bluuebunny/crossref_metadata_2025 huggingface dataset:
The Efficacy of Cyranose in Detecting In Vitro Volatile Organic Compounds
Authors: Dalis Costa , Shelley Christopher , Brokaw John , Markel Troy
Published: January 2023

Background and Hypothesis: Electronic-noses are a subtype of electronic-sensing technology designed to reproduce human smell via sensor arrays and pattern recognition algorithms. Specifically, they can detectheadspace volatile organic compounds (VOCs)  , which are end products of human metabolism (normal and disease-specific) mainly excreted in the breath, urine, and feces. VOCs are often emitted before the onset of clinical symptoms of many diseases, making them useful screening biomarkers. Additionally, the portable, inexpensive, and non-invasive nature of e-noses allows for easy clinical implementation for point-of-care (POC) disease screening/diagnosis. We hypothesize that Cyranose, one e-nose model, can differentiate headspace VOCs between healthy cells and cells stressed with an in vitro inflammatory state.
Project Methods: Human Intestinal Epithelial Cells (HIEC-6s) and Umbilical Stem Cells (USCs) were cultured in their respective 50 mL complete media at 37o C in 5% CO2. Upon reaching appropriate confluence, cells were washed using PBS and passaged with TrypLE Express. Cells werecounted with a hemocytometer and Trypan blue exclusion, then added to a 12 well plate and exposed to either TNF-α (50 ng/mL), LPS (200 ng/mL), or hypoxia (5% O2) for 24 hours.Supernatant (1.5 mL) was   added to Eppendorf tubes, sealed with parafilm, and heated to 40o C for 30 minutes. Headspace VOC profiles were analyzed with Cyranose and compared to controls.
Results: Using the “identify” function on Cyranose, it was unreliable in correctly distinguishing VOCs between HIEC-6s and USCs from their controls under all treatment conditions. While Cyranosesensors did generate smellprint profiles that showed differences between HIEC-6s and USCsagainst controls with LPS treatment, small sample sizes limit these results.  
Conclusion and Future Directions: This study demonstrates that new method designs   are necessary when identifying in vitro VOC profiles using Cyranose. Future considerations should include the concentration of treatments/cells, cell types, treatment duration, supernatant volume, number of samples prepared, heatblock temperature, and/or a different e-nose model.
Biomarker Profiles and Immunologic Predictors of Neurodevelopment in Children who are HIV Exposed Uninfected
Authors: Egler Ashley , Jang Jeong Hoon , Li Wei , McHenry Megan , Oyungu Eren , Yu Qigui , Khaitan Alka
Published: January 2023

Background: Children who are HIV-exposed uninfected (HEU) have higher morbidity and mortality rates than their unexposed uninfected counterparts (HU). HEU also exhibit lower neurodevelopmental outcomes. Previous studies show that HIV-induced immune dysregulation can be linked to decreased neurodevelopment in HIV+ children. However, the role of inflammation on neurodevelopment in    HEU remains unclear.  
Methods: This study investigated the plasma levels of 81 biomarkers in    82 Kenyan children between the ages of 18 and 36 months. Neurodevelopment was measured using the Bayley Scales of Infant and Toddler Development, 3rd edition. Bayesian model averaging was used to identify significant biomarkers.  
Results: HEU showed lower levels of 12 different proinflammatorycytokines/chemokines/growth factors: IL-12, leukemia inhibitory factor (LIF), macrophage migration inhibitory factor (MIF), TNF-related weak inducer of apoptosis (TWEAK), and A proliferation inducing ligand (APRIL); BLC, eoxtaxin-2, I-TAC, monokine induced by gamma interferon (MIG), and MIP-3a; fibroblast growth factor-2 (FGF-2) and granulocyte colony-stimulating factor (G-CSF). HEU showed higher levels of 2 inhibitory soluble immune checkpoints: T-cell immunoglobulin and mucin-domain containing-3 (TIM-3) and CD40. Bayesian model averaging identified the biomarkers to best predict HEU vs. HU status were IL-12, IL-13, and CD40. In HU children, hepatocyte growth factor (HGF) and IL-5 predicted cognitive scores, BLC and IL-7 predicted motor outcomes, and IL-1a, IL-2R, IL-5, and maternal education predicted language scores. In HEU, FGF-2 predicted language scores, and IL-22 predicted motor development. Statistical analysis identified IL-2R and IL-22 as the strongest predictors of neurodevelopmental outcomes in HU and HEU, respectively.
Conclusion/Potential Impact: This study shows that HEU exhibit an immune suppressive biomarker profile, rather than an inflammatory profile as indicated in previous studies. The significant biomarkers we found may be used to determine children at risk of decreased poor neurodevelopmental outcomes, allowing more time for intervention.
Creating Interactive Digital Anatomy Modules for the Indiana University School of Medicine Human Structure Course
Authors: Farrell Rowan , Eckel Christine , Mas Jose
Published: January 2023

