, and mixed in equimolar concentration (250 μl each). Working stocks were diluted to 50 μM for PCR1.
[RETRACTED] Refine365 Keto Gummies v1
Authors: Shi H
Published: April 2022

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Ministry of Health should have the power to instruct regional authorities to make systemic and resource changes based on the statistics collected and analyzed. Regional
Controversias hídricas e intereses privados en Chile. Los grupos de interés frente a la reforma al Código de Aguas, 2014-2020
Authors: Avendaño Pavez Octavio , Osorio Gonnet Cecilia , Vergara Vidal Jorge
Published: April 2022

Este artículo analiza la participación y el comportamiento de los grupos de interés en la discusión y tramitación de la reforma al Código de Aguas promovida en Chile desde mayo de 2014. Basándose en la teoría de los grupos de interés, se establece una clasificación para tipificar a las organizaciones que más se involucran y participan de la discusión, así como las estrategias y acciones desplegadas a fin de influir en los resultados del proyecto de reforma. El análisis cuantitativo y cualitativo permite constatar la menor participación de los grupos de interés empresarial, a diferencia de lo registrado por otros estudios. A su vez, se observa el mayor involucramiento e incidencia por parte de las organizaciones de riego, lo que demuestra la importancia que alcanza el fenómeno de la especialización temática en el marco de la competencia que desarrollan los diferentes grupos de interés.
La madre del libro: usos y funciones del Corán en la obra de Jorge Luis Borges
Authors: Adur Lucas Martín
Published: April 2022

Abordamos la influencia del Corán en la obra de Jorge Luis Borges. Comenzamos con un breve estado de la cuestión sobre los estudios de Borges y Oriente, especialmente los referidos al islam. A continuación, caracterizamos el uso del texto sagrado islámico por parte del escritor argentino como irreverente, con un fin literario. Luego, sistematizamos las funciones del Corán en la obra borgiana. Por último, consideramos que el principal propósito del Corán para Borges es ser un ejemplo cabal del texto absoluto y eterno, a partir del cual define sus escritos y, sobre todo, una poética de la lectura.
ÜNİVERSİTELERİN BİLİM İLETİŞİMİ ETKİNLİKLERİNİN KURUMSALLAŞTIRILMASI ÜZERİNE YENİ BİR ÖLÇEK ÖNERİSİ
Authors: Öztunç Müge , Bedir Umur , Suerdem Ahmet
Published: April 2022

Üniversiteler bir yandan öğrenci çekmek ve kurumsal itibarlarını güçlendirmek gibi stratejik amaçlar, diğer taraftan toplumu bilimsel süreçlere dahil etmek ve siyasal karar alma süreçlerine bilimsel temelli katkı sunmak gibi kamusal faydayı önceleyen hedefler çerçevesinde bilim iletişimi etkinliklerinde bulunmaktadırlar. Bu araştırma bilim iletişiminin en önemli kurumsal aktörlerinden biri olan üniversitelerin bünyelerindeki merkezi iletişim birimlerinin bu kapsamdaki rolünü ve gerçekleştirdikleri etkinlikleri konu almaktadır. Araştırmanın temel amacı ise bilim iletişimi etkinliklerinin üniversitelerde kurumsal olarak nasıl şekillendiğini analiz etmeye dönük bir ölçek geliştirmektir. Bu kapsamda ölçekte yer alacak bilim iletişimi etkinlikleri literatür taraması, keşfedici mülakatlar ve kart sıralama tekniği gibi tümdengelimsel ve tümevarımsal yöntemler kullanılarak belirlenmiş, pazarlama, halkla ilişkiler, kamusal katılım ve kamu işleri olmak üzere 4 alt-faktör çerçevesinde değerlendirilmiştir. Ölçek, istatistiksel olarak ölçüm değişmezliğinin test edilmesi amacıyla Türkiye’de faaliyet gösteren devlet, vakıf ve araştırma üniversitelerinin %48’ini temsilen 92 üniversitenin merkezi iletişim birimleri yetkilileri üzerinde uygulanmıştır. Geliştirilen ölçek üniversitelerin hangi bilim iletişimi etkinliklerini gerçekleştirdikleri, bu etkinlikleri hangi iletişim işlevleri altında tanımladıkları ve nasıl organize ettikleri konusunda önemli bulgular sunmaktadır. Bu anlamda üniversitelerin bilim iletişimi etkinliklerini geliştirmeleri konusunda yol göstermektedir. Ölçek mevcut haliyle kullanılabileceği gibi yeni araştırmacıların katkılarıyla da geliştirilebilir niteliktedir.
Institutional quality and health outcomes: evidence from the EU countries
Authors: Sharma Anand , Sharma Vipin , Tokas Shekhar
Published: April 2022

