bluuebunny/crossref_metadata_2025 huggingface dataset:
Classification of Rajayoga Meditators Based on the Duration of Practice Using Graph Theoretical Measures of Functional Connectivity from Task-Based Functional Magnetic Resonance Imaging
Authors: Savanth Ashwini S. , Vijaya P. A. , Nair Ajay Kumar , Kutty Bindu M.
Published: April 2023

Context:

Functional magnetic resonance imaging (fMRI) studies on mental training techniques such as meditation have reported benefits like increased attention and concentration, better emotional regulation, as well as reduced stress and anxiety. Although several studies have examined functional activation and connectivity in long-term as well as short-term meditators from different meditation traditions, it is unclear if long-term meditation practice brings about distinct changes in network properties of brain functional connectivity that persist during task performance. Indeed, task-based functional connectivity studies of meditators are rare.

Aims:

This study aimed to differentiate between long-term and short-term Rajayoga meditators based on functional connectivity between regions of interest in the brain. Task-based fMRI was captured as the meditators performed an engaging task. The graph theoretical-based functional connectivity measures of task-based fMRI were calculated using CONN toolbox and were used as features to classify the two groups using Machine Learning models.

Subjects and Methods:

In this study, we recruited two age and sex-matched groups of Rajayoga meditators from the Brahma Kumaris tradition that differed in the duration of their meditation experience: Long-term practitioners (n = 12, mean 13,596 h) and short-term practitioners (n = 10, mean 1095 h). fMRI data were acquired as they performed an engaging task and functional connectivity metrics were calculated from this data. These metrics were used as features in training machine learning algorithms. Specifically, we used adjacency matrices generated from graph measures, global efficiency, and local efficiency, as features. We computed functional connectivity with 132 ROIs as well as 32 network ROIs.

Statistical Analysis Used:

Five machine learning models, such as logistic regression, SVM, decision tree, random forest, and gradient boosted tree, were trained to classify the two groups. Accuracy, precision, sensitivity, selectivity, area under the curve receiver operating characteristics curve were used as performance measures.

Results:

The graph measures were effective features, and tree-based algorithms such as decision tree, random forest, and gradient boosted tree yielded the best performance (test accuracy >84% with 132 ROIs) in classifying the two groups of meditators.

Conclusions:

Our results support the hypothesis that long-term meditative practices alter brain functional connectivity networks even in nonmeditative contexts. Further, the use of adjacency matrices from graph theoretical measures of high-dimensional fMRI data yields a promising feature set for machine learning classifiers.
Integrative Medicine Enhances Motor and Sensory Recovery in Guillain–Barre Syndrome – A Case Study
Authors: Soman Akhila , Chikkanna Umesh , Ramakrishna Kishore Kumar , Bhargav Hemant , Venkataram Shivakumar , Jasti Nishitha Lakshmi , Sharma Shubham , Ganapathy Velayutham Selva , Varambally Shivarama
Published: April 2023

Guillain–Barre syndrome (GBS) is a heterogenous group of immune-mediated conditions affecting peripheral nerves. About 40% of patients treated with standard dosage of plasma exchange or intravenous immunoglobulins do not improve in the first 4 weeks following treatment. Add-on treatment from traditional medical approaches such as Yoga therapy and Ayurveda are increasingly being sought for rehabilitation of patients with chronic neurological disorders. The current case study reports the clinical utility of adjunct Yoga and Ayurveda treatment in the treatment of residual symptoms of GBS.
Yoga and Integrative Healthcare
Authors: Bhargav Hemant , Holla Bharath , Ramakrishna Kishore Kumar , Shivakumar Venkataram , Gokulakrishnan K. , Varambally Shivarama , Gangadhar B. N.
Published: April 2023

Background:

There is growing evidence and increasing interest for systemic integration of medicine (synergistic and evidence-based combination of different systems along with conventional biomedicine). The National Institute of Mental Health and Neurosciences (NIMHANS), an Institute of National Importance and a tertiary mental and neurological healthcare hospital situated in Bengaluru, India, has established one such integrative model. The present manuscript traces the history and describes the important steps followed in this integrative approach.

Methodology:

The NIMHANS model followed a stage-wise two-step approach: (1) First stage – Starting with Integration of Yoga: The process began more than a decade ago, with integrating yoga into a clinical department (rather than an exclusive research-based approach) of the institute which had relatively high clinical service load (For example, Department of Psychiatry in NIMHANS). Yoga was gradually formalized into academic and clinical activities (outpatient and inpatient services) by appointing a Yoga faculty with a medical background with an MD/PhD in Yoga. The research was primarily directed by the clinical observations of patients receiving yoga therapy. (2) Second stage: Adding an appropriate and compatible discipline from Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) system (Ayurveda in this case): The center for yoga gradually evolved into the Department of Integrative Medicine with the appointment of faculty from the Ayurveda stream. In this model, specialists from each discipline provide clinical inputs after simultaneous consultation with the patient through systemic integration in clinical, academic, and research domains rather than mere co-location of AYUSH services with mainstream medicine.

