bluuebunny/crossref_metadata_2025 huggingface dataset:
Cryopreservation of Hematopoietic Stem Cells for Pediatric Autologous Stem Cell Transplantation
Authors: Setia Rasika Dhawan , Dogra Mitu , Sharma Sanjeev Kumar , Doval Divya
Published: November 2024

ABSTRACT

Background and Objectives:

Dimethylsulfoxide(DMSO) is gold standard for cryopreservation of hematopoietic progenitor cells (HPC) to reconstitute hematopoiesis in autologous stem cell transplants (auto-HSCT). Higher DMSO-related adverse effects (AEs) are reported in pediatric patients due to lower body weight with the recommended maximal dose of 1g/kg bodyweight. This study compares adding Hhydroxyethyl starch Vs Pentastarch to DMSO in order to reduce the DMSO related adverse effects. Adding a non-permeating cryoprotectant like Hydroxyethyl starch (HES) lowers DMSO concentration. HES is known to cause pruritus and nephrotoxicity. Pentastarch has lower molecular weight hence faster renal elimination with fewer reported AEs. Adding a non-permeating cryoprotectant like Hydroxyethyl starch (HES) lowers DMSO concentration.

Methods:

This study is a single-centre retrospective-comparative analysis from October 2022 to February 2024, comparing cryopreservation outcomes using standard cryoprotectant-DMSO+ HES+albumin solution (CPS-1) with pentastarch+albumin+DMSO solution (CPS-2). During the study period, 20 pediatric patients who underwent auto-HSCT requiring cryopreserved HPC-A were included.

Results:

Average CD34+ recovery with CPS-1 and CPS-2 were 86.58±13.42 and 87.5±13.2% (P-value=0.879). Median time to neutrophil engraftment was comparable (10 days) and no significant difference in platelet engraftment was observed, median 13.5 and 15 days with CPS-1 and CPS-2. Post-cryopreservation product volume was lesser with CPS-2 compared to CPS-1 (271±34.77ml and 78±24.7; P< 0.0001). Mean DMSO volume in CPS-2 was significantly lower than in CPS-1 (7.5±2.63ml and 13.55±1.83ml; P<0.0001). AEs were lesser with CPS-2 than CPS-1 (P = 0.178), and most patients with AEs were <25kg. Reducing volume of DMSO infusion with CPS-2 decreased AEs without impairing hematopoietic function of the HPC graft.

Conclusion:

Pentastarch containing freezing solution appears to be suitable for pediatric auto-HSCT cases, especially with body weight<25kgs offering additional advantage in case of patients with renal impairment.
Prevalence and Cause of Direct Antiglobulin Test in Pediatric Patient Population: Experience from a Tertiary Health Center of North India
Authors: Ashraf Faisal , Sidhu Meena , Saini G. S. , Qureshi Mohd Zubair
Published: November 2024

ABSTRACT

Background and Objectives:

The direct antiglobulin test (DAT) is a blood test that can help differentiate immune from non-immune causes of hemolysis. The Initial DAT performed with a polyspecific anti-human globulin (AHG) reagent typically containing antibodies to immunoglobulin G (IgG) and C3d component is used to demonstrate in vivo antibodies and/or complement coating red blood cells by causing their agglutination. If the tests are positive, tests with monospecific AHG reagents containing antibodies to IgG, IgM, IgA, and C3b/d are performed to appropriately characterize the immune process involved and determine the diagnosis. The study was performed to find the prevalence of DAT in pediatric patients and its correlation with other etiologies.

Methods:

A hospital-based cross-sectional prospective study was conducted over a period of 1 year with effect from November 2020 to October 2021. The study population comprised pediatric patients who met our inclusion and exclusion criteria. These patients were tested for polyspecific DAT by column agglutination technique and on showing positive results were subjected to monospecific DAT using the same technique.

Results:

Out of all 542 hospitalized pediatric patients included in the study, 31 (5.72%) patients had a positive polyspecific DAT, of which 18 (58.06%) were male and 13 (41.94%) were female patients. Of the total 31 polyspecific DAT-positive cases, 08 (25.81%) cases showed grade 1+ reactions, 15 (48.39%) cases showed grade 2+ reactions, 06 (19.35%) cases showed grade 3+ reactions, and 02 (6.45%) cases showed grade 4+ strong reactions. After performing monospecific DAT test on positive polyspecific DAT cases, it was noticed that the C3b/d complement component showed reactivity in 38.71% of cases followed by both IgG, C3b/d positive results in 25.80% of cases. The majority of cases, i.e., 13 (41.94%) were found to have infections followed by sepsis with 07 (22.58%) cases.

Conclusion:

The prevalence of DAT positivity in our study was 5.72% with C3b/d complement being the most common cause of DAT positive results. Infections and sepsis were commonly found to show DAT positivity with C3b/d component.
Effectiveness of Double-volume Exchange Transfusion in Neonates with Hyperbilirubinemia: A Single-center Experience
Authors: Patra Kaushik , Mahapatra Smita
Published: November 2024

ABSTRACT

Background and Objectives:

Double-volume exchange transfusion (DVET) is a life-saving procedure that replaces a neonate’s blood volume twice over with adult donor blood to treat neonatal hyperbilirubinemia and prevent kernicterus. This study assessed DVET’s effectiveness in reducing total serum bilirubin (TSB) concentration in neonates at risk of kernicterus and examined the disease conditions that necessitate DVET.