This paper examines the effect of the quality of economic institutions on health outcomes for the E.U. countries from 2000 to 2018. Using data from the World Bank and the Fraser Institute, the paper uses fixed effects and random effects models to investigate the relationship between institutional quality and health. The results suggest that an improvement in the quality of economic institutions has a favourable effect on health. Specifically, the results highlight that an efficient legal system, a stable macroeconomic environment, and fewer regulations improve health outcomes in the E.U. countries. The paper also finds that higher per capita income, increase in education, and faster urbanization enhance health outcomes.
A note on the human capital and tourism growth nexus: a semi-parametric approach
Authors: Polemis Michael , Oikonomou AIkaterina
Published: April 2022

We investigate the impact of human capital on tourism growth by using a semi-parametric fixed effects estimator developed in Baltagi and Li (2002). The results shed new light on the existing literature since they unveil strong non-linear effects of human capital on tourism growth. Furthermore, we uncover a non-monotonic “M-shaped” curve between human capital and growth when we impose the assumption of imperfect labor substitutability.
Development of the Teacher Efficacy Toward Providing Physical Activity in the Classroom Scale
Authors: Centeio Erin E. , Moore E. Whitney G. , Barcelona Jeanne , McKown Hayley B. , Erwin Heather E. , Garn Alex C.
Published: April 2022

The overall aim for this study was to create and validate an instrument that helps researchers measure and better understand classroom teachers’
efficacy toward providing physical activity throughout the school day. The development of the Teacher Efficacy Toward Providing Physical Activity
in the Classroom Scale (TETPPACS) occurred in two phases. First, in study one, after item development and face validity review, an exploratory
factor analysis was conducted with pilot data (N = 320) to discover the factor structure of the TETPPACS. Second, with a follow-up sample (N = 192),
a confirmatory factor analysis (CFA) was performed to confirm the factor structure and measurement quality of the instrument. The final bi-factor
model with three efficacy-specific constructs and the general efficacy construct resulted in an acceptable fitting two-group configural model
across elementary and high school teachers ( =363.791; CFI=.91; TLI=.87; SRMR=.066; RMSEA=.081). The results of this study suggest the new
TETPPACS is a valid and reliable instrument to measure classroom teacher’s efficacy toward providing physical activity during the school day.
This instrument can help researchers further investigate how teacher efficacy relates to implementation and facilitation of physical activity
experiences throughout the school day.
Numericalinvestigationtodeterminetheoptimaltiltangleofsingleslopesolarstillduringsummerseason
Authors: Uzair Muhammad , Naqvi Asad , Uzair uhammad
Published: April 2022

