bluuebunny/crossref_metadata_2025 huggingface dataset:
A review of Eupholidoptera (Orthoptera, Tettigoniidae) from Crete, Gavdos, Gavdopoula, and Andikithira
Authors: Willemse Luc , Tilmans Jos , Kotitsa Nefeli , Trichas Apostolos , Heller Klaus-Gerhard , Chobanov Dragan , Odé Baudewijn
Published: March 2023

Being nocturnal, hiding in prickly bushes and shrubs during the day, Eupholidoptera species in Crete and its neighbouring islands are easily overlooked, and until now our knowledge about their distribution was based on some thirty sightings across 11 species. In this paper results are presented of a study of Eupholidoptera specimens collected between 1987 and 2020 by hand-catches and pitfall and fermenting traps on the Greek islands of Crete, Gavdos, Gavdopoula, and Andikithira. Diagnostic features of all known species are presented and illustrated with stacked images. An updated key to all species is provided. Eupholidoptera francisae Tilmans & Odé, sp. nov. from Andikithira and southwestern Crete and Eupholidoptera marietheresae Willemse & Kotitsa, sp. nov. from Mt. Dikti are described. Female E. cretica, E. gemellata, and E. mariannae are described, and the female of E. astyla is redescribed. Bioacoustics for E. francisae Tilmans & Odé, sp. nov., E. giuliae, and E. jacquelinae are presented for the first time. Eupholidoptera smyrnensis is reported for the first time from Crete. A substantial amount of new distribution data for Eupholidoptera species on Crete is presented. The current distribution pattern and first analyses of phylogeny based on molecular data of Eupholidoptera species on Crete are discussed in relation to paleogeographical events.
Relire la parabole du Bon Samaritain en situations extrêmes
Authors: Zielinski Agata
Published: March 2023

Comment reconnaître et tenir en « celui qui n’a plus figure humaine » une commune humanité ? Dans la suite d’un précédent article (Études, n° 4299, décembre 2022), nous interrogeons les situations extrêmes, celles où l’appartenance à l’humanité ne va pas de soi, lorsque la communication et la conscience semblent avoir disparu. Relire la parabole du Bon Samaritain en de telles situations ouvre à la possibilité de maintenir une appartenance à un monde commun, en refusant qu’un seul en soit exclu.
Impact of Lactobacillus crispatus-containing oral and vaginal probiotics on vaginal health: a randomised double-blind placebo controlled clinical trial
Authors: Mändar R. , Sõerunurk G. , Štšepetova J. , Smidt I. , Rööp T. , Kõljalg S. , Saare M. , Ausmees K. , Le D.D. , Jaagura M. , Piiskop S. , Tamm H. , Salumets A.
Published: March 2023

Health of reproductive tract is tightly associated with balance of microbial communities in this area. Bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) represent common disturbances of vaginal communities. Vaginal discharge due to BV or VVC is a very frequent reason for visiting gynaecologist. We aimed to evaluate the impact of the novel evidence-based probiotics on BV and VVC patients. The study group included 89 BV and 93 VVC patients (aged 18-50 years) who were recruited into randomised double-blind placebo-controlled two-arm parallel trial. The patients of each diagnosis group received oral or vaginal probiotic capsules, or placebo capsules during 3 months. A probiotic capsule contained two (DSM32717 and DSM32720, in case of BV) or three (DSM32720, DSM32718 and DSM32716, in case of VVC) Lactobacillus crispatus strains. Vaginal, intestinal and general health was monitored weekly by questionnaire. Blood analyses were done in the beginning and at the end of trial. Vaginal samples were collected monthly, microscopic and molecular analyses were performed. The study revealed that both oral and vaginal capsules reduced the signs and symptoms in BV patients. Remarkable improvement was noted in Nugent score, amount and smell of discharge, but also in itching/irritation. Consumption of vaginal probiotics significantly increased the lactobacilli counts in their vagina while mean proportion of some BV-related bacteria decreased. In VVC patients, both oral and vaginal capsules lowered the combined score of two most important symptoms, amount of discharge and itching/irritation. In conclusion, the novel formulations of evidence-based well-focused probiotic L. crispatus strains are effective against BV and VVC being suitable for both vaginal and oral administration.

Clinical trial registration: ISRCTN34840624, BioMed Central
Some new results in $ \mathcal{F} $-metric spaces with applications
Authors: Albargi Amer Hassan
Published: March 2023

In this research article, we give the notion of graphic $ F $-contraction in the setting of $ \mathcal{F} $-metric space and establish some fixed point results. We also supply some examples to demonstrate the brilliance of the established results. We also establish some fixed point results for orbitally continuous and orbitally $ G $ -continuous graphic $ F $-contractions as applications of our main results. Also, we discuss the existence and the uniqueness of solutions of functional equations involving in dynamic programming.
Accreditation standards items of post-2nd cycle related to the decision of accreditation of medical schools by the Korean Institute of Medical Education and Evaluation
Authors: Park Kwi Hwa , Lee Geon Ho , Chae Su Jin , Kim Seong Yong
Published: March 2023