Conclusion:

The NIMHANS model of integration suggests the application of yoga into mainstream clinical service as the first step toward integration. Yoga should be added as a formalized clinical discipline with systemic integration. Gradually, other feasible systems of traditional medicine from AYUSH can be integrated at a later stage in a step-by-step manner based on clinical practice and evidence.
Slivers of Hair – A Clue to Uncover Silver Hair Syndromes
Authors: Ganeshan Nivetha , Rajaram Muthukumaran , Ramamoorthy Madhavan , Sukumar Bharathi
Published: April 2023

Silver hair syndromes (SHS) consist of rare autosomal recessive disorders, Chediak–Higashi syndrome (CHS), Griscelli syndrome (GS), and Elejalde disease. CHS is a disorder of vesicle trafficking; characterized by silvery hair, diffuse pigment dilution, immunodeficiency, bleeding diathesis, neurological manifestations, and an accelerated phase due to lymphohistiocytic infiltration. GS is characterized by hypopigmentation of skin and hair, with large clumps of pigment in the hair shaft. There are three types of GS. GS1 and GS2 show neurologic and hematologic impairments; GS3 is restricted to the skin. Some authors suggest that Elejalde syndrome is synonymous with GS Type 1. Here, we report two cases who presented with silver-gray hair but with varied clinical manifestations. With a light microscopic examination of the hair and peripheral smear, a diagnosis has been made. This report highlights the importance of hair shaft microscopy, an inexpensive, noninvasive, and simple tool in the diagnosis of SHS.
Study on Results of Laminectomy with Short-Segment Pedicle Screw Fixation in Dorsolumbar Fractures with Respect to Anatomical Reduction, Functional Recovery and Pain
Authors: Maheshwari Deepanshu , Tonk Gyaneshwar , Agarwal Sumit
Published: April 2023

Background:

The aim of this study was to report the results of laminectomy with short-segment pedicle screw fixation in thoracolumbar fracture.

Materials and Methods:

Forty-two patients were analyzed prospectively, followed up in the outpatient department for the period of 24 months.

Results:

Most of the patients in the study had reasonable to good neurological recovery in the postoperative period assessed in the form of American Spinal Cord Injury Association (ASIA) score. There was also an excellent improvement in the components of anatomical reduction such as vertebral height, Cobb’s angle, and anterior wedge angle, which was directly related to functional recovery of the patient. Patients postoperatively also got relieved in pain in the dorsolumbar region assessed based on Denis pain scale.

Conclusion:

Laminectomy with pedicle screw fixation is an excellent option for patients with thoracolumbar fracture; it not only decompresses the spine but also provides stability with minimal manageable complications.
Physiological Adaptations of Skeletal Muscle and Bone to Resistance Training and Its Applications in Orthopedics
Authors: Pal Chandra Prakash , Agarwal Vipul , Srivastav Richa , Gupta Mayur , Singh Sanjai
Published: April 2023

Resistance training is defined as practicing the execution of different physical exercises that steadily upsurges the muscular force production for improving musculoskeletal strength, power, and endurance. It is of several types and utilizes specific equipment that provides gradational weight increases and can direct them toward the aimed muscle group. Physiological adaptations occur in muscles in response to increasing resistance at levels of muscle fibers and neuromuscular motor units. It increases the cross-sectional area of the individual muscle fiber causing muscle hypertrophy, which is expressed as increased diameter, thickness, and strength of the muscle. There is an increase in the number of motor units recruited, the firing rate of each motor unit during a maximal contraction, activation, and force generation by the muscle. Resistance training enhances bone mineral content and density. New bone formation occurs in areas experiencing mechanical strain that exceeds a minimum force level encountered in daily activities. Benefits of resistance training include significant improvements in general health, balance, coordination, physical vigor, and mental well-being. Functional gains occur in terms of boosted joint function and reduced potential for injury due to increased bone, muscle, tendon, and ligament strengths. It has been safely used across a multitude of disorders requiring physical therapy. It plays a credible role in the rehabilitation of orthopedics patients suffering from disabling musculoskeletal weakness after fracture treatment and chronic painful ailments such as osteoarthritis, osteoporosis, rotator cuff tendinopathy, and neck and low back pain. We here present a review of the varied musculoskeletal physiological adaptations seen in the human body in response to resistance training and its applications in orthopedics.
Autonomic Functions in Hypothyroidism
Authors: Jose Antony , Maroli Roshan , George Peter
Published: April 2023

Background:

Hypothyroidism is a common endocrine disorder in the general population. Most of the cardiovascular and neurological manifestations of hypothyroidism are due to autonomic dysfunction. The American Academy of Neurology has recommended simple bedside autonomic function tests for the diagnosis and follow-up of autonomic functions. Recognition of autonomic dysfunction and treatment of hypothyroidism may improve cardiovascular outcomes. This study aims to assess autonomic dysfunction in hypothyroidism and correlate it with serum thyroid-stimulating hormone (TSH) levels.

Materials and Methods:

This cross-sectional study was conducted on 60 patients diagnosed with hypothyroidism for 12 months at a tertiary care center in Southern India. Patients with a Zulewski clinical score over 5 and fulfilling the selection criteria were included in the study after obtaining written informed consent. Details of history, treatment, examination, and thyroid function tests data were collected and bedside tests for autonomic functions were performed.

