bluuebunny/crossref_metadata_2025 huggingface dataset:
Neurodevelopmental outcomes in children with cyanotic congenital heart disease following open heart surgery
Authors: Shakya Samir , Saxena Anita , Gulati Sheffali , Kothari Shyam Sunder , Ramakrishnan Sivasubramanian , Gupta Saurabh Kumar , Devagourou Velayoudam , Talwar Sachin , Rajashekar Palleti , Sharma Shobha
Published: February 2023

Background:

Neurodevelopmental abnormalities are common in congenital heart disease (CHD), more so in cyanotic CHDs. Perioperative factors have been known to affect neurodevelopmental outcomes.

Aim:

We aimed to determine the neurodevelopmental outcomes following open-heart surgery in cyanotic CHD.

Methods:

In this prospective observational study, eligible infants and children ≤21 months with cyanotic CHD planned for open-heart surgery underwent preoperative neurodevelopmental assessment using Developmental Assessment Scale for Indian Infants (DASII) to look for any motor and/or mental delay. A second neurodevelopmental assessment was performed after 9 months ± 2 weeks of cardiac surgery. Follow-up DASII was conducted through interactive video conferencing in 23 of 60 patients due to COVID-19 pandemic. The univentricular and biventricular repair groups were compared in terms of their neurodevelopmental outcomes. Perioperative factors were compared between neurodevelopmental “delay” and “no delay” groups.

Results:

Of the 89 children enrolled, preoperative motor and mental delay were present in 29 and 24 children, respectively. Follow-up DASII could be performed in 60 children. At follow-up, motor delay was present in seven and mental delay in four children. Overall, there was a significant improvement in both motor and mental developmental quotient at follow-up. There was no significant difference in either motor or mental domains between univentricular and biventricular groups. Among the perioperative variables, only the postoperative length of stay in intensive care unit was significantly different between neurodevelopmental “delay” and “no delay” groups (P = 0.04).

Conclusion:

Neurodevelopmental delay occurred substantially among unoperated children with cyanotic CHD. The neurodevelopmental status improved significantly following open-heart surgery among the survivors. Delay was associated with length of stay in intensive care following cardiac surgery.
Repercussions of a giant major aortopulmonary collateral aneurysm adjacent to vertebral artery origin
Authors: Anoop Ayyappan , Valakkada Jineesh , Sasikumar Deepa , Menon Sabarinath
Published: February 2023

An aneurysm of major aortopulmonary collateral in an adult with congenital cyanotic heart disease was detected incidentally following a hemoptysis episode. The location and size of the aneurysm needed special concern during treatment to avoid aneurysm-related complications and thromboembolism secondary to intervention.
Pediatric cardiac surgery following severe acute respiratory syndrome coronavirus-2 infection
Authors: Sen Supratim , Joshi Vinay , Majhi Lopamudra , Pradhan Priya M. , Jain Sneha , Dhabe Vaibhav , Trivedi Dipesh , Kaushik Pradeep K.
Published: February 2023

Background:

We evaluated our early experience of cardiac procedures in children with congenital heart defects (CHD) after asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, to understand whether recent reverse transcription-polymerase chain reaction (RT-PCR) positivity had a negative impact on their postprocedural recovery and outcomes.

Materials and Methods:

In this retrospective observational study, all patients with CHD who underwent cardiac surgery or transcatheter intervention at our institution between March 2020 and June 2021 who were detected to have asymptomatic SARS-CoV-2 infection on routine RT-PCR were included. Details of the cardiac procedure and postprocedural recovery were reviewed and compared with RT-PCR-negative patients who concurrently underwent similar cardiac surgeries or interventions at our center.

Results:

Thirteen patients underwent cardiac surgery after recent SARS-CoV-2 positivity after a mean interval of 25.4 ± 12.9 days. One patient expired with multiorgan dysfunction and systemic inflammatory response with elevated D-dimer, serum Ferritin, C-reactive protein, and significant ground-glass opacities on chest radiograph. Another patient developed spontaneous thrombosis of the infrarenal abdominal aorta, bilateral iliac arteries, and bilateral femoral veins, requiring low-molecular weight heparin postoperatively. This patient's postoperative recovery was also prolonged due to lung changes delaying extubation. All other patients had uneventful postprocedural recovery with intensive care unit and hospital stays comparable to non-SARS-CoV-2-infected patients.

Conclusions:

From our early experience, we can surmise that an interval of 2–3 weeks after asymptomatic SARS-CoV-2 infection is adequate to undertake elective or semi-elective pediatric cardiac surgeries. For patients requiring emergent cardiac surgery prior to this interval, there is potentially increased risk of inflammatory and/or thrombotic complications.
Ivabradine monotherapy in congenital junctional ectopic tachycardia
Authors: Devaprasath Sivalingam , Buddhavarapu Siddartha , Mariam Suja , Krishna Mani Ram
Published: February 2023

Congenital JET (junctional ectopic tachycardia) is a rare and often difficult to treat tachyarrhythmia in young infants. The addition of Ivabradine to standard Congenital JET therapy has been shown to improve arrhythmia control. However, Ivabradine has not been reported as a single drug in the control of congenital JET. We report a pre-term neonate in whom Ivabradine monotherapy was successful in treating congenital JET.
Scimitar syndrome and left pulmonary vein stenosis
Authors: Mendoza Alberto , Herrera Dolores , Caro Ana T. , García Enrique , Montañés Elena , Granados Miguel Angel
Published: February 2023