Background and Hypothesis: The Human Structure (HS) course at Indiana University School of Medicine (IUSM) wascondensed from 115 contact hours over 34 weeks to 96 hours over 17 weeks in 2016. The current course is delivered via block schedule over 10 weeks. A 2016 institutional review of IUSM found that examination scores after the curricular change were significantly lower than those prior to 2016.  The data regarding the effect of similar curricular change in U.S. medical programs is mixed. There are consistent findings that interactive, streamlined, manipulatable, and testable review materials support learning and retention of information better than passive review. We hypothesize that incorporating interactive anatomy quiz modules created specifically for the statewide HS course at IUSM will improve learner acquisition of gross anatomy.
Methods and Results: Using high-quality dissection photographs, we constructed 11 interactive learning modulesincluding the lower extremity, abdomen, pelvis, and muscles of facial expression (MOFE).Modules adhered to the Session Learning Objectives and Structures to Know lists for the course. We built modules in PowerPoint, then made them interactive and easily quizzable in Canvas using HTML5 Package (H5P). Modules were peer-reviewed by two anatomy professors and a third collaborator. The Urogenital Triangle and MOFE modules have been fully approved by the CMT for inclusion in the 2022 Course. We expect additional approval of all completed modules.
Potential Impact:  We expect that providing students with native interactive modules for gross anatomy will make learning more efficient and reduce the time students spend searching for adequate practicematerials from outside sources. We expect this will improve student learning and increase examination scores.
Analysis of Factors Contributing to Antenatal Corticosteroid Administration in Threatened Preterm Labor
Authors: Bode Leah , Alexandra McKinzie , Gidia Nadia , Ibrahim Sherrine , Haas David
Published: January 2023

Introduction:
Antenatal corticosteroids (ACS) are recommended for pregnant persons who are between 24 and 36+6/7 weeks’ gestational age (GA) and at risk for imminent delivery within 7 days. Many individuals diagnosed as having threatened preterm labor (tPTL) are given ACS but do not deliver until they reach term. This study aimed to describe characteristics of those seen for tPTL who receive ACS to better understand clinical decision-making.
Methods:
This retrospective cohort study consisted of mothers seen in triage at Eskenazi Hospital in 2021 for tPTL during pregnancy. Multiple demographic variables were evaluated against the primary outcome of ACS administration including maternal age, race/ethnicity, and prior preterm delivery, as well as obstetrical variables such as cervical dilation, effacement, membrane rupture, and tocolytic administration.
Results:
After exclusions, a cohort of 290 pregnant people with 372 unique encounters remained. The average maternal age was 26.7, and 15.6% of patients had a history of prior preterm birth. 107 patients in 111 encounters received ACS, which were associated with lower BMI, greater cervical dilation, greater effacement, membrane rupture, and more frequent contractions (all p<0.01). The mean GA at triage was 33.5 weeks. Logistic regression, adjusting for significant factors in the univariable analysis, found that BMI (OR 0.93, 0.89-0.97), cervical dilation (OR 1.34, 1.07-1.71), and cervical effacement (OR 1.02, 1.01-1.03) were significantly associated with giving ACS. 44% of those receiving ACS delivered within 7 days, compared to 11% of those who did not receive ACS (p<0.001).
Conclusion:
Greater cervical dilation and effacement and a lower BMI were associated with ACS administration, though most patients receiving ACS still did not deliver within 7 days. These findings will be further categorized and used to develop a clinical decisional model for administering ACS in those likely to imminently deliver preterm.
Assessing the Impact of Physician Pain on Motivation to Provide Longitudinal Osteopathic Manipulative Therapy to Patients and its Correlation to Opioid Prescribing: A Cohort Study
Authors: Braly Tyler , Jefferson Erin , Henriksen Brian
Published: January 2023

Background/Objective:
In recent years physician wellness has become a priority. Current well- being initiatives focus on the emotional and spiritual components of health. However, physical pain and its relationship to wellbeing and patient care has not been examined. We hypothesized that reductions in resident’s physical pain would impact their enthusiasm for providing OMT services to patients in need of pain management while also reducing opioid prescribing.
Methods:
Both allopathic and osteopathic residents were offered biweekly osteopathic treatments by board certified osteopathic physicians. Participant pain scores were obtained prior to each treatment. The osteopathic resident cohort was surveyed regarding their motivation to perform OMT (SIM Scale). Patient OMT encounters provided by the participants were evaluated by tracking the number of segments, attempts, OMT modality and BMI were correlated with the participants pain scores. Finally, the opioids prescribed by all of the participants was compared to their pain scores. Pearson’s correlation and independent t-tests were used for this project with an alpha of 0.05 for significance.
Results:
A correlation was demonstrated between patient BMI and participants delivering osteopathic treatments (p= .006). This study did not identify any statistically significant correlations between the regularity of received OMT services and physician physical wellness. Additionally, there was not a statistically significant correlation between the other data points included in this study.
Conclusion:
Patients BMI as a surrogate value for their body habitus did correlate with DO physician pain scores. Longitudinal OMT did not improve provider pain over time thus supporting OMT use in alleviating acute somatic dysfunction. Provider pain did not correlate with opioid prescribing habits or frequency of OMT as a pain management option. There remains a need for physical wellness interventions to improve provider wellness and especially for providers using OMT on large body habitus patients due to its impact on the providers health.
Alteration of the Essential Role of Endothelial Cells for Promoting Self-Renewal and Lineage Differentiation by Glucosylceramide and 16,16-dimethyl Prostaglandin E2
Authors: Chacon Nieves Keyshla , Blankenship Ross , Lajiness Jacquelyn , Cook-Mills Joan , Hoji Aki
Published: January 2023