Water, a basic human need can be purified by different techniques like membrane distillation, boiling and solar still. Among all types, solar still is considered to be the most economical and simpler one. In this study, the geometrical aspects of the solar still for Karachi by varying the tilt has been simulated. The study is conducted by varying the height and length of the solar still by keeping the constant glass surface area and by varying the height and length of the glass cover while keeping the constant basin area. The study is conducted between the time duration from 08:00 to 18:00 hours which is generally the sunshine duration for Karachi. The simulation results are verified with the experimental results which shows the good agreement with each other. For constant glass cover area, the maximum mass production of water has been observed at a tilt of 60° while for constant basin area the maximum tilt is observed for 24.8° equal to the latitude of Karachi. For both the cases, the maximum temperature of water and glass and maximum mass production of water is observed at around 13:00 hours.
Comparing the effects of vaginal misoprostol and isosorbide mononitrate on cervical ripening in abortions under 20 weeks: a randomized controlled trial
Authors: Farzipour Shahla , Amani Firouz , Rezaei Mahsa
Published: April 2022

Background: In the first trimester of pregnancy, 15 to 20 percent of pregnancies result in miscarriage. Misoprostol is a widely medication that used for induction of labor in the second trimester; therapies, early termination of pregnancy and also used in duration of term delivery. The objective of this study was to comparing the effects of vaginal misoprostol and isosorbide menonitrate on cervical ripening in abortion under 20 weeks.

Methods: In this prospective randomized clinical trial, 120 pregnant women with miscarriage were enrolled in the study and randomly divided into 3 groups: vaginal misoprostol, isosorbide mononitrate and control group. The effect of all drugs on cervical dilatation and ripening, time needed for abortion, and also their side effects were evaluated.

Results: The mean of VAS in misoprostol group with 6.2±2.3 was significantly more than isosorbide mononitrate group with 3.4±1.5 and control group with 3.2±2.4. The rate of abortion in misoprostol group was significantly lower than other two groups. The change in dilation rate more than 3 cm in misoprostol group with 50% was significantly more than other two groups with 35% and 20%. Nausea, diarrhea, fever and bleeding rate were higher in the misoprostol group than other two groups. Headache in the isosorbide mononitrate group was significantly higher than the other groups.  

Conclusions: The results showed that we can use isosorbide mononitrate as a suitable alternative with better safety to vaginal misoprostol in cervical repining in abortions under 20 week.
Comparative evaluation of efficacy of two doses of dexmedetomidine as adjuvant to ropivacaine ultrasound guided supraclavicular brachial plexus block
Authors: Badugu Jalaja Praveena , Mokkarala Rama Rao
Published: April 2022

Background: Dexmedetomidine as neuraxial adjuvant decreased postoperative pain intensity, prolonged analgesic duration. But use of dexmedetomidine is associated with doses dependent increase in adverse effect like hypertension, hypotension, bradycardia, excessive sedation, sleepiness. Optimal dose of dexmedetomidine is still uncertain. Present study has been designed with an aim to evaluation of efficacy of two doses of dexmedetomidine as adjuvant to ropivacaine ultrasound guided supraclavicular brachial plexus block.

Methods: The patients were randomly divided in to two groups. Group A were received 15 ml of 0.5% ropivacaine with 50 µg one ml dexmedetomidine. Group B were received 15 ml of 0.5% of ropivacaine with 100 µg of dexmedetomidine. Parameters observed were onset of motor block, onset of sensory block, duration of sensory block, duration of motor block. Adverse drug reaction like hypertension, hypotension, bradycardia and sedation were recorded.

Results: We have observed that mean duration of analgesia was longer in group B than group A (650.54±98.54 min versus 702.22±80.24 min) but the difference is not significant statistically (p=0.08). Time for requirement of rescue analgesia was longer in group B than group A (713.45±96.21 min versus 789.23±99.23 min) but the difference is significant statistically (p=0.04).

Conclusions: From present study we can conclude that 100 µg dexmedetomidine as adjuvant to ropivacaine is no significantly better that reducing time of onset of sensory and motor block and prolongation of motor and sensory block. Duration of analgesia was comparable in both doses but time required for rescue analgesia was significantly longer higher dose group.
Osteopathy in the treatment of irritable bowel syndrome symptoms in adults: study protocol for a randomized controlled trial
Authors: Amsallem Florent , Sanchez Stéphane , Mion François
Published: April 2022

Background: Osteopathy is chosen by patients as a treatment for irritable bowel syndrome (IBS) but evidence for its effectiveness is poor. The purpose of this study is to evaluate the effectiveness of osteopathy for IBS at 1 month follow-up in IBS adults.