Methods:

This observational study assessed the effectiveness of DVET in 104 neonates at risk of kernicterus. Neonates meeting the American Academy of Pediatrics guidelines were selected. Blood samples were collected before and 24 h after DVET for TSB estimation and complete blood count analysis. Blood components were selected based on ABO, Rh, and other minor blood group incompatibility. DVET was performed using the push–pull method.

Results:

This study of DVET in 104 neonates with hyperbilirubinemia found that DVET is an effective treatment, reducing TSB levels by 61.72% on average. The most common cause of hyperbilirubinemia was idiopathic (25.6%), followed by ABO incompatibility (22.12%) and anti-D alloimmunization (17.31%). In hypothyroid, preterm, and sepsis cases, hemoglobin levels decreased by an average of 17.7%, 12.9%, and 13.9%, respectively, after DVET. However, in cases of minor alloimmunization and anti-D alloimmunization, hemoglobin levels increased by an average of 29% and 40.5%, respectively, after DVET. The maximum decrease in TSB level was observed in cases of ABO incompatibility with sepsis (82%), while the minimum decrease was seen in neonates undergoing DVET due to sepsis (50%). The percentage reduction of TSB level after DVET was similar for different etiologies, ranging from 50.2% to 65.4%.

Conclusion:

DVET is a rarely used procedure in the age of phototherapy and intravenous immunoglobulin for neonatal hyperbilirubinemia. However, it is the only effective treatment for very high bilirubin levels to prevent kernicterus or bilirubin encephalopathy.
Rare “P-null” Phenotype – Two Case Reports from Western India
Authors: Gajera Drashti , Ahuja Ujjwal , Gupta Kamini , Bhatnagar Nidhi , Kulkarni Swati S. , Kshirsagar Pooja D.
Published: November 2024

ABSTRACT

The null phenotype in the P1PK blood group, known as “p,” is extremely rare in the world. Such individuals lack the three high-incidence antigens P, P1, and Pk. Individuals of p phenotype spontaneously form anti-PP1PK isoantibody in the serum which is also known as anti-Tja against the missing antigens. We present the two cases of p phenotype with naturally occurring anti-PP1PK isoantibodies in an infant and a young female. Serological tests, including alloantibodies screening and identification, were conducted to demonstrate the phenotype in the P1PK blood group. Both cases were serologically confirmed by higher reference laboratory in India. A well-planned patient blood management strategy can manage the repeated transfusion needs of rare blood group patients. As one of the cases is a young female, monitoring the titer of anti-PP1PK and early initiation of medical intervention are essential after her pregnancy.
Utility of Toll-Free Interactive Voice Response System (IVRS) Helpline under National Oral Health Program (NOHP) - A Cross-Sectional Hospital Based Study
Authors: Mohanty Utkal K. , Sarit Swapna , Sharma Gaurav , Dash Jayanta K.
Published: November 2024

Background:

India launched the National Oral Health Program (NOHP) in the year 2014-15 to support the states for improved oral healthcare delivery and reduce the burden of oral diseases. The toll-free Interactive Voice Response System (IVRS) with contact number 1800112032, was initiated to deliver oral health-related information to users and guide them for proper treatment on World Oral Health Day on 20th March 2017. There is scarcity of data regarding the utility and perception of users about IVRS. This study will try to underpin the factors, which can be useful in further improvement in the helpline operation.

Aims:

To assess the perception of patients regarding the use of the existing IVRS helpline under NOHP for oral health-related information.

Methods and Material:

The present cross-sectional nonclinical dental survey was carried out among 980 adults aged 18 years and above visiting SCB Dental College and Hospital, Cuttack, Odisha.

Statistical Analysis:

Descriptive statistics with proportions were calculated and Chi-square was computed, P < 0.05 was considered significant for all statistical inferences.

Results:

None of the participants were aware of the existence of the toll-free helpline number of NOHP. A significantly higher proportion of female participants responded that IVRS was useful in getting unassisted oral health-related information (P < 0.001).

Conclusions:

The services of IVRS remains underutilised by the general population due to lack of awareness regarding its existence. The IVRS helpline can be readily accessed for information regarding common oral diseases, immediate home-based care and when to approach for professional help for the common oral health issues.
Depression, anxiety, and suicidal ideation in college students in the aftermath of COVID-19 pandemic
Authors: Kelker Parisha , Singh Sneha , Ali Tahoora , Chaudhury Suprakash , Saldanha Daniel , Patil Jaideep
Published: November 2024

Background:

The COVID-19 pandemic was not merely limited to physical health concerns, and after the pandemic, the mental health consequences of the pandemic are still reverberating within our societies, especially in India. The college students in India were left to grapple with unforeseen circumstances, facing abrupt uncertainties with respect to their education and careers. Although their physical health was relatively more robust, their mental health status was left unexplored.

Aim:

To assess depression, anxiety, and suicidal ideation in college students in the aftermath of COVID-19 pandemic.

Materials and Methods:

An observational cross-sectional survey was conducted on 323 undergraduate students from June 2021 to August 2021, who were required to fill a survey form which comprised basic sociodemographic details, student’s concerns about COVID-19 and the following scales: Hospital Anxiety and Depression Scale (HADS) and Positive and Negative Suicide Ideation Scale (PANSI) after obtaining written and informed consent from them. The data collected was analyzed using descriptive and inferential statistics.