Bone marrow endothelial cells (BMECs) play an essential role for supporting hematopoietic stem cell expansion, self-renewal, and lineage differentiation. It has been known that BMECs receiving chronic constitutive inflammatory signals play a significant role in promoting functional alterations in hematopoietic stem cells (HSCs). Among many types of Inflammatory agents, bioactive lipids, including glucosylceramide (GlcCer) and dimethyl-Prostaglandin (dmPGE2) has been recently shown to be the potent mediator of inflammation through their own cognate receptor, CLEC4E (Mincle) and PGE receptors, respectively. Despite their biological significance, however, it is not known if GlcCer and dmPGE2, directly induce gene expression of self-renewal and lineage differentiation factors in BMECs or any other endothelial cells in general. We attempt to model the effect of GlcCer and dmPGE2 in vitro by employing primary human vein endothelial cells (HUVECs), and modified HUVECs transduced with E4ORF1 enhancing glucose uptake pathway. We hypothesize that GlcCer and dmPGE2 treatment will trigger reduction in the expression of ANGPTL2, JAG1, and PTN, while an increase in KITLG, CCL5, M-CSF, and GM-CSF in HUVEC. The significance of this study could be identifying a major pathway that contributes to the loss of self-renewal and increased myeloid lineage differentiated mediated by endothelial cells upon exposure to GlcCer. Results showed varied expressions of self-renewal and maintenance genes by GlcCer and dmPGE2. In conclusion, HUVEC may not be a good model for in vitro study as there was no expression seen in the lineage differentiation gene M-CSF and varied GM-CSF expression. However, the results of our study could potentially be utilized for in vitro expansion of HSCs for autologous bone marrow transfer, further genetic manipulation of endothelial cells, and characterization of the signal transduction pathway.
Developing the Study Question: Relationship Between Cardiologist Age and Delivery of Aortic Valve Replacement
Authors: Shinnerl Alexander , Torabi Asad , Knapp Shannon , Breathett Khadijah
Published: January 2023

Introduction:Aortic stenosis (AS) is the most common valve disease worldwide, but intervention for symptomatic AS is variable and dependent on patient age, frailty, and co-morbidities. Recent studies have suggested that the greatest determinant of receipt of aortic valve replacement (AVR) is a supportive recommendation by the patient’s cardiologist. Given that recommendations for cardiovascular therapies sometimes vary by clinician age, it is unclear whether cardiologist age is associated with referral for AVR.
Objective:To determine whether cardiologist age is associated with referral for AVR.
Hypothesis:We hypothesized that receipt of AVR is more likely to be associated with younger aged cardiologists (</= 40 years) than older aged cardiologists (>40 years).
Methods:Using the Centers for Medicare and Medicaid services (CMS) national database, we will use hierarchical logistic regression models to assess odds of AVR delivery according to cardiologist age group among patients hospitalized with primary diagnosis of AS. Models will be adjusted for patient-level covariates (demographics, insurance, comorbidities, comorbidity index) and hospital-level covariates (location, number of cardiologists per hospital). Secondary analyses will include stratifying odds AVR by type (transcatheter and surgical).
Discussion:We expect to find that physicians who have completed their training more recently may have higher rates of AVR referrals. This includes the use of transcatheter AVR, in patients with elevated surgical risk, which is an established non-inferior alternative to surgical AVR in many patients. While there are many factors which dictate intervention for AS, we hope that by performing this study, we will be able to promote a guideline directed approach to the management of symptomatic AS. we will be limited in the ability to classify severity of AS, selecting patients with primary admit diagnosis of AS will likely focus on patients with symptoms related to AS, which would support severe AS diagnosis.
Epidemiology of Pediatric Uveitis in Indiana
Authors: Smith Paul , Edwards Cameron , Taylor Nicole M. , Tarvin Stacey E. , Rodriguez Martha
Published: January 2023

Background: Pediatric uveitis is a rare, often idiopathic and poorly characterized autoimmune disorder with severe morbidity and uncertain outcomes. The aim of this study is to better characterize the epidemiology, treatments, and comorbidities of this condition.
Methods: A retrospective chart review was completed of children diagnosed with pediatric uveitis at Riley Hospital for Children from 1997-2022. Patients were identified via ICD-10 codes and data was extracted from electronic medical records. Deidentified data was stored in IU secure RedCap. Patient characteristics were outlined in frequencies and descriptive statistics. Data was analyzed using SPSS. Indiana University IRB approval was obtained. Data collected included age at onset of uveitis, sex, anatomic location of ocular inflammation, comorbid disease (including systemic inflammatory disease), ocular complications, relevant laboratory data, and treatment.
Results: A total of 120 patients were included in this study. 53.3% were female. The median age of diagnosis was 10 years of age. Out of the 122 individuals diagnosed with Uveitis or JIA, the majority were White (68.9%), followed by Black/African American (10.7%), Hispanic/Latino (6.6%), other (2.4%), and Asian (.8%). Anterior uveitis (45.1%) was the most frequent subtype, followed by Intermediate (15.6%), and posterior uveitis (0.8%). 27.9% of individuals had uveitis associated with juvenile idiopathic arthritis. 22.1% of individuals were ANA positive, and 5.7% were HLAB27 positive. Regarding eye complications in patients with Uveitis, 18% reported Cataracts and 10.7% reported glaucoma. 44.3% of patients were treated with immunosuppressive medications such as methotrexate, 25.4% with Humira, and 54.1% with steroids.
Conclusion and Potential Impact: This retrospective chart review of 122 individuals with pediatric uveitis contributes to the epidemiologic description of this patient population in this single center setting over a 25-year period of time. These findings help better characterize the population with regard to concomitant conditions, treatment patterns, and comorbidities for broader generalization in future work.
Peripheral Neuropathy in Long-COVID Patients: Demographic Distribution and Medical Risk Factors
Authors: Li Jason , Bohn Camden , Todd Noah , Pater Jessica , Carroll Jeanne , Henriksen Brian
Published: January 2023