Scimitar syndrome is a rare constellation of cardiovascular anomalies consisting of partial right anomalous pulmonary venous drainage to the inferior vena cava, hypoplasia of the right lung, cardiac dextroposition, and in many cases, one or more aortopulmonary collaterals from the descending aorta to the hypoplastic lung. The “infantile form” commonly presents with significant heart failure and pulmonary hypertension. Stenosis of the left pulmonary veins associated with scimitar syndrome is a rare but well-described combination, usually associated with a poor prognosis. We describe two patients with this association in whom the left pulmonary vein stenosis manifested months after the initial diagnosis as a progressive lesion that complicated the course of the disease due to severe pulmonary hypertension. Both patients were successfully treated with a combination of surgical, percutaneous, and hybrid treatment.
Validation of the HPLC Analytical Method for the Determination of Chemical and Radiochemical Purity of Ga-68-DOTATATE
Authors: Sammartano Antonino , Migliari Silvia , Serreli Giulio , Scarlattei Maura , Baldari Giorgio , Ruffini Livia
Published: February 2023

Purpose of the Study:

Ga-68-DOTA-peptides targeting somatostatin receptors have been assessed as a valuable tool in neuroendocrine tumors imaging using positron emission tomography (PET). A new selective and sensitive high-pressure liquid chromatography (HPLC) method was developed for determining chemical and radiochemical purity of Ga-68-DOTATATE (PET) tracer. The identification of peaks was achieved on a symmetry C18 column 3 μm 120Å (3.0 mm × 150 mm spherical particles) using (A) water + 0.1% trifluoroacetic acid (TFA) and (B) acetonitrile + 0.1% TFA, as the mobile phases at a flow rate of 0.600 mL/min and monitored at 220 nm. The run time was 16 min.

Materials and Methods:

The method was validated to fulfill International Conference on Harmonization requirements and EDQM guidelines, and it included specificity, linearity, limit of detection (LOD), limit of quantification (LOQ), accuracy, and precision.

Results:

The calibration curve was linear over the concentration range from 0.5 to 3 μg/ml, with a correlation coefficient (r2) equal to 0.999, average coefficient of variation (CV%) 2%, and average bias% did not deviate more than 5% for all concentrations. The LOD and LOQ for DOTATATE were 0.5 and 0.1 μg/mL, respectively. The method was considered precise, obtaining coefficients of variation between 0.22% and 0.52% for intraday and 0.20% and 0.61% for interday precision. Accuracy of method was confirmed with average bias% that did not deviate more than 5% for all concentrations.

Conclusion:

All results were acceptable and this confirmed that the method is suitable for its intended use in routine quality control of Ga-68-DOTATATE to guarantee the high quality of the finished product before release.
Tibial Stress Fracture and “Shin Splint” Syndrome in the Same Patient Diagnosed on 99mTC-Methylene Diphosphonate Bone Scintigraphy and Single-Photon Emission/Computed Tomography
Authors: Mishra Rajesh , Meena Anjali , Sanjith L. S. , Jha Shranav , Dhingra Vandana Kumar
Published: February 2023

We present a case of an 18-year-old male athlete who presented with complaints of right lower leg pain for 10 days following intense exercise. The most likely diagnosis was a possible tibial stress fracture or a "shin splint" syndrome. The radiograph did not reveal any significant abnormality in the form of any fracture or a cortical break. We performed planar bone scintigraphy including single-photon emission computed tomography (CT)/CT that revealed the presence of the two concomitant pathologies in the form of a hot spot which corresponded with a bone lesion in the tibial stress fracture and subtle remodeling activity without evidence of significant cortical lesion in the shin splints in bilateral lower limbs (R>L).
Acute Myeloid Leukemia following Radioactive Iodine Therapy for Metastatic Follicular Carcinoma of the Thyroid
Authors: Bishnoi Komal , Emerson Ralph , Parida Girish Kumar , Acharya Prapti , Padhi Somanath , Agrawal Kanhaiyalal
Published: February 2023

Radioactive iodine (RAI) therapy is widely used and has an important role in the management of hyperthyroidism and thyroid malignancies. The development of acute or chronic leukemia is a very rare complication of RAI therapy. We report a case of metastatic Follicular thyroid cancer (FTC) who underwent total thyroidectomy followed by treatment with a cumulative dose of 1600 mCi of RAI (for 4 years) and by palliative radiotherapy for L4 spinal metastasis, later on, developed acute myeloid leukemia. Thus, all patients with thyroid carcinoma treated with RAI should undergo periodic hematological examinations irrespective of RAI dose.
Askin Tumor - Presenting as a Case of Paraparesis
Authors: Das Kalpa Jyoti , Kumar Akash , Prakash Sneha , Singhal Abhinav
Published: February 2023

Askin tumors are rare malignant neoplasms located in the thoracopulmonary region and mainly occur in children and adolescents. In this report, we describe a case of histologically proven Askin's tumor in a 24-year-old male. The patient was admitted with a history of 3-month lower back pain and with a rare presentation of paraparesis.
18F Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Findings in a Case of Metastatic Eccrine Porocarcinoma – An Extremely Rare Malignant Adnexal Tumor
Authors: Krishna Sarin , Ravina Mudalsha , Kumar Amit , Dasgupta Subhajit , Kote Rutuja
Published: February 2023