Results:

The study revealed that 23.52% of the participants suffered from depressive disorders, and 34.98% from anxiety disorders. Although a statistically higher number of males were depressed as compared to females (33.87% versus 17.08%), it was the opposite for anxiety disorders (47.73% females versus 14.51% males). HADS anxiety score was positively correlated with worrying about family members, COVID-19 infection in family members, fear of contracting the infection, presence of psychiatric illness in family, and history of attempted suicide. HADS depression score was positively correlated with worrying about family, COVID-19 infection in family members, a prior consultation with a mental health professional, and history of attempted suicide. Suicidal ideations as predicted by PANSI Positive score was predicted by rural place of residence, number of family members, and presence of psychiatry patient in the family.

Conclusion:

In the following era of the COVID-19 pandemic, anxiety and depression were high amongst college students. Various COVID-19-related and personal correlates for anxiety and depression as well as predictors for suicidal ideations could also be delineated. Institutions need to find out at-risk students and plan active measures for them.
Uremic Stomatitis: A Rare Entity in a Patient with Chronic Kidney Disease
Authors: Raghunath Mullapillil , Cyril Kumbalaparambil Ambu , George Roshan Mary , Thomas Binoy
Published: November 2024

Uremic stomatitis is a rare mucosal disorder reported in untreated chronic renal failure. It may present in different forms such as ulcerative, nonulcerative, hemorrhagic, hyperkeratotic, and pseudomembranous. The tongue and the floor of the mouth are more frequently affected. In this report, we present a case of 59-year-old male patient with chronic kidney disease Stage 5 who presented with multiple thick whitish-gray pseudomembranous plaques on the dorsal surface of the tongue. The patient was treated with intensive hemodialysis, mouthwash, and antimicrobials. The oral lesions improved with the treatment.
Impact of Decentralization on Elder Care Institutions in Kerala, India
Authors: Nesan Deepa , Iype Thomas , Johndas Binod , Sathish Syama , Swarnabai Siji Vincent , Stanley Antony , Karunakaran Vidhukumar
Published: November 2024

Introduction:

Kerala has a high percentage of people aged. Urbanization has changed the family value system and contributed to an increasing need for an alternate arrangement to stay outside their homes in their later years. This study analyzes the dynamics of elder care institutions during the last decade from the perspective of the government-driven decentralization process in Kerala, India.

Methods:

This study utilized analytical (document review and secondary data) and empirical (key informant interviews) methods. Purposive sampling was used to select the key informants. Data were collected through the Google Meet platform through face-to-face interviews using open-ended questions. The interviews were audio-recorded, transcribed, and coded. Then, the similar codes were grouped into categories.

Results:

The four themes that emerged from the study were Kerala government initiatives following decentralization toward elder care institutions, increased demand for old age homes (OAHs) following decentralization, changes in dynamics in the quality of services after decentralization, and changes in thinking after decentralization among the stakeholders but yet to be implemented.

Conclusions:

Decentralization caused the transfer of OAHs from the social justice department to the local government, which enhanced transparency, participation, and accountability. Elders started getting involved in decision-making matters focused on rights rather than welfare-oriented approaches. However, there is a need for more coordinated activities by multiple governmental agencies for the well-being of OAH residents.
Assessing the Profile of Health-related Projects and Its Financial Allocation and Utilization of Funds at Kerala’s Local Self-governing Institutions from 2014 to 2020
Authors: Jose Arun , Stanley Antony , Vasu Bibind , Renu V. P. , Sreeshma K. S. , Mavila Amrita Das , Kodickal George Joseph , Krishnapillai Vijayakumar
Published: November 2024

This study evaluates the post-decentralization financial landscape of public health projects within Kerala’s local self-governing institutions (LSGIs). With the use of narrative synthesis from many government sources, the study shows notable trends in budgetary allotments and spending for a range of health-related projects from 2014 to 2020. Nutritional projects claimed the top spot in terms of both budget allocation and utilization, highlighting their prioritization within LSGIs. However, a concerning trend of uneven resource distribution across projects and institutions emerged. Moreover, significant underutilization of allocated funds was observed, indicating a need for a more strategic and targeted approach to funding distribution. To optimize resource utilization and foster improved public health outcomes, the study recommends a two-pronged strategy: firstly, ensuring a more equitable distribution of funds across the spectrum of health projects, and secondly, investigating and addressing the underlying causes of fund underutilization at the LSGIs level. In conclusion, this study sheds light on the promising potential and persistent challenges associated with decentralization in the context of Kerala’s public health initiatives. By paving the way for further research and targeted interventions, the study ultimately aims to optimize resource utilization and create a healthier future for all residents of Kerala.
A Rare Case of Dermatomyositis Sine Dermatitis in an Indian Geriatric Patient
Authors: Pal Saumyarup , Rao Akshata , Rao Abhijith R. , Narsinhbhai Bhabhor Kaminiben , Waris Mujtaba , Sahu Saumya , Chakrawarty Avinash
Published: November 2024

Dermatomyositis sine dermatitis (DMSD) is a rare form of dermatomyositis (DM). They present with subacute to chronic symmetrical proximal muscle weakness, with a female preponderance. It is distinguished from classical DM by the absence of typical skin manifestations. We present a rare case of DMSD in a 65-year-old male patient who had an atypical presentation of subacute swelling and proximal muscle weakness of bilateral upper limbs followed by lower limbs, associated with pain, frailty, and dependency for daily activities. The diagnosis of DMSD was based on the typical muscle biopsy findings in the absence of any skin manifestations aided by elevated muscle-related enzymes, and myopathic patterns on electromyography. The screening was negative for muscle-specific antigens, malignancy, and extra muscular involvement. Pulse steroid therapy followed by gradual tapering, methotrexate, and regular physiotherapy significantly improved functionality.
Frailty: A Familiar Challenge or an Unknown Question for Anesthesiologist – Results of an Indian Survey
Authors: Dwivedi Deepak , Guha Debarshi , Sikdar Indranill , Bhan Sonia , Sharma Ridhima , Chawnhhim Abraham Lalchhana
Published: November 2024

Background:

Frailty is a public health issue, and with increased life expectancy, more elderly patients are coming for surgical interventions. It is a multidimensional condition, characterized by loss of functional reserve which leads to adverse perioperative outcomes. This novel survey in the Indian scenario not only identifies the knowledge and orientation of the Indian anesthesiologists but also their day-to-day practice of frailty assessment.