Objective: A retrospective study was conducted to examine the relationship between long-COVID peripheral neuropathy and patient demographics and comorbid medical conditions.
Methods: Electronic health records of 543 patients from the Parkview Post-COVID Clinic were reviewed for their demographic information, past medical histories, and post-COVID clinic visit summaries. Based on whether patients had peripheral neuropathy as a post-COVID clinical visit diagnosis and whether they had had a history of neuropathy prior to COVID infection, the patients were assigned into the new-onset neuropathy group, progressing and non-progressing neuropathy groups, and non-neuropathy group. Age and BMI were compared among the four groups using two-sampled t test. Sex, prior COVID hospitalization status, and chronic comorbidities including hypertension, diabetes, and anemia were compared using chi-squared test.
Results: 19 of 543 (3.5%) patients had new-onset neuropathy and 18 (3.3%) were found to have progressing neuropathy. The study’s incidence of new-onset peripheral neuropathy (3.5% over two years) in long-COVID patients is higher than the incidence of non-COVID-related neuropathy indicated in literature (0.76% each year, p = 0.025). Compared with patients with no neuropathy, patients with new-onset neuropathy were of older age (p = 0.042), more male (p = 0.022), and more frequently hospitalized for COVID (p = 0.003). Compared to patients with no neuropathy, patients with progressing neuropathy were of older age (p < 0.001), had more COVID hospitalization (p = 0.033), diabetes (0.014), hypertension (p < 0.001), and anemia (p = 0.02).
Conclusion: Age and COVID hospitalization were found to be risk factors for both new-onset and progressing neuropathy. Being male was a risk factor for new-onset neuropathy only. Diabetes, anemia, and hypertensionwere risk factors for both progressing and non-progressing neuropathy but not for new-onset neuropathy. The results can prompt clinicians to assess peripheral neuropathy in long-COVID patients that have high demographic and medical risk factors.
Girls STEM Institute – Identity Formation for Black Girls in STEM Fields
Authors: Abufares Sabria A. , Morton Crystal Hill , Messmore Niki
Published: January 2023

Background: Women of color are disproportionately represented in STEM fields. While many systemic barriers exist due to institutional racism, other barriers begin in school that impact students’ perceptions of self and STEM. Identity formation is an integral part of learner development but adverse learning experiences have drastic effects on Black girls’ perceptions and self-efficacy within STEM fields. Girls STEM Institute (GSI) is an organization that develops a transformative space to empower girls of color through exploration of STEM concepts in meaningful, culturally-grounded ways. The purpose of this study is to examine and explore how the GSI experience impact students’ interest and attitudes towards STEM fields.
Methods: The STEM semantics survey measuring students’ interest in STEM subjects and careers was conducted amongst 42 scholars. Student perceptions of their GSI experience were obtained through journal reflections. A literature review was conducted to gain an understanding of the intersectionality of the Black girl experience, especially within STEM topics.
Results: The study is currently in progress. Preliminary data has been obtained but further data analysis is required.
Potential Impact: While the inequities that minoritized students face have been well researched and documented, critically developing initiatives to reform these inequities have been limited to individual pipeline programs and undergraduate research programs focused on diversity. While these programs have been beneficial in increasing inclusivity of minoritized students in collegiate settings, it is not enough to study and discuss the barriers that minoritized students face. It is essential to transform communities through the empowerment of youth, especially Black girls. GSI provides a framework for holistically engaging with the girls to develop their self-identity, instilling the confidence to pursue STEM careers, and providing career readiness experiences, which can cultivate a strong STEM-minded identity for Black girls.
Understanding the Impact of Adverse Childhood Experiences (ACEs) on Children at the Boys and Girls Club of Tippecanoe County, Indiana
Authors: Zeh Janie , Thomas Jordan , Messmore Niki
Published: January 2023

Background/Objective:Children with multiple Adverse Childhood Experiences (ACEs) have been shown to be at greater risk for chronic health conditions. Providing Trauma-Informed Care (TIC) to children with ACEs has been linked to better downstream health outcomes. Out-of-school time (OST) programs, such as Boys and Girls Clubs (BGC), can play an important role in supporting children with ACEs. Currently, BGC of Tippecanoe County does not require staff or volunteers to participate in training on ACEs or TIC. This study aims to determine the number of ACEs that children at BGC experience, and subsequently if training for staff and volunteers should be required.
Methods:An anonymous survey was developed using a template from ACEs Aware. The survey included ten ACEs questions and nine Related Life Events questions (considered additional ACEs in this study). An optional demographics section was also included. Caregivers of children at BGC were asked to participate. Staff and volunteers were also surveyed regarding their history of training in TIC.
Results:A total of 64 surveys were distributed to parents and 52 were completed (81.3% response rate). Of the completed surveys, the mean number of ACEs experienced per child was 4.6, the median was 3, and the mode was 2. The maximum number of ACEs experienced by a child was 14. Fifty percent of the staff and volunteers surveyed (n = 18) had no formal TIC training. Further data analysis is still in progress.
Conclusion and Potential Impact:Children who attend BGC may experience on average a higher number of ACEs than the general population. Requiring training on ACEs and TIC for staff and volunteers may help better identify and respond to child behaviors linked to ACEs. Helping children feel safe and empowered through TIC provided at OST programs may have a positive impact on their physical and social health.
Heat transfer performance of nanofluids in heat exchanger: a review
Authors: BARAI Rohinee , KUMAR Devesh , WANKHADE Atul
Published: January 2023

