bluuebunny/crossref_metadata_2025 huggingface dataset:
Illuminating the Marginalization of International Students in the United States and the Ways Forward
Authors: Harati Hoda , Shelton Catharyn Crane , Sujo-Montes Laura E. , Tu Chih-Hsiung , Armfield Shadow J. W.
Published: July 2022

In this chapter, the researchers showcased the story of an international student to critically illustrate issues impacting international students in higher education within the U.S. and to offer ways forward to create more equitable and inclusive universities for these students. Such critical examination of these students' experiences is important because their enrollment in higher education has expanded considerably in the past decades. Support of these students may be a valuable investment in the future infrastructure of the U.S. and the world. However, they may experience a variety of challenges navigating university systems imbued with structures that have historically created and continue to perpetuate systemic marginalization of students based on ethnicity, racialized identity, and religious beliefs, among other social identities. Here, the autoethnography of an international Ph.D. student upon her arrival into the U.S. towards her graduation was collaboratively and critically examined and explored. Then, ways to deal with those issues at the college level were suggested.
“Outsiders” Hurting From Within
Authors: Krsmanovic Masha
Published: July 2022

This chapter discusses the contemporary empirical evidence on racialization, discrimination, and microaggression experiences of international students on U.S. campuses. Specifically, this chapter illustrates the most prominent challenges in international students' experiences with becoming a marginalized minority in their host setting, encountering racism and discrimination from the members of the host community, and being subject to a wide range of microaggressions. As demonstrated, international students are in many aspects marginalized in higher education due to their complex and intersected identities which often remain neglected, misunderstood, or even denied. Acknowledging and understanding these narratives carries important implications for higher education practice and recommendations for future scholarly contributions.
Becoming...
Authors: Graham Kara-Aretha , Hite Rebecca L. , Kim Jeong-Hee
Published: July 2022

Using Bildung, this chapter explores a recursive nature of mentoring through a continuum of three interconnected mentor-experiences, from a novice mentor (doctoral student now new faculty member), a competent mentor (untenured faculty member on the graduate student's dissertation committee), and an expert mentor (tenured faculty member and chair of the student's committee). It illuminates how the evolving relationship among these three women in academe situated to a traditional academic event of shepherding a student through a dissertation study, developed their respective knowledges and skills, as well as nurtured their scholarly potentials through mutual investment via three-layered mentorship. The chapter utilizes five poems that correspond with important stages of the doctoral student process, looking at each process through the novice mentor's perspective, reflecting on experiences and ways in which the mentor experience can be improved. The authors aim to challenge the 'standard' ways of mentoring in higher education, encouraging more innovative practices moving forward.
Delving Into Expectations, Experiences, Exploitations, and Erosion of Tenure-Track Faculty
Authors: Gallavan Nancy P.
Published: July 2022

Institutions of higher education seek to fill tenure-track positions with academic professionals who possess the appropriate education, experience, and expertise and who fit the institution's culture, climate, and community. Professional educators also seek fit that enables them to fulfill their expectations to feel safe, function securely, foster innovation, and flourish holistically. However, many tenure-track faculty frequently encounter exploitation of fairness (i.e., respect, acceptance, equity, inclusion, and belonging). Exploitations can be attributed to dysconsciousness determined by the exploiter's self-determined stance as the status quo that accelerates disenfranchisement. Examining relevant contexts, conditions, causes, and catalysts reveals explicit and implicit biases emphasizing the importance for professional discernment. This chapter offers eight commitments of critical consciousness to spark fairness and strengthen fit for all administrators and faculty.
A Review of Technologies Trending Towards 5G Networks for Smart Healthcare Using IoT
Authors: Kaushik Harsh , Sharma Neelam , Pathak Nitish
Published: July 2022

Healthcare is rapidly evolving from a standard hospital and specialist-centered strategy to a dispersed patient-centered one. Communication technology among other technologies have made it possible to provide tailored and distant healthcare services. Currently, the existent 4G network and other communications technologies are generally used in smart healthcare activities. Present communication technologies are inadequate to meet the increasing demands that smart healthcare applications impose on communication networks. The rising 5G is anticipated to bolster applications, which can fulfil most of the prerequisites such as high bandwidth, ultra-high reliability, high energy efficiency, and ultra-low latency. The futurity of the smart healthcare networks is anticipated to be a combination of 5G and IoT devices, which are anticipated to extend the cellular scope and handle security problems. This chapter provides an overview of taxonomy, research trends, difficulties, and future research themes.
A Novel SOM Ensemble Classification Technique for Limited Data
Authors: Hafiz Abdul Mueed
Published: July 2022