Methods:

This 22-question survey was distributed to mostly Indian anesthesiologists practicing in various cities through electronic media. The first section included the electronic addresses and the informed consent. The second section contains the academic background and demography of the respondents. The third section includes their awareness about frailty and how they perceive it as a clinical entity. The last section focuses on the actual practice of frailty assessment by the participants.

Results:

We received 306 responses, among them 295 doctors practice anesthesia. Ninety-four percent of respondents agreed that the concept of frailty should be known to all anesthesiologists, 89% of the responses concurred that frailty affects postoperative outcomes. Only 54% respondents were properly trained in this topic during their training days and 45% of all were only confident to diagnose frailty in the preanesthetic check (PAC) clinic. Thirty seven percent of respondents lacked basic knowledge about different frailty tools. Forty-three percent of respondents revealed that they do not report the presence of frailty in patient files during PAC. Only 10% of the respondents have ever used any point-of-care ultrasound for frailty assessment. In 73% of cases, there was no geriatric team available in the hospitals, and 71% said that there is no well-implemented preoperative approach in their hospital for elderly frail patients for elective surgery.

Conclusions:

Despite the awareness of the importance of frailty in preoperative assessment, there is a huge void in the identification and assessment of frail patients in hospitals. There is an absolute need for a uniform and standardized national guideline.
A Prospective Observational Study of Incidence, Associated Factors, and Impact of Spontaneous Intracranial Hematoma Expansion Admitted at a Teaching Hospital of North Western India
Authors: Chaudhary Rajesh , Kumawat Rohit , Kumar Kamlesh , Jakhar Punam
Published: November 2024

Background:

Intra cranial hematoma (ICH) can be a life-threatening condition in many cases. The outcome depends on various factors, one such being spontaneous ICH expansion. Timely identification of ICH expansion can help us prognosticate the patient and provide individualized care. The present study aimed to determine the incidence of ICH expansion and determine the clinical and radiological variables predicting expansion; along with the prognosis of these patients.

Materials and Methods:

This prospective and observational study included 94 ICH patients, who presented within 24 h of symptom onset. ICH volume was measured using ABC/2 method, and repeat computed tomography was done within 72 h or when clinically indicated. Clinical and radiological parameters were noted and looked for the prognosis of patient after expansion in the form of average hospital stay, ICH score, and modified Rankin Scale (mRS).

Results:

Out of 94 patients, 14 (15%) patients showed expansion (10 males [71%], 4 females [29%]). In clinical profile, headache (P = 0.04) and hemiparesis (P < 0.001), and radiologically marginal irregularity (P < 0.001), hypodensities (P < 0.001), ovoid shape (P = 0.004), and circular shape (P = 0.04) showed significant results. While initial volume (P = 0.16), systolic blood pressure (P = 0.28), fluid level (P = 0.15), cerebral edema (P = 0.18), and Intra ventricular extension (IV) (P = 0.98) were more in expander group but did not reach to statistically significant level. Prognosis worsened with prolonged stay (P = 0.05) and deterioration of ICH score (P = 0.02) as well as mRS.

Conclusions:

Certain clinical (early presentation and hemiparesis) and radiological (hypodensity within hematoma, marginal irregularity, and ellipsoid shapes) parameters are significantly associated with hematoma expansion. Insight into these predictors can improve the prognosis of hematoma expansion in patients with spontaneous ICH.
Geriatric Research – Indian Perspective
Authors: Saini Mamta , Gambhir Indrajeet Singh
Published: November 2024

With the rapidly growing older population in India, age-related diseases, disabilities, and socioeconomic issues are also increasing. Providing quality of life to this ever-increasing older population is impossible by any agency or government in the present setup. Geriatric research is a need of the hour in India to provide health care, prevention of disease, and better management of disabilities and maintain the autonomy of our older population.
Food Security and Household Influencing Factors in Dire Dawa and Harar, Eastern Ethiopia, 2021
Authors: Asfaw Tariku Derese , Belay Yalelet , Fentie Dilnesa
Published: November 2024

Background:

Many households in urban areas suffer from severe food insecurity, and the current economic recession, pandemic, and conflict in the region have disproportionately aggravated the problems. Even if it is a social and public health challenge, the problems have been overlooked in the planning area. Measuring food security status in an urban setting is crucial to developing a sustainable and effective intervention. This study is designed to assess food security and household influencing factors in the eastern part of urban areas in Ethiopia.

Materials and Methods:

A community-based cross-sectional study was conducted to assess 616 households. Of the total of 616 samples, 405 were from Dire Dawa and 211 were from Harar, using simple random sampling. Validated questionnaires from previous studies were accustomed to collecting information. Three kebeles from Dire Dawa and three kebeles from Harar were selected using lottery methods. The data were collected by health extension workers. The information was entered into Epi-data version 3.02 and exported to SPSS version 21. To identify significant factors influencing household food insecurity, binary regression analysis was performed, and a P < 0.05 at a 95% confidence interval (CI) was considered statistically significant. Model fitness was checked using the Hosmer-Lemeshow test with a P > 0.05.