Porocarcinoma is a rare malignant neoplasm of eccrine sweat glands representing 0.005 to 0.1% of all cutaneous tumors. As eccrine porocarcinoma carries a high risk of recurrence and metastases, early diagnosis and management are crucial to lower mortality rate. We present the case of porocarcinoma in a 69-years-old woman who underwent 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for staging the disease. PET/CT showed metabolically active multiple cutaneous lesions and also picked up lymph nodal and distant metastases to lungs and breast accurately. PET/CT is useful for accurate staging of the disease and for treatment planning.
A Case Series of Neurolymphomatosis
Authors: Gupta Manoj , Pasricha Sunil , Ahmed Rayaz , Choudhury Partha Sarathi
Published: February 2023

Neurolymphomatosis is rarely encountered in high-grade lymphomas. In this case series, we retrospectively analyzed six neurolymphomatosis cases to look for possible risk factors, common and uncommon presentations, and the lessons learned. Neuropathic pain was the most common symptom with mono or polyradiculopathy in this series. However, all lymphomatous infiltrated nerves diagnosed on fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) were not symptomatic. The lumbar, brachial plexus, and trigeminal nerve were the most common sites and were depicted well on FDG PET/CT. Magnetic resonance imaging (MRI) of the brain better delineates cranial nerves and meningeal involvement. Cerebrospinal fluid flow cytometry was normal until meninges were involved. FDG PET/CT incrementally evaluated extra-neural disease sites, thus helping in deciding biopsy sites and further management. We concluded that a whole-body FDG PET/CT including limbs with MRI brain was the appropriate investigation for evaluating suspected neurolymphomatosis in advanced-stage diffuse large B-cell lymphoma.
A Rare Case of Plasmablastic Lymphoma of the Ovary with Synchronous Lung Malignancy
Authors: Kale Shubham , Shah Sneha , Purandare Nilendu , Puranik Ameya , Agrawal Archi , Rangarajan Venkatesh
Published: February 2023

Primary ovarian lymphoma is a rare malignancy with <1% incidence. Plasmablastic lymphoma usually associated with immunocompromised diseases such as HIV rarely involves the ovary; only two case studies are reported in the literature – plasmablastic lymphomatous involvement of an ovarian teratoma and another of plasmablastic variant of B-cell lymphoma involving bilateral ovaries. There are reported case series of synchronous presentation of carcinomas usually including lung, stomach, and colon and nonaggressive lymphomas. Here, we report a rare case of synchronous aggressive primary plasmablastic ovarian lymphoma with adenocarcinoma of the lung, both of which are associated with immune-compromised conditions.
Intense Fluorodeoxyglucose Uptake in Aggressive Systemic Mastocytosis without Associated Hematological Neoplasm
Authors: Fatima Nosheen , Zaman Areeba , Zaman Sidra , Zaman Unaiza , Zaman Maseeh U. Z.
Published: February 2023

Systemic mastocytosis (SM) is a relatively rare heterogeneous group of disorders characterized by uncontrolled proliferation and accumulation of clonal mast cells in one or more organs. Indolent SM is the most common variety. Less common variety is aggressive systemic mastocytosis (aSM) type with or without associated hematological neopalsm (AHN). Fludeoxyglucose (FDG) positron emission tomography/computed tomography has a limited role in aSM without AHN as these exhibit low FDG avidity. We are presenting a biopsy-proven case of aSM without AHN showing abnormally high FDG uptake in lesions involving skin, nodes, marrow, and muscles.
Variations in Anatomical Landmarks of Mandible Using Cone Beam Computed Tomography - A Cross-Sectional Study
Authors: Tyagi Nitesh , Patil Neelkant , Sareen Mohit , Meena Manoj , Rathore Supriya , Kaswan Shobhit
Published: February 2023

Background:

Cone beam computed tomography (CBCT) is a diagnostic imaging modality for implant and surgical procedures in anterior and posterior mandibular area. It provides adequate information concerning maxillofacial regions, optimum image quality, excellent geometric accuracy, and low radiation dose.

Aim:

The aim of this study was to evaluate prevalence and anatomical variations in Mandible (Mandibular Incisive canal, Lingual Foramen, Mental Foramen, and Mandibular canal) in CBCT scans of the maxillofacial region.

Methodology:

All CBCT cross-sectional images of 40 study participants was analyzed for the presence of anatomical landmarks. All the anatomical parameters were compared with respect to age groups, dentition, gender, and right and left side and their respective distances from the inferior border of mandible and alveolar crest were measured using CS 3D imaging software (Kodak).

Results:

Lingual Foramen, Mental Foramen, and Mandibular Foramen were seen in all (100%) study samples, incisive foramen 83% and anterior loop in 25% of study samples. On statistical analysis, the difference of the mean distance of incisive foramen, mental foramen, anterior loop and mandibular foramen from lower border of mandible and alveolar crest was significant with relation to gender (P = 0.006) and with relation to dentate, partially dentate, and edentulous were found to be significantly different (P < 0.001).

Conclusions:

Careful assessment of the anatomical landmarks is essential to avoid neurosensory and bleeding complications using CBCT.
Knowledge, Awareness and Outlook on the COVID-19 Disease Among the Dental Professionals in Tamil Nadu
Authors: Muth Lakshmi K.S. Sethna , Krithika C.L. , Kannan A. , Aniyan Yesoda
Published: February 2023

Aim:

The aim of this study was to analyze the knowledge, level of awareness, and the attitude of the dental professionals towards the pandemic disease (COVID-19).