Energy is a key aspect of any country’s economic development. Improving heat transfer performance leads to saving energy. Nanotechnology has a key role to play in optimizing heat exchangers. Fluids containing nanosized particles are called nanofluids. Nanofluids have higher thermal conductivity than typical liquids. This paper outlines current research on convective heat transfer performance, thermophysical properties, particle size, and volume concentration effects in nanofluid studies. M easurement m ethods f ort h ermal conductivity and correlations used by earlier researchers to determine thermal conductivity are also encompassed. The main applications of nanofluids as liibricants a nd radiator systems to improve the efficiency of he at removal fr om ve hicle en gines ha ve al so be en emphasized. Results suggest that by using a larger size of particle some drawbacks include particle sedimentation, clogging, erosion, stability, and increasing pressure drop. Enhancing thermal conductivity with optimum volume concentration. Improving the efficiency of heat exchange systems is one of the possible ways to reduce energy consumption. The need for optimum concentration of nanofluids is required. The Problem of stability, corrosion, and erosion arrived by increasing the volume concentration of nanoparticles in a nanofluid.
A study of feto-maternal outcome in case of premature rupture of membrane at a tertiary care center
Authors: Shah Sushma R. , Patel Aastha H. , Doshi Haresh U. , Sindhav Gaurang , Verma R. , Mehta Ami V. , Raval Bina M. , Vaghela Riya B. , Jadhav Amit R.
Published: January 2023

Background: Premature rupture of membranes is the rupture of the fetal membranes in the absence of uterine contraction or before the onset of labor. When this occurs before 37 weeks of gestation, it is termed as preterm premature rupture of membranes. Management depends upon gestational age and the presence of complicating factors. An accurate assessment of gestational age and knowledge of the maternal, fetal and neonatal risks are essential to appropriate evaluation, counselling, and care of patients with PROM. The purpose of the study is timely diagnosis and appropriate management of the cases of PROM and PPROM to improve maternal and neonatal outcomes.
Methods: A Prospective study was performed at the department of obstetrics and gynecology, at a tertiary care center from August 2020 to December 2021. A clinical data sheet was made for recording all information about the pregnant women after taking their consent. And their maternal and neonatal outcomes were recorded.
Results: a total of 150 cases of PROM and PPROM were taken during our study out of which 53.33% belong to the younger age group, 43.33% were primi gravida, 66.66% belonged to the lower socioeconomic class, 25.33% had a previous history of abortion followed by dilatation and evacuation, rate of cesarean delivery was 34.66% and rate of NICU admission of neonates was 15.78% and 57.87% babies had low birth weight and rate of stillbirth was 1.97%. whereas 34.66% of cases had various complications related to PROM.
Conclusions: Individualized management of PROM cases depending on the gestational age and risk of complications and antibiotic coverage is the best way to achieve a good fetomaternal outcome.
A rare case of ruptured gravid horn of a bicornuate uterus
Authors: Borthakur Pratyusha , Munisamaih Munikrisha
Published: January 2023

The incidence of the uterine malformations is estimated to be 3% to 5% in the general population. Bicornuate uterus (BU) is a rare uterine anomaly result from incomplete fusion of the two Müllerian ducts during embryogenesis. Bicornuate uterus very rarely can lead to rupture of the uterus during the early pregnancy with high mortality and morbidity rates. In this case, rupture was diagnosed at an earlier gestational age, where the patient was also stable. There was a favourable outcome with timely intervention.
A rare case of xanthogranulomatous oophoritis
Authors: Patil Shaifali , Pandey Kajal
Published: January 2023

Xantho-granulomatous oophoritis is an uncommon, non-neoplastic, chronic process affecting female genital tract. Its clinical and radiological features mimic ovarian neoplasm. Here we present a case report of 42-year-old female with chronic pelvic pain with adnexal mass with infertility and raised CA 125 levels. Histopathological examination revealed it to be a case of xantho-granuous oophoritis. Xantho-granulomatous oophoritis is very rare disease and only few cases have been reported so far and this case is being reported in view of its rarity.
Role of surgical management in invasive mole: a report of 2 cases and review of literature
Authors: Khoiwal Kavita , Yadav Kripa , Dash Kanhu C. , Kumar Arvind , Chaturvedi Jaya
Published: January 2023

Invasive mole is a rare gestational trophoblastic neoplasia with proliferative trophoblast invading into myometrium or uterine vasculature. Primary management of invasive mole is chemotherapy, but hysterectomy can be performed in selective cases. In this report, we discuss two cases of invasive mole, which required surgical intervention in the form of a hysterectomy. Both patients had a favorable outcome and are in remission.
Perceived professionalism and its relationship with communication skills, social interaction and attitude towards medical subjects among undergraduate medical students in Malaysia
Authors: Rahman M. Mizanur , Raman Daneish , Anthony Elvyronna , Hazwani Nor Syamimi , Iffah Nurul
Published: January 2023

