bluuebunny/crossref_metadata_2025 huggingface dataset:
Photographic Estate of Barbora Markéta Eliášová in the Náprstek Museum Collections: Negatives and Slides
Authors: Šejbl Jan
Published: November 2022

The study focuses on the photographic negatives and slides from the personal estate of traveller Barbora Marketa Eliášova stored in the National Museum – Náprstek Museum of Asian, African and American Cultures. Photographic negatives and slides were divided between the archival fund and the museum collection. With the use of digital technologies, it was possible to reunite separated parts and study them as a whole. For negatives, the main question was to find out which images Eliášova took herself on her travels and which are image reproductions from other sources. In the same way, slides were examined as evidence of the use of photographic techniques in lecture activities.
The Collections of Milan Rastislav Štefánik and Bedřich Feuerstein in the Náprstek Museum
Authors: Tůmová Adéla
Published: November 2022

The paper deals with two collections in the Náprstek Museum, the collection of M. R. Štefánik, a Slovak politician, soldier and astronomer, who visited Japan in 1919, and the collection of Bedřich Feuerstein, Czech architect, who lived in Japan in 1926–1930. These collections, similar in size and in the time of creation, reflect different reasons for obtaining the objects. Both collections are only a small part of the objects originally belonging to Štefánik and Feuerstein, and had been unpublished for long time.
Pectoral for the Lector Priest Panakht
Authors: Onderka Pavel
Published: November 2022

An ancient Egyptian pectoral dated to the New Kingdom and belonging to the lector priest Panakht, entered the collections of the now National Museum, Prague, in the second half of the 19th century. The pectoral is decorated with a scene representing the rising sun on the recto and a scene of the worship of Osiris by the owner on the verso.
Leveraging Text Mining for Trend Analysis and Comparison of Sustainability Reports: Evidence from Fortune 500 Companies
Authors: Sharma Anuj , Kaushik Kapil , Awasthy Prakash , Gawande Abhishek
Published: November 2022

In the recent upsurge in environmental concerns, business sustainability has become more prominent than ever. Organizations worldwide are expected to function sustainably, causing the least negative impact on the environment and promoting harmony among the firm, environment, and society. Most firms report their actions related to sustainability in corporate social responsibility (CSR) reports. This research aims to understand and analyze contemporary trends in CSR reports by Fortune 500 companies using text mining. It compares how the focus of sustainability reports varies across countries and industries along key dimensions of sustainability (i.e., environmental, economic, social, and government). Findings from the study suggest variations in the focus of sustainability reports based on various factors, such as country of origin and company size, sector, and tenure, on the Fortune 500 list. Thus, it helps to gain a deeper understanding of the company’s motivations for focusing on various dimensions of corporate sustainability.
Pengaruh Model Example Non Example Berbantukan Media Powtoon terhadap Hasil Belajar Matematika Siswa Kelas IV SD
Authors: Nursafiri Mellynia Dwi , Kusumawati Naniek , Retno Raras Setyo
Published: November 2022

This study aims to determine the effect of the Example Non Example model with the help of Powtoon media on the mathematics learning outcomes of fourth-grade students at SDN 01 Taman. This type of research is experimental quantitative research. This research method Experiment Design with Pretest-Posttest Control Group Design. This study took two classes as samples: class IV A as the experimental class and class IV B as the control class. Sampling using Simple Random Sampling. The technique of collecting data on mathematics learning outcomes uses interviews, observations, tests and documentation. From the data analysis using the t test, it is known that ttable = 2.069 for 5% with dk = 25, if tcount = 5.784 > ttable = 2.069 then H0 is rejected and H1 is accepted. Thus it can be said that the influence of the Example Non Example model with the help of Powtoon media affects the mathematics learning outcomes of fourth-grade students at SDN 01 Taman
Pengaruh Strategi Pembelajaran Online dan Gaya Belajar terhadap Hasil Belajar Aplikasi Konsep
Authors: Pratama Angga
Published: November 2022

This study aims to determine the differences in the learning outcomes of the application of concepts to students who learn to use online strategies with face-to-face learning strategies, as well as to test whether there is a difference in the average learning outcomes of the application of concepts to students who have different learning styles and to test whether there is an interaction between learning strategies and learning outcomes. learning styles on the learning outcomes of student concept applications. This study used a quasi-experimental research design. 2x2 factorial design The variables of this study are the independent variables are online learning strategies and face-to-face learning, the control variables are learning styles and the dependent variable is the learning outcomes of concept application. This research instrument is a question of pretest and posttest which was developed in accordance with the research objectives of the lectures listed in the RPS. The hypothesis testing of this research uses 2-way Analysis of Variance (ANOVA) to test the hypothesis, in the form of the Univariate Test of Between-Subject Effects. The results of this study indicate (1) there are significant differences, including learning outcomes of student concept applications using online learning strategies with face-to-face learning strategies. The use of online learning strategies is significantly superior to face-to-face learning strategies., (2) there is a significant difference in the acquisition of concept application learning outcomes between students who have an active learning style and a reflective learning style, significantly students who have an active learning style are more superior in learning outcomes of concept applications compared to students who have reflective learning styles. (3) there is an interaction between online learning, learning strategies and learning styles on concept application learning outcomes. the influence between the interaction, the independent variable and the moderator variable on the dependent variable, both for the learning outcomes of the application of the concept.
Digitalisasi dan Disparitas Pendidikan di Sekolah Dasar
Authors: Miftah Zaini , Fahrurrozi Fahrurrozi
Published: November 2022