Results:

Ninety percent of individuals were female, and the average age of the included study population was 40.38 ± 11.78 years. Based on TSH and FT4 values, the patients were subgrouped into currently euthyroid and overt hypothyroid individuals. The majority of the individuals (81.67%) included in the study had autonomic dysfunction. Based on the autonomic dysfunction score, there was a significantly higher proportion of overt hypothyroid individuals (n = 18) with severe autonomic dysfunction compared to euthyroid individuals (n = 4). About 75% of the study individuals had sympathetic dysfunction and 66.7% of individuals had parasympathetic dysfunction. There was no statistically significant association between autonomic dysfunction and the duration of hypothyroidism.

Conclusion:

Autonomic dysfunction in hypothyroidism is common; sympathetic dysfunction was observed more as compared to parasympathetic dysfunction.
Impact of Percutaneous Coronary Intervention in the Right Coronary Artery on Right Ventricular Function in Patients with Acute Myocardial Infarction
Authors: Kiran Ganthala Paul , Santosh T. , John Grace Madhuri , Rao M. Srinivasa
Published: April 2023

Background:

Right ventricular (RV) dysfunction is a potent predictor of mortality and morbidity after acute myocardial infarction (MI). Even though elective percutaneous coronary intervention (PCI) has significantly decreased myocardial damage of the left ventricle; in literature, there has been a lack of information regarding the effect of PCI on RV function.

Objective:

The objective of this study is to examine the effect of the right coronary artery (RCA) revascularization on systolic and diastolic functions of the right ventricle following acute inferior wall MI (IWMI).

Subjects and Methods:

Fifty-nine patients diagnosed with acute IWMI following RCA revascularization were prospectively investigated between April 2018 and January 2020. Patients were subjected to two-dimensional echocardiography. RV systolic and diastolic functions were reported before and after the PCI procedure and compared using different echocardiographic RV systolic and diastolic parameters.

Results:

After PCI, echocardiographic RV systolic and diastolic functions were significantly improved in proximal and mid RCA in terms of tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (RVFAC), and early RV filling velocity/late RV filling velocity (E/A). Significant improvement was found in mid RCA in terms of peak systolic (S’) velocity (P = 0.008) and proximal RCA in terms of early RV filling velocity/early diastolic tricuspid annulus velocity (E/e’) (P = 0.021). Overall echocardiographic systolic and diastolic parameters in patients with RV dysfunction following PCI were improved (TAPSE [37.29% vs. 81.82%], S’ velocity [37.29% vs. 68.18%], RVFAC [33.90% vs. 90.00%], and E/A [33.90% vs. 75.00%]).

Conclusions:

Patients with RV dysfunction were remarkably improved after RCA revascularization. Hence, RCA revascularization can become an appropriate treatment alternative for the recovery of patients who suffer from RV dysfunction.
How Accurately FNAC Reflects the Breast Papillary Lesions?
Authors: Gümrükçü Gülistan , Doğan Meryem , Gürsan Nilüfer , Boylu Barış , Ekren Erhan , Aker Fügen Vardar
Published: April 2023

Context:

Diagnosis of papillary lesions of the breast by fine needle aspiration cytology (FNAC) is problematic. For this reason, it is situated in the indeterminate zone in classification systems.

Aims:

To ascertain the accuracy of cytological diagnosis of papillary lesions in distinguishing papillary lesions from non-papillary lesions and to determine whether papillomas can be reliably distinguished from malignant papillary lesions by FNAC.

Material and Methods:

A total of 346 cases with the diagnoses of breast papillary lesions were selected among 5112 breast FNAC procedures performed in our center. One hundred and thirty-nine cases with excised lesions were included in this study, and their corresponding histology was reviewed.

Results:

Papillary lesion diagnosis was confirmed by histopathology in 103 (74.1%) of 139 patients. Cytology and histopathology results were not found to be compatible in 35 (25.2%) cases. The diagnostic accuracy of distinguishing papillary breast lesions as malignant or benign was assessed statistically. According to the cytology–histology comparison, one case was evaluated as false negative (FN) and twelve cases as false positive (FP). Overall accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FNAC in distinguishing papillary lesions as benign or malignant were calculated as 87%, 97%, 83%, 72%, and 98%, respectively.

Conclusions:

The diagnostic accuracy of papillary breast lesions classified by FNAC might be improved by careful evaluation together with cytological, radiological, and clinical findings (triple test). Cell block may allow more accurate evaluation of the papillary lesion and can be applied to immunohistochemical examination. It may also facilitate the differentiation of benign/malignant papillary lesions.
Evaluation of Use of RPMI Medium to Preserve Cell Morphology for Pleural/Peritoneal Fluid Cytology
Authors: Rani Usha , Singh Meeta , Saith Armaan , Jain Shayama L. , Aggarwal Anurag , Aggarwal Sunita
Published: April 2023

Introduction:

Cytologic evaluation is the best way to detect the presence of malignancy in body cavity fluids. Roswell Park Memorial Institute (RPMI) medium or RPMI 1640 is used in cell culture, tissue culture, and also to improve the cellularity and morphology of CSF cytology specimens.

Objectives:

To determine whether RPMI medium can be used to preserve cell morphology in pleural/peritoneal effusion samples.

Method and Material:

The study was conducted on 30 pleural/peritoneal fluid samples received routinely during 2 months for diagnostic purposes in our department. The samples were divided into four parts. One-fourth of the sample was directly refrigerated and the other fourth was at room temperature. In the other two parts, an equal volume of RPMI media was added, and one was kept at room temperature and the other refrigerated. These cytospin-prepared Giemsa-stained smears were examined for cell morphology, cellularity, and occurrence of bacterial colonies at 24 h, 48 h, 72 h, and 1 week, respectively.