Purpose: The purpose of this study is to analyze the accreditation standards items related to the decision of accreditation of medical schools by the Korea Institute of Medical Education and Evaluation (KIMEE).Methods: The subjects are medical schools in Korea that have received post-2nd cycle accreditation from the KIMEE between 2012 and 2016. Analyses were conducted for differences in accreditation decisions according to the characteristics of medical schools, sufficient ratios of basic standards items, and correlation between standards items related to accreditation decisions.Results: After examining differences in accreditation decisions by the medical school’s characteristics, there were no significant correlations between accreditation standard items and accreditation decisions. Second, according to the number of schools that sufficiently or insufficiently met each standard item, from the total of 97 standard items, 20 (20.6%) were sufficiently fulfilled by all medical schools. Standard item 2-5-2 demonstrated the highest insufficiency ratio. Third, with respect to the standard item that had an effect on accreditation decisions, standard item 1-5-1 showed the highest correlation with the sufficiency rate.Conclusion: The validity of accreditation standards items was assured as this study evaluated the post-2nd cycle accreditation standards items regardless of each medical school’s characteristics. The accreditation standards items were found to have a meaningful impact on the development of medical schools and qualitative improvement in medical education. The findings are expected to contribute to guaranteeing the validity and reliability of accreditation decisions and raising the quality of accreditation.
Differences in perception of online anesthesiology between Thai medical students and teachers during the COVID-19 pandemic
Authors: Sripadungkul Darunee , Sripadungkul Suwitcha , Boonmak Suhattaya , Boonmak Polpun
Published: March 2023

Purpose: Traditional anesthesiology learning was disrupted by the coronavirus disease 2019 pandemic and replaced by online learning. Students and teachers did not prepare well for this change. Determining the differences in perceptions can close the gap and develop more effective curricula. Our study aims to compare students’ and teachers’ perceptions of online anesthesiology learning.Methods: We conducted a prospective descriptive study, a cross-sectional survey between July 2020 and January 2021 in the Anesthesiology Department, Faculty of Medicine, Khon Kaen University, Thailand. Our participants were fifth-year medical students and teachers participating in online anesthesiology. We compared the perception of the teaching process, support system, learning outcomes, satisfaction, and preference. Using an online structured questionnaire survey with a 4-point Likert scale to measure the degree of agreement with each item. We analyzed the difference between students’ and teachers’ perceptions by topic.Results: We received responses from 174 students and 24 teachers. Students had a significantly higher proportion of positive perceptions than teachers on the teaching process (theoretical teaching, problem-based learning, feedback, and response system), on a support system (technological support, connectivity, and learning materials), on learning outcomes (clinical practice readiness, critical thinking, long-term memory, and enthusiasm), satisfaction score, and online learning preference (p<0.05).Conclusion: Differences in perception were high in many aspects of online anesthesiology learning. This perception gap was particularly evident in the teaching process, support system, and learning outcomes. And Thai students had more preference for online learning than teachers. Strategies to reduce the gap should focus on teachers’ training and supporting online learning should be concerned.
Evaluation of the public health clinical rotation in medical school: a qualitative case study design
Authors: Ghazali Pariawan Lutfi , Soleman Sani Rachman
Published: March 2023

Public health clinical rotation in the Faculty of Medicine, Universitas Islam Indonesia, was conducted in Puskesmas (community health center). This study aims to evaluate the public health clinical rotation in Puskesmas, part of the clinical clerkship of the Faculty of Medicine, Universitas Islam Indonesia. Several concerns have been highlighted regarding the implementation of clinical rotations in public health in Puskesmas. A briefing session before placement in the village must be coherent with a guidebook. The placement of students in the village was based on community health issues determined by the Puskesmas supervisor. Priority in the curriculum was given to converting the alertness village (Desa Siaga) into a Program Indonesia Sehat–Pendekatan Keluarga (Healthy Indonesia Program–Family Education) program throughout implementation. Moreover, scheduling after four major clinical programs was difficult, and the writing of reports served as a guide for establishing the correct format. Therefore, the objective of the evaluation was to assess knowledge, skill, and psychomotor, and the burden of assignment in Puskesmas was difficult to accomplish a primary task in the community.
Deslumbramiento molesto en textiles: métricas basadas en efecto de saturación y/o contraste
Authors: Yamin Julieta , Villalba Ayelén , De Gastines Maureen , Rodríguez Roberto , Pattini Andrea
Published: March 2023

Se evaluó el nivel de deslumbramiento producido por nueve textiles. Este tipo de sistema de sombreado muchas veces es comercializado sin una adecuada caracterización fotométrica, lo que conlleva a una aplicación inadecuada de los mismos, produciendo incrementos en las molestias visuales de los usuarios y mayores consumos de energía. Para evaluar el deslumbramiento, se calcularon cuatro métricas diferentes. Estas métricas están basadas en el efecto de saturación, contraste o ambas. Asimismo, se evaluó qué métricas conviene utilizar, si una específica a la condición lumínica predominante, una métrica general aplicable a todas las condiciones lumínicas o una combinación de ambas. En este estudio se observó que la métrica de contraste fue más sensible al deslumbramiento, pero la utilización de dos métricas de una manera aditiva ofrece una mejor jerarquización de los textiles. Como objetivo final se propone un sistema de puntuación para evaluar el comportamiento de textiles frente al deslumbramiento.
Entre obéissance et apostasie. La conversion des Poméraniens au christianisme (xiie siècle)
Authors: Dragnea Mihai
Published: March 2023