Methods: Design: a multicenter, two-group parallel, randomized, double-blind, placebo-controlled trial. Inclusion criteria: adult IBS patients (Rome IV criteria) with similar baseline symptom severity, and comparable expectations of active and sham osteopathic treatment before. Treatment group included active osteopathic treatment. Control group included sham osteopathic treatment. Randomization was in allocation ratio 1:1. Assessment time was carried as inclusion and baseline assessment (day-1; initial visit V0), day 8, day 15 and follow-up (1 month and 3 months), treatments (day 0, day 8, day 15). Primary endpoint was effectiveness at 1 month (response to treatment defined as at least a 50-point reduction in IBS severity on the IBS-symptom severity score). Secondary endpoint was effectiveness at 3 months (response to treatment) and changes in total IBS quality of life scores up to 3 months. Sample size was 404 individuals to achieve 90% power to detect a 15% difference in treatment response at 1 month between the two groups (20% of patients lost to follow-up).

Conclusions: The two-group parallel, randomized, double-blind, placebo-controlled trial (sham therapy) in which the expectations and experiences of patients in the control group are comparable to the experimental group is the most accurate design for demonstrating the effectiveness of osteopathy on IBS symptoms. Future studies could use such a design to assert causality.

Trial registration: The trial has been registered in clinicalTrials.gov. Registration number: NCT05230277; registered on 7 February 2022.
Comparison of the low-dose oral therapy results with literature and parenteral therapy in children with vitamin B12 deficiency
Authors: Sarbay Hakan , Akin Mehmet
Published: April 2022

Background: It was aimed to investigate the results of vitamin B12 deficiency treatment with a lower vitamin B12 loading dose and compare with literature.Methods: Patients diagnosed with vitamin B12 deficiency at the pediatric hematology and oncology clinic between May 2017 and May 2018 were evaluated retrospectively. Patients who received a total of five doses of oral or parenteral cyanocobalamin treatment, 500 mcg two days a week in terms of region's socio-cultural status and accessibility to the health institution were included in the study. Vitamin B12 deficiency was defined as below 200 pg/ml. Post-treatment blood counts and vitamin B12 levels were reevaluated one month later after treatment was started. Vitamin B12 treatment responses were compared between the oral and parenteral groups and the results in the literature.Results: Parenteral cyanocobalamin was used in 134 patients and oral cyanocobalamin was used in 146 patients. Post-treatment vitamin B12 values at first month were investigated in 115 and 123 children in parenteral and oral arms, respectively. A total of 238 patients were included in the study. Although control mean±standard deviation (SD) vitamin B12 values increased significantly in both groups. Compared to the literature, vitamin B12 mean±SD values (oral treatment group 349.48±179.12, parenteral treatment group 486.77±52.77) after treatment did not differ significantly according to higher doses and longer treatment.Conclusions: In vitamin B12 deficiency, 500 mcg twice a week and a total of five dose oral cyanocobalamin is sufficient to increase the levels of vitamin B12.
Progressive familial intrahepatic cholestasis-2 and concomitant cytomegalovirus infection in an infant: a case report
Authors: Mukherjee Ananya , Veluru Nithin , Ranabijuli Pradeep Kumar , Tambe Anil
Published: April 2022

