bluuebunny/crossref_metadata_2025 huggingface dataset:
An old drug and different ways to treat cutaneous leishmaniasis: Intralesional and intramuscular meglumine antimoniate in a reference center, Rio de Janeiro, Brazil
Authors: Oliveira-Ribeiro Carla , Pimentel Maria Inês Fernandes , Oliveira Liliane de Fátima Antonio , Vasconcellos Érica de Camargo Ferreira e , Conceição-Silva Fatima , Schubach Armando de Oliveira , Fagundes Aline , de Mello Cintia Xavier , Mouta-Confort Eliame , Miranda Luciana de Freitas Campos , Valete-Rosalino Claudia Maria , Martins Ana Cristina da Costa , Oliveira Raquel de Vasconcellos Carvalhaes de , Quintella Leonardo Pereira , Lyra Marcelo Rosandiski
Published: September 2021

Background

Treatment of cutaneous leishmaniasis (CL) remains challenging since the drugs currently used are quite toxic, thus contributing to lethality unrelated to the disease itself but to adverse events (AE). The main objective was to evaluate different treatment regimens with meglumine antimoniate (MA), in a reference center in Rio de Janeiro, Brazil.

Methodology

A historical cohort of 592 patients that underwent physical and laboratory examination were enrolled between 2000 and 2017. The outcome measures of effectiveness were epithelialization and complete healing of cutaneous lesions. AE were graded using a standardized scale. Three groups were evaluated: Standard regimen (SR): intramuscular (IM) MA 10–20 mg Sb5+/kg/day during 20 days (n = 46); Alternative regimen (AR): IM MA 5 mg