Small datasets are common in research areas where measurement of data is expensive or difficult (e.g., healthcare). For small datasets, training of a data model and classification using the same remains a challenge. To address the issue of limited data training and classification, the authors propose to use a novel ensemble of self-organizing maps (SOMs). SOMs are shallow neural networks, and as a result, the number of parameters is not very high. This avoids over-fitting and over-parameterization of the network. For the SOM ensemble, a novel early stopping training technique is proposed that requires a small number of samples for training. In the ensemble, one SOM is used for every class. For benchmarking the proposed technique, its performance is compared with that of other state-of-the-art techniques like deep learning, CATBOOST decision tree approach, etc. For reproducibility of results, three popular and extensively benchmarked digit image datasets have been used (i.e., MNIST, USPS+, and MADB). The proposed technique generally outperforms all other techniques with which it is compared.
An Android App Permission Analysis for User Privacy and Security
Authors: Tyagi Vaibhav , Singh Rupali , Tripathi Ashish , Agarwal Vasu , Pandey Shubhankar
Published: July 2022

Android applications require necessary permissions to perform the right function, but at the same time, there are other permissions that may affect the user privacy that need to be retrieved and revoked. Each step forward in digitization is also leading to an increase in the number of malware attacks by the malicious applications with the use of permissions. To solve the problem of APK app user data privacy and security, the authors created a system that searches for and downloads Android apps from the Android Market automatically. In addition, they produced a thorough mapping of Android application programming interface (API) calls to the needed permission(s) for each call, if any were required. Based on a static examination of each application's APK bytecode, they next ran an analysis of 141,372 Android applications to see if they had the right set of permissions. According to the research, most mobile app developers do not use the proper permission set and either over-specify or under-specify their security requirements.
Implications Between Environmental Management and Green Transformational Leadership in Greening Organizations
Authors: Vargas-Hernández José G.
Published: July 2022

This chapter analyzes the implications that the organizational environmental management and green transformational leadership have between them and with the green organizational innovation aimed to achieve sustainable development. It departs from the assumption that green organizations have implemented environmental management and green innovation enhanced by green transformational leadership to achieve organizational sustainable competitive advantage. The method employed is the analytic-reflective based on the review of the theoretical and empirical literature. It is concluded that the environmental management issues guided by a green transformational leadership are related to organizational sustainable development encouraging organizations to act in favor of greening organizations, green consumers, and achieving a sustainable competitive advantage with the Sustainable Development Goals (SDGs).
Development of a Sustainable and Inclusive Entrepreneurship Ecosystem Model in Occupied Palestinian Territories
Authors: Morrar Rabeh , Taweel Rand Jibril , Rayyan Fuad
Published: July 2022

This chapter identifies the gaps and weakness in the current Palestinian entrepreneurial ecosystem, impeding the development of economically and socially responsive, inclusive, and sustainable entrepreneurship. It seeks to determine what factors are necessary to develop an inclusive and sustainable model for these forms of entrepreneurship to thrive. This study draws on semi-structured interviews with various actors/players in the Palestinian entrepreneurial ecosystem. The chapter finds that all existing elements in the ecosystem are yet to be developed, resulting in a fragmented ecosystem. More importantly, it finds that the dependence on foreign donors and, consequently, donor agendas in terms of entrepreneurial development frameworks has generated entrepreneurship and an entrepreneurial ecosystem that is unresponsive, unsustainable, inaccessible, and far removed from the Palestinian market needs; hence, most efforts are yet to produce significant economic and social impacts.
Shifting the Ownership of Learning From Instructor to Students Through Student-Led Instructor-Facilitated Guided-Inquiry Learning
Authors: Gupta Tanya , Burke K. A. , Greenbowe Thomas J.
Published: July 2022

This chapter presents an overview of the development and implementation of a student-centered teaching approach, namely the Student-Led Instructor Facilitated Guided-Inquiry Learning (SLIFGIL), in an undergraduate chemistry laboratory course. SLIFGIL is a hybrid approach to teaching and is based on the science writing heuristic (SWH) approach used in the laboratory settings. The SWH approach has been used for two decades in school and college science classrooms. Prior studies have reported the effectiveness of the SWH approach in improving student academic performance and conceptual understanding. Though the SWH approach has its strengths, student participation in collaborative group work and continued reliance on the instructor to step in to guide the flow of laboratory activities and facilitate student learning was observed to be a challenge by the first author. To address these challenges, SLIFGIL approach was developed to shift the ownership of learning to the students. In this chapter, an overview of the SLIFGIL approach and results on its effectiveness are presented.
“We Are All in This Together”
Authors: Tecce DeCarlo Mary Jean , Adams Jennifer , Kemery Dana , Provinzano Kathleen , May Toni
Published: July 2022

This study uses a sequential explanatory mixed method case study approach to explore feelings of self-efficacy about learning and teaching during the shift to emergency remote instruction among faculty and students at Chestnut University (pseudonym), a large, private, comprehensive research university in the Mid-Atlantic region of the United States during Spring 2020. New modalities for teaching and learning resulting from the shift to emergency remote instruction rendered many classroom-based experts online novices. This study found that, in general, most faculty and students at Chestnut University reported high levels of self-efficacy teaching and learning online. Factors such as age, gender, previous experience teaching and learning in virtual spaces, and having a dedicated workspace for online teaching and learning influenced feelings of self-efficacy.
Reflecting on the Hive
Authors: DeHart Jason D.
Published: July 2022