Background: Professionalism is an essential core competency in medical education in line with societal expectations.  It is expected that the medical professionals show a specified set of behaviours and attitudes towards patients and society. This study assessed professionalism and its relationship with undergraduate medical students’ communication competency skills, learning attitude, and social interaction.
Methods: This was a cross-sectional-correlation study conducted among undergraduate medical students irrespective of gender and nationality. A total of 319 students’ data were collected using a validated self-administered questionnaire. The collected data were analysed using IBM SPSS version 27.0. Pearson’s moment correlation and multiple linear regression analysis were done to identify the potential predictors of perceived medical professionalism. A p value of less than 0.05 was considered statistically significant.
Results: The study showed that professional relationship was significantly correlated with a positive attitude on communication skill (p<0.001), environmental control (p<0.001), interaction management (p<0.01), immediacy (p<0.01), attitude towards the medical subject (p<0.001). However, no statistically significant correlation was found between perceived empathy and age, gender, year of study, parental education and previous CGPA (p>0.05).
Conclusions: The study found an interrelationship between professionalism, communication skills, interpersonal communication, and attitude towards medical subjects. However, the multivariate analysis revealed different weightage of influence to professionalism. Further advanced analysis is warranted to get the impact of each of the contributing variables to academic achievement.
Functional evolution in total knee arthroplasty: first and second-generation patient-specific instrumentation compared with conventional instrumentation
Authors: Fontes Ana Paula , Rui Miguel Cintra  , Luís Gomes  , João Paulo Sousa
Published: January 2023

Background: This study compares the functional evolution between the first- and second-generation patient-specific instrumentation and conventional instrumentation pre-surgery and the third month post-surgery after TKA. We analyzed the functional outcomes achieved and the absolute gains of each study variable. In addition, we aimed to elucidate the results of the three surgical techniques regarding the surgery length of time, length of hospital stay, percentage drop in hemoglobin (Hg) at 24 h, and hip-knee-ankle angle post-surgery.
Methods: We reported our experience in TKA using PSI Visionaire System® and CI technique in 688 procedures. The patients were divided into first (N=272) and second-generation (N=151) PSI designs. The control group (N=265) underwent TKA with the CI. The instruments for assessing the functioning were: visual analog scale, goniometry, 6-minute walk test (6MWT), and domains of the WOMAC Index.
Results: The functioning achieved three months after surgery was lower in the CI than the first-generation PSI. The respective differences at absolute gains were found in the 6MWT and pain and function WOMAC scores (p=0.023, p=0.049, and p=0.018, respectively). The mean surgical time was higher in the CI compared to PSI designs (both p<0.001), and the mean hospital length of stay was higher in the CI compared to second-generation PSI (p=0.002). The percentual drop in Hg was higher in the first-generation PSI than with the CI (p=0.006).
Conclusions: Three months after TKA, the functioning achieved with the first-generation PSI was greater than the CI. However, the functional results between second-generation PSI and CI were similar.
Study on awareness and utilization of Ayushman Bharat Arogya Karnataka scheme in Chamarajanagar taluk: a cross-sectional study
Authors: Girish B.  , Jithin Surendran  , Vishma B. K.  , Jyothika V.  , Shifa Tahreem
Published: January 2023

Background: Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is India's government-funded health insurance scheme that covers over 10.74 crore poor and vulnerable families. Karnataka has been at the forefront of successfully implementing this health scheme which named as Ayushman Bharat Arogya Karnataka (ABArK) through Suvarna Arogya Suraksha trust (SAST).
Methods: This cross-sectional study was conducted in Chamarajanagar Taluk. All the 22 rural and urban field practice area of Chamarajanagara medical college and hospital were enlisted and the study subjects were randomly selected. After obtaining consent, the head of the family or in his absence the eldest adult in the households were taken as respondents.
Results: The study included 1027 households; out of which 452 (44%) are card holders. The majority of ABArK card holders 434 (96%) are BPL card holders and rural residents (60%). The totals of 666 (65%) study subjects are aware about the scheme, out of which 68% are the beneficiaries. Unfortunately, only 3% of the card holders were utilized the scheme and get benefitted.
Conclusions: The ABArK scheme and service utilisation by the study population were inadequate. The lack of adequate awareness and poor communication between health workers are the major factors for under-utilization of the scheme.
Generalised anxiety and depression during COVID-19 pandemic among post-metric science students at Baramulla
Authors: Syed Nasir Ahmad Gilani  , Ain Syed Najmul , Gilani Mohamad Azhar
Published: January 2023

Background: COVID-19 pandemic has greatly affected the studies of students because of strict lockdown and closure of schools. As such students might have developed a lot of stress. Primary objective of this study was to find out the prevalence of generalized anxiety and depression during the COVID-19 pandemic among post-metric science students at Baramulla preparing for professional exams after senior secondary.
Methods: This cross-sectional study was conducted by distributing a pre-designed questionnaire among post-metric science students at Baramulla, Kashmir. Two tuition centres were randomly selected out of all the centres. All the students who returned filled questionnaires were included. Binary logistic regression was employed to find the association of anxiety and depression with independent variables.
Results: Of the 173 participants, 91 were male (52.6%), the mean age was 16.9±1.4 years. For 81% of students, the pandemic had negatively affected their studies. About 16% (28) students had severe anxiety whereas 33% (57) had moderate anxiety and 14 students (8%) had severe depression whereas 23 (13%) had moderately severe depression. Those who did not perform routine exercise daily had higher odds of depression (AOR=2.86) and anxiety (AOR=2.3).
Conclusions: Anxiety and depression levels among young students as high as found in this study cannot be ignored. A habit of routine exercise that may have been hampered during the current pandemic must be inculcated among youngsters for healthier mental health.
Tuberous sclerosis complex type 2 in a subgroup of 7 pediatric patients
Authors: Kumaraku Aferdita Tako , Aleksi Kristi , Bushati Aida , Shehu Armand , Tomori Sonila , Mecani Renald , Cullufi Paskal
Published: January 2023