Materials and Methods:

This questionnaire-based survey was conducted among 295 dental professionals residing in Tamil Nadu through an online portal. The questionnaire consisted of four sections that addressed the demographic data, knowledge, awareness, and outlook of the COVID-19 disease by dental professionals. All the received responses were tabulated and the results were represented graphically.

Result:

The result of the study showed significant awareness among dental professionals towards COVID-19. The dental professionals needed more attention towards the precautions to be followed during this pandemic as personal protection and a safe environment are essential for a secure practice.

Conclusion:

This study emphasizes the role of oral health professionals in the prevention of the transmission of coronavirus among the public along with the management of dental emergencies with appropriate personal protective measures. This study also enforced the need to enrich the knowledge about infection, transmission, prevention, and control towards COVID-19. This may act as a source of information for the future pandemic crisis.
Establishment of Sexual Dimorphism by Odontometric Analysis of Permanent Maxillary and Mandibular Canines
Authors: Sireesha Gunduji , Ramaswamy P. , Saikiran Ch. , Swathi M. , Raju B. Mrudula
Published: February 2023

Background:

In forensic identification, gender estimation is one of the most important parameters. Being the main component of the masticatory apparatus of the skull, teeth are a good source of material for the civil and medico-legal purpose. Gender estimation using dental features is mainly based on the comparison of tooth dimensions.

Aim:

This study aims at investigating and analyzing the presence of sexual dimorphism in maxillary and mandibular canine using crown dimensions.

Settings and Design:

The study sample consisted of a total of 204 subjects. The greatest mesiodistal (MD), labiolingual (LL) diameter, and crown height (CH) of the maxillary and mandibular canines were recorded clinically on the subjects with the help of a Digital Vernier Caliper and tight divider.

Statistical Analysis:

The data sample was computed using SPSS statistical program, version 21. Discriminant analysis was used to find the dimorphism in canine measurements between males and females.

Results:

This study revealed that males showed greater mean CH and mesiodistal dimensions for mandibular canine teeth in comparison to females. Out of the four canines, the mesiodistal dimensions of right maxillary and mandibular canines and CH of maxillary left and mandibular right canines were significantly different in males compared to those in females. According to the study, the right mandibular canine and left maxillary canine show highly consistent results for sexual dimorphism.

Conclusion:

The findings support the usefulness of odontometric analysis of the canine teeth in gender estimation. Therefore, it can be used as an adjunct along with other procedures for gender estimation.
Asymptomatic Shedding of Herpes Simplex Virus in Oral Cavity
Authors: Kulkarni Abhay , Wadne Shruti , Birangane Rajendra , Chaudhari Rohan , Kole Nitin , Sankpal Supriya
Published: February 2023

Herpes simplex virus (HSV) is a significant human pathogen. Dental surgeons and Dental Hygienists come across many patients which are not having clinical symptoms but are the carriers of the disease. The person working in the oral cavity is at high risk for getting infected and also the risk of cross-infection in the general population.

Aim:

In this study, we determine the prevalence of HSV qualitatively and quantitatively in the oral cavity in apparently asymptomatic patients.

Study Setting:

Institutional and PCR testing Labs.

Methods & Materials:

The study analyzed saliva samples derived from 220 individuals which were collected with sterile swabs. The traditional PCR method was done for qualitative analysis and real-time PCR for the quantitative analysis.

Results:

The results of qualitative analysis showed that HSV-2 was more commonly shed than HSV-1 in the oral cavity, while the infected persons showed more genomic copy numbers.

Conclusion:

The presence of asymptomatic shedding of HSV-2 may be an indicator of future immunosuppression which should be followed up.
Estimation and Correlation of Serum and Salivary C-Reactive Protein in Oral Potentially Malignant Disorders
Authors: Uppal Mansimranjit Kaur , Iyengar Asha R , Subash BV , Patil Seema , Sharma Manisha Lakhanpal , Thakar Sahil
Published: February 2023

Background:

A large proportion of oral cancers arise from oral potentially malignant disorders (OPMDs). Very few studies have assessed serum and salivary C-reactive protein (CRP) levels in OPMDs warranting further research. Furthermore, no study has evaluated the correlation of serum and salivary CRP in OPMDs to the best of our knowledge.

Objectives:

The study aimed to compare serum and salivary CRP levels between subjects with OPMDs and controls along with their correlation.

Materials and Methods:

A total of 60 subjects with 30 subjects each in the study (Group 1) and control group (Group 2) were included. Group 1 was further categorized into group 1a, 1b, and 1c comprising 10 subjects each of Leukoplakia, Oral lichen planus (OLP), and Oral submucous fibrosis (OSMF). Group 2 comprised of 30 age and gender-matched controls.

Results:

Higher mean serum and salivary CRP levels were found in subjects of Group 1 (5.91 ± 3.11 mg/L and 1.00 ± 0.45 mg/L, respectively) as compared to group 2 (2.18 ± 0.66 mg/L and 0.48 ± 0.33 mg/L) with a statistically significant difference (P < 0.001). There was a positive correlation between serum and salivary CRP levels values in both group 1 (P < 0.001) and group 2.