Conjugated hyperbilirubinemia (CH) in infancy can have anatomic, infectious, auto-immune and metabolic causes. We reported a case of CH presented at 2 months and 20 days, with clinical jaundice and evidence of acute on chronic liver failure. Significant history of elder sibling death at the age of 5 months due to hepatic failure and intracranial bleed was present. Investigations revealed a normal gamma glutamyl transpeptidase (GGT) levels. Toxoplasmosis, rubella, cytomegalovirus and herpes simplex (TORCH) panel showed cytomegalovirus (CMV) immunoglobulin M (IgM), immunoglobulin G (IgG) and deoxyribonucleic acid polymerase chain reaction (DNA PCR) positive with mother’s serum CMV IgG, so she was started on oral valganciclovir in addition to other treatment for cholestasis. A clinical exome panel was also sent which showed homozygous two base-pair deletion in exon 27 of the ABCB11 gene [c.3659 3660del (p.Ser1220Ter)] suggestive of benign recurrent intrahepatic cholestasis (BRIC)/progressive familial intrahepatic cholestasis-2 (PFIC-2). The child responded initially to treatment showing reduced serum conjugated bilirubin level and near normalization of INR. However, she was re-admitted with deranged coagulation profile and rising conjugated bilirubin levels after 30 days of discharge and expired due to fulminant hepatic failure with encephalopathy at 6 months of age while she was being prepared for live donor (father) liver transplantation. We presented this case because we found evidence of CMV infection in a child with PFIC-2. The relative contribution of either aetiology needs to be ascertained in view of early recurrence of CH despite standard management protocol including oral valgancyclovir for CMV infection.
Clinical profile of patients with acute kidney injury admitted in intensive care unit
Authors: Sah Vijay Kumar , Prakash Satyam
Published: April 2022

Background: Acute kidney injury (AKI) is a frequent complication in critically sick patients admitted to the intensive care unit (ICU). The objective of this study was to assess the risk factors and clinical outcomes of AKI in patients admitted to a teaching hospital's intensive care unit.Methods: This prospective observational study was conducted in the department of internal medicine, Janaki Medical College, Janakpur, Nepal from June 2018 till May 2019. Adults (aged 18 years or more) diagnosed with AKI using RIFLE criteria and were either admitted in ICU with diagnosis of AKI or developed AKI after admission to ICU. AKI patients were classified as those who satisfied any of the RIFLE categorization criteria.Results: The most common presenting complaint was fever (77%). The most common etiology of AKI was sepsis (71%). Other causes of AKI were post-operative cases (16%) and alcoholic liver disease (13%). When classified as per RIFLE criteria, we classified 38 cases (31.9%) as ‘risk’, 53 (44.54%) as ‘injury’ and 28 (23.53%) as ‘failure’. The etiological classification of our patients to be significantly associated with RIFLE classification (p<0.01). However, we found the mortality not to be significantly associated with RIFLE classification (p=0.74).  Conclusions: AKI classification should be used as a risk assessment tool towards the AKI's influence on the prognosis of ICU patients. Further study should investigate determining the death rate according to the RIFLE criteria in this region of Nepal.
A study of non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus and its correlation with cardiovascular risk
Authors: Giri Richa , Kumar Vinit , Kumar Vinay , Agarwal Saurabh
Published: April 2022