In this chapter, the author collected the words of online poetry writers and curators through Google form interviews to examine the inspiration and experience of sharing poetic work online, particularly in the absence of outward material gains. The activity of these online creators inspired connections to digital literacy instruction and acknowledgement of ongoing trends in the context of the COVID-19 pandemic. The results of the study included four themes that followed the analysis phase, including themes that spoke to the purposes of this work and the ways in which curators/poets viewed the functions of their sites. The study holds implications for examining modes of creation and features of accessing a wide audience through the internet. The study also began prior to the pandemic but was able to be completed due to the digital nature of the work.
Perception of Virtual Learning
Authors: Gupta Sandhya , Prajapati Renu
Published: July 2022

In the midst of the COVID-19 period, pupils' perceptions of their online/virtual lessons can be characterised in light of teacher-student engagement/interaction. The degree upon which communicative actions increase proximity and decrease bodily and/or mental interspace amidst instructors-pupils is referred to as teacher immediacy. This study investigated the teacher immediacy as a potent predictor of curiosity and study approaches. Standardized tools were used to measure constructs under study. An online survey was conducted on college students studying in non-residential private universities of Rajasthan. Findings revealed that teacher immediacy (relational, personal, and instructional) emerged as a significant predictor of curiosity, critical thinking, mental health, and study approaches.
An Exploration Into Post-Primary School Teachers' Perceptions About the Use of Google Classroom
Authors: Scanlon Joseph , Li Xiuping
Published: July 2022

This chapter aims to present a study that has explored the perceptions of post-primary school teachers, based at St Brigid's College in Derry, Northern Ireland, using Google Classroom (GC) to support pupils in remote and blended learning during the COVID-19 pandemic. The aims and objectives of the study are addressed through a mixed method approach. Data instrumentation consisted of teacher questionnaires, focus groups held with teachers, and semi-structured interviews with members of the senior leadership team (SLT). Quantitative data was analysed through Microsoft Forms, and qualitative data collected from the focus groups and semi-structured interviews was thematically analysed using NVivo. The findings of this study provide insightful suggestions as to the outlook for schools which integrate remote and blended learning systems post-COVID-19. Holistically, parents, guardians, pupils, and staff must be involved to sustain progress made by schools to support and enrich the educational experiences of all shareholders.
Sustainable Accommodation in Low Density Areas
Authors: Bouzis Stylianos A. , Filiopoulos Alexandros
Published: July 2022

The main criterion for writing this research is the spatial dimension that tourism takes in some cases. In particular, tourism activity in areas exposed to the Northern Lights, which already exists and tends to develop further through sustainable glamping accommodations in low-density areas, passes into the sphere of interest for this chapter. The aim is to document and make known these attractive sustainable businesses, as well as the common characteristics they share on the supply axis. The geographic restriction concerns six countries in the Arctic Circle that exhibit these characteristics. In a second year, conclusions are drawn from the comparative case study; the research questions designed are answered, and future perspectives are presented that are fully in line with the new external changes that have formed in recent years.
Enthusiastic Cyber Surveillance for Intimidation Comprehension on the Dark Web and the Deep Web
Authors: Mahor Vinod , Bijrothiya Sadhna , Bhujade Rakesh Kumar , Mandloi Jasvant , Mandloi Harshita , Asthana Stuti
Published: July 2022

The authors offer an operational method for obtaining cyber intimidation intelligence from diverse social platforms on the internet, notably dark-web and deep-web sites with Tor, in this study. They concentrate their efforts on gathering information from hacker forums and marketplaces that sell harmful hacking-related items and services. They've established an operational mechanism for gathering information from these sites. This system now collects 400 high-quality cyber-intimidation notifications every week on average. These danger alerts provide details on newly generated malware and exploits that have yet to be used in a cyber-attack. This is a valuable service for cyber-surveillance. Various machine learning approaches are used to dramatically improve the system. They can recall 93% of items in marketplaces and 85% of comments on forums about harmful hacking with great precision using machine learning models. They do preliminary analysis on the data gathered, illustrating how it might be used to assist a security professional in improved intimidation analysis.
Chinese Foreign Direct Investment in the Belt and Road Initiative
Authors: Yu Poshan , Meng Zhu , Hanes Emanuela , Misuko Nyaribo Wycliffe
Published: July 2022

Motivated by the Chinese government's foreign direct investment (FDI) promotion policies, this paper is attempting to examine the implications of these policies to the Belt and Road (B&R) regions under the unique institutional settings. By applying the software tool CiteSpace, which is developed for visual analyze of science mapping (Chen, 2017), this paper aims to investigate the dynamics of Chinese cross-border investment activities in B&R countries, taking the China-Pakistan Economic Corridor as an example, and discuss the question whether & how these policies and activities could drive more Chinese multinational enterprises (MNEs) to exploit these emerging business opportunities in B&R regions, as well as investigate what is the trend of Chinese FDI in B&R.
The Impact of Investment on the Economic Activity of the Balkan Silk Road Countries
Authors: Bodroža Duško , Kolavčić Miloš
Published: July 2022