Au cours de la première moitié du xiie siècle, les païens et le paganisme de Poméranie peuvent être documentés. L’historiographie présente leur idolâtrie selon les schémas du christianisme primitif. La conversion des Poméraniens au christianisme passe par l’abandon du culte des idoles et la soumission à la foi chrétienne. C’est par l’obéissance aux autorités ecclésiastiques allemandes et au duc polonais qu’ils sont considérés comme des vrais chrétiens. L’article montre que le paganisme poméranien apparaît comme une construction chrétienne d’une identité socio-religieuse, en antithèse du christianisme.
L’eau dans la maison : puits domestiques recensés dans le Site patrimonial remarquable de Toulouse – premier bilan
Authors: Bos Teddy , Chaillou Mélanie , Friquart Louise-Emmanuelle , Krispin Laure
Published: March 2023

L’inventaire du Site patrimonial remarquable de Toulouse mené dans le cadre de l’élaboration du Plan de Sauvegarde et de Mise en Valeur (2018-2021) a permis de repérer un grand nombre de puits, certains encore en eau, dans les cours ou les caves des immeubles où l’accès a été possible. Après avoir exposé le contexte hydrologique du sous-sol toulousain, un bilan de ce recensement est proposé. La réflexion s’est d’abord portée sur la localisation de ces aménagements, dans les quartiers du centre-ville et sur la parcelle elle-même, en confrontant les puits vus avec ceux apparaissant sur le cadastre Grandvoinet (1788-1821) et en mettant l’accent sur une typologie de puits particulière : les puits mitoyens. L’analyse des éléments de puisage encore en place, de la mise en œuvre de ces édicules et de leurs décors complète ce premier état des lieux des puits domestiques dans le centre ancien de Toulouse.
Le Sor en Montagne noire, histoire d’une source d’énergie hydraulique
Authors: Pousthomis Bernard
Published: March 2023

Un débit raisonnable et un des plus réguliers du piémont de la Montagne noire sont à l’origine de l’installation de moulins hydrauliques sur la rivière Sor, plus précisément dans la vallée de Durfort, dans le Tarn. On trouve les premières mentions de moulins à grains ou bladiers et de moulins foulons ou drapiers au XIIIe siècle. Apparaissent au XVe siècle les premières moulines à métal ou martinets qui, aux XVIe et XVIIe siècles, remplacent et supplantent progressivement les moulins foulons. Ce n’est qu’à partir du début du XVIIe siècle que ces martinets se spécialisent dans le travail du cuivre, faisant la renommée de Durfort jusqu’à la fin du XXe siècle. Il faut ajouter à tout cela quelques scies hydrauliques ou ressègues et de rares clouteries. Cette industrie hydraulique constitue un cas particulier dans l’histoire économique du Lauragais par l’exceptionnelle densité de ses usines.La documentation historique, vérifiée et complétée par des prospections sur le terrain, a permis de dresser une carte exhaustive de toutes ces usines, dans les limites de la vallée du Sor, et d’en établir un inventaire chronologique du XIIIe siècle à nos jours.
De l’eau au moulin : enquête sur les moulins de sources et de rivières dans le piémont biterrois
Authors: Orengo Karyn
Published: March 2023

En mars 2020, le Pays d’art et d’histoire Haut Languedoc et Vignobles (34) a entrepris, en partenariat avec la Région Occitanie, une étude thématique des moulins hydrauliques de son territoire. L’enquête appréhende ces bâtiments non seulement en tant que sites de production, mais aussi comme composants d’un environnement global. Après une première phase circonscrite à sept communes du Minervois héraultais, l’enquête s’est poursuivie entre mars et décembre 2022 sur le périmètre de l’actuelle Communauté de communes Les Avant-Monts (25 communes). Ce nouveau terrain a offert l’opportunité de confronter les observations précédemment recueillies et de développer de nouvelles problématiques. Cette contribution s’attachera à restituer le paysage du moulin hydraulique dans toute sa complexité, à mettre en lumière l’adaptation des hommes au contexte hydrologique et topographique local et à questionner les stratégies de réaction et de dépassement mises en œuvre en réponse aux événements environnementaux.
Le flottage sur l’Aude et le commerce du bois de la haute vallée (XVIIIe-XIXe siècle)
Authors: Fabre Éric
Published: March 2023

Longtemps l’économie ne peut fonctionner sans bois, autant pour le chauffage domestique et industriel que pour la construction et la fabrication de mille objets du quotidien. Dans le Midi, entre montagne et Méditerranée, la tension est forte : les contrées trop sèches ne peuvent fournir du bois en qualité et quantité, alors que la montagne est riche de forêts qui sont bien peu accessibles. La solution est partout la même en Europe : utiliser les cours d’eau pour mettre en relation les espaces producteurs et consommateurs. Les pièces de bois, grosses et petites, sont flottées, qu’elles restent isolées dans le flottage à bûches perdues ou qu’elles soient assemblées en radeau. Ce travail analyse les modalités du flottage sur le fleuve Aude dont la tête du bassin versant est riche de hêtre et de sapin, entre contraintes hydrologiques, obstacles que constituent les prises d’eau des établissements hydrauliques et exigences des marchands de bois qui commanditent le travail des radeliers.
Le dossier thématique de l’Inventaire général, un outil pour la recherche textile
Authors: Pagnon Josiane
Published: March 2023

Cet article vise à présenter des cas pratiques - concernant les textiles – d’application d’un type particulier de dossier de l’Inventaire général du patrimoine culturel, le dossier thématique. Cet outil documentaire permet de regrouper autrement les informations sur des biens culturels de types variés, ici des maisons de chasublerie religieuse, des dessins textiles fameux, des constats de découvertes de terrain qui mériteraient des recherches approfondies.
Les eaux vives de l’Adour. Maîtrise et devenir au fil du temps
Authors: Gaillaguet Danièle , Rösch Didier , Sabatier Richard
Published: March 2023