Background: NAFLD (non-alcoholic fatty liver disease) encompasses a variety of disorders of lipid metabolism ranging from NAFL, NASH to cirrhosis and rarely HCC. A great deal of evidence suggests that the metabolic syndrome predicts incident cardiovascular disease (CVD), so it is possible to hypothesize that NAFLD patients might portend a greater CVD risk and that NAFLD itself might confer a CVD risk above that associated with individual metabolic syndrome risk factors.Methods: 55 T2DM patients were included in current study conducted from August 2019 to September 2021 for assessment of NAFLD using USG abdomen, NAFLD fibrosis score and FIBROSCAN. ASCVD score was used for correlation between CVD risk and NAFLD.Results: Out of 55 patients 42 (76.4%) were having fatty liver based on USG abdomen while 13 (23.4%) patients were having no fatty liver. As far as steatosis is concerned mean CAP (dB/m) was 245±50.89 out of which 24 (43.6%) were having no or minimal steatosis (S0), while 31 (56.4%) were having significant steatosis with 11 (20%), 9 (16.4%) and 11 (20%) having S1, S2 and S3 grade of steatosis respectively. 15 patients out of 55 were of F0 grade while 19 (34.5%), 9 (16.4%), 7 (12.7%) and 5 (9.1%) were of grade F1, F2, F3 and F4 respectively. There was a positive statistically significant (p≤0.001) association of ASCVD risk score with NAFLD fibrosis score and fibroscan: E (KPa). Conclusions: Our study found that the prevalence of NAFLD was quite higher in patients with T2DM based on both USG abdomen (76.4%) and transient elastography (steatosis-56.4% and fibrosis-65.5%) and a statistically significant association between fibrosis and ASCVD score with higher fibrosis associated with higher 10 years ASCVD score.
Utility of Amrut Pushti Vardhak powder in enhancing physical fitness
Authors: Katti Anand , . Ashok , G. Phanikumar , K. R. Anilakumar
Published: April 2022

Background: Physical performance depends on physical fitness. Fit persons can accomplish the tasks. Fitness is modifiable and hence the fitness level can be increased. In this background a need was felt to validate the efficacy of the Amrut Pushti Vardhak (APV) powder, a product developed by DFRL Mysore, for its physical performance enhancing activity by fitness tests. The result of pre-clinical study of the product was encouraging; hence clinical trial was taken up.Methods: All norms of good clinical practice and ethics were abided. The subjects were assigned in two homogenous groups, as control and trial groups. The trial group was given APV powder 30 gms/day for 21 days in the morning. The other group served as negative control. To evaluate the efficacy modified Harward step test was conducted before and after the intervention.Results: The test group showed statistically significant increase in the duration of exercise with p value 0.027 and increase in physical fitness index (PFI) with p value 0.01. The test group also showed statistically significant increase in the maximal oxygen consumption (VO2 max) (p=0.004). The increase in physical fitness level can be attributed to ingredients of APV powder.Conclusions: Healthy volunteers who received APV powder 30 gms/day for the duration of 21 days reported statistically significant increase in their duration of exercise, PFI and VO2 max. This indicates the APV powder increases in the physical fitness level.
A case on novel treatment protocol for difficult to treat foot myiasis
Authors: Dabhade Mayur
Published: April 2022

Foot myiasis is a rare condition, with only a few reported cases and no treatment consensus. We proposed a conservative and unique treatment approach with VAC dressing method. The patient administered in the hospital with presentation of deep tissue injury from a sharp stone, from 3 months back which was maggot infested.  The patient had approached local physicians before been admitted in our facility. The wound was severe with maggot infestation. The patient was non diabetic with no other comorbid conditions. We had the aim of infection free wound with faster rate of healing, which was fulfilled by the novel treatment protocol using vacuum-assisted closure (VAC®) dressing method. Culture sensitivity tests ruled out infection and maggot infestation. The wound was closed surgically after healthy uninfected granulation tissue confirmed with culture sensitivity report. No recurrence of maggot or any other infection were found.  The protocol performed was safe and effective in critical case of myiasis.
A study to assess the clinical and functional outcome of sub-vastus approach for total knee arthroplasty
Authors: Gupta Tarun , Nigam Anuj , Neema Pramod P. , Rassiwala Murtuza
Published: April 2022

Background: Osteoarthritis and rheumatoid arthritis affects all patients of age more than 50 years, requiring total knee replacement. There are two major approaches to total knee replacement- sub-vastus approach and medial parapatellar approach. There is no common consensus on superiority of sub-vastus approach. So, we undertook the present study to evaluate the functional and clinical outcome of total knee replacement via sub-vastus approach in terms of knee society clinical and functional scores and visual analog scale along with monitoring of range of motion in the post-operative knee in the follow up period.