Results:

The prevalence of household food insecurity among urban residences in Dire Dawa and Harar was 41.7% [95% CI: 37.4–45.6]. The following factors were identified as influencing factors: household head sex (adjusted odds ratio [AOR] = 1.75, 95% CI: 1.08–2.84), household head education status (primary level) (AOR = 0.52, 95% CI: 0.33–0.99), household mother occupation (private business workers) (AOR = 0.3, 95% CI: 0.19–0.57), households with the medium wealth index (AOR = 1.72, 95% CI: 1.06–2.78) and households with the poorest wealth index (AOR = 4.01, 95% CI: 2.35–6.86).

Conclusions:

In this study, mild and moderate household food insecurity is increasing alarmingly. However, the prevalence of household food insecurity is low compared to the other findings. It is essential to design and implement appropriate small-scale household income generation systems for urban areas to tackle the food insecurity problem in the eastern parts of urban areas in Ethiopia.
On the homotopy groups of the automorphism groups of Cuntz–Krieger algebras
Authors: Matsumoto Kengo , Sogabe Taro
Published: November 2024

In this paper, we first present the homotopy groups of the automorphism groups of Cuntz–Krieger algebras in terms of the underlying matrices defining the Cuntz–Krieger algebras. We also show that the homotopy groups are complete invariants of the isomorphism classes of Cuntz–Krieger algebras. As a result, the isomorphism class of a Cuntz–Krieger algebra is completely determined by the group structure of its weak extension group and strong extension group.
Thematic Working Group on the Professional Practices, Preparation and Support of Mathematics Teacher Educators, TWG27
Authors: Karsenty Ronnie , Rösken-Winter Bettina , Zehetmeier Stefan , Pöhler-Friedrich Birte , Borko Hilda , Coles Alf
Published: November 2024

In this issue presented by the group leaders Ronnie Karsenty, Bettina Rösken-Winter, Stefan Zehetmeier, Birte Pöhler-Friedrich, Hilda Borko
and Alf Coles
Every file is a program, but not the reverse
Authors: Mélès Baptiste
Published: November 2024

The concept of a program, unlike that of a file, is an informal one,
giving rise to inaccurate or even false assumptions. In this article,
we will contest two of them. First, using historical examples, we
will show that there are programs that are not files. Then, more
surprisingly, we will argue that any file can be seen as a program,
since all criteria characterizing programs hold true for files. In
particular, we will conclude that there is no technical reason to
distinguish between file/program and program/interpreter pairs.
Visual Communication Bridging Intercultural Barriers: Collaborative Methods Supporting the Social Inclusion of Young Refugees
Authors: Jekli Ágnes
Published: November 2024

This paper explores the possibilities of graphic languages in an intercultural context while analysing the potential of creative methods when working with refugee youth. The practice-based aspect of this research is undertaken with Open Doors Hungary, a community-based design project that creates a programme for unaccompanied refugee minors. The aim of Open Doors is to help young refugees integrate into Hungarian society and develop means of communication and quality relations with the host society.          
Refugee youth arriving in Hungary face serious problems: the loss of home and community, the traumas suffered during the journey, the cultural differences, and the lack of a common language make their social integration extremely challenging. These challenges are exacerbated by xenophobia and stereotypical opinions about foreigners. Social inclusion requires frequent contact with the local society, and refugee youth need new tools (cultural knowledge, language skills, intercultural skills) to overcome their disadvantages. 
Since 2013, the author has been working with refugee youth using participatory design tools such as regular creative sessions, workshops, and eight camps based on the integrating role of creativity and art. During these sessions, young refugees and their Hungarian and European peers learned about different visual communication tools and created common messages in the form of videos, animations, photos, posters, booklets, and murals. Through these activities, refugee youth become part of the design process, and the final result is based on their choices. 
In the theoretical research and field experiences, this paper states that design thinking and the creative process allow interactive cultural exchange, value sharing, safe and open discussions, and community building. As a global language, visual communication can be a tool for intercultural communication, storytelling, and self-expression. The opportunity for refugee youth and their Hungarian peers to work in intercultural teams develops new competencies and creates shared ownership and community.
Effect of nutrition on the nutritional status in preterm infants with very low birth weight
Authors: Pinaeva-Slysh Evgeniya L. , Skvortsova Vera A. , Borovik Tatyana E. , Basargina Milana A. , Zimina Elena P. , Petrova Anastasiya S. , Malyutina Lyudmila V. , Lukoyanova Olga L. , Illarionova Maria S.
Published: November 2024