Conclusion:

Higher serum and salivary CRP levels in OPMD subjects in comparison with controls indicate its role as a potential biomarker in the early detection of oral cancer. A positive correlation between the two potentiates the use of saliva as a non-invasive diagnostic tool for detection of CRP.
Knowledge Regarding Breast Cancer and Breast Self-examination amongst Urban Females of North India
Authors: Bansal Priya , Chaudhary Anurag , Girdhar Sangeeta , Jain Tiber , Sharma Sarit , Satija Mahesh , Gupta Vikram Kumar , Sharma Pranjl , Singh Surinder Pal
Published: February 2023

Introduction:

In this era of epidemiological transition where noncommunicable diseases are on a significant rise, cancer is a major public health problem globally. Out of all cancers, breast cancer is the most common female cancer worldwide.

Aim:

To determine the knowledge of breast cancer and its risk factors and breast self-examination (BSE) practice amongst urban women of North India.

Patients and Methods:

A cross-sectional study was carried out amongst 370 women aged between 20 and 60 years of age using pretested self-administered questionnaire. The collected information was entered into Microsoft Excel sheet and analysed using SPSS.

Results:

Mean age of the study participants was 40.3 ± 12.1 years and majority of the study participants (87%) were married. It was seen that the proportion of women who were aware increased as their literacy status increased, and this was statistically significant (P = 0.00). About 18.4% of the participants were aware regarding BSE. The most mentioned reason for not practicing BSE amongst those who were aware was that they considered themselves healthy (63.2%).

Conclusions:

In the current study, half of the women were aware of breast cancer and few were aware of BSE and very few were practicing BSE. It was seen that women with a higher level of education had better knowledge regarding breast cancer than women with low educational status. For the prevention of breast cancer, women are the most important stakeholder. There is a need to sensitise women regarding risk factors of breast cancer and preventive practices like BSE.
Incidence and clinical characteristics of pediatric inflammatory bowel disease in Oman
Authors: Al Lawati Tawfiq Taki , Al Rawahi Yusriya , Al Bahlani Al Qasim , Al Jamei Adawiya , Ramatalla Dafalla , Saadah Omar I.
Published: February 2023

Background:

Pediatric inflammatory bowel disease (PIBD) has been documented all over the world, and there is now a large body of clinical, pathological, and treatment knowledge and protocols in place in many countries. There is currently limited knowledge on the prevalence and pathology of PIBD in Omani population. The aim of this study is to report the incidence and clinical features of PIBD in Oman.

Methods:

This was a retrospective, cross-sectional, multicenter study carried out on all children <13 years of age between January 1, 2010 and December 31, 2021.

Results:

Fifty-one children were identified, 22 males (43.1%) and 29 females (56.9%), who were mostly from the Muscat region of Oman. The median incidence in the country was 0.57 (confidence interval [CI]: 0.31–0.64) per 105 children for inflammatory bowel disease (IBD), 0.18 (CI: 0.07–0.38) per 105 children for ulcerative colitis (UC), and 0.19 (CI: 0.12–0.33) per 105 children for Crohn’s disease (CD). There was a significant increase in the incidence of all PIBD types after the year 2015. Bloody diarrhea was the most common symptom, followed by abdominal pain. Perianal disease affected nine children (40.9%) with CD.

Conclusion:

The incidence of PIBD in Oman is lower than in some neighboring Gulf countries but similar to that of Saudi Arabia. An alarming upward trend was noted from the year 2015. Large-scale population-based studies are required to investigate the possible causes of this increasing incidence.
“Nor was there any role for you”: Unsettling canonical frames in Abdulrazak Gurnah’s By The Sea (2001) and Gravel Heart (2017)
Authors: Bosman Sean James
Published: February 2023

In this paper, I consider By the Sea (2001) and Gravel Heart (2017) as examples of how the Zanzibari-born British writer Abdulrazak Gurnah’s fiction unsettles the disempowering frames that his refugee and marginalised migrant characters encounter as they attempt to find new homes. To understand how Gurnah engages productively with his intertexts, this paper draws on work by Judith Butler to characterise Western canonical literature as frames, as well as Ankhi Mukherjee’s description of canonicity. What becomes apparent in my examination of the selected works is a trajectory in Gurnah’s authorial project from the simple rejection of frames towards new representations of refugees and marginalised migrants as fully ethical agents rather than emblematic victims. Thus, Gurnah’s work could be read as an exemplar of the narrative recalibration of the representation of migrants called for by scholars such as Loren B. Landau and Elena Fiddian-Qasmiyeh.
A New Enhanced Trilateral Security Partnership between Australia, the United Kingdom, and the USA (AUKUS): Reasons for Creation, Consequences for International Security
Authors: Poshedin O.
Published: February 2023

The article examines the reasons for creating a new trilateral security partnership between Australia, the United Kingdom, and the United States (AUKUS) and predicts the impact of AUKUS on international security. The strategic political and defense documents of the AUKUS states regarding their policies in the Indo-Pacific region are analyzed. China’s policy in the Asia-Pacific region is also analyzed.

It has been established that the Indo-Pacific region plays an important role both for the AUKUS states and for the whole world. During the remarks on the creation of AUKUS, the leaders of the states of the new trilateral partnership did not mention China, emphasizing the need to maintain security and stability in the Indo-Pacific region. However, the reason for creating AUKUS is the aggressive policy of the People’s Republic of China in the region, which ranges from economic coercion to direct threats to use force against Taiwan. The main areas of cooperation identified by AUKUS will enhance the defense capabilities of each of the three states. A key project of AUKUS – to deliver a nuclear-powered submarine fleet for Australia is an important tool for deterring China and maintaining a balance of power in the Indo-Pacific region.