Result:

Refrigerated RPMI medium is the best preservative for pleural/peritoneal samples; however, samples with RPMI at room temperature were equivalent/even worse than the simple refrigerated sample.
Intraoperative Sentinel Lymph Node Imprint Cytology Diagnosis in Breast Cancer Patients by General Surgical Pathologists
Authors: Chang Yi-Chin , Tzen Chi-Yuan
Published: April 2023

Context:

Sentinel lymph node (SLN) biopsy is the standard of care for breast cancer (BC) patient staging. The axillary node status can be evaluated by frozen section (FS) or imprint cytology (IC). Despite the major disadvantages of tissue loss and freezing artifact in FS, many pathologists consider SLN IC a more difficult task requiring special expertise and prefer FS to IC.

Aims:

To conduct a large cohort study to evaluate the results of intraoperative SLN IC, compare them with those of FS and permanent section (PS), and determine the best method for general pathologists.

Settings and Design:

A very large cohort study with many pathologists engaged was designed and the diagnostic results were compared.

Materials and Methods:

With 12 pathologists engaged, we conducted the largest patient cohort study of SLN IC to date, including 4,327 consecutive BC patients undergoing SLN biopsy during the past 15 years. The touch imprints were stained using three different methods and evaluated. The PS was used as the gold standard for evaluation.

Statistical Analysis:

The false positivity, false negativity, accuracy, sensitivity, and specificity of the IC and FS for each pathologist were evaluated and compared.

Results:

Our results showed an overall sensitivity of 82.7%, specificity of 99.3%, and an accuracy rate of 95.9% for SLN IC, which were comparable to those of FS. The accuracy rate did not correlate with the length of working experience and the staining method.

Conclusions:

Intraoperative hematoxylin and eosin (H&E)-stained IC preparation was found to be the best SLN examination method for general pathologists.
The effect of breastfeeding on children's growth indices up to 6 months: An application of multivariate t linear mixed model
Authors: Moradi Maryam , Angali Kambiz Ahmadi , Behzadi Mohammad Hassan , Farnoosh Rahman
Published: April 2023

Background:

This study aimed to determine the effect of breastfeeding on children's growth indices.

Materials and Methods:

Longitudinal data of children's growth (height, weight, and head circumference) were as a dependent variable and type of nutrition as an independent variable with using multivariate t linear mixed model.

Results:

The indicated that the height, weight, and head circumference of infants who were fed with breast milk showed a statistically significant difference (P < 0.05) with those of infants receiving formula.

Conclusion:

Exclusive feeding with breast milk, especially in the first 6 months of life, has a significant impact on the child's growth indicators compared to formula or, or a combination of both.
The effect of depression on cognitive decline among Korean retirees
Authors: Hwang In Cheol , Ahn Hong Yup
Published: April 2023

Background:

Little information is available on the characteristics of cognitive ability among retirees. This study aimed to identify factors associated with cognitive impairment among Korean retirees.

Materials and Methods:

We used data from the Korean Longitudinal Study of Ageing survey. A total of 1755 retirees aged 45 years or older who had normal cognition were followed up for 12 years to identify cognitive impairment. Stepwise multivariate logistic models were used to assess odds ratios (ORs) and 95% confidence intervals (CIs) for cognitive decline.

Results:

Well-known risk factors, such as age (OR, 1.07; 95% CI, 1.06–1.09), female sex (OR, 1.49; 95% CI, 1.08–2.04), low education (OR, 2.45; 95% CI, 1.91–3.14), and depressive mood (OR, 1.51; 95% CI, 1.16–1.97), remained significantly associated with cognitive decline. Sex-stratified analysis revealed that depressive mood was significantly associated with cognitive decline in male retirees only (OR, 1.90; 95% CI, 1.31–2.75).

Conclusion:

Our finding indicates that screening male retirees for depressive mood is required to retard cognitive aging.
Quality and Appropriateness of Uro-surgical Referrals at a Nigerian Teaching Hospital
Authors: Ojewola Rufus Wale , Tijani Kehinde Habeeb , Hassan Jamiu Oyedele , Okeke Chike John , Akinyemi Opeoluwa Jesuyemi
Published: April 2023

Introduction:

An effective referral system is crucial for a high-quality health system that provides safe medical care.

Aim and Objectives:

This study aimed at evaluating the appropriateness and adequacies of information in the referral letters of patients.

Materials and Methods:

A prospective study of referral letters of all new patients in the urology clinic. Information retrieved was socio-demographic characteristics, source of referral and presence or absence of important information in their letters. We compared the information provided to the new history taken to determine the appropriateness and adequacy using different domains of medical history. Referrals were adjudged appropriate if the diagnosis is urologic, while any referral lacking relevant information is adjudged inadequate. The results were displayed using the simple proportions in tables and charts.

Results:

A total of 1188 referrals were reviewed. There were 997 (83.9%) males and 191 (16.1%) females. Referrals from private hospitals were the most common in 627 (52.8%) cases. Of all new referrals, 1165 (98.1%) were adjudged to be appropriate, while 23 (1.9%) were inappropriately referred. Referrals from teaching hospitals had higher proportions of good-quality referrals than those from primary healthcare and private centres. The most common deficiencies were the lack of documentation of relevant examination findings (37.8%) and provisional diagnosis (21.4%). The majority, 956 (80.5%), of letters were narrative in nature, whereas 232 (19.5%) were structured. Structured letters were found to be more informative.