Introduction. Postnatal growth retardation in premature infants with very low birth weight (VLBW) remains an unresolved problem. There are different approaches regarding the duration of use of breast milk fortifiers during breastfeeding and specialized formulas during formula feeding, as well as the timing of the appointment of complementary feeding.
Objective: to evaluate the physical development and component body composition in VLBW infants, depending on nutritional support over the first year of life.
Materials and methods. The study included ninety three VLBW premature infants of 2 to 11 months postnatal age (PNA). The main (1st) group included infants (n = 74) who received dietary correction depending on the nutritional status, while no such intervention was performed in the (2nd) comparison group (n = 19). Up to 64 weeks of postconceptional age (PCA), weight, body length, and head circumference were assessed using INTERGROWTH-21st international growth standards, then in the software “WHO Anthro (2009)”. Fat and fat-free (lean) mass were determined using the air plethysmography method (PEA POD, LMi, USA).
Results. The analysis of the nutritional status revealed a moderate deviation, not exceeding 1 sigma, decrease in indices (Z-scores) of anthropometric indices in infants of the 1st and 2nd groups by PNA of 2–3 months. Further in infants of the 1st group on the background of prolonged use of fortified nutrition (breast milk fortifier or specialized formulas for preterm infants) and timely introduction of complementary foods, nutritional deficiencies throughout the first year of life in general were not revealed. In the 2nd group of infants without additional correction of nutrition by 4–5 months of age, the development of mild nutritional deficiency was noted by 6–7 months of age. By 6–7 months of age, it turned into moderate nutritional deficiency, which persisted until 8–9 months of age and then turned into mild nutritional deficiency. Analysis of the component body composition showed that during the observation period, the fat-free body mass (FFM) gain in infants in the 1st group was 3.40 kg, in Group 2 infants — 2.2 kg. At the same time, % body fat mass (FM) in infants in groups 1 and 2 had no significant differences (%FM 1 = 19.3 [15.3–22.5], %FM 2 = 19.9 [16.7–24.6], p = 0.769) and did not exceed the values characteristic of preterm infants.
Conclusion. A comprehensive assessment of the nutritional status of VLBW infants during the first year of life allowed us to eva­luate the positive impact of long-term use of fortified diets and timely introduction of certain complementary foods. Optimization of nutrition made it possible to prevent the development of nutritional deficiency, which can have a significant positive impact on their further growth, development, and health status.
Myocarditis in children. Modern aspects of diagnostics
Authors: Vasichkina Elena S. , Balykova Larisa A. , Basargina Elena N. , Bregel Lyudmila V. , Degtyareva Elena A. , Kovalev Igor A. , Kotlukova Nataliya P. , Leontyeva Irina V. , Yakovleva Lyudmila V. , Groznova Olga S.
Published: November 2024

Introduction. A review of the current literature on the features of the diagnosis of myocarditis in children is presented. Myocarditis is an acute or chronic inflammatory myocardial disease characterized by a variety of clinical manifestations, nonspecific symptoms and physical data. With insufficient number of informative diagnostic tests, there is a challenge for practitioners at all stages of medical care. Aim of the review is to comprehensively present the features of the clinical diagnosis of myocarditis in children. The presence of myocarditis should be assumed in situations where children, regardless of the age, first developed symptoms of heart failure (HF), as well as in the presence of a clinic of viral infections accompanied by respiratory or abdominal symptoms, combined with the development of tachycardia, hypotension or cardiac arrhythmias, even in the absence of cardiomegaly. Myocarditis should be clinically suspected at the stage when the necessary decisions should be made about the patient’s routing, the formation of a complex of diagnostic examinations and the start of therapy. Magnetic resonance imaging (MRI) of the heart is today the non-invasive gold standard for the diagnosis of myocarditis that allows detecting myocarditis within 2–3 weeks after the first symptoms appear. Endomyocardial biopsy can be used for accurate morphological diagnosis of myocarditis in children. Molecular biological and genetic studies that determine the severity and outcome of the disease are important for the diagnosis of myocarditis in children.
Conclusion. Based on the literature data and own experience in diagnosing myocarditis, the authors have developed an original diagnostic algorithm to make the right medical decision in case of suspected acute myocarditis in children.
ANTIOXIDANT, INHIBITION OF ADVANCED GLYCATION END-PRODUCT FORMATION AND ANTIMICROBIAL ACTIVITIES OF OCIMUM GRATISSIMUM (SCENT LEAF) METHANOLIC LEAF EXTRACT AGAINST Escherichia coli AND Bacillus SPP
Authors: Momoh J. O. , Ayinde F. A. , Awote O. K. , Adekunle O. M. , Obayomi A. A.
Published: November 2024

The study investigates the antioxidant, inhibition of advanced glycation end-product formation and antimicrobial activities of methanolic leaf extract of Ocimum gratissimum. GC-MS, qualitative, antioxidant scavenging and antiglycation activities of the extract of Ocimum gratissimum were determined using standard procedures. The antimicrobial activity was evaluated by agar well diffusion method. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined using standard methods. The GC-MS analysis of Ocimum gratissimum leaf revealed the presence of 49 compounds with P –cymene been the most abundant. The phytochemical screening of the extract shows the presence of alkaloids, tannins, phenolic, flavonoids, saponins etc. The in-vitro antioxidant assay of the extract was found to have ?-carotene, lycopene, total phenolic compounds, total flavonoid compounds, reducing power and DPPH scavenging activities. The extract showed significant inhibitory effects on the formation of compounds containing two carbonyl groups and Advanced Glycated End products formation with IC50 of 75.85 ±4.87 µg/mL. Agar well diffusion assay was characterized by inhibition zones of 21.0 ± 0.30, 19.66 ± 0.20, 33.78± 0.30 and 33.25 ± 0.40 mm for Escherichia coli and Bacillus spp respectively at 250 mg/ml for Ocimum gratissimum and 25 mg/ml for tetracycline solution. The MIC values for E.coli and Bacillus spp were 33.33, 66.67, 0.78 and 0.78 for both extract and tetracycline while their MBC values were 66.67, 133.00, 1.56 and 1.56 respectively. MBC/ MIC values showed that Ocimum gratissimum extract and tetracycline had bactericidal effects. These results indicated that Ocimum gratissimum possesses antioxidant, prevents glycation and has antimicrobial activities.
Reporte de caso: estimación de IPM (Intervalo Post Morten) en un perro mediante la entomofauna cadavérica
Authors: Punina Tituaña Alexander Danny , Ayora Muñoz Jorge Luis , Castillo Hidalgo Edy Paúl
Published: November 2024