Digitalization in education is essentially a government effort to uniform access to education and reduce the problem of digital inequality in the world of education. The purpose of this article is to identify aspects of the education digitization policy implemented at SDN Ngayung and the extent to which the digitalization policy can help SDN teachers improve access to education and participate in digitalization. The method used in this research is qualitative with a case study approach. The survey respondents in this study were six teachers, school principals and SDN supervisors. Data was collected through in-depth interviews and documentation. The survey found that SDN teachers in Ngayung village felt firsthand two aspects of the digitalization policy in education. The first is the digitization of education policy communications and the second is the digitization of learning. In the first dimension, teachers experience faster access to education policies. Teachers can better understand national education policies and follow direct instructions from the central government through available information channels. But for the second aspect, teachers are not ready in terms of content even though they are familiar with the media, they do not use various software products to maximize learning.
Pengaruh Metode Role Playing terhadap Prestasi Belajar Peserta Didik pada Mata Pelajaran Sejarah Kebudayaan Islam di Madrasah Ibtidaiah
Authors: Hasyim Hasyim , Mauliana Nia Siska
Published: November 2022

Using appropriate and effective learning methods is one of the factors that determine the success of the teaching and learning process. The purpose of this study is to describe the application of the Role Playing method in SK subjects, to identify student achievement in Islamic Cultural History subjects, and to measure the effect of the application of the Role Playing method on student achievement in SKI subjects. This research is a quantitative correlative type. The results of this study indicate that the percentage of the Role playing method in the Islamic Cultural History subject at MI Azhariyah Tegalrejo for the 2021/2022 academic year is 91%, which indicates very well. The level of learning achievement of students in the Islamic Cultural History subject is 76.67%, indicating good. The Role Playing method has a strong influence on student achievement in SKI subjects at Madrasah Ibtidaiyah.
Pengaruh Penerapan Metode Pembelajaran Everyone is a Teacher Here terhadap Minat dan Hasil Belajar Matematika Materi Pecahan di Madrasah Ibtidaiah
Authors: Hikmah Dewi Wahyuning , Septiani Putri
Published: November 2022

The purpose of this study was to find out whether by applying the Everyone is teacher here learning method, there was an increase in the learning interest of fourth graders in the Mathematics subject matter of fractions at MI Tanwirul Mubtadiin Pendil-Banyuanyar. The method used in this research is classroom action research method. Data collection techniques used are observation, interviews, tests, and documentation. Based on research that has been carried out in class IV MI Tanwirul Mubtadiin and from the analysis of the data, it can be concluded that through the learning method everyone is teacher here can increase student interest and learning outcomes. This is indicated by the increasing average mathematical reasoning ability and student interest from pre-cycle 40 to 65.71 in cycle 1 and increased to 88.57 in cycle 2. Likewise, students' interest in learning which was originally with a percentage of 52.04% in cycle 1 to 85.71% in cycle 2.
Penyuluhan Webinar Kajian Fatwa MUI Tentang Akad Murabahah di Komunitas Pegiat Ekonomi Syariah di Surakarta
Authors: Alam Azhar , Cahyaningrum Linda Islam , Rama Nabila Rahmawati , Hamidah Raisa Aribatul
Published: November 2022

The community of Islamic economic activists in Surakarta and surrounding areas is committed to advancing the sharia economy. They form a community to carry out discussions and outreach studies to increase Islamic economic literacy. Financial literacy in general or mainly in Islamic economics is still very low in Indonesian society, so it requires significant efforts to increase literacy through outreach activities. Murabahah contract is the most common contract widely used in Islamic economic activities by Islamic financial institutions, banking, and microfinance. This outreach activity aims to increase the knowledge of the community of Islamic economic activists in Surakarta and its surroundings regarding the study of the fatwa on murabahah contracts and current issues related to one of the muamalah contracts. Contract problems and disputes that occur in the relationship of Islamic financial institutions with customers or customers are also dominated by Murabahah contracts. Murabahah contract is also a contract with a nominal amount of transactions large enough to take the form of a sharia financing syndicate with a Murabahah contract. This counseling activity suggests that every party involved in a murabahah contract is obliged and needs to uphold what has been contracted.
Pendampingan Pemanfaatan Sumber Pustaka Dalam Menunjang Penulisan Karya Ilmiah Pada Anggota Opsi
Authors: Syeptiani Silvia
Published: November 2022

Kegiatan pengabdian ini dilaksanakan di SMP N 1 Rejang Lebong pada bulan maret 2022. SMP N 1 Rejang Lebong setiap tahunnya mengirim perwakilan siswa-siswinya untuk mengikuti kegiatan Olimpiade Penelitian Siswa Indonesia (OPSI) yang di selenggarakan oleh Kementerian Pendidikan, Kebudayaan, Riset dan Teknologi. Namun pihak sekolah mengalami kendala karena kurangnya pengetahuan siswa-siswi dalam memilih sumber pustaka yang akan digunakan sebagai acuan baik dalam penelitian maupun dalam penulisan karya ilmiah. Objek pengabdian kepada masyarakat ini adalah siswa-siswi yang tergabung dalam kelompok kegiatan Olimpiade Penelitian Siswa Indonesia (OPSI) SMP N 1 Rejang Lebong. Proses pelatihan dapat diselesaikan tepat waktu dan tanpa hambatan serta siswa-siswi anggota kegiatan Olimpiade Penelitian Siswa Indonesia (OPSI) SMP N 1 Rejang Lebong dapat memilih sumber pustaka untuk referensi kegiatan penelitian yang akan di usulkan pada bulan Juni 2022
Sosialisasi Tanaman Toga Pelancar Asi Di Daerah Limbungan RW 08 Kelurahan Rumbai Pesisir Kota Pekanbaru
Authors: Febriani Ade
Published: November 2022