Le « courtaou1 » des Esclozes, situé à une petite heure de marche du site touristique de Payolle, comprenait une vingtaine de cabanes, en ruines depuis plus d’une cinquantaine d’années. L’une de ces cabanes et l’abri de traite attenant, bâtis en pierres sèches, ont fait l’objet d’une restauration à l’identique par l’association Pierre des Esclozes créée dans ce but en 2012. Une rigole d’amenée d’eau de plus d’un kilomètre a également été remise en service.Ce chantier réalisé par des bénévoles et soutenu par la municipalité de Campan a attiré depuis de nombreux visiteurs. Pendant l’été, des membres de l’association viennent chaque semaine assurer l’entretien du site. Ces journées et les deux grands chantiers annuels annoncés par voie de presse sont l’occasion de nouvelles rencontres.Divers travaux et recherches se sont développés à la périphérie de ces activités concernant la vie pastorale et l’histoire du très remarquable système d’irrigation gravitaire qui caractérise la vallée de Campan. Le site contribue de la sorte à l’information et à la mobilisation de bénévoles en vue de mieux comprendre l’évolution des paysages et des cours d’eau qui les animent ainsi que les modalités de leur entretien régulier.
Root Cause Failure Analysis of Waterwall Tube Boiler
Authors: Kokong Acep M. , Safitri Rizky Haura Nindya , Jannah Miftahul , Suwarno
Published: March 2023

Failure of tubing boilers in power plants can be caused by several things including creep, corrosion, erosion, and overheating. In this study, an analysis of waterwall boiler failure is presented. Visual examination, dimension measurements, chemical analysis, microstructural tests, hardness test, and corrosion tests were carried out to determine the mechanism and causes of failure of waterwall tubing. From the sample, it can be observed that the tubing is experiencing local thinning due to corrosion with the oxides resulting from the corrosion sticking to the corroded tube surface. There is no difference microstructure between the area that is experiencing thinning and that not, namely ferrite and pearlite. Further observations with SEM EDS showed the presence of salt deposits with a thick chemical composition of Ca, and Na. The quality of the boiler seal water with a position that is very close to the leak point of the tube is the cause of the deposit. Keywords: seal water, waterwall tube, corrosion, salt deposits.
Fatigue Detection System Based on Heart Rate and Eye Blink Equipped with Email and Buzzer Alerts to Increase Health Workers Productivity
Authors: Callista Vivi Bella , Firnanda Mochammad Fadhel , Anugraheni Rewila Fajar , Wikarta Alief
Published: March 2023

During COVID-19 pandemic, health workers have a crucial role in promotion, prevention, communication, and education to the public. Limited human resources, longer working hours, high risk of infection, and negative stigma from the community are challenges for health workers in treating COVID-19 patients. If there is no change in the near future, then health workers are threatened with excessive fatigue. A heart rate and eye blink fatigue detection system equipped with email and buzzer alerts is developed as an effort to increase the productivity of health workers in the midst of a pandemic. For heart rate based fatigue detection system, the placement of the sensor on the wrist is chosen with 82% accuracy. Two of five battery bars left for five hours of operation. For eye blink based fatigue detection system, EAR 0.32 is chosen because health workers use mask and glasses while working. The potential benefits of this fatigue detection system are buzzer alert for user, email alert for supervisor, track record, increase service quality, time and workload management. All these potential advantages are expected to prevent fatigue which can increase the productivity of health workers.
Normal Modes Study on Half Wing Structure of N219 Aircraft Using Computational Method
Authors: Sari Mirna , Guntur Harus Laksana , Pratama Mochammad Bayu Sakti
Published: March 2023

This paper investigates the result of normal modes study on half wing structure of N219 aircraft. The analysis was completed using computational method with stick model for wing structure. A short mathematical review of the normal mode study is investigated in this paper. The study was completed for three cases of flight: zero fuel, minimum fuel and maximum fuel. The results of study, i.e., natural frequencies and mode shapes, are shown here. The results will be used for further dynamic study to analyze the flutter speed of N219 aircraft. The result comparison shows that for the same normal mode input parameters, each three cases have different number of mode shapes and different frequency value. The increments of natural frequencies between full fuel to minimum fuel is 2.5% and minimum fuel to zero fuel is 2.8%.
Pneumatic Underwater Coral-Coring Drill
Authors: Bell Tomoko , Endo Tetsuya , Jenson John W. , Lander Mark A. , Bautista Kaylyn K.
Published: March 2023

Abstract To extract meter-length, large-diameter cores from live massive corals on shallow reefs we developed a versatile underwater pneumatic drill driven by a portable gasoline-powered air compressor carried onboard a small boat. This drill was used to obtain intact cores
8.0 cm in diameter and 0.5‐1.5 m long from Guam's coastal waters. Advantages of this pneumatic drill over standard hydraulic drills include (1) lower cost; (2) easier portability; (3) more stable, safer, and faster drilling; and (4) elimination of the need to carry and use hydraulic
fluid on the coral reef. The pivotal innovation in the application of pneumatic technology was use of an air motor rather than a conventional handheld pneumatic drill. Another significant innovation was employment of a pneumatic water pump to provide a continuous flow that purges debris from
the borehole and the cutting edge of the diamond drill bit. This drill can provide paleo-climate researchers and others interested in retrieving high-quality coral core samples with a reliable, economical, easy to operate, safe, and environmentally friendly alternative to more expensive and
cumbersome hydraulic drills.
Surface Currents Along the Coast of the Chinese Mainland Observed by Coastal Drifters During April‐May 2019
Authors: Yang Longqi , Sun Zhenyu , Hu Zhiyuan , Huang Zhida , Chen Zhaozhang , Zhu Jia , Hu Jianyu
Published: March 2023