The article predicts that the creation of AUKUS will have a positive impact on security in the Indo-Pacific region and international security in general. This partnership will not create geopolitical tension and will not lead to an arms race in the region. China, even before the creation of AUKUS, carried out the militarization of the Indo-Pacific region and rejected the involvement of international organizations in resolving disputes with neighboring states, interpreting all disputes in its favor. Will not undermine the creation of AUKUS and the unity of NATO due to the cancellation by Australia of the contract with France for the construction of diesel submarines. The financial dispute with French submarine maker has been settled, and defense cooperation between the two states is being strengthened.
PENGARUH PEMBELAJARAN BERBASIS MASALAH DAN PEMBELAJARAN KONTEKSTUAL TERHADAP KEMAMPUAN BERPIKIR KRITIS SISWA SMKN3 JAKARTA
Authors: Hamida Hamida , Wiradendi Wolor Christian , Firdausi Rachmadania Rizki
Published: February 2023

Tujuan penelitian ini adalah untuk melihat pengaruh pembelajaran berbasis masalah dan pembelajaran kontekstual terhadap kemampuan berpikir kritis siswa kelas XII SMKN 3 Jakarta. Penelitian ini dilakukan di SMKN 3 Jakarta tahun 2022 pada kelas XII OTKP dengan jumlah sample sebanyak 33 siswa. Penelitian ini menggunakan metode Quasi Experimental Design dengan desain penelitian The Matching Pretest-Posttest Control Group Design. Teknik pengambilan sample menggunakan jenis Non probability sampling dengan teknik Purposive sampling. Teknik pengolahan data melalui uji normalitas, uji homogenitas dan uji-t dua pihak dengan bantuan program IBM SPSS 22. Hasil analisi data menunjukkan adanya pengaruh pembelajaran berbasis masalah dan pembelajaran kontekstual terhadap kemampuan berpikir kritis siswa kelompok eksperimen 1 diperoleh nilai sig (2-tailed) sebesar 0,000, data tersebut jika dilihat dari kriteria uji-t adalah 0,000 < 0,05, maka data pada kelompok eksperimen 1 PBL dapat dinyatakan H0 ditolak dan Ha diterima, dan pada kelompok eksperimen 2 diperoleh nilai sig (2-tailed) sebesar 0,043, data tersebut jika dilihat dari kriteria uji-t adalah 0,043 < 0,05, maka data pada kelompok eksperimen 2 Kontekstual dapat dinyatakan H0 ditolak dan Ha diterima. Sehingga berdasarkan data penelitian tersebut, pembelajaran berbasis masalah dan pembelajaran kontekstual dapat membantu meningkatkan kemampuan berpikir kritis siswa.
DEVELOPING AN E-GOVERNANCE MODEL FOR CITIZEN CENTRIC ADMINISTRATION
Authors: Singh Aman
Published: February 2023

The term e-governance is frequently used in the discussions in seminars, conferences, leadership summits, print and social media. The use of information communication technology has transformed the world and the governance. every nation is extensively relying on the technology to establish a Simple, Moral, Accountable, Responsive and Transparent (SMART) public administration system in the country. The interaction between the government, citizens and business community depends on the use of modern technology for exchange of thoughts and ideas. The journey from web 1.o to 5.o has transformed the society and revamped the public administration system of every country. Use of technology has created opportunity for start-up companies to work in various sectors ranging from agriculture to delivery of public services. e-governance has helped in curbing corruption and time-consuming official rules and procedures.  This paper explores the meaning, challenges of e governance. the paper highlights the meaning of citizen centric administration, how can e-governance be used in public delivery of services, focusses on citizen centric approach to policy making and delivery of public services.
Green manure for soil salinity reclamation- A comprehensive review
Authors: IJ Irin , MN Hoque , A Hannan , MM Alam
Published: February 2023

Large areas of the world are affected by high levels of soil salinity.Global warming causes a rapid rise of the sea level and enhancing new salt-affected areas inundating new agricultural land through saltwater intrusion. Salinity management through breeding strategies, land management or organic amendment could be wise strategies for salt management. Exogenous application of legumes as green manure can potentially reduce negative effects of soil salinity through growth improvement, ionic homeostasis via enhancing Ca/Na ratio in soil, adding organic matter, over expressing SOD, POD, CAT, APX, and lessening membrane leakage that upsurge crop productivity in saline environments. Such contribution to the sustainable agricultural systems is considered an alternate way towards enhancing crop cultivation in saline ecosystems. This review focused on the mechanisms of green manuring crops in soil salinity reclamation and subsequent contribution on crop growth and development.
EFFICACY OF THE INTERNSHIP PROGRAMME IN THE SOUTH AFRICAN PUBLIC SERVICE WITH A PARTICULAR FOCUS ON THE NATIONAL SCHOOL OF GOVERNMENT
Authors:   National School of Government, Pietersen JM , Malatjie I ,   National School of Government
Published: February 2023