This community service activity program is so that mothers, especially breastfeeding mothers, can know the types and benefits of the toga plant to facilitate breastfeeding. This community service is carried out in the form of counseling and implementation of the introduction of special toga plants to facilitate breastfeeding for breastfeeding mothers directly and planting toga plants in the area around the mother's house (respondents). Community service consists of 2 stages, the first stage is collecting data on breastfeeding mothers and planting toga seedlings and the second stage is the distribution of seeds which will be carried out during the posyandu schedule in the Limbungan RW 08 Kelurahan Rumbai Pesisir, namely on June 08 2022. the result of this community service activity is a good response from the respondents. Participants are able and have been able to do processing and understand about the toga plant to facilitate the production of breast milk. During the activity, it was found that the mother's knowledge about the toga plant to increase breast milk was good and all the audience understood about the toga plant to increase breast milk.
Sosialisasi Dan Edukasi Software Accounting Dalam Pencatatan Laporan Keuangan Pada Bmt Dmi Kota Pekanbaru
Authors: Putri Annie Mustika , Andisfa Rio
Published: November 2022

Islamic financial institutions or can be called interest-free banks are finance/banking whose operations and products are developed based on the arguments of the Qur'an and the Hadith of the Prophet SAW. Islamic financial institutions are banks whose working mechanism uses a profit-sharing system. Currently IAI (Indonesian Accounting Associations) has issued a statement of financial accounting standards (PSAK) which regulates Islamic Financial Accounting. The purpose of this activity is to provide knowledge and insight to readers about the role of the importance of accounting software in sharia cooperatives in recording their financial statements in the era of all-technology at this time, the role of technology in each activity is greatly assisted, for that it is necessary to have good socialization related to software Accounting in Sharia cooperatives. And help the BMT DMI in Pekanbaru. As for the target, the members/managers of the sharia cooperative BMT DMI Pekanbaru City understand and understand Accounting Software which can facilitate managers in recording financial statements properly and correctly. This activity will greatly assist the management of BMT DMI to run the program and its financial system. The result is that Accounting Software can help BMT DMI in doing accounting
Strategi peningkatan Proses Produksi dan Pemasaran pada Usaha Mikro Kerupuk Sumber Rejeki
Authors: Sunanto Sunanto , Rudy Asrianto  , Puji Ari Andriyas
Published: November 2022

Krupuk adalah makanan kas Indonesia yang terbuat dari berbagai tepung dan kombinasi bahan  protein  lainnya.  Usaha  Kerupuk  Sumber  Rejeki  yang  beralamat  di  Jl.Guru  No.11  RT/RW:003/009 Kelurahan Sidomulyo Barat Kec.Tampan Kota Pekanbaru adalah suatu bentuk usaha mikro bidang kerupuk yang telah berdiri pada tahun 2008.   Semenjak pademi covid 19 Usaha Kerupuk Sumber Rejeki mengalami penurunan omset. Proses pemasaran yang tidak dapat dijangkau langsung oleh konsumen menurunkan omset pada saat pemerintah melakukan PSBB (Pembatasan Sosial Berskala Besar). Pada saat WFH masyarakat tidak berani keluar rumah sehingga makanan pokok saja yang dikonsumsi kerupuk mulai di tingalkan sehingga pemilik Usaha Kerupuk Sumber Rejeki terpaksa harus memberhentikan semua karyawannya. Untuk mempertahankan usaha kerupuk tersebut pemilik menjalankan usahanya sendiri dibantu anggota keluarga.  Selain peralatan produksi yang seadanya segmentasi pasar pun berebut dengan produsen kerupuk besar. Desain kemasan yang standar dan tidak menarik menjadi faktor menurunnya minat masyarakat untuk membeli kerupuk tersebut. Untuk mengatasi permasalahan mitra dibutuhkan beberapa kepakaran untuk membantu merancang, mendesain dan menyediakan peralatan produksi, untuk menembus segmentasi pasar yang lebih luas disiapkan sebuah aplikasi bernama kerupuk-Ku agar dapat menjangkau pasar yang luas.
MEASURING INTANGIBLE ASSET: FIRM REPUTATION
Authors: Edi Edi , Wati Erna
Published: November 2022