Conclusion:

A significant percentage of referral letters lacked completeness in many key areas. We recommend the use of structured forms or template letters to improve the quality of referrals.
Bilateral optic disc edema and serous retinal detachment as initial ocular manifestations of systemic lymphoma: A case report and literature review
Authors: Wu Chi-Yeh , Chen Chun-Chen , Liou Shiow-Wen , Yen Ju-Chuan
Published: April 2023

This report describes a unique case of systemic diffuse large B-cell lymphoma (DLBCL) with initial ocular manifestations of bilateral optic disc edema and serous retinal detachment (SRD). A 29-year-old man presented with altered color vision in the left eye, mild fever, weakness, and headache, followed by bilaterally reduced visual acuity. Anterior segment and vitreous examinations showed no inflammation with sluggish response of light reflex. His fundus examination revealed bilateral multiple SRDs and optic disc swelling with choroidal thickening. On fluorescein angiography, pinpoint hyperfluorescence, associated dye pooling, and optic disc staining with leakage were found bilaterally. Laboratory studies revealed elevated C-reactive protein and mild leukocytosis with neutrophil predominance. He was provisionally diagnosed with probable Vogt-Koyanagi-Harada syndrome and received methylprednisolone pulse therapy. Five days later, his systemic condition deteriorated following initial ocular symptom improvement. Whole-body computerized tomography revealed clustered lymphadenopathies, which were interpreted as DLBCL after lymph node biopsy. His ocular condition improved after DLBCL chemotherapy. We hope to promote early recognition with appropriate workups through this case and literature review.
Les formes d’intégration agriculture-élevage. Le cas des systèmes de polyculture-élevage bovin laitier de la plaine de la Mitidja – Algérie
Authors: Laribi Sabria , Boutonnet Jean-pierre , Brabez Fatima , Adem Rachid , Kheffache Hamida
Published: April 2023

Cette étude a pour objectif de mesurer le niveau d’intégration agriculture-élevage bovin lait au sein des différents systèmes de culture dans la plaine de la Mitidja. Un premier travail de terrain a été effectué en 2014 dans la wilaya de Blida (Mitidja-centre) auprés de 75 éleveurs de bovins laitiers pour caractériser les types d’intégration par le biais des flux échangés entre l’élevage bovin laitier et les autres cultures des exploitations. En second lieu, une enquête plus approfondie auprès de 30 éleveurs a été réalisée en 2017, pour calculer le niveau d‘intégration selon la contribution de chaque catégorie d’aliment dans les apports alimentaires fournis au bétail. Nous montrons que l’élevage bovin est très intégré au marché international avec un taux de 45%, par le recours aux aliments concentrés. L’intégration de l’élevage aux ressources fourragères produites au sein des exploitations laitières représente 29% des apports. Ce faible niveau d’intégration est expliqué par les difficultés d’accès aux ressources (terre et eau) pour produire des fourrages verts au sein des exploitations laitières, qui sont concurrencées par le maraichage et l’arboriculture. L’intégration de voisinage par le biais du fauchage des herbes spontanées, le pâturage sur les jachères et les chaumes des céréales et la distribution des sous-produits des cultures maraichères est faible. Elle est de 16% du total des apports. L’intégration de l’élevage au marché national pour l’achat des aliments grossiers représente 10% des apports.

The aim of this study work is to measure the level of integration between crop and dairy farming in the various farming systems in the Mitidja plain. A field research was carried out in 2014 in the wilaya of Blida (Central Mitidja) among 75 dairy cattle farmers in a first passage. This first step aims to characterize the types of integration through the flows exchanged between crops and livestock systems. In the second step, a further investigation was carried out with 30 farmers, in 2017, to calculate the level of integration according to the contribution of each feedstuff in livestock feed intake. The results show that cattle farming is more integrated into the world market at a rate of 45% through imported concentrate. On the other hand, the integration of livestock with fodder resources, produced on dairy farms, represents 29% of feed intakes. This low level of integration can be explained by the difficulties of access to the resources (land and water) to produce green fodder on dairy farms, which are competing with more profitable crops, mainly orchards. Neighbourhood integration through the mowing of spontaneous grass, grazing on fallow land and cereal stubble and the distribution of by-products from grain crops is weak (16% of the total intake). The integration of livestock within the national market through the purchase of hay and straw accounts for 10% of total intake.
Management control, for better performance of public management-case study of healthcare facilities in Algeria
Authors: Lechab Safa , Hamdi Pacha Nadia
Published: April 2023

The objective of this work is to empirically show the active role of the management control performance variable, in improving management performance at public healthcare facilities. The determination of the levers on which management controllers can act to maximize the performance of this process, is also discussed. The results indicate the existence of a significant direct link between the performance of management control and that of managers of public health establishments. They also suggest interesting elements for practitioners, particularly as regards the levers to prioritize, to maximize management control performance and thus that of public managers. It turns out that the levers of the technical dimension are the most decisive for the sample of this study.