The public service in South Africa implements a graduate internship programme in line with a national policy and, in some instances, departmental policy. This article analyses the efficacy of internship programmes in the context of the achievement of policy imperatives, the provision of work experience and the contribution of such programmes to graduate employability. The public service requires a constant supply of skills for a professional public institution with generational competence. However, in spite of this demand, 12.5% of graduates are unemployed. Data to establish this figure was collected by means of questionnaires and interviews with interns who were contracted to the National School of Government (NSG). The questionnaires were administered to a sample of 40 graduate interns from 2010-2018 with the intention of analysing data on the basis of contractual commitments, training, conditions of service, performance management and opportunities of employability after an internship programme. The findings from 62,5% of the sample indicated that graduate interns in the NSG appreciated the effectiveness of the graduate internship programme, albeit with an opinion that certain mentoring and coaching aspects could be improved.
Knowledge, Attitude and Practices of Menstrual Hygiene Management among Orphan and Vulnerable Adolescents in Lagos State
Authors: Jimin Sontyo , Felix Iwuala , Faith Lannap , Olufemi Oke , Olugbenga Ayeni , Kumolu Grace , Osinowo Olakunle
Published: February 2023

Purpose: During adolescence, young people develop their adult identity, and move toward physical and psychological maturity. Puberty, marked by the onset of menarche, is recognized as an important stage, marking the transition from girlhood to womanhood. From this stage until menopause, reproductive health and basic menstrual hygiene practices are important aspects in their lives. The study examined the knowledge, attitude, and practices of menstrual hygiene management among orphan and vulnerable adolescents in Lagos State.

Methodology: the study was cross sectional and used quantitative research methods. Semi-structured questionnaires were used to collect data from the female adolescent students aged 8-17 years. A total of 434 orphan and vulnerable female adolescents enrolled in the Integrated Child Health and Social Services Award (ICHSSA 2) project funded by USAID in Lagos State, Nigeria. The study was conducted across the 11 local government areas where the ICHSSA 2 project is being implemented. Adolescents were scored for their level of knowledge, attitude, and practices of menstrual hygiene management.

Findings: the study found that the mean age at menarche is 12 years. Knowledge and menstruation about menstruation is appreciable. About 92% of the participants had knowledge about menstruation before experiencing it, Majority of the adolescent receive information on MHM first from their mother (62.7%) and 88.5% of the participants use sanitary pads using 3-4 pads per day. 94.5% of the participants have good Practices (WASH) of Menstrual Hygiene Management. Access to sanitary pads is challenging.

Unique Contribution to Theory, Practice and Policy: Most of the orphans and vulnerable adolescent girls had good knowledge and practices of menstrual hygiene management. This demonstrates a need to design acceptable awareness creation and advocacy programs to improve the knowledge and promote safe hygiene practices of adolescent girls, in line with the SCT and KAP theory. Provision of MHM materials in schools and the inclusion of menstrual hygiene management into the school curriculum to achieve a near total coverage of safe hygiene practices among adolescent girls should also be prioritized as a matter of policy.
DESCRIPTION OF BLOOD GLUCOSE LEVELS IN OBESITY PATIENTS IN PUSKESMAS NORTH CITY
Authors: Tantu Rayhan , Titin Dunggio  , Niluh Arwati
Published: February 2023

Excess weight can cause changes to the body's cells, making the body's cells resistant to the hormone insulin. This can cause blood glucose levels to increase. This study aims to determine blood glucose levels in obese patients and the factors that influence them. This study aims to assess blood glucose levels in obese patients at the North City Health Center and the factors that affect them.The method in this study uses a descriptive quantitative approach. The type of data used is primary data from research results of blood glucose levels in obese patients and secondary data in data from the literature, books, questionnaires, and medical record books. The sampling technique in this study used accidental sampling, with a total sample of 29 people.The results showed that from 29 obese patients, there were 24 people or 82.8% whose blood glucose levels were abnormal, while five people, or 17.2%, had normal blood glucose levels. Factors that affect blood glucose levels in obese patients are gender, age, physical pattern (Body Mass Index/BMI), physical activity, and eating patterns (number of calories). Suggestions to the next researcher are suggested to examine blood sugar levels between the obese and non-obese groups as a comparison.
Wybrane elementy poziomu i jakości życia ludności obwodu wołyńskiego: diagnoza stanu
Authors: PETROVSKA Myroslava , PANTYLEY Viktoriya
Published: February 2023

The study of the level and quality of life, especially in cross-border regions, is one of the current research problems, bearing in mind the pursuit of socio-economic convergence. One of these regions with relatively little knowledge about the situation is the Volyn Oblast (Ukraine), which borders directly on the EU (Poland). Therefore, the main goal of the research is to diagnose the level and quality of life of the population, considering statistical measures and materials of field study. The results of the research indicate that the standard of living of the Volyn Oblast could be estimated as low in comparison with average values for Ukraine as well as in the light of selected measures of stimulants and de-stimulants. The obtained results were also confirmed by field research in randomly selected administrative units of the region.
Proposal for a Low-Cost Monitoring System to Assess the Pavement Deterioration in Urban Roads
Authors: Bruno Salvatore
Published: February 2023

Effective scheduling of pavement monitoring and maintenance activities plays a pivotal role in ensuring safety and comfort for road users. The Pavement Management System (PMS) is a traditional tool to assist the road manager in the decision-making process on which priority maintenance activities to carry out. However, for urban road networks the implementation of a PMS can be complicated due to the many functional and operational problems. This paper presents a prototype low-cost inertial sensor-based system for monitoring the pavement conditions in urban road networks. Starting by the measurements of the vertical accelerations collected in a vehicle riding on a rough pavement, the frequency-weighted vertical acceleration a_wz was calculated according to ISO 2631 standard. This parameter can be adopted as a Key Performance Indicator (KPI) by relating the road roughness to the human whole-body vibration (WBV) exposure on the road user. Some field tests were carried out identifying urban roads in an Italian city with different levels of pavement deterioration. Measurements to evaluate the pavement deterioration were performed using traditional visual inspections and the proposed sensor embedded in a test vehicle (run at different speeds) in order to identify a relationship between these indices in terms of performance classes.
Heritage BIM Approach for roman pavements
Authors: Biancardo Salvatore Antonio
Published: February 2023