The purpose of this research is to find out the measurement of firm reputation that are still relevant to represent firm reputation. The measurement that are being tested in this research are CSR Award, Firm Age, Listing Age, Market Capitalization, Buy and Hold Abnormal Return and Price Earnings Ratio as the measurement for firm reputation. The novelty of this research is able to prove LQ45 are able to become a measurement to represent firm reputation. The data sample of this research are companies that listed in Indonesia stock exchange between 2016 till 2020. To select the research sample,this research conducted purposive sampling. This research data analysis is using SPSS program to conduct descriptive statistical test and spearman correlation test to measure the correlation between each variable. The results of this study show that measurement like listing age and BHAR are no longer a relevant measurement to measure firm reputation but CSR Award, Firm Age, Market Capitalization and Price earning Ratio are still a relevant measurement to measure firm reputation.This research also found that LQ45 can be used as the novel measurement for firm reputation. This research results will be helpful for researcher in firm reputation area.
Protective effect of lacosamide and topiramate treatment against Pentylenetetrazole-induced kindling and associated cognitive dysfunction in rats
Authors: Shishmanova-Doseva Michaela
Published: November 2022

Cognitive impairment is considered the most common comorbidity in epilepsy. The aim of the present study was to explore the effects of long-term treatment with lacosamide and topiramate on epileptogenesis and related cognitive dysfunction in an experimental model of pentylenetetrazole (PTZ)-induced kindling. The latter was induced by the repeated administration of subconvulsive dose of PTZ (40 mg/kg, s.c.) on every alternate day for 8–9 weeks. Both drugs were applied daily in a dose of 10 mg/kg p.o. 30 min before PTZ injection. To assess behavioral comorbidities all rats underwent one active and one passive avoidance tests. The results show that lacosamide significantly suppressed the progression of kindling, while the effect of topiramate was not so pronounced on seizure development. Long-term treatment with both antiepileptic drugs managed to ameliorate the kindling-associated impairment of learning and memory. Lacosamide and topiramate improved active and passive learning abilities and facilitated the formation of short- and long-term memory traces. Both drugs failed to prevent the hyperactivity associated with epilepsy.
Dissection of tumor antigens and immune landscape in clear cell renal cell carcinoma: Preconditions for development and precision medicine of mRNA vaccine
Authors: Hu Jianpei , Mo Zengnan
Published: November 2022

Accumulating evidence reveals that mRNA-type cancer vaccines could be exploited as cancer immunotherapies in various solid tumors. However, the use of mRNA-type cancer vaccines in clear cell renal cell carcinoma (ccRCC) remains unclear. This study aimed to identify potential tumor antigens for the development of an anti-ccRCC mRNA vaccine. In addition, this study aimed to determine immune subtypes of ccRCC to guide the selection of patients to receive the vaccine. Raw sequencing and clinical data were downloaded from The Cancer Genome Atlas (TCGA) database. Further, the cBioPortal website was used to visualize and compare genetic alterations. GEPIA2 was employed to evaluate the prognostic value of preliminary tumor antigens. Moreover, the TIMER web server was used to evaluate correlations between the expression of specific antigens and the abundance of infiltrated antigen-presenting cells (APCs). Single-cell RNA sequencing data of ccRCC was used to explore the expression of potential tumor antigens at single-cell resolution. The immune subtypes of patients were analyzed by the consensus clustering algorithm. Furthermore, the clinical and molecular discrepancies were further explored for a deep understanding of the immune subtypes. Weighted gene co-expression network analysis (WGCNA) was used to cluster the genes according to the immune subtypes. Finally, the sensitivity of drugs commonly used in ccRCC with diverse immune subtypes was investigated. The results revealed that the tumor antigen, LRP2, was associated with a good prognosis and enhanced the infiltration of APCs. ccRCC could be divided into two immune subtypes (IS1 and IS2) with distinct clinical and molecular characteristics. The IS1 group showed a poorer overall survival with an immune-suppressive phenotype than the IS2 group. Additionally, a large spectrum of differences in the expression of immune checkpoints and immunogenic cell death modulators were observed between the two subtypes. Lastly, the genes correlated with the immune subtypes were involved in multiple immune-related processes. Therefore, LRP2 is a potential tumor antigen that could be used to develop an mRNA-type cancer vaccine in ccRCC. Furthermore, patients in the IS2 group were more suitable for vaccination than those in the IS1 group.
Teaching Young Children About Sustainability
Authors: Rizzuto Kerry Carley , Henning John E. , Nielsen Katlyn M. , Duckett Catherine
Published: November 2022

The purpose of the article is to provide and an exemplar of an inquiry-based unit on pollination for designing and implementing constructivist instructional practices while simultaneously providing outstanding teacher preparation. The unit on pollination was developed by preservice teachers through a partnership between the Monmouth Conservation Foundation and the Monmouth University School of Education. Through collective action, these institutions were able to enhance student learning on a vital part of the science curriculum, provide a rich clinical experience for pre-service teachers, and familiarize teachers with a more constructivist approach to pre-school science instruction.
What Should a Startup Know About Software Customization?
Authors: Parthasarathy S. , Sivagurunathan Shanmugam , Subramanian Girish H.
Published: November 2022

Due to the expansion of new markets, accessible technologies, and venture funding, software startup growth is amazing. Moreover, startups are frequently required to adapt their software products prior to deployment at a customer's location. The authors collected a data set of 30 software projects retrieved from three software businesses using a case study research approach, with each software startup supplying a data set of 10 of its software projects tagged as failure projects in their project repository. The authors quantify and demonstrate the level of substantial software customization in startup software projects. The authors have also presented a simplified technique for quantifying customization requests for startups. Additionally, they offer tips and best practices to assist entrepreneurs in managing software customization.
Sustainability Challenges in the MSME Sector of India Post COVID-19
Authors: Satapathy Smruti Ranjan , Mishra Meghana
Published: November 2022