L'objectif de ce travail est de montrer empiriquement le rôle actif de la variable "performance du contrôle de gestion", dans l'amélioration de la performance de gestion des établissements publics de santé. La détermination des leviers sur lesquels les contrôleurs de gestion peuvent agir pour maximiser la performance de ce processus, est également abordée. Les résultats indiquent l'existence d'un lien direct significatif entre la performance du contrôle de gestion et celle des responsables des établissements publics de santé. Ils suggèrent également des éléments intéressants pour les praticiens, notamment en ce qui concerne les leviers à prioriser pour maximiser la performance du contrôle de gestion et donc celle des managers du secteur public. Il s'avère que les leviers de la dimension technique sont les plus déterminants pour l'échantillon de cette étude.
Physicochemical and Heavy Metals Analysis of Different Brands of Sachet Water Sold in Benin City, Nigeria
Authors: Igbinevbo I. D. , Akiri-Obaroakpo T. M. , Ebun-Igbeare O. E.
Published: April 2023

Water of good quality is essential for environmental and public health. In Nigeria, majority of the population rely on sachet/packed water for drinking purpose. This study was carried out to assess physico-chemical characteristics and levels of Fe, Zn, Cu, Pb and Mn in ten brands of sachet water sold in Benin City, Nigeria using standard methods. The lowest and highest values of the physico-chemical parameters were: pH (5.20 - 7.00), EC (10 - 170)µS/cm, turbidity (0.00 - 10.00)NTU TDS (5.30 - 90.10)mg/l, hardness (6.00 - 30.00)mg/l, chloride (7.06 - 21.18)mg/l, alkalinity (4.00 – 16.00)mg/l, nitrate (0.64 - 1.22)mg/l and phosphate (0.01 - 1.15)mg/l. They were all within the WHO permissible limits for drinking water except pH and turbidity that revealed a slight increase in concentrations in two brands, which could be indicative of high level of suspended solids and the presence of cations in the groundwater and could pose serious health threat to consumers. Therefore, proper treatment of water in the water packaging facilities and improved sanitary practices of workers and facilities in general are recommended. UNI data from heavy metals (Fe, Zn, Cu, Pb and Mn) analysis showed no evidence of contamination as they were all within their respective permissible limits of drinking water. It is therefore concluded that the sachet water brands sold in the study area are of good physical and chemical quality.
A Review of Optimisation of Transportation of Drill Cuttings Waste
Authors: Moro O.
Published: April 2023

Transportation and monitoring of oil and gas operations require advanced logistics supply chain management. This paper adopts the desktop study research method, using credible pieces of literature such as textbooks and online journals and articles, to identify preferable waste management options for transportation drill cuttings wastes and improving the oil and gas business. Findings reveal that haulage of drill cuttings is regulated differently depending on the environmental compliance requirements locally and internationally. Though challenging, the shipment of drill cuttings from cradle to grave can be improved, based on the localised monitoring mechanisms and possibly, the adaptation of spatial technologies which inversely progress logistic outcomes.
The Relative Quantification of Hedgehog Signalling Components of Hepatocellular Carcinoma (Hepg-2) Cells Treated With Sorghum bicolor Leaf Stalk Ethanolic Extract
Authors: Adewole A. R. , Tiamiyu A. O. , Minari J. B. , Okpuzor J. E.
Published: April 2023

Hepatocellular carcinoma (HCC) is the most frequent type of primary liver cancer. Patients with advanced HCC have a dismal prognosis due to the limited therapy choices available. Hence, this present study evaluates the cytotoxic potential of the ethanolic crude extract of Sorghum bicolor leaf stalk (SBELSE) against human hepatocellular carcinoma (HEPG2) cell line, and its effect in the expression of its Hh signaling component-GLI1 and PTCH. The leaf stalk of Sorghum bicolor (SB) was pulverized and extracted with 70% ethanol. HEPG2 cells were treated with different concentration of ethanol extract of SBELSE which was subjected to 2-fold serial dilution to achieve a graded concentration (9.77-5000 µg/ml). Cell viability was performed using CCK-8 assay. The cells were treated with 8 µg/mL and 23 µg/mL concentration of SBELSE for 48 hour, after which RNA was isolated for downstream gene expression studies using RT-qPCR. The expression level of GLI1 and PTCH genes in cell line was examined relative to the untreated group. SBELSE exerted a cytotoxic effect on HEPG-2 cells with an inhibitory concentration (IC50) of 150 µg/mL. After 48 hours of treatment and evaluation, Expression of GLI1 and PTCH genes was seen in all cell group but was increased in groups treated with 8µg/mL concentration of S. bicolor extract than in the control group.  The findings of this study suggest the possibility of the extract to contain agonistic component that might support cancer cell proliferation.
Addenda à l’article Revue des textes fonciers et forestiers pour la mise en œuvre de la restauration des paysages forestiers à Madagascar
Authors: Rajaonarivelo Herimino Manoa , Rakotonarivo O. Sarobidy , Raharijaona Stefana , Raparison Eric , Rakotoarisoa Mirindra , Hockley Neal
Published: April 2023

No Abstract.
Insights from practitioners in Madagascar to inform more effective international conservation funding
Authors: Eklund Johanna , Cheek Jennifer Zavaleta , Andriamaro Luciano , Bakoliarimisa Tsiorisoa Mihanta , Galitsky Christina , Rabearivololona Ony , Rakotobe Domoina J. , Ralison Harifidy O. , Randriamiharisoa Lalatiana Odile , Rasamoelinarivo Joe , Rasolofoson David , Ratsirarson Joelisoa , Razafimpahanana Andriamandimbisoa , Temba Eric Marcel , Pyhälä Aili , Miller Daniel C.
Published: April 2023