Abstract We have analyzed the surface current characteristics along the coast of the Chinese mainland in autumn and winter by the trajectories of coastal drifters in a previous study (Yang et al., 2021). This paper is a follow-up study focusing on the surface current characteristics
in spring. By the trajectories of coastal drifters in April‐May 2019, we continue to analyze the characteristics of surface currents. It is indicated that: (1) the surface currents were generally southwestward along the coasts of Zhejiang and Fujian, while they flowed northeastward
in the offshore area in April 2019. (2) In May 2019, the surface current in the sea area north of 28°N had a small speed without a fixed direction nearshore, but had larger speed offshore. (3) The surface currents along the Zhejiang coast were variable in April‐May 2019, mainly
corresponding to the change of wind field. (4) The coastal drifter is a useful instrument to observe circulation systems more precisely in nearshore but not deep ocean.
Development and Validation of Embedded System Architecture for Shallow-Water Based H-AUV
Authors: Shaik Shakeera , Jyothi Vandavasi Bala Naga , Narayanaswamy Vedachalam , Venkataraman Hrishikesh
Published: March 2023

Abstract Autonomous underwater vehicles (AUVs) have gained enormous popularity over the years and are employed extensively in various industries, including bio-research, subsea industries, and military applications. Most of the available commercial AUVs are very expensive
and complex. This makes it unsuitable to be used for civilian applications. On the other hand, recent technological advancements have made it possible to have highly capable sensors at acceptable prices as an alternative to expensive commercial vehicles. In this paper, an embedded system-based
multi-sensor hardware architecture for an H-configured AUV, called H-AUV, is designed and developed with low-cost, power-efficient, real-time controllers with a small footprint for data acquisition and sensors. These parameters play an important role for designing and developing energy-efficient
autonomous vehicles. Significantly, auto navigation is a very important mechanism for AUVs, which includes auto heading control and depth keeping control techniques developed, deployed, and tested in the H-AUV. Additionally, the denoise filters such as moving average, exponential, and dynamic
linear Kalman filter (KF) have been exercised and validated for heading and depth control of an H-AUV. It was found that the dynamic KF is very efficient and performs with 88% accuracy in the heading and depth control mechanisms. The KF is also found to perform with 98% accuracy for surface
navigation of the H-AUV. Finally, an indigenous graphical user interface has been developed for data telemetry, command, and logging in autonomous and manual modes through wired and wireless communication. The proposed development and validation of an efficient and low-cost H-AUV shall support
academic researchers for subsea applications.
Research on an Active Heat Insulation Device for the Hadal Sample
Authors: Wang Wei , Ren Xueyu , Chen Jiawang , Peng Xiaoqing , Guo Jin , Wang Ying , Lin Yuan
Published: March 2023

Abstract Since the temperature between 1,000 m and 11,000 m below the sea surface is between 2‐8°C, a thermal insulation measure is needed when taking samples of the deep sea to obtain the in-situ properties from the samples more accurately in laboratory tests.
Most of the current deep-sea thermal insulation sampling devices use passive thermal insulation, and the thermal insulation effect of adding thermal insulation coating, vacuuming, and exterior coating thermal insulation materials in the sample device is not ideal. This study uses a Thermoelectric
Cooler (TEC) to cool active heat preservation equipment. TEC has the characteristics of light weight, small size, rapid response, and cool high efficiency. The device has carried out a series of preliminary experiments in the laboratory, which shows that the temperature can be kept between
2‐4°C. Through experimental verification, it is found that this thermal insulation system can maintain the temperature of the sample chamber well. The device can be mounted on various underwater robots and landers to provide technical and equipment support for marine scientific
research.
Intrapulmonary Feeding Tube Placements While Using an Electromagnetic Placement Device: A Review (2019–2021)
Authors: Metheny Norma A. , Taylor Stephen J. , Meert Kathleen L.
Published: March 2023

Background

Intrapulmonary placements of feeding tubes inserted with use of an electromagnetic placement device (EMPD) continue to occur.

Objective

To describe circumstances and outcomes associated with intrapulmonary feeding tube placements during use of an EMPD.

Methods

A retrospective review of reports to the US Food and Drug Administration’s Manufacturer and User Facility Device Experience (MAUDE) database of intrapulmonary feeding tube placements during use of an EMPD from 2019 through 2021. Complications, outcomes, operator training, interference from anatomical variations and medical devices, and the use and accuracy of radiographs in identifying pulmonary placements were recorded.

Results

Sixty-two cases of intrapulmonary tube placement were identified; 10 were associated with a fatal outcome. Pneumothorax occurred in 35 cases and feedings were delivered into the lung in 11 cases. User error was cited in 6 cases and was implicit in most others. Little information was provided about operator training. Four intrapulmonary placements were associated with anatomical variations and 1 with a left ventricular assist device. Radiographic follow-up was described in 28 cases and correctly identified 23 of the intrapulmonary placements.