El IPM (Intervalo Post Morten), en el área de Medicina forense veterinaria tiene mucha importancia para estimar el tiempo transcurrido desde la muerte del individuo hasta su descubrimiento. Al utilizar la fauna asociada al cadáver nos permite guiarnos en el tanatocronodiagnóstico, aun cuando el cadáver este en estados avanzados de putrefacción, gracias a la llegada de los insectos al cadáver en forma ordenada. Conociendo que la especie con más importancia forense son los dípteros ya que cumplen todo su ciclo de vida en el cadáver lo cual ayuda a determinar con más precisión el IPM, para lo cual se recolectaron larvas, pupas y fueron enviadas al laboratorio, estas fueron conservadas hasta su estadio adulto donde se identificó como Calliphora vicina. De esta manera se pudo usar a la Entomología forense como un instrumento más para el área de Medicina veterinaria forense y determinar el tiempo de muerte. El objetivo de este trabajo fue evaluar el IPM mediante la entomofauna cadavérica en un canino utilizando las unidades de calor.
Efecto del aceite de extracto de lavanda en el postoperatorio de OVH en gatas
Authors: Andrade Zuleta Priscila , Maldonado Cornejo Manuel Esteban
Published: November 2024

El proceso de recuperación postoperatorio en felinos adultos sometidos a OVH, es muy importante para lograr una buena cicatrización, sin presentar complicaciones por estrés post quirúrgico. Este estudio experimental tuvo como objetivo evaluar el efecto de la aromaterapia con lavanda durante la recuperación del paciente para lograr la reducción del estrés postquirúrgico y controlar el dolor en 30 gatas adultas sometidas a OVH en el Hospital Municipal de la Mascota en Cuenca. Para esto se comparó un grupo que recibió aromaterapia con lavanda por medio de un difusor ambiental frente a grupo control, sin exposición. Se evaluaron las constantes fisiológicas: frecuencia cardíaca, frecuencia respiratoria y temperatura corporal; conductuales: nivel de actividad cada 15, 45 y 90 minutos. Además, se utilizó la escala GRIMACE para evaluar también el dolor postoperatorio, siendo la disminución de estos signos un indicador de confort en los animales. Aunque no se encontró diferencia significativa en el tiempo final de recuperación, las gatas tratadas con aromaterapia presentaron una recuperación menos traumática, reflejada en la estabilización de los signos vitales tanto en frecuencia cardiaca (p=0,041) y en la frecuencia respiratoria (p≤0,001) a los 90 minutos, así como el descenso gradual del dolor postoperatorio, donde el Tratamiento presentó valores estadísticamente menores (Antes 5 y Después 3) que el Testigo (Antes 7 y Después 6). Estos resultados sugieren que la lavanda podría ser una herramienta útil para mejorar el bienestar animal durante la recuperación postquirúrgica.
Trilogi Kapabilitas Pemimpin Perspektif Al- Qur’an dalam Usaha Pengkolaborasian Tenaga Kependidikan
Authors: Anwar Khoirul , Sukarman Sukarman , Ulfah Mariya , Ordiana Eva
Published: November 2024

This study aims to investigate a tripology of leader capabilities structured in three aspects namely, how a leader can respond, how a leader has the management abilityto respond so as to anticipate changes and how to control the work capacity of managers in the organization, so that the work carried out in every management, in particular educational management, can run as expected. This study uses qualitative method which the discussion source is obtained through a literature review methodology by collecting data in related literature. The results of the study reveal that social resources collabaration in educational field is an effective strategy that integrates professional collaboration, sustainable training, and shared leaarning to vercome challenges in education and to improve the quality of teaching. By educational staff collaboration, it allows teachers to meet. Share best practices, and adopt innovative methods which relevant to the needs of the current curriculum. In line to the Holly Qur’an which instructs educational staff to give maximum efforts by optimizing social resources in educational field.
Materiales nanoestructurados como potenciales neurotóxicos.
Authors: Ramirez-Herrera Angel Daniel
Published: November 2024

Estimada Editora: Los avances científicos revolucionaron la vida actual, generando innovaciones tecnológicas como los materiales nanoestructurados (MNs). No obstante, debido a su versatilidad y amplia gama de aplicaciones su uso ha sido extensivo e intensivo, sin conocer debidamente las consecuencias adversas para la salud humana o el medio ambiente. Su ínfimo tamaño le permite ingresar a cualquier organismo, siendo en el humano, las principales rutas de ingreso la vía dérmica, respiratoria y digestiva. Esta última de gran relevancia, ya que, la industria alimentaria ha adoptado el uso de MNs para mejorar la calidad y propiedades de los alimentos.1 Es necesario enfatizar que pese a que se utilicen no existen estudios concluyentes sobre el efecto toxicológico de los MNs. Es sabido que estos materiales se transfieren a través de los niveles tróficos pudiendo bioacumularse en diversos órganos entre ellos el cerebro.
Parkinsonismo y deterioro cognitivo rápidamente progresivo en un paciente con lupus eritematoso sistémico y síndrome antifosfolípido triple positivo.
Authors: Guzmán-Serrano Carlos Alberto , Gómez Narvaez Verónica , Felipe Cárdenas Andrés , Moreno López Claudia Lucia
Published: November 2024