The aim of this chapter is to examine the impact of investment in research and development on economic growth, as well as the nature of the impact of trade openness and foreign direct investment on extended Balkan Silk Road economies. The authors used the general econometric specification of the regression panel model and for the period from 2002 to 2018. The results showed that expenditures on research and development and trade openness have a significant positive effect on the gross domestic product of the countries with lower GDP per capita, while foreign direct investment in these countries has a neutral and nonsignificant impact on gross domestic product. For the countries with higher GDP per capita, expenditures on research and development have a marginally negative effect on the gross domestic product. Trade openness is significantly positive, while foreign direct investments have a significant but neutral effect on the gross domestic product. The main limitations of the research are the use of data on total R&D investment and foreign trade relations instead of sectoral.
“Belt and Road” Initiative as a Development Chance for the Western Balkan Countries
Authors: Marjanović Darko , Beraha Isidora , Domazet Ivana
Published: July 2022

Foreign direct investment (FDI) is a very important element of economic integration because it creates an opportunity for accelerated development, technological innovation, and corporate restructuring. Western Balkan countries mainly focused their activities on attracting investments from EU countries. However, as investments from these countries have been reduced recently, the countries of the Western Balkans have opened their markets to incoming Chinese investments. Serbia is currently the first country in the Western Balkans. Based on the inflow of Chinese investments, and in the coming period, we can expect a trend of intensive growth of Chinese investments related to the “Belt and Road” Initiative, which will lead to additional development of the Serbian economy. The main subject of this research focuses on the distribution of Chinese investments on a global scale, as well as the importance of the “Belt and Road” Initiative for both multinational companies and recipient countries of Western Balkans, with special reference to Serbia.
The Role and Significance of Chinese Investments in the Modernization of Railway Infrastructure in Serbia
Authors: Stojanović Danijela , Jovičić Elena , Stanisavljević Nenad
Published: July 2022

The subject of the research is Chinese investments in the modernization and reconstruction of railway infrastructure in Serbia, with a focus on the construction of the Belgrade-Budapest high-speed rail line up to 200 km/h, on the sections Belgrade-Stara Pazova and Novi Sad-Subotica-Kelebija. The research aims to analyze the impact of Chinese investment projects on the railway infrastructure in Serbia and examine the effects of projects' implementation at different levels, including the challenges they face. The analysis covers the traffic, technical-technological and financial aspects of the project. The importance of building a high-speed railway through Serbia, but also of the shortest railway connection from Western and Central Europe in the countries of Southern Europe and the Middle and the Far East, is considered, especially in the context of the cooperation within the BRI. The research results are the presentation of the effects railway infrastructure projects have on the development of Serbian economy, as well as the challenges that arise during the implementation process.
China's Trade and Investment in the Western Balkans Under the Belt and Road Initiative
Authors: Stancheva Gigov Iskra , Poposka Klimentina
Published: July 2022

The China Belt and Road Initiative (BRI) and the 17+1 cooperation platform, as an integral part of it, is the key framework for China's foreign policy towards most parts of the world, including the Western Balkans (WB). Through its global initiative and cooperation platform, China creates a range of opportunities for facilitating trade and increasing export, financial integration and greater Chinese investment, major infrastructure projects, as well as their funding. This chapter analyzes the real situation regarding these aspects in the WB countries, especially focused on North Macedonia. The analysis indicates that there has been some progress in co-operation, but the WB countries (excluding Serbia) have failed to maximize their interests either in bilateral co-operation or in the framework of the BRI initiative and the 17+1 platform. Conclusively, despite all the great expectations, the trade exchange, Chinese investments, and the realized infrastructure projects do not reach a significant level.
Does Social Media Usage Influence Selective Attention
Authors: Shukla Abhishek
Published: July 2022

Previous few studies reported about the social media effect on mental health. However, the influence of social media usage on selective attention is still missing. The current study intends to understand the influence of social media usage on selective attention in an experimental setup. 221 participants performed a computer-based flanker task, in which they responded to the flankers (centrally positioned letter) that appeared in between five-letter strings. Participant's responses in the flanker task were recorded as the response time of compatible and incompatible conditions. Results revealed that the social media platforms, time spend on social media and gender were strongly influenced the selective attention. It was also found that female's flanker effect was larger as compared to males. Additionally, the log flanker effect (response time) revealed the same results. Based on the current study, gender differences can be explained as differences in their core cognitive abilities and from the study, it is recommended to limit the longer usage of social media.
Factors affecting the Use of Information by Visually Impaired Students: With Special reference to the Library, University of Colombo
Authors: Lankathilake M. A. , Ramanan T.
Published: July 2022