Conclusions

User error was a significant factor, which highlights the need for empirical data to clarify the amount of training needed to safely credential EMPD operators. Clearer information is needed about anatomical variations that may contraindicate use of an EMPD, as well as medical devices that may interfere with an EMPD. Use of follow-up radiographs, interpreted by qualified personnel, is supported to increase the probability of identifying intrapulmonary tube placements.
Last-minute abstracts of 2023 Padua Days of Muscle and Mobility Medicine (2023 Pdm3) and 2023 Editorial board of EJTM
Authors: Zampieri Sandra , Carraro Ugo
Published: March 2023

The 2023 Padua Days of Muscle and Mobility Medicine (Pdm3) are scheduled from March 29th to April 1st, 2023. The abstracts collected during autumn and early winter of 2022 were e- published in the issue 33 (1) 2023 of the European Journal of Translational Myology (EJTM). Now the last-minute abstracts are reported here (100 Oral presentations are listed in the final Program). All together they confirm the interest of very different international specialists, filling the four days of 2023Pdm3. Indeed, scientists and clinicians from Austria, Bulgaria, Canada, Denmark, France, Georgia, Germany, Iceland, Ireland, Italy, Mongolia, Norway, Russia, Slovakia, Slovenia, Spain, Switzerland, The Netherlands and USA will gather to the Hotel Petrarca of Thermae of Euganean Hills, Padua, Italy. The apparent heterogeneity of the specialists, collectively raccolti under the umbrella of the Mobility Medicine neologism is stressed by the need to extend the Sections of the 2023 Editorial Borad of EJTM also here reported. We hope that Speakers of the 2023 Pdm3 and readers of EJTM will submit “Communications” to the European Journal of Translational Myology by May 20, 2023 and/or to the 2023 Special Issue: “Pdm3” of the Journal Diagnostics, MDPI, Basel, Switzerland with deadline September 30, 2023. See you soon at the Hotel Petrarca of Montegrotto Terme, Padua, Italy. For a promo of the 2023 Pdm3 link to: https://www.youtube.com/watch?v=zC02D4uPWRg
Factors influencing insulin initiation in primary care facilities in Cape Town, South Africa
Authors: Mathose Tasunungurwa T. , Mash Robert
Published: March 2023

Background: Type 2 diabetes (T2DM) is a leading cause of mortality in South Africa and resistance to the use of insulin is common. This study aimed to explore factors that influence the initiation of insulin in patients with T2DM in primary care facilities in Cape Town, South Africa.Methods: An exploratory descriptive qualitative study was conducted. Seventeen semi-structured interviews were held with patients eligible for insulin, on insulin and primary care providers. Participants were selected by maximum variation purposive sampling. Data were analysed using the framework method in Atlas-ti.Results: Factors related to the health system, service delivery, clinical care and patients. Systemic issues related to the required inputs of workforce, educational materials, and supplies. Service delivery issues related to workload, poor continuity and parallel coordination of care. Clinical issues related to adequate counselling. Patient factors included a lack of trust, concerns about injections, impact on lifestyle and disposal of needles.Conclusion: Although resource constraints are likely to remain, district and facility managers can improve supplies, educational materials, continuity and coordination. Counselling must be improved and may require innovative alternative approaches to support clinicians who face high number of patients. Alternative approaches using group education, telehealth and digital solutions should be considered.Contribution: This study identified key factors influencing insulin initiation in patients with T2DM in primary care. These can be addressed by those responsible for clinical governance, service delivery and in further research.
A Christian ethical analysis of the importance of prophetic leadership for sustainable leadership
Authors: Kretzschmar Louise
Published: March 2023

In this article, firstly, prophetic leadership is defined and some of its key features are outlined. Secondly, the contribution made by prophetic leadership to sustainable leadership is investigated, using examples from historical and contemporary societies and organisations. The role of truth-tellers and whistleblowers is also discussed. Thirdly, the importance of utilising and nurturing prophetic leadership in church and theological education settings is discussed.Intradisciplinary and/or interdisciplinary implications: In its analysis of prophetic and sustainable leadership in historical and contemporary settings, this article draws primarily on the theological discipline of Christian Ethics and, secondarily, on biblical studies and Leadership and Management Sciences.
Adrenal Venous Sampling in Primary Aldosteronism: Single-Centre Experience from Western India
Authors: Rathod Krantikumar , Memon Saba S. , Mahajan Punit , Lila Anurag , Thakkar Dhaval , Deshmukh Hemant , Bandgar Tushar
Published: March 2023

Introduction:

The protocols and criteria used for adrenal venous sampling (AVS) differ across centres. There are no studies from the Indian subcontinent describing AVS-based outcomes in primary aldosteronism (PA). We aim to describe our experience from a single centre.

Methods:

Retrospective records from 2018 to 2020 of patients with confirmed PA who underwent AVS were reviewed. Clinical, imaging, AVS data and outcomes (as per PASO criteria) were recorded. AVS was performed by sequential sampling with cosyntropin stimulation with intraprocedural cortisol and cut-off of selectivity >5 and lateralization >4 by a single radiologist.

Results:

Fifteen patients with median age of 50 years (41–58) and duration of hypertension of 156 (36–204) months were included. Ten had grade 3 hypertension, 13 had hypokalaemia and 3 had hypokalaemic paralysis. On CT scan, eight patients had bilateral adrenal lesions, four had unilateral adenoma and three patients had normal adrenals. AVS was bilaterally successful in all and showed lateralization of disease in 10 patients and was bilateral in the remaining 5 patients. Overall concordance of CT and AVS was 5/15 (33.3%). Among seven patients who underwent surgery, complete clinical success was seen in two and partial clinical success in the remaining five. Complete biochemical success was seen in two and partial in one. There were no major complications.