Bending the curve on biodiversity loss will require increased conservation funding and a wiser resource allocation. Local conservation practitioner  expertise will be vital in decision-making processes related to funding. Yet, the integration of their insights into funder priorities and strategies is often  insufficient, particularly in countries where international funding comprises the bulk of support for conservation. More generally, the role of funding  remains under-analyzed in conservation and opportunities for funder-practitioner dialogue at a broad strategic level are limited. We seek to address  these critical gaps by presenting results from a participatory workshop of conservation practitioners in Madagascar, one of the world’s biodiversity  hotspots. Five major areas of need emerged, and these challenges need to be addressed if we are to see long-term solutions to the biodiversity crisis: (1)  strengthen law and policy implementation; (2) ensure sustainability of funding; (3) improve coherence and coordination within and beyond the  conservation sector; (4) support self-strengthening of local communities; and (5) invest in capacity development. This article elaborates on these thematic  areas and their implications for international donors in Madagascar and beyond. Our approach demonstrates a way for amplifying in-country  practitioner voices in a collaborative way and highlights the need for their inclusion at all stages of conservation program development so that funding  priorities better reflect local needs and aspirations while enhancing prospects for enduring conservation outcomes.
A case of a pregnant woman with a special splenic artery aneurysm
Authors: Xu Yujia , Wu Zhoupeng
Published: April 2023

Visceral artery aneurysm, especially splenic artery aneurysm, is rare and is usually associated with pregnancy. When such aneurysms rupture, they can be fatal, and they often require emergency surgery. This case report includes a review of the literature and describes a effective multidisciplinary approach to managing this type of aneurysm. We describe the treatment of a ruptured splenic artery aneurysm and the careful coordination of obstetric, vascular surgery, and intensive care teams. The uniqueness of this case arose from the metal embolization coil that was found to have fallen off from a recently embolized ruptured splenic artery aneurysm.

The management of this ruptured splenic artery aneurysm and iatrogenic foreign body insult required a combination of multiple specialties to provide life-saving treatment. Such cases should be managed by multidisciplinary teams if institutional resources allow for it.
Quality of life of primary caregivers of children living with cerebral palsy at two clinics in Blantyre, Malawi
Authors: Namanja Alice , Phiri Vincent Samuel
Published: April 2023

Introduction

In Malawi, Primary Caregivers (PCGs) of children living with Cerebral Palsy report challenges such as physical strain and lack of

resources that affect care giving. Although such experiences affect the PCGs’ Quality of Life (QoL), there is paucity of data for

Malawi. Understanding their QoL would inform establishment of holistic intervention(s) tailored to meet their needs. Therefore, the

purposes of this study were to determine QoL of PCGs of the children who were receiving rehabilitation at Queen Elizabeth Central

Hospital (QECH) and Feed the Children (FtC), to identify PCG’s and children’s socio-demographic factors that may attribute to the

perceived QoL, and to compare the PCGs’ QoL between the sites.

Methods

A cross-sectional study was conducted from January to April 2019 on 142 PCGs of children aged between 2 and 18 years of age. All PCGs who were employed for the child-care, or had a chronic sickness were excluded. QoL was assessed using the World Health Organization Brief questionnaire, with a cut-off point of <60% for poor QoL. The severity of children’s impairments was assessed using Gross Motor Function Classification System. Descriptive and inferential statistics were conducted to analyze the data. The PCGs’ age, sex, marital status and level of education, and child’s severity of impairment were compared with QoL.

Results

The majority of PCGs (61.30%) had poor QoL, and there was no significant difference in overall QoL of the PCGs between the sites (p<0.31). The PCGs at QECH had significantly higher physical domain mean scores than at FtC (U=1906, p<0.01). The overall QoL differed significantly across the marital statuses of the PCGs (p<0.03).

Conclusion 

The study has established that most PCGs at both sites possess poor QoL. However, there is need to investigate how the rehabilitation institutions and workers influence the QoL of the PCGs within and between the facilities.
Exploring perceived barriers to effective utilization of learner-centred teaching methods by tutors at Holy Family College of Nursing and Midwifery, Phalombe, Malawi
Authors: Matewere Ireneo , Msosa Annie , Mfuni Joseph
Published: April 2023

Introduction

Learner-centred teaching implies a paradigmatic shift in roles of a teacher from being a source of knowledge to that of a facilitator in the process of knowledge construction. Literature shows that perceptions which teachers hold about barriers to utilisation of learner-centred teaching methods influence how the teachers teach. Anecdotal records as well as observation of classroom teaching demonstrate that tutors at Holy Family College of Nursing and Midwifery dominantly use traditional teacher-centred teaching methods.

Research Design and Methods

This was a qualitative study based on the philosophical principle of constructivism.

Study population and sample

All tutors at Holy Family College of Nursing and Midwifery were the study population. Purposive sampling technique was used to select participants. In-depth interviews with 12 tutors were held using a semi-structured interview guide.

Data analysis

Data were analysed using the 6-step thematic method.

Findings

The participants suggested that effective utilization of learner-centred teaching methods is negatively affected by teacher-related as well as technical barriers.