MSME area adds to business age at a low capital expense contrasted with enormous businesses. It helps in the sustainable industrialization of metropolitan and country zones, decreases provincial irregularity, and guarantees evenhanded conveyance of pay and abundance. This examination paper talks about the different issues of financing for miniature, little, and medium undertakings during and post COVID-19. Through the writing survey, plainly money is a basic device for the development and improvement of SMEs. The challenges of sustainable MSMEs are money, policies, environmental regulation, supply chain, etc., but during and post COVID-19, problems and challenges are tackling financial issues of companies, restart supply chain management, new startups, etc. Although government endeavors have been made for the smooth progression of credit to MSMEs areas, MSMEs require more research. Hence, an attempt is made to prioritize challenges of MSMEs during and post COVID-19.
Sustainability in the Service Quality of Healthcare Facilities
Authors: Khan Mohammed Sadique , Hafiz Azeem , Abdul Khadar Shaik Dawood , Fahad Mohammed
Published: November 2022

The basic determining elements of a healthcare centre are the patient's satisfaction provided by the hospitals, behavioral and psychological aspects, quality and efficiency of the hospitals. The imprecise response of patients adds to the complexity in evaluation of quality. On the other hand, in order to have a sustainable service quality in healthcare centre, environment issues related to patient wellness play a greater role. The major indicator in this regard is the disposal of medical waste and the cleanliness of the centre. Thus, the involvement of multiple criteria, uncertainty, and qualitative factors make the quality evaluation of healthcare facilities very complicated. In this research, a pilot study has been carried out. The ranking of dimensions as well as the hospitals are established using fuzzy analysis. The outcome of this study can be helpful to choose a better service from the range of service provider options, and secondly, managers can locate their area of weakness for continuous improvement and sustainability in health service quality.
Teachers' and Principals' Views Regarding School-Based Professional Learning Communities
Authors: Levy-Feldman Irit , Levi-Keren Michal
Published: November 2022

The study's aim was to examine the views of teachers and principals regarding teachers' professional development (PD) carried out in their school's professional learning communities (PLC), in order to identify the conditions that promote its success. This quantitative study collected information from 193 teachers and 10 principals from 10 schools in the north district of Israel. The study findings are based on a meta-evaluation of several PLCs in which different models of teachers' PD operated, and therefore, indicates a broad point of view beyond a specific PD model or a specific school-based PLC. Main findings emphasize the importance of a 'tailor-made' PD in a local school PLC, on one hand, and the relationship between teachers' PD in school PLCs and the growth-oriented organizational culture, on the other hand. Results further highlight the importance of simultaneously reinforcing both in order to improve the overall educational endeavor in the school organization.
Review of Literature on Managing Information Technology Investment for Firm Performance: A Bibliometric Approach
Authors: Ilmudeen A.
Published: November 2022

The many-sided view or the role of information technology (IT) towards firm performance has been extensively examined. The academic scholars and industry practitioners agree that there are underlying theories for managing IT, still, the literature is suffering the comprehensive review-based research. Similarly, though there is extensive empirical evidence on managing information technology investment and firm performance, complete thoughtful research directions and the recent progress in the field are limited. Hence, a strong understanding of the present lay of the paradigm is required to assist in this research domain. Against these backdrops, this study explores an overview of this research field using a bibliometric approach focusing on the published academic journal articles in Web of Science for the period between 2000 and 2021. This study demonstrates maps for the journal name, keywords, title and abstract section keywords, co-authorship for counties, co-citation for a cited author, and cited sources are demonstrated.
Congenital portosystemic shunt with multiple splenic artery aneurysms
Authors: Subramanian Anand P. , Bharath Adaligere Paraswanath , Barthur Ashita , Jayranganath Mahimarangaiah
Published: November 2022

We report an unusual occurrence of multiple splenic artery aneurysms and splenomegaly in a young woman with severe pulmonary hypertension, secondary to a congenital portosystemic shunt (CPS). The splenic artery was occluded using an Amplatzer Duct Occluder-II device, and closure of the large intrahepatic CPS was achieved using a muscular ventricular septal defect occluder. There was resolution of splenomegaly with normal pulmonary artery pressures, a few months after the procedure.
Ventricular septal defect Doppler peak gradient underestimates right ventricular systolic pressure in the presence of right bundle branch block
Authors: Uppu Santosh C. , Srivastava Shubhika , Love Barry A.
Published: November 2022

Estimation of the right ventricular systolic pressure (RVSP) using echocardiographically derived maximal instantaneous gradient across the ventricular septal defect is a well-utilized tool, which can potentially underestimate the RVSP in patients with conduction abnormalities as such its utility in these patients is questionable.
Oncogenesis in patients with congenital heart disease
Authors: Ferrero Paolo , Piazza Isabelle , Giamberti Alessandro , Chessa Massimo
Published: November 2022

Patients with congenital heart disease (CHD) seem to have a higher risk for specific malignancies. We hypothesize a pathogenetic link between particular congenital heart defects and cancer originating from specific cellular lineages. We report a series of patients, followed in two high-volume referral centers, with CHD involving neural crest-derived structures who developed cancer later in life. Fourteen patients (five female) developed neoplasia with a cellular origin embryologically linked to the neural crest between 2010 and 2020. If confirmed on larger datasets, this observation might support the hypothesis of common embryogenetic pathway suggesting tailored surveillance of a specific subset of patients.
A large basal left ventricular pseudoaneurysm following pediatric cardiac surgery
Authors: Scrascia Giuseppe , Lamparelli Raffaella , Gaeta Alberto , Troise Dario , Stellacci Giandomenico , Vairo Ugo , Scalzo Gabriele
Published: November 2022