Conclusions:

AVS performed by a single radiologist with defined protocols has a good success rate. AVS has additional value over CT scan in lateralization, especially when CT shows bilateral disease.
Study of Correlation between Serum Osteoprotegerin, TNF-Alfa, and Biomarkers of Bone Metabolism in Patients with Treatment-Naive Graves’ Disease—A Cross-Sectional Study
Authors: Behera Kishore , Sahu Suchanda , Agrawal Kanhaiyalal , Soren Uttam K. , Parida Girish K. , Srinivasan Anand
Published: March 2023

Objectives:

Primary – a study of the correlation between serum osteoprotegerin (OPG), and biomarkers of bone metabolism in patients with treatment-naive Graves’ disease (GD). Secondary – serum level of OPG, TNF-alfa, and biomarkers of bone metabolism in patients three months after treatment of GD with methimazole (MMI).

Materials and Methods:

A total of thirty-five treatment-naive newly diagnosed GDs were recruited for the study, most of them female. All patients started with MMI for treatment and various blood parameters were measured at baseline and three months after treatment. Measurements: Serum calcium (Ca), phosphorus (P), bone-specific alkaline phosphatase (B-ALP), OPG, TNF-alfa, and urine deoxypyridinoline (U-DPD) along with serum-free T3 and T4, thyroid-stimulating hormone (TSH) and thyroid receptor antibody (TR-ab) were analysed at baseline and three months after MMI treatment. All the patients had euthyroid at three months of MMI treatment.

Results:

Mean serum OPG (0.94 ± 1.39 vs. 0.63 ± 0.27 ng/ml; P = 0.262) level at baseline and after treatment with MMI did not show any significant change. Mean TSH level (0.207 ± 0.59 vs. 1.00 ± 1.95, P = 0.025) was significantly low at baseline than after treatment; FT4 (5.9 ± 5.22 v 1.77 ± 1.89 ng/dl; P < 0.001), FT3 (12.19 ± 6.91 vs. 4.99 ± 3.55 pg/ml; P < 0.001), and TNF-alfa values decreased significantly after treatment, however, PTH (58.09 ± 28.75 vs. 75.57 ± 41.50; P < 0.026) increased significantly after treatment.

Discussion:

There is no correlation of OPG with thyroid hormone profile, TSH, thyroid receptor antibody (TR-ab), and bone metabolic parameters such as serum Ca, P, B-ALP, TNF-alfa, and U-DPD in our study. Mean TNF-alfa decreased significantly (393.43 ± 270.473 vs. 139.34 ± 101.264 pg/ml; P = 0.001) level after treatment with MMI. TNF-alfa was positively correlated with TR-ab (r = 0.374; P = 0.027) and B-ALP (r = 0.388; P = 0.021).

Conclusion:

The bone turnover marker in GD seems to be mediated other than OPG. We observed an increase in circulating TNF-alfa in GD with a significant decrease after treatment. TNF-alfa could be a marker of GD activity as evidenced by a close positive correlation with TR-ab, a sensitive marker of GD autoimmunity. TNF-alfa could be a factor associated with bone turnover markers in GD despite its euthyroid state.
Are Severe Forms of Thyroid Eye Disease Common in the Indian Population? Clinical Characteristics of 136 Patients from a Tertiary Eye Care Centre
Authors: Subramaniam Dhakshini L. , Yadalla Dayakar , Rajagopalan Jayagayathri
Published: March 2023

Context:

Considerable evidence of gender, ethnicity, thyroid dysfunction, and environmental factors including smoking influencing the development and progression of thyroid eye disease (TED).

Settings and Design:

Cross-sectional study of the clinical characteristics of 136 patients with TED who presented to the Orbit and Oculoplasty services at a tertiary eye care center in south India between October 2018 and June 2020.

Results:

Among the 136 patients (M: 61, F: 75), the mean age was 47.04 (SD ± 13.24) years. Hyperthyroid disease was present in 53%, hypothyroid disease in 40%, and 7.3% were euthyroid. Active disease was noted in 25% and inactive disease in 75% of patients. Active disease was present in 25% of hyperthyroid, 18.5% of hypothyroid, and 15% of euthyroid patients. Active TED showed statistically significant association toward development of greater severity of proptosis (P = 0.001), optic neuropathy (P = 0.004), and extraocular movement restriction (P < 0.001) as compared to inactive disease. Mild, moderate to severe, and sight-threatening TED was noted in 34.6%, 59.6%, and 6% of patients, respectively. Nine eyes had dysthyroid optic neuropathy, of which eight had either mild or no proptosis while one had moderate to severe proptosis.