Tuberous sclerosis complex (TSC) is a multisystemic genetic disorder with autosomal dominant inheritance, characterized by hamartomas that affect multiple organs, including the central nervous system, skin, heart, kidneys, and lungs. It occurs due to variants in the tumor suppressor genes TSC1 or TSC2. In this case series, we present a subgroup of 7 pediatric patients with variants in the TSC2 gene and discuss their genotypes, phenotypes as well as genotype-phenotype correlation.
Review on phytochemical composition and pharmacological activities of Bixa orellana
Authors: Raju Senthil Kumar , Chandrasekar Sabarainath , Vengadhajalapathy Priyadharshini , Sundaram Revathy , Periyasamyy Sangeetha , Chinnaraj Thatchayani , Sekar Praveen , Kumar Shridharshini
Published: January 2023

commonly known as Annatto is a lipstick tree belonging to the family Indigenous populations in Brazil and other tropical nations have employed for a variety of therapeutic purposes which is also known as "". The essential natural apocarotenoid obtained from seeds namely bixin is broadly applied as a cosmetic and textile colorant. The carotenoids, which contribute to more than 80% of the annatto seed coat are responsible for the color orange-red. It is well known for its medicinal value and as a coloring agent. Annatto is used in food dye, body paint and the treatment of heartburn and it also reduces inflammation and blood sugar. The various parts of this plant has been reported to show many therapeutic indications like anti-bacterial, anti-hyperglycaemic, anti-histaminic, anti-diarrheal, anti-cancer, anti-inflammatory and anti-oxidant activities. Carotenoids, apocarotenoids, terpenes, terpenoids, sterols and aliphatic compounds are the main compounds found in all parts of this plant. The various annatto plant parts have been utilized in traditional medicine for both the prevention and treatment of a variety of health issues. This review aimed to report the primary evidence found in the literature, concerning the pharmacological activities and phytochemical studies related to . Regarding its application in food, cosmetics, leather, solar cells and other industries, significant research has already been done and is presently being conducted. This review demonstrates the well-studied pharmacological effect that might be relevant for the upcoming creation of a novel therapeutic medication.
Nuevos horizontes de transformación productiva en la Región Andina
Authors: Abuelafia Emmanuel , Andrian Leandro Gaston , Beverinotti Javier , Castilleja Vargas Liliana , Diaz Lina M. , Gutiérrez Juárez Priscilla , Manzano Osmel , Moreno Kenji
Published: January 2023

Las economías desarrolladas y emergentes, así como el contexto internacional dentro del cual interactúan, han enfrentado eventos que vienen transformando estructuralmente sus procesos de producción. El cambio climático, la digitalización y la pandemia del COVID-19 están generando grandes cambios en el mundo. La estructura productiva de los países andinos está siendo afectada por estas tendencias. Dada esta coyuntura, urge tomar decisiones sobre políticas para afrontar esta situación pues, de no hacerlo, habría serias consecuencias sobre el ingreso de los países andinos. Existen muchos sectores que han sido afectados y también beneficiados por la pandemia. Resulta fundamental atender los desafíos del sector agrícola, especialmente aquellos relacionados con su baja productividad. Cabe señalar que, a pesar del entorno, este sector ha crecido. El reposicionamiento de las cadenas globales de valor destaca las oportunidades no aprovechadas por la región andina. Además, el sector servicios, principal empleador de las economías andinas, fue impactado fuertemente por la pandemia. Por otro lado, el sector extractivo ya presentaba retos importantes, aun antes de este proceso de transformación. Esto ocurre en un contexto donde, pese a su crecimiento, la digitalización sigue teniendo grandes rezagos. Más aún, la región se ha caracterizado por presentar retos de desigualdad, que representan un desafío adicional de una transición que va a tener impactos sociales considerables. Este contexto abre oportunidades para la región, pero exige un importante esfuerzo de coordinación de políticas públicas. La región tiene la tarea de diversificarse. Esta publicación presenta recomendaciones al respecto. Al revisar los sectores antes mencionados, resulta fundamental atender los desafíos del sector agrícola, en particular los relacionados con su baja productividad. Existen oportunidades para integrarse a las cadenas globales de valor, pero los países andinos deberán hacer un mejor uso de los tratados comerciales existentes, buscando reducir costos para el comercio. Cabe mencionar que la región tiene espacio para aprovechar las transformaciones que están ocurriendo en el sector servicios. Finalmente, pese a existir desafíos importantes para el sector de industrias extractivas, también se presentan oportunidades para aprovechar este sector como palanca para la transformación productiva. Para lograrlo, es necesario promover la digitalización empresarial y facilitar a las empresas la decisión de qué tecnologías digitales implementar y cómo hacerlo. Cualquier estrategia de transformación productiva debe generar oportunidades para la población. Por tanto, es necesario considerar que el fomentar sectores de la economía más diversos e inclusivos no solo es más equitativo y justo, también es más rentable.
O lugar do Turismo no processo de gestão territorial e ambiental na terra indígena Mura do Careiro da Várzea-AM
Authors: Andrade Andreia Benchimol de , Cruz Jocilene Gomes da
Published: January 2023