Antecedentes: La asociación entre el parkinsonismo y el lupus eritematoso sistémico está insuficientemente descrita y, hasta la fecha, los mecanismos fisiopatológicos subyacentes no están completamente establecidos, abarcando desde alteraciones vasculares hasta fenómenos inmunomediados. El análisis de la literatura identificó solo 28 casos de parkinsonismo en pacientes con lupus eritematoso sistémico, destacando la limitada atención a estas asociaciones y sus respectivos enfoques terapéuticos. Reporte de Caso: Presentamos el caso de un paciente con una presentación atípica de lupus eritematoso sistémico y un diagnóstico de síndrome antifosfolípido triple positivo. A pesar de la ausencia de actividad lúpica, el paciente desarrolló síntomas de parkinsonismo y un rápido declive cognitivo. No se encontraron otras causas subyacentes ni eventos trombóticos en la imagen cerebral que explicaran la presentación clínica atípica. La administración simultánea de terapia inmunosupresora y levodopa/carbidopa resultó en una mejora de los síntomas. Conclusión: Se ha realizado una investigación insuficiente sobre la correlación entre el lupus eritematoso sistémico y el parkinsonismo, principalmente debido a su aparentemente baja incidencia en la literatura médica. Por lo tanto, este informe de caso ofrece perspectivas adicionales sobre esta asociación, sentando posiblemente las bases para futuros estudios estructurados y bien diseñados. La eficacia de la levodopa y la terapia inmunosupresora en el tratamiento de estos pacientes sigue siendo incierta y requiere una investigación adicional.
Mixoma de aurícula derecha como probable causa de migraña.
Authors: Medrano-Plana Yuri , Hernández-Borroto Carlos Enrique , Salazar-Raodríguez Sirced , Sánchez-Torres Nadia
Published: November 2024

Introducción: El mixoma cardiaco es un tumor benigno conocido como el “gran simulador”, ya que puede manifestarse clínicamente de forma muy variada y/o con hallazgos inespecíficos que crean mucha confusión y dificultan su diagnóstico. Se asocia a manifestaciones neurológicas secundarias generalmente a complicaciones embólicas al sistema nervioso, como los accidentes cerebrovasculares isquémicos, que pueden provocar: mareos, cefalea, perdida del conocimiento, y/o alteraciones de la visión y el lenguaje. Caso Clínico: Paciente femenina de 16 años con episodios de cefaleas de seis meses de evolución y sin otros antecedentes neurológicos. Hospitalizada para estudio diagnóstico, por el servicio de neurología, que se interpretó como una cefalea primaria del tipo migraña sin aura. Entre los exámenes realizados durante su ingreso hospitalario, se detectó una masa intracardiaca a nivel de la aurícula derecha compatible con mixoma cardiaco mediante el análisis histopatológico postoperatorio. Evolucionó favorablemente sin presentar nuevamente sintomatología neurológica. Conclusión: La aparición de migraña en pacientes portadores de mixomas cardiacos, es raramente reportada, asociándose únicamente la presencia de esta enfermedad a mixomas ubicados en cavidades cardiacas izquierdas. Al describir los diferentes mecanismos fisiopatológicos publicados que pueden dar origen a este cuadro neurológico y debido a lo extraño del caso reportado, por la ubicación de la neoplasia en cavidades derechas, se considera plantear como posible mecanismo de origen de la migraña: la síntesis y liberación de polipéptido intestinal vasoactivo por el tumor mixomatoso.
NOTAS SOBRE A EXPERIÊNCIA ÉPICA DE ITALO CALVINO
Authors: Miranda Igor
Published: November 2024

Este artigo apresenta breves notas sobre os processos literários relacionados ao épico nas ficções e nos ensaios de Italo Calvino. Identifica-se o épico entre o realismo e o fantástico, o epos do pós-guerra italiano em A especulação imobiliária (2011) e a matéria épica de transfiguração fantástica em O cavaleiro inexistente (2014). Para tanto, a fundamentação teórico-metodológica envolve conceitos dos Estudos Épicos (Silva; Ramalho, 2022; Ramalho, 2018) e o aporte de alguns interpretes da obra de Calvino (Klein, 2008; Fioretti, 2017; Cueto, 2020). Além desses estudos, aborda-se alguns ensaios críticos de Calvino que demonstram sua compreensão do épico na relação entre literatura e sociedade e como modelo de criação literária.
The Clash of Civilizations and War Against Terrorism: A Synoptic Study (2001-2008)
Authors: Khan Muhammad Mumtaz Ali , Hussain Mazher , Bibi Khushbakht , Qaisar Zarfishan
Published: November 2024

On the advent of new millennium, the attack on WTC on 9/11 set a new paradigm of terrorism in world scenario. The defensive “anti-terrorist” policy of the United States gave way to offensive “counter terrorism” which posed a real threat to the Islamic world and Muslim civilization. WAT couldn’t restore peace; instead, it resulted in turmoil, chaos, commotion, culminating in suicide attacks and bomb explosions at public places. This research highlights the threat which Islamic theology and civilization faces from Western counter-terrorism policies. It also analyzes the factors that foment fanaticism i.e., policies of Western think-tanks, theological contests among the Abrahamic religions (Judaism, Christianity, Islam) and Islam-phobia. This study further emphasizes the economical component hidden behind Western counter terrorism campaign, that entered in radical Islamic belt holding cosmopolitan, pluralistic, multiethnic and multicultural slogan.