Visually-impaired (VI) students still face unusual difficulties in accessing library resources although there are several assistive technologies and devices being available to help them to get access to information resources. Equality in services mandates libraries to strive for their best to assist these special-need users by examining and mitigating the challenges faced by them. In this regard, a case study was carried out at the Main Library of the University of Colombo, where 42 visually-impaired students were interviewed using a set of semi-structured interview questions. The study population constituted totally blind and partially impaired students. Issues facing by the respondents were identified over institutional, personal and technological factors. Out of different challenges they mentioned, lack of appropriate resources was drawing primary concern. Problems relevant to use of the Internet were identified based on 5 aspects: social, institutional, financial, personal, and technical issues. Those challenges significantly affected VI users having access to their learning resources. It was found that VI users were largely left out in the mainstream student community since they make up a very miniscule faction of the entire student population. Hence, it is recommended to establish a special assistance mechanism for VI users of the library, meanwhile training both VI students and library staff on finding information resources specifically intended for VI users, and using the assistive technologies and equipment.
Out of Intensive Care and Operating Theatre Intubations: Prospective Observational Study
Authors: Priyankara W. D. D. , Manoj E. M. , Samaranayake Waruni , Ranaweera Amanda
Published: July 2022

Tracheal intubations are not infrequent out of ICUs and operating theatres and carry a substantial risk of adverse events. Our objective was to study the current practices of tracheal intubations in medical wards of the national hospital of Sri Lanka (NHSL). A prospective observational study was performed among all adult patients who had an endotracheal intubation in a medical ward of NHSL over a 6-month period. There were 47 intubations. Majority, 29 (61.7%) of intubations occurred during out of hours (after 4pm) and 23 (48.9%) of them were emergency intubations. Most common reason for intubation was respiratory distress 26 (55.3%). Other indications were cardiac arrest 11 (23.4%), Low GCS 7 (14.9%) and shock 2 (4.3%). Capnography and 2 laryngoscopes were not available during any of the intubations. Bougie was available only in 23 (48.9%) cases and alternative airway equipment were available only in 9 (19.1) cases. Midazolam was the most common induction agent 34 (72.3%). Majority 27 (57.4%) of the intubators had less than 6 months of experience in anaesthesia. Most of the intubations 32 (68.1%) were done by a registrar and 6 (12.8%) were done by an intern medical officer. There were 39 adverse events during all intubations and hypotension 14 (29.8%) was the most frequent adverse event. Therefore, we conclude that intubations in medical wards are done by less experienced doctors with lack of facilities and has high incidence of adverse events.
Bevel Position and Its Effect on Success of Intubation Through Intubating Laryngeal Mask Airway
Authors: Mustahsin Mohd , Podder Subrata , Yaddanapudi L. N. , Bala Indu
Published: July 2022

Background: The bevel position of tracheal tube (TT) affects the success rate while using intubating laryngeal mask airway (ILMA). The present study compared the success of intubation on the basis of anterior and posterior position of the bevel of conventional polyvinylchloride (PVC) tracheal tube through an ILMA.
Methods: Two hundred adult ASA I or II patients, having Mallampati class 1 or 2 airway, and undergoing elective surgery under general anesthesia were included in the study. Patients were randomized in two groups based on anterior or posterior bevel position while intubating. If proper tracheal position was established within 3 insertion attempts tracheal intubation was considered successful.
Results: Successful tracheal intubation was achieved in 191/200 patients (95.5%). There was higher first attempt success rate in bevel anterior group (88.6% vs 65.5%, relative risk ratio 1.418, 95% C.I. 1.18-16.8; p= 0.00006). There was similar overall success rate between the bevel anterior and posterior groups (97.0% vs 94.0%, relative risk ratio 1.03, 95% C.I. 0.97-1.10; p=0.5).
Conclusion: Tracheal intubation was successful in 95.5% of patients through an ILMA using PVC tracheal tube. Success rate of intubation was similar in both the groups. Bevel anterior group had higher success on first attempt intubation.
Role of Point-of-Care ultrasound as a Bridge Investigation for Management of Upper Oesophageal Coins in Children.
Authors: Nazir Ovais , Yatoo Hamid , Singh Shiv kumar , Kumar Amit
Published: July 2022

Coins are commonly ingested foreign body (FB) in children, particularly the area just below the cricopharyngeus muscle, being the most common site of lodgement. The aim of the present study was to evaluate the effectiveness of point-of-care ultrasound (POCUS) of the upper airway as an investigation arm to guide and assist the clinical management of foreign body coin in children with expectant management for spontaneous passage. A total of 50 children with coin in upper oesophagus were chosen and POCUS was done in the preoperative area. Those in whom coin was visualised on POCUS were taken for retrieval under general anaesthesia and in whom coin was not visualised were taken for 2nd X-ray to confirm passage. In 50 children with a coin in upper oesophagus, point-of-care ultrasound (POCUS) showed the presence of coin in 44 children (confirmed on esophagoscopy) and spontaneous passage in 6 children (confirmed on 2nd X-ray), thus resulting in the reduction of approximately 88% of 2nd check X-ray to demonstrate the position of coin.
Improved Durability to SARS-CoV-2 Vaccine Immunity following Coimmunization with Molecular Adjuvant Adenosine Deaminase-1
Authors: Cusimano Gina M , Gary Ebony N , Bell Matthew R , Warner Bryce M , Connors Jennifer , Tursi Nicholas J , Ali Ali R , Zhang Shiyu , Canziani Gabriela , Taramangalam Bhavani , Gordon Emma A , Chaiken Irwin M , Wootton Sarah K , Smith Trevor , Ramos Stephanie , Kobasa Darwyn , Weiner David B , Kutzler Michele A , Haddad Elias K
Published: July 2022

Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines have demonstrated strong immunogenicity and protection against severe disease, concerns about the duration and breadth of these responses remain. In this study, we show that codelivery of plasmid-encoded adenosine deaminase-1 (pADA) with SARS-CoV-2 spike glycoprotein DNA enhances immune memory and durability in vivo. Coimmunized mice displayed increased spike-specific IgG of higher affinity and neutralizing capacity as compared with plasmid-encoded spike-only–immunized animals. Importantly, pADA significantly improved the longevity of these enhanced responses in vivo. This coincided with durable increases in frequencies of plasmablasts, receptor-binding domain–specific memory B cells, and SARS-CoV-2–specific T follicular helper cells. Increased spike-specific T cell polyfunctionality was also observed. Notably, animals coimmunized with pADA had significantly reduced viral loads compared with their nonadjuvanted counterparts in a SARS-CoV-2 infection model. These data suggest that pADA enhances immune memory and durability and supports further translational studies.
Atypical Manifestations of Dengue
Authors: Kamath Vasantha , Radhakrishnan Buvana , Markanday Kushal
Published: July 2022

Dengue is a major concern in India. It has a diverse spectrum of atypical manifestations across the various systems of the human body with significant mortality and morbidity rates. The following review emphasizes on the various systemic manifestations, including the need for their early recognition and treatment.
Changing Trends of Adenocarcinoma Among other nOnperipheral Lung Tumors in Smokers and Nonsmokers
Authors: Harsha Ajit , Katare Srikanth , Kumar Adimalla Raja , Bhat Shuaeb , Dhulipala Suhas
Published: July 2022

Background:

Globally, modern lifestyles and the increasing incidence of lung cancer have changed the histopathological presentation of lung cancer to the point that it has reached epidemic proportions. It is well known that tobacco smokers are more prone to lung cancer. Nonsmokers are no exception. We conducted this study to determine if primary lung cancer is increasing in nonsmokers and examine the differences in clinicopathological patterns and disease staging between smokers and nonsmokers.

Objective:

(1) Comparing the occurrence of nonperipheral lung tumors in smokers and nonsmokers, (2) to determine whether bronchogenic carcinoma in smokers and nonsmokers exhibited the same histopathological shift, (3) a comparison of lung cancer in smokers and nonsmokers based on clinical and radiological findings.

Materials and Methods:

A prospective study in Pulmonary Medicine was conducted over 7 years from August 2012 to January 2020. All adult patients were screened with a detailed history and risk factors. Histopathological analysis was performed on patients with X-ray findings that appeared to be a mass or collapse caused by endobronchial growth, as well as on patients who were clinically, radiologically, and bronchoscopically suspicious for malignancy.

Results:

The study reports that out of the 386 cases of bronchogenic carcinoma, 295 (76.4%) were between 46 and 70 years of age, 282 (73.05%) were male, 250 (85%) smokers, and 104 (27%) females, 44 (14.9%) smokers. Smokers outnumbered nonsmokers by a ratio of 3.1:1. In 257 patients, fever was the most common symptom, followed by hemoptysis in 245 patients. Mass lesion was the most common radiological finding in 245 (63.4%) patients. Squamous cell carcinoma 123 patients (43.6%), Adenocarcinoma 107 patients (37.9%) and small cell carcinoma 35 patients (12.4%) were more common in males, while adenocarcinoma patients 48 (46.1%), squamous cell carcinoma 36 patients (34.6%) and small cell carcinoma 12 patients (11.5%) were more common in females.

Conclusion:

Majority of elderly patients have an increased risk of developing malignancy, as shown by this study. Smokers are still more likely to develop primary lung cancer than nonsmokers. Squamous cell carcinomas constituted a greater proportion of all histopathological types than adenocarcinomas. Adenocarcinomas are more likely to develop centrally during their later stages. The majority of adenocarcinoma patients presented at the terminal stage and were not smokers.
Autopsy versus Clinical Decisions Regarding Causes of Maternal Death in Iraq
Authors: Ghalib Yassin Batool Ali , Hassan AL-Safi Aliaa Makki , AL-Saneed Enaam Hasson
Published: July 2022

Background:

Complications during pregnancy and childbirth are a leading cause of death and disability among women in developing countries. The target for mortality reduction is important, yet accurate data of maternal mortality remains challenging as reporting errors including misclassification of cause of death continue to pose a major challenge.

Objectives:

This study aimed to identify if there is any discrepancy between clinical and autopsy causes of maternal death.

Methods:

A review of all maternal deaths records that had two sources for registered cause of death; one made by the obstetrician depending on clinical setting and the other by forensic medicine after autopsy and search for any discrepancies between the two sources.