The growing necessity to design and digitally representation of historical pavements has led the specialists to use different Building Information Modelling (BIM) tools to control the road design and construction phases. In this research paper, a Heritage BIM (H-BIM) approach was developed to recreate an archaeological road to accomplish the disruption analysis of stone pavements. In detail, within Autodesk Infraworks the conceptual model of the road and the digital terrain model (DTM) was generated; then the road corridor design process was performed within Autodesk Civil 3D using a parametric road section which was created by means of Subassembly composer, a Civil 3D extension. Subsequently, a visual programming application, Dynamo, based on Python language, was adopted to extract and update corridor information. In detail, a workflow was developed to implement a disruption analysis of road stone pavements and the output of the calculation were inserted in the model. As preliminary results, a tool is proposed to support the authorities and experts during the managing processes.
Durvalumab (Imfinzi)
Authors: CADTH
Published: February 2023

CADTH recommends that Imfinzi should be reimbursed by public drug plans for the treatment of locally advanced or metastatic biliary tract cancer (BTC) if certain conditions are met.

Imfinzi in combination with gemcitabine plus platinum-based chemotherapy should only be covered to treat patients with locally advanced or metastatic BTC who have not received prior treatment. Patients receiving Imfinzi should be in relatively good health (i.e., have a good performance status, as determined by a specialist).

Imfinzi should only be reimbursed when it is used in combination with gemcitabine and platinum-based chemotherapy, if prescribed by specialists with experience in managing BTC, and if the cost of Imfinzi is reduced. Imfinzi should not be reimbursed if it is used to treat patients with Ampulla of Vater (AoV) cancer.
Impact of Smog on Wheat Productivity and Determinants of Smog Adaptation Options: A Case Study of Layyah and Lodhran
Authors: Safdar Sadia , Padda Ihtsham Ul Haq , Andlib Zubaria , Khan Azra , Javed Kainat
Published: February 2023

Smog is very harmful to agricultural productivity as it directly affects the growth and yield of crops. This study investigates the impact of smog on the wheat crop. For the present analysis, the study chose two agricultural districts (Layyah and Lodhran) of Pakistan. A survey was conducted from July to September 2019, by 400 farmers. Fully structured questionnaire is used for data collection while logit regression is used for empirical estimation. The results reveal that smog has a negative effect on wheat productivity as the size and weight of wheat grains decrease due to smog. The results also depict that the farmers’ perception regarding adaptations options improves productivity. The results show that education, extension services, irrigation source, and credit services significantly impact adaptation options. The study suggests that government should take serious steps to get rid of smog as it adversely affects theproductivity of crops. For this purpose, strict enforcement of National Environment Quality Standards (NEQS) for the reduction of emission of smoke and other pollutants in the air by industry and other sectors can be useful. Additionally, government policy should target improving farmers’ education (training and refresher courses), extension services, and credit facilities to increase farmers’ adaptations.
Microphysics of liquid water in sub-10 nm ultrafine aerosol particles
Authors: Li Xiaohan , Bourg Ian C.
Published: February 2023

Abstract. Ultrafine aerosol particles with sizes smaller than 50 nm have been shown in recent studies to serve as a large source of cloud condensation nuclei that can promote additional cloud droplet formation under supersaturation conditions. Knowledge of the microphysics of liquid water in these droplets remains limited, particularly in the sub-10 nm particle size range, due to experimental and theoretical challenges associated with the complexity of aerosol components and the small length scales of interest (e.g., difficulty of precisely sampling the liquid–air interface, questionable validity of mean-field theoretical representations). Here, we carried out molecular dynamics (MD) simulations of aerosol particles with diameters between 1 and 10 nm and characterized atomistic-level structure and water dynamics in well-mixed and phase-separated systems with different particle sizes, NaCl salinities, and pimelic acid (PML) organic surface loadings as a function of distance from the time-averaged Gibbs dividing interface or instantaneous water–air interface. We define a sphericity factor (ϕ) that can shed light on the phase-mixing state of nanodroplets, and we reveal an unexpected dependence of mixing state on droplet size. Our results also evidence an ion concentration enhancement in ultrafine aerosols, which should modulate salt nucleation kinetics in sub-10 nm droplets, and provide detailed characterization of the influence of droplet size on surface tension and on water self-diffusivity near the interface. Analysis of water evaporation free energy and water activity demonstrates the validity of the Kelvin equation and Köhler theory at droplet sizes larger than 4 nm under moderate salinities and organic loadings and the need for further extension to account for ion concentration enhancement in sub-10 nm aerosols, droplet-size-dependent phase separation effects, and a sharp decrease in the cohesiveness of liquid water in sub-4 nm droplets. Finally, we show that an idealized fractional surface coating factor (fs) can be used to categorize and reconcile water accommodation coefficients (α*) observed in MD simulations and experimental results in the presence of organic coatings, and we resolve the droplet size dependence of α*.