Left ventricular pseudoaneurysm (LV-PSA) is a rare complication in children, usually developing after cardiac surgery, percutaneous procedures, infections, or trauma. Herein, we report a case of large basal submitral LV-PSA in a 36-day-old baby, detected 26 days after cardiac operation for hypoplastic arch, aortic coarctation, and small ventricular septal defect. No complications occurred in the first postoperative course, and early postoperative echocardiograms were normal. Despite large dimension of pseudoaneurysm, the baby presented with only mild tachypnea. The baby was successfully operated. Pseudoaneurysm, besides rare, could have an extremely broad and insidious clinical presentation and had to be considered in post-cardiac surgery follow-up echocardiogram at any time lapse.
Small cell neuroendocrine carcinoma with primary orbital involvement – The unseen, and a review of literature
Authors: Agrawal Sahil , Deora Aarush , Sen Seema , Gupta Saloni , Das Deepsekhar
Published: November 2022

Neuroendocrine neoplasms are derived from the epithelial lineages mainly of respiratory tract, with predominant neuroendocrine differentiation. There are only a handful of documented cases of paranasal small cell neuroendocrine carcinomas (SNEC) with primary orbital involvement. Here, the authors describe a 33-year-old male patient with rapidly progressive swelling of the right lower lid with proptosis since 4 weeks. On contrast-MRI orbit, an ill-defined multilobulated mass measuring 3.6 × 3.1 cm with intense homogenous enhancement was seen in the right retrobulbar space involving the right ethmoid sinus. On incisional biopsy, a poorly differentiated mass containing numerous small round blue cells and scanty intervening stroma with prominent necrosis and apoptosis was seen. Immunohistochemistry was strongly positive for synaptophysin. He was diagnosed as a case of SNEC and received chemotherapy, with good response till date of 9 months of follow up. The authors present a literature review and describe challenges in management of a primary orbital SNEC.
Combined hepatocellular cholangiocarcinoma in hepatectomy specimens: A clinicopathologic analysis
Authors: Patil Nayana , Sahai Puja , Rastogi Archana , Sharma Namita , Shasthry Saggere Muralikrishna , Mukund Amar , Laroia Shalini Thapar , Kumar Guresh , Pamecha Viniyendra , Sarin Shiv Kumar
Published: November 2022

Background:

Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is an uncommon form of primary liver carcinoma. It is heterogenous in terms of morphology, immunohistochemistry, radiology, and clinical features; making it a challenging entity for diagnosis.

Aims:

The purpose of the present study was to evaluate clinicopathological characteristics of patients with cHCC-CCA.

Settings and Design:

Retrospective observational study.

Materials and Methods:

The patients diagnosed with cHCC-CC were identified from hepatic surgical specimens and were evaluated.

Statistical Analysis:

Survival was estimated as per Kaplan–Meier method.

Results:

Out of six patients, five had undergone resection while one had liver transplant. Five were male and one was female and the mean age was 52 years. Tumor markers revealed raised serum alfa-fetoprotein and CA19.9 in four and three patients, respectively. Five of the liver specimens were cirrhotic. Diagnosis was predominantly based on tumor morphology. All cases were of Allen and Lisa type B and cHCC-CCA as per WHO (2019) classification. Stem cell features <5% were noted in two cases. Immunohistochemistry for programmed death 1/programmed death ligand 1 (PD1/PDL1) was negative in both the hepatocellular and cholangiocellular components in all six cases. Mismatch repair (MMR) protein expression was retained in two and deficient in four cases. The median follow-up after surgery was 21.3 months (range, 5-46.2 months). Five patients had intrahepatic and/or extrahepatic recurrence on follow-up after surgery. The median recurrence-free survival was estimated at 13.1 months (95% CI 5.67-20.6). Three patients had received salvage treatment. The median overall survival was estimated at 20 months (95% CI 0-45.3).

Conclusions:

The present study highlights the role of morphology in the diagnosis of cHCC-CCA. The choice of locoregional and/or systemic therapy after surgery may be individualized based on the clinicopathological characteristics.
Understanding drug resistance patterns across different classes of antiretrovirals used in HIV-1-infected treatment-Naïve and experienced patients in Mumbai, India
Authors: Harjani Raj Gurubuxrai , Iyer Asha Krishnaraj , Chaurasia Ankita
Published: November 2022

Background:

The aim of this study is to find out the proportion of treatment-naïve (Tn) and treatment-experienced (Te) patients experiencing HIV drug resistance (DR) to different classes of antiretrovirals (ARVs) being used for HIV treatment and their in class DR correlation.

Methods:

A cross-sectional study was done on 109 HIV patients enrolled at a private hospital in Thane, India, from 2014 to 2019. All patients were tested for CD4 count, viral load, and resistance to ARVs.