Results:

A total of 468 maternal death reports were reviewed; the discrepancies were more with the second commonest cause of maternal death in Iraq which is pulmonary embolism. The review revealed that 10.1% of those clinically died because of pulmonary embolism turned to be dead from other causes; 8.7% of them from postpartum hemorrhage, and the rest from sepsis and other indirect causes.

Conclusion:

There is a substantial discrepancy between clinical and autopsy causes of maternal death which necessitates asking for autopsy in cases of maternal mortality of uncertain cause. The use of maternal death review within 3–6 weeks of death as a tool to identify causes of maternal deaths is recommended.
Prevalence and Predictors of Risk Factors for Noncommunicable Diseases among women in an Urbanized Village of India
Authors: Behera Shyambhavee , Chhabra Pragti , Rajoura O. P.
Published: July 2022

Background:

The burden of noncommunicable diseases (NCDs) and their risk factors among the underprivileged women of the urban areas are expected to increase. The objective of the study was to estimate the prevalence and sociodemographic predictors of these risk factors.

Materials and Methods:

A cross-sectional study was conducted among 370 women between 25 and 64 years in an urbanized village of India. Risk factors for NCDs were assessed using the WHO STEPS instrument. To determine the sociodemographic predictors of these risk factors binary logistic regression was used.

Results:

The prevalence of tobacco consumption, physical inactivity, and insufficient fruit and vegetable intake, overweight, and obesity was found to be 18.3%, 61.6%, 96.5%, 27.6%, and 5.9%, respectively. Raised blood pressure, blood glucose, and cholesterol were found to be present in 23%, 22%, and 42%, respectively. Older age was found to be a significant predictor of tobacco consumption, physical inactivity, raised blood pressure, and raised blood glucose.

Conclusion:

The current study reported a high prevalence of physical inactivity and insufficient fruit and vegetable intake, with age being a significant predictor of the majority of risk factors. Thus, arises the need for programs and policies tailored toward addressing the local needs, targeted toward older women.
COVID-19 Vaccines Portray the Bright Side of Human Creativity, But It Means Nothing until They Prove Their Worth
Authors: Varghese Sangeetha Merrin , Sachu Arun , Jacob Linda , George Geomcy , Chandy George Mateethra , Samuel Johnson Abel K , John Grace Mary
Published: July 2022

Background:

COVID-19 vaccines, we believe, have come to rescue us from the clutches of the dreaded severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). With rapid ongoing mutations, it is difficult to predict the effectiveness of seroconversion following vaccination. This study aims to find out the proportion of people with seroconversion following first dose of Covishield vaccine.

Methods:

Randomly selected health-care workers were followed up for SARS-CoV-2 immunoglobulin G (IgG) antibodies between 28 and 42 days after receiving their first vaccine dose. The VITROS SARS-CoV-2 IgG test (Ortho-Clinical Diagnostics, USA) with 100% specificity and > 90% sensitivity was used to assess seroconversion.

Results:

The first dose of vaccine induced seroconversion in 91.7% of beneficiaries. Nearly one-third (30.2%) of them had high antibody titers, and it showed a significant association with female gender (9.6 ± 5.5 vs. 7.6 ± 5.6) and younger age (P = 0.008). In addition, those with previous COVID infection showed a more robust immune response when compared to others (P = 0.001).

Conclusion:

Seroconversion rate of more than 90% offers a promising hope toward successful pandemic control. In the current scenario, the inability to attain the targeted coverage due to an upsurge in vaccine hesitancy, compounded with only lower proportion of seroconversion in elderly, faster rollout of the vaccines without any age limit, will help achieve the herd threshold more rapidly.
Assessment of Characteristics and Exposure to Vulnerable Factors for Drug use among Male Illicit Drug Users in Sri Lanka
Authors: Darshana Nuwan , Wijesinghe Champa Jayalakshmie , De Silva P Vijitha
Published: July 2022

Background:

Illicit drug use has become a significant public health problem in Sri Lanka. This study was conducted to assess characteristics and exposure to vulnerable factors for drug use among institutionalized male drug users.

Methodology:

A cross-sectional study was conducted among 431 institutionalized male drug users from five selected rehabilitation centers in Sri Lanka. An interviewer-administered questionnaire was used for data collection. The history of exposure to vulnerable factors was assessed using a series of questions based on existing evidence. Chi-square test was used to identify factors associated with exposure to vulnerable factors for drug use at 0.05 significance level.

Results:

Experimental usage, peer pressure, being unaware about harmful outcomes of drug use, ability to conceal drug use behavior from family, easy accessibility, previous use of alcohol and tobacco, history of exposure to psychoactive substance use within the usual living set up, being in a family with inadequate protection and an unsatisfactory parenting status were identified as common characteristics of people with illicit drug use disorders and drug use behavior. The age of the first drug use was positively correlated with the age of the first alcohol use (r = 0.687; P < 0.01) and first smoking (r = 0.732; P < 0.01). Ethnicity, area of residence, severity of drug use, and age of initiation of drug use had statistically significant association with exposure to vulnerable factors for drug use (P < 0.05 for all).