A Instrução Normativa 03/2015 da FUNAI é um marco importante no contexto da regulamentação do Turismo em Terras Indígenas, nela o etnoturismo e o ecoturismo aparecem como uma alternativa de renda sustentável, se respeitadas as especificidades dos diferentes territórios. Neste artigo propôs-se analisar o processo de elaboração de um projeto de ecoturismo conduzido pelo Povo Indígena Mura do Careiro da Várzea-Am, por meio da sua Organização formal, a Organização de Lideranças Indígenas Mura do Careiro da Várzea (OLIMCV), a partir de 2019. Objetivou-se, ainda, evidenciar as motivações do referido povo para desenvolver um projeto de turismo nos seus territórios; identificar os agentes sociais (indígenas e não indígenas) envolvidos na elaboração e as articulações políticos culturais em torno dessa construção. Utilizou-se a Teoria Ator Rede de Latour (2012) nas análises dos dados; fazendo-se uso de pesquisa bibliográfica, documental e de campo. Com a pesquisa constatou-se que os conflitos territoriais e sociais com os não indígenas foram as principais motivações. Dentre alguns desafios enfrentados pelo povo estão, conter o desmatamento, o turismo ilegal, as tentativas de legalização de atividade de mineração dentro do território, as invasões de fazendeiros, dentre outros. Esses fatores mobilizaram o referido povo a buscar estratégias visando a proteção dos seus territórios, sendo a elaboração de um projeto de Ecoturismo Comunitário uma delas, por a conceberem uma alternativa sustentável.
New Details About the Biography of Stephan Kalinowski
Authors: Fediai Mykola
Published: January 2023

There is no specific study about Stephan Kalynovskyi, and the texts written about him contain many mistakes. This article presents the biography of Kalynovskyi, including the following stages of his life: student and professor at the Kyiv Academy, archimandrite of the Zaikonospassky Monastery, rector and professor at the Moscow Academy, archimandrite of the Alexander Nevsky Lavra, member of the Synod, bishop of Pskov, archbishop of Novgorod. In this article, attention is paid to his relations with students and brethren of monasteries, as well as to his intellectual heritage (philosophical course, Bible translation, his library). The sources portray Kalynovskyi as an innovative teacher because he was one of the first at the Kyiv Academy to teach Greek language, history in the course of rhetoric and ethics in the course of philosophy, and also as an organizer of educational institutions. At the same time, he was a very conflict person. His philosophical course, taught at the Kyiv Academy, was copied verbatim from the philosophical course of the French author Franciscus le Rées.
Avaliação da segurança do paciente no serviço de emergência de um hospital geral
Authors: Nascimento Taciana Melo do , Carvalho Lorena Rodrigues de , Pires Patrícia da Silva , Oliveira Ana Paula de Freitas
Published: January 2023

Objetivo: identificar as ações de segurança do paciente adotadas em um serviço de emergência de um hospital público. Método: estudo descritivo, observacional, transversal realizado em um hospital no Sudoeste da Bahia, no primeiro semestre de 2021. A observação foi realizada por noventa dias consecutivos, utilizando-se uma lista de verificação, e para a análise dos dados utilizou-se a estatística descritiva. Resultados: considerou-se 545 pacientes, 62,9% do sexo masculino; 37,4% permaneceram por 82 horas ou mais no serviço; 98,2% estavam com identificação; em 55,2% das observações não havia solução alcoólica de fácil acesso; 37,5% das infusões não estavam identificadas; 54,3% possuíam risco de queda e 52,3% de lesão por pressão. Conclusão: os resultados evidenciaram uma longa permanência dos pacientes e que estes estão expostos a riscos decorrentes de falhas observadas nos itens relacionados a segurança do paciente.
La educación en Colombia como herramienta para mejorar las condiciones sociales y culturales.
Authors: Peña Rodríguez Faustino , Montiel Chamorro Marta Luisa
Published: January 2023

En el marco de una investigación sobre cómo influye el nivel educativo en las condiciones sociales y culturales de quienes se gradúan de carreras profesionales, el presente artículo de reflexión da cuenta de una detallada revisión documental sobre las principales políticas y normatividad que, desde comienzos de la década de los ochenta, se han gestado y promovido en Colombia con miras a generar una mejora en las condiciones de vida y bienestar general de los sujetos, a partir del acceso a procesos educativos. Se analiza que la política pública colombiana fue consistente en tener la educación como eje de sus planteamientos de transformación social, pero al igual inconsistente en su capacidad de lograrlo generando inequidades, desigualdades y en general injusticias. Se concluye que desde la educación se hacen esfuerzos en relación con los cambios mundiales sin la suficiente claridad y continuidad.
ILHAS DE BELÉM – MAPEANDO VULNERABILIDADES SOCIOAMBIENTAIS
Authors: Rocha Gilberto de Miranda , Rocha Emílio Chaves , Barata Clícia Julie Batista , Soares Daniel Araújo Sombra
Published: January 2023

O presente artigo objetiva contribuir com a identificação, mapeamento e análise  dos espaços de vulnerabilidade socioambiental na área insular do Município de Belém do Pará, a fim de contribuir para a elaboração do mapa do território adscrito à Atenção Básica à Saúde, tendo em vista contribuir com as políticas e ações de saúde, a tornar operativo e significativo o atendimento da população.