Results:

Sixty-six patients were Tn and 43 patients were Te. Among Tn and Te patients, the percentage of high-level resistance (HLR) for nonnucleoside reverse transcriptase inhibitors (NNRTI) was 4.55% and 37.8%, respectively, for nucleoside reverse transcriptase inhibitors (NRTI) was 0.43% and 36.4%, respectively. No HLR was observed for protease inhibitors (PIs) among Tn patients, while Te patients showed 2.62% HLR. Tn and Te patients showed high susceptibility for Darunavir (98.48% and 95.34%, respectively) followed by Atazanavir and Lopinavir (96.96%, each and 90.69%, each). Tn patients showed HLR for Lamivudine and Emtricitabine (1.52%, each). Integrase Strand Transfer Inhibitors were susceptible (100%) in both Tn and Te patients. A positive correlation was observed for within class across ARVs.

Conclusion:

An increased incidence of HLR was observed for NNRTI as compared to NRTI while PIs and integrase strand transfer inhibitors (INSTIs) demonstrated no HLR in either group of patients. When selecting a regimen for Tn patients consisting of NRTIs + NNRTIs genotypic DR test is essential. While with PIs or INSTIs its optional. Among Te patients, DR testing is recommended for all classes of drugs.
An inscrutable entity
Authors: Rathwa Pratiksha Kanubhai , Chauhan Jatin , Patel Nidhi Pravinkumar , Shah Hiral , Vara Nipul V
Published: November 2022

Congenital syphilis is an outcome of maternal syphilis that occurs due to the transmission of Treponema pallidum via the placenta of untreated or inadequately treated pregnant women to their newborns. It is now a very rare cause of neurological, developmental, and musculoskeletal disability and death in infants after the advent of penicillin. Here, we report a case of late congenital syphilis presented with classic stigmata of syphilis at the age of 10 years. Reactive serological titer of rapid plasma reagin test and venereal disease research laboratory test confirmed the diagnosis.
Study of clinical profile and outcomes in progressive multifocal leukoencephalopathy in acquired immunodeficiency syndrome patients in the highly active antiretroviral therapy era – An observational study
Authors: Arora Sumit , Ahmad Faiz M. H. , Deshwal Rajesh , Behal Pradeep
Published: November 2022

Background and Objectives:

Progressive multifocal leukoencephalopathy (PML) is a viral infection affecting the central nervous system (CNS) seen mostly in advanced human immunodeficiency virus (HIV) infection. There is limited data on the epidemiology and disease course of these patients from India. This study was aimed to determine the frequency of PML in patients with HIV/acquired immunodeficiency syndrome (AIDS) and the clinical presentation and prognosis of these patients.

Materials and Methods:

The study was conducted at a tertiary care HIV center in New Delhi. Data of 765 patients from our anti-retroviral therapy (ART) clinic during a span of 4 years were retrospectively analyzed and reviewed. The diagnosis was based on the clinical and radiological picture and exclusion of other differential diagnosis by cerebrospinal fluid and serological studies.

Results:

Of 765 patients with HIV/AIDS, 12 (1.56%) were diagnosed with PML on the basis of consistent clinical and radiological features after ruling out other differential diagnosis. PML was the initial presentation of HIV infection in 8 (55.5%) patients. 11 (89%) patients had CD4 count <200/μl. Insidious onset focal limb weakness (50%) and dysarthria (50%) were common symptoms. Magnetic resonance imaging of the brain revealed characteristic white matter lesions in all the patients. The estimated median survival was 40 months (95% confidence interval, 23.88–53.19 months).

Interpretation and Conclusions:

Our results show that PML is associated with high morbidity despite the institution of highly active ART (HAART), but mortality has significantly declined if ART is started early. Key to good response is early diagnosis and HAART.
Bowen's disease on two different unrelated anatomical sites (genitals and nail) in succession in an immunocompromised patient
Authors: Musaddique Ansari Saba Mohammed , Gupta Ankit , Nayak Chitra Shivanand
Published: November 2022

Bowen's disease (BD) is a premalignant condition. Its exact etiology is unknown but chronic arsenic and sun exposure, and human papillomavirus infection is known predisposing factors. Pigmented lesions of BD represent 1.7%–5.5% of all BD cases. BD in the nail unit is challenging due to its varied clinical presentations such as fissure, ulceration, warty lesion, paronychia, onychocryptosis, and nail dystrophy. We present the case of a 43-year-old married, immunocompromised male (HIV), with a CD 4 count of 478, on tenofovir, atazanavir boosted with ritonavir regimen, known diabetic presented with multiple asymptomatic discrete, rounded, hyperpigmented verrucous papules on both surfaces of shaft of penis and scrotum and a single, 4 cm × 3 cm, irregular, smooth surfaced, hyperpigmented plaque, on the base of the penis extending to the upper part of the scrotum of 1-year duration with history of multiple unprotected sexual exposures with unknown female partners. Regional lymphadenopathy and systemic complaints were absent. Biopsy from hyperpigmented verrucous papule and hyperpigmented plaque was consistent with verruca vulgaris and pigmented Bowen's disease, respectively. The patient was lost to follow-up. Ten months later, he presented with longitudinal melanonychia with a subungual hyperpigmented mass protruding beyond the distal nail margin near the lateral nail fold of the right middle finger nail with an absent Hutchinson's sign. Longitudinal excisional biopsy of nail lesion was consistent with BD. He was started on 5-fluorouracil 5% for BD of genitals and podophyllin application for verruca vulgaris with remarkable improvement in both the lesions and there is no recurrence of nail lesion after 9 months of excision.
Prozone phenomenon in secondary syphilis with HIV co-infection
Authors: Awake Praneet , Angadi Kalpana , Sen Sourav , Bhadange Prasad
Published: November 2022