Conclusion:

Prevalence of active as well as severe thyroid eye disease is common in our population. Recommendation for ophthalmological examination of patients even with milder disease especially when associated with decreased vision and signs of inflammation. Active disease is less common in euthyroid patients, thus necessitating maintaining the euthyroid status toward reducing disease activity and progression.
IDEA Group Consensus Statement on Medical Management of Adult Gender Incongruent Individuals Seeking Gender Affirmation as Male
Authors: Majumder Anirban , Chatterjee Sudip , Maji Debasis , Ghosh Sujoy , Selvan Chitra , George Belinda , Kalra Pramila , Chandrasekaran Shruti , Priya Gagan , Sukumar Suja , Sanyal Debmalya , Roychaudhuri Soumyabrata
Published: March 2023

Gender-affirming hormone therapy (GAHT) is the most frequent treatment offered to gender-incongruent individuals, which reduces dysphoria. The goal of therapy among gender-incongruent individuals seeking gender affirmation as male is to change their secondary sex characteristics to affect masculine physical appearances. GAHT greatly improves mental health and quality of life among gender incongruent individuals. India-specific guideline for appropriate care for gender-incongruent individuals is almost absent. This document is intended to assist endocrinologists and other healthcare professionals interested in gender incongruity for individuals seeking gender affirmation as male. A safe and effective GAHT regimen aims to effect masculinising physical features without adverse effects. In this document, we offer suggestions based on an in-depth review of national and international guidelines, recently available evidence and collegial meetings with expert Indian clinicians working in this field. Clinicians represented in our expert panel have developed expertise due to the volume of gender incongruent individuals they manage. This consensus statement provides protocols for the hormone prescribing physicians relating to diagnosis, baseline evaluation and counselling, prescription planning for masculinising hormone therapy, choice of therapy, targets for monitoring masculinising hormone therapy, clinical and biochemical monitoring, recommending sex affirmation surgery and peri-operative hormone therapy. The recommendations made in this document are not rigid guidelines, and the hormone-prescribing physicians are encouraged to modify the suggested protocol to address emerging issues.
Practical and Pragmatic Usage of T3 in Hypothyroidism
Authors: Kalra Sanjay , Dhingra Atul , Kapoor Nitin , Sahay Rakesh
Published: March 2023

Hypothyroidism is one of the common endocrine disorders encountered in clinical practice. Though thyroxine (T4) remains the treatment of choice in most clinical situations, with the recent introduction of oral triiodothyronine (T3) in South Asian countries, it is important to know about its utility in clinical practice. In this brief communication, we delineate potential clinical indications for T3 therapy, while highlighting possible concerns and caveats.
A cross-sectional study to assess the post-traumatic stress disorder among discharged coronavirus disease-19-infected individuals in Karnataka, Southern India
Authors: Gudegowda Kishore Shettihalli , George Riya , Partheeban Iswarya , Sobagaiah Ranganath T.
Published: March 2023

Background:

Posttraumatic stress disorder (PTSD) is a mental disorder that may develop after exposure to a horrifying or traumatic event. India reported a high number of cases worldwide during the waves of the coronavirus disease-19 (COVID-19) pandemic. Even though a high prevalence of PTSD is expected among hospitalized COVID-19 patients, only a very few studies have addressed the issue till now. The objectives of the study were to assess the prevalence and risk factors associated with PTSD among discharged COVID-19-infected individuals from a designated COVID-19 hospital in Karnataka.

Methodology:

A cross-sectional study was conducted among a total of 120 patients who were discharged after recovery from a designated COVID-19 hospital in Karnataka. Multistage random sampling was done, and equal representation was ensured from all the zones as per the hospital protocol from April 2021 to June 2021. Telephonic interviews with the subjects were conducted; participants were evaluated for PTSD using a semi-structured, prevalidated questionnaire (impact of events scale-revised) after 1 month of discharge from the hospital.

Results:

The prevalence of PTSD was found to be 29.16%. PTSD was more commonly associated among the middle age group, presence of comorbidities, and with an increased number of days of hospitalization stay especially in ICU with the ventilator.

Conclusions:

Studying PTSD and its associated factors is necessary to inform about the COVID-19 prognosis. Physicians treating the patient and caretakers of patients should be aware of PTSD risk and should consider PTSD Screening.
Comparison of I-gel™ versus Baska mask® on oropharyngeal sealing pressure in patients receiving general anesthesia under spontaneous ventilation
Authors: Ramya Bhimala Naga , Dav Sandeep Kumar , Segaran Sivakumar , Sivaramakrishnan D. , Zachariah Mamie , Ranjan R. V.
Published: March 2023

Background:

Baska mask® is a newer third-generation supraglottic airway device (SAD) having a self-sealing membranous cuff that does not require inflation. Oropharyngeal sealing pressure (OSP) is used to quantify the efficacy of airway sealing in SAD. Our primary objective was to compare OSP between Baska mask® and I-gel™ in patients receiving general anesthesia on spontaneous ventilation. The secondary objectives were to determine the ease, duration, number of attempts during insertion, hemodynamic responses, and perioperative complications.

Methodology:

Fifty patients scheduled for a variety of surgical procedures lasting up to 90 min under general anesthesia were randomly allocated to one of the two groups, Group B (Baska mask®) and Group I (I-gel™). Data were collected and entered into an Excel sheet. Statistical analysis was performed using SPSS. Statistical tests used were Student's unpaired t-test, Mann–Whitney U-test, and Fisher's exact test. P < 0.05 was considered statistically significant.

Results:

The OSP was significantly higher in Group B than in Group I (29.4 ± 6.01 vs. 26.32 ± 4.26 cmH2O, respectively) (P = 0.042). The number of attempts, mean duration, and grade of ease of insertion in both groups had no statistical difference. Hemodynamic parameters were not significantly different between both groups. No postoperative complications were noticed in either group.

Conclusion:

Baska mask® offers a superior airway sealing pressure compared to I-gel™ without significant hemodynamic changes, with equal first-pass success rate and postoperative complications.