Conclusion:

Characteristics of people with illicit drug use disorders and drug use behavior were varied while the history of exposure to vulnerable factors for drug use was not uncommon in the sample. The study recommends considering these study findings during designing appropriate preventive and harm reduction strategies for illicit drug use.
Prevalence of Oral Lesions and Its Associated Risk Factors Among PLHIV Availing Anti-Retroviral Therapy from a Selected Tertiary Care Hospital, Puducherry - A Cross Sectional Analytical Study
Authors: Jana Pradip Kumar , Sahu Swaroop Kumar , Sivaranjini K. , Hamide Abdoul , Roy Gautam
Published: July 2022

Background and Objectives:

Oral lesions are among the earliest and most important indicators of infection with human immunodeficiency virus (HIV). The presence of oral lesions has a significant impact on the physical and mental health of the PLHIV. Hence, a novel attempt is made to assess the prevalence of various types of oral lesions among the adult people living with human immunodeficiency virus (PLHIV) undergoing antiretroviral therapy.

Methodology:

In this facility-based cross-sectional study, a total of 239 out of 300 eligible PLHIV were assessed between September and October 2018. All consecutive eligible patients encountered during the data collection period were included. Oral examination was carried out using disposable mouth mirrors, sterile piece of cotton, and bright illuminated torch.

Results:

The prevalence of oral mucosal abnormalities was found to be 25% (95% confidence interval: 20.03–30.97). The most prevalent oral lesions were acute necrotizing ulcerative gingivitis, acute necrotizing ulcerative periodontitis, and candidiasis. CD4 count <200 cells/mm3, current tobacco use, and alcohol usage were significantly associated with the prevalence of oral lesions.

Conclusion and Recommendations:

The study revealed that one-fourth of the study participants had oral lesions. Strategies for early detection and prompt treatment of oral lesions need to be planned and incorporated in the program to reduce the morbidity due to oral lesions.
Factors Associated with Health Facility Delivery in the 12th District of Kandahar City, Kandahar, Afghanistan
Authors: Khan Ahmad , Stanikzai Muhammad Haroon , Wyar Wali Mohammad , Wasiq Abdul Wahed , Sayam Hadia
Published: July 2022

Background:

Maternal mortality and morbidity are increasing public health concerns in Afghanistan. Even more worrying is maternal death due to causes that can be prevented through maternal healthcare services utilization during pregnancy and delivery.

Objectives:

We sought to investigate the magnitude of women giving birth in a health facility and its associated factors in the 12th district of Kandahar city, Kandahar province, Afghanistan.

Materials and Methods:

A community-based cross-sectional study of women who gave birth in the last 2 years in the 12th district of Kandahar city was conducted in early 2021. We used a systematic random sampling method to enroll 850 women. We collected data on sociodemographics, reproductive characteristics, and delivery practices of respondents. Factors associated with health facility delivery were identified using a multivariable logistic regression model.

Results:

The proportion of women who gave birth at health facilities was 71.8% (confidence interval [CI]; 68.61%–74.77%). In this study, health facility delivery was associated with husbands’ education (adjusted odds ratio [AOR] = 3.07, 95% CI: 1.50–6.31), antenatal care (ANC) services utilization (AOR = 17.84, 95% CI: 11.86–26.8), and history of complications in previous births (AOR = 3.65, 95% CI: 2.32–5.74).

Conclusion:

In this study, the utilization of a health facility for delivery was slightly lower than reported on the national level. Our study found potential factors such as ANC visits, husbands’ education, and history of complications in previous births, for which interventions aimed at enhancing the proportion of health facility deliveries.
Evaluation of clinical profile and screening guidelines of retinopathy of prematurity in an urban level III neonatal intensive care unit
Authors: Sanghi Gaurav , Sawhney Jaskaran S , Kaur Saranjit , Kumar Neeraj
Published: July 2022

Purpose:

To evaluate the clinical profile and screening guidelines of retinopathy of prematurity (ROP) in an urban level III neonatal intensive care unit (NICU).

Methods:

Infants with ≤2000-gm birth weight or <34 weeks gestational age were prospectively screened for ROP in an urban level III NICU between January 2018 and December 2020, based on national screening guidelines. Standard guidelines were used for ROP classification and treatment.

Results:

In total, 211 infants completed screening; 46 (21.8%) infants developed ROP and 13 (6.2%) had type 1 (laser treatable) ROP. Of the 46 infants with ROP, 44 (95.65%) had zone 2 and two (4.34%) had zone 1 disease. In the 102 infants with ≤1500-gm birth weight, the incidence of ROP and type 1 ROP were 41.18% and 11.76%, respectively. Out of the 109 infants with >1500-gm birth weight, four (3.67%) developed ROP and one (0.91%) infant (an outborn) required treatment.

Conclusion:

The majority of infants developing ROP in a level III urban NICU had ≤1500-gm birth weight. Zone 1 ROP was uncommon. Incidence of ROP in heavier infants (>1500-gm birth weight) was low, and treatment was required in a rare instance. In an urban NICU, the burden of ROP screening and treatments shifts to small and low-birth-weight infants.