Prozone phenomenon is defined as a false-negative response resulting from higher antibody titer which interferes with formation of antigen–antibody lattice, necessary to visualize a positive flocculation test. The prozone effect can be observed in syphilis testing with cases of very high antibody titers, such as secondary syphilis, or with human immunodeficiency virus (HIV) co-infection. We report two cases of prozone phenomenon in secondary syphilis with HIV co-infection who initially tested nonreactive for rapid plasma reagin test but tested positive with further higher dilution.
Case report of co-existing keratotic balanitis and squamous cell carcinoma in a 42-year-old male
Authors: Puri Neerja , Singh Onkar , Brar Balvinder Kaur
Published: November 2022

Although a number of premalignant and malignant lesions affect the genitalia of men, such as condyloma acuminata, erythroplasia of queyrat, squamous cell carcinoma, hyperkeratotic balanitis is rare and a patient showing both hyperkeratotic and well-differentaited squamous cell carcinoma is rarer. We report the case of a 42-year-old male, who had a hyperkeratotic plaque like lesions over the glans, with accompanied atrophic areas.
A systematic review of eHealth modes in preventing sexually transmitted infections
Authors: Nourimand Firoozeh , Keramat Afsaneh , Sayahi Masoumeh , Bozorgian Leila , Hashempour Zahra
Published: November 2022

Prevention of sexually transmitted diseases (STDs) is critical. Despite developing treatment and prevention programs, sexually transmitted infections (STIs) are essential in developing acute and chronic diseases. Because “eHealth” (electronic-Health) has excellent potential for disseminating health information to the public regarding STDs, we aimed to identify and review all published articles focusing on preventing STIs. After constructing the design and answering population, intervention, comparison, and outcome questions, two authors conducted a systematic literature search in four online databases in January 2022. The screening process and data extraction were conducted by two authors independently, and then, a quality assessment was performed. After removing duplicates, and two rounds of shortlisting, 16 articles were included for data extraction out of 5113 entries. Included studies were of different designs and assessed six preventive outcomes categories, with condom use being the most frequent result among studies. We also extracted implementation outcomes and reviewed them. Included studies with 13,137 participants have provided reasonable evidence of the effectiveness of different types of eHealth in improving STI prevention interventions. Although this systematic review was not without limitations, it can no longer be ignored that eHealth modes offer many opportunities to prevent STDs, especially among the young population.
Congenital syphilis presenting as fulminant early-onset sepsis
Authors: Shah Mayur Sureshbhai , Jain Apexa Prakash , Rathod Ashutoshsingh N. , Jain Harshita P. , Sheth Dhrumika N , Bhargava Shruchi
Published: November 2022

Congenital syphilis (CS) is a rare entity and one of the most well-known congenital infections. A case of early CS presenting with fulminant sepsis is reported. A high index of suspicion is needed by the clinician to diagnose and treat this potentially life-threatening disease.
Etiology of cervicitis
Authors: Bansal Shikha , Bhargava Aradhana , Verma Prashant , Khunger Niti , Panchal Paveen , Joshi Naveen
Published: November 2022

Background:

Considering the changing causative and resistance pattern of agents implicated in sexually transmitted infections (STIs), etiological diagnosis is imperative, especially in countries practicing syndromic management. This study was designed to identify etiological agents associated with cervicitis and to analyze their association with clinical and behavioral profile.

Materials and Methods:

Female STI clinic attendees presenting with cervico-vaginal discharge were examined for the presence of cervicitis. Endocervical swabs were collected for gram staining and real-time polymerase chain reaction was performed for various bacterial and viral STI agents in patients presenting with cervical discharge. A vaginal swab was also evaluated for bacterial vaginosis by Nugent's criteria.

Results:

Of 64 patients with vaginal discharge, 26.6% and 12.5% patients complained of genital itching and lower abdominal pain, respectively. Mean of 36.6 pus cells/hpf were observed, appreciably greater number in patients with Neisseria gonorrhoeae and Chlamydia trachomatis infections (P = 0.0063 and 0.0032, respectively). Pus cells were high (mean 68 pus cells/hpf) in patients with Ureaplasma urealyticum, though this may be attributed to coexisting N. gonorrhoeae. Agents isolated from endocervix were N. gonorrhoeae, 17 (26.6%), Trichomonas vaginalis, 4 (6.3%), HSV1 and C. trachomatis, 1 each (1.6%), HSV2, 9 (14.1%), U. urealyticum 5 (7.8%), Ureaplasma parvum 26 (40.6%), Mycoplasma genitalium (0%), and Mycoplasma hominis 11 (17.2%). Bacterial vaginosis was diagnosed in 14 (21.9%) patients. Multiple agents were isolated in 10 (two), 6 (three), 6 (four), and 1 (five) patients. Isolation of M. hominis and U. parvum was significantly associated with bacterial vaginosis (P = 0.04 and 0.003, respectively). Nonusage of condoms and mental stress predisposed to cervicitis.

Conclusion:

We concluded that there are changing etiological patterns of cervicitis. There is need to use tests that detect wider array of organisms, and can replace standard culture methods with molecular assays, to increase the ability to diagnose more number of organisms implicated in cervicitis.