Methods: The present prospective and observational study was conducted in the Department of Orthopaedics, Unique Super Speciality Hospital, Indore, Madhya Pradesh for a period of 12 from June 2019-May 2020 with sample size of 30 patients undergoing total knee arthroplasty. All the patients had undergone total knee replacement via sub-vastus approach. The functional and clinical results of our study were compared with available literature.

Results: The mean KFS and KCS scores showed a statistically significant improvement over a period of 12 months (p<0.05), while the mean ROM showed an improvement till 6 months (p<0.05) and then it remained stable till 12 months in comparison to 6 months (p>0.05).

Conclusions: On comparing the results of sub-vastus approach with the available literature we found a significant improvement in functional and clinical outcome with a stable improvement in range of motion with very few complications.
Closed reduction and internal fixation with titanium elastic nailing system in pediatric both-bone forearm fractures
Authors: Singh Harpreet , Oza Bineet , Agarwal Kamal Kumar K. , Makadia Prashant , Jain Pranjal , Patel Meet
Published: April 2022

Background: The present study is designed to analyse the postoperative clinical and functional outcome of closed reduction and internal fixation of pediatric both-bone forearm fractures with titanium elastic nailing system (TENS).

Methods: A total of 32 patients in the age group of 5 to 15 years with fracture both-bone forearm underwent closed reduction and internal fixation with TENS at our hospital. Patients with displaced fractures having angulation more than 10° and rotation of more than 45° or fractures with unacceptable reduction post conservative management were included in this study. For functional outcome, upper extremity rating scale (UERS) was used to evaluate the range of motion and grip strength.

Results: Patients were followed up for a period of 6 months. In all cases fracture united in the range of 6-14 weeks without any malunion. All 32 cases had excellent outcomes according to UERS score. Two patients had deficient forearm pronation of 10° and 15° respectively. Skin irritation and implant impingement was seen in two patients each at final follow-up.

Conclusions: Closed reduction and internal fixation with TENS seems to be a good treatment option for fixation of pediatric both bone forearm fractures. It gives excellent functional outcome in terms of range of motion and grip strength without any major complications.
Study of midterm outcome of spinal fusion in low grade spondylolisthesis
Authors: Tuse Sushant Sopan , Matin Aamir , Kaware Rohit Suresh , Dhamdhare Saurabh Sunil , Gursale Amey , Patil Nilesh , Mesare Vaibhav Ukarda , Borse Amey Mahesh
Published: April 2022

Background: The objective of our study is to measure clinical and radiological outcome of spinal fusion in low grade spondylolisthesis at minimum 5 years following surgery.

Methods: Monocenteric prospective observational study was conducted to assess the mid-term outcome of spinal fusion in low grade spondylolisthesis with minimum 5 years following surgery in patients who underwent surgery from 2010 to 2015 in department of orthopaedics of Seth Nandlal Dhoot hospital, Aurangabad. Out of total 51 participants, there were 24 males and 27 females with mean age of 55.90 years of study participants. The patients were evaluated radiologically with AP and lateral X-rays views and dynamic flexion and extension views were taken and was evaluated with Lenke method and clinically with the visual analog scale (VAS) for back and leg pain, the Oswestry disability index (ODI), and the physical component (Physical functioning) of SF-36 health survey at minimum 5 years following surgery.

Results: In our study we observed high spinal fusion rate of 96.1% and satisfactory improvement in clinical outcome at minimum 5 years following surgery in 51 study participants who underwent spinal fusion for low grade spondylolisthesis.

Conclusions: The spinal fusion in low grade spondylolisthesis is a safe, simple and less morbid approach with low complication rate. We observed 96.1% of spinal fusion rate and highly significant decrease in post-operative mean ODI score, mean SF-36 physical component and mean VAS score with 78.4% patient did not develop any complications. Spinal fusion provides better functional outcome by providing pain relief and improving the quality of life in the patients. Spinal fusion restores the normal sagittal balance of spine and maintains the disc space height and also provides better fusion rates.

 