Conclusion

Teachers clinging to power and need for more resources negatively affect utilisation of learner-centred teaching methods
If AFP is elevated, where is cancer? The case report on hereditary persistence of Alpha-fetoprotein
Authors: SARACOGLU Hatice , BASKOL Mevlut , SARACOGLU Hakan
Published: April 2023

Alpha-fetoprotein (AFP) is expressed by tumors with a high mitotic index such as hepatocellular carcinoma and germ cell tumors, therefore it is used as a tumor biomarker. Interestingly, although there is no underlying cause, elevated AFP has been reported in some genetically predisposed individuals. This is a very rare and benign condition called “hereditary persistence of AFP (HPAFP)” and an inherited in an autosomal dominant manner. To our knowledge, only 28 families have been reported to date. Some of the reported cases received inappropriate treatments such as chemotherapy and surgery. The possibility of HPAFP should be kept in mind in patients with high AFP in the absence of radiological evidence of hepatocellular carcinoma or germ cell tumor to avoid harmful procedures. It can be easily confirmed by analyzing AFP levels in other family members. We report a case of HPAFP with surprisingly higher AFP levels than previously reported cases and this is the first case reported from Turkey.
The clinical characteristics and the risk factors for mortality in Non-COVID-19 critical patients in a pandemic hospital in Turkey: a retrospective crosssectional study
Authors: Cevik Banu , Kuzhan Burcu , Bombacı Elif , Saracoglu Kemal Tolga
Published: April 2023

BackgroundCoronavirus disease 2019 (COVID-19) disrupted standard health policies and routine medical care, and thus, the management andtreatment pathways of many clinical conditions have changed as never before. The negative impact of the pandemic rendered thesystemic disease more complicated and accelerated mortality. For the last two years, clinicians have primarily focused on COVID-19patients; however, the non-COVID-19 critically ill patients needed to be addressed from multiple perspectives. This study investigatedthe demographic and clinical characteristics of non-COVID-19 critical care patients admitted concurrently with a COVID-19 wave.The objective of this study was to identify the risk factors for mortality in critically ill non-COVID-19 patients.MethodsAll consecutive cases admitted to the intensive care unit (ICU) were included in the study between January 1, 2021 and July 14, 2021.All data, including age, gender, admission characteristics, patient dependency, pre-existing systemic diseases, the severity of illness(Acute Physiology and Chronic Health Evaluation –APACHE-II), predicted death rate in ICU, life-sustaining medical procedures onadmission or during ICU stay, length of stay, and admission time to the ICU, were obtained from the hospital’s electronic database. TheCharlson Comorbidity Index (CCI) was assessed for all patients.ResultsA total of 192 patients were screened during the study period. Mortality was significantly increased in non-surgical patients, previouslydependent patients, patients requiring mechanical ventilation, continuous renal replacement therapy, and patients requiring the infusionof vasoactive medications. The number of pre-existing diseases and the admission time had no impact on mortality. The mean CCIwas significantly higher in non-survivors but was not a strong predictor of mortality as APACHE II.ConclusionsIn this retrospective study, the severity of illness and the need for vasoactive agent infusion were significantly higher in non-survivorsconfirmed by multivariate analysis as predictive factors for mortality in critical non-COVID-19 patients.
“Our [Yao people’s] circumcision is of the ‘brain’ not of the ‘penis’”: factors behind the resistance to voluntary medical male circumcision among Yao people of Mangochi in Southern Malawi
Authors: Mphepo Kent Y.G. , Muula Adamson S. , Sadalaki John R. , Phuka Felix , Bengo Joseph Mfutso-
Published: April 2023

AimMalawi officially launched Voluntary Male Medical Circumcision (VMMC) in 2012 after the 2007 joint WHO /UNAIDSrecommendation that VMMC be a key HIV prevention strategy for Sub-Sahara African region. Malawi data, however, contradicted thefindings of three randomized studies conducted in Uganda, Kenya and South Africa between 2005 and 2007. While randomized trialsdemonstrated that male circumcision could contribute to a 60% relative reduction of HIV acquisition by men through heterosexualintercourse, HIV prevalence in Malawi was highest in the Southern Region where 47% of males were traditionally circumcised yetCentral Region had 15.4% and Northern Region, 6.3%. By December 2018, Malawi had only achieved 756, 780 surgeries constituting31% against the target of 60% of eligible men. The low achievement was due to resistance to services even in traditionally circumcisingYao communities. This study sought views of Yao respondents in Mangochi district, in Southern Malawi, on VMMC.Methods156 participants were interviewed (103 males and 53 females): 15 FGDs (involving 86 males and 50 females); 17 IDIs (involving 14males, 3 females); 3 Key KIIs (involving 3 males, 0 females). For this paper, the authors only analyzed FGDs, IDIs and KIIs. Quotesfrom FGDs were not significant.ResultsThe study identified that VMMC: a) did not contribute to societal moral values; b) involved female circumcisers; c) threatenedchiefs’ political authority and economic gains; d) threatened continuity of jando; e) was impotent against witchcraft; f) provided byinefficient providers; g) resembled Yao circumcision; h) wrongly translated as ‘m’dulidwe wa abambo.’ConclusionsThe key barrier to VMMC services in Yao communities of Mangochi was the mistrust between government and implementers on onehand and Yao communities on the other due to inadequate engagement prior to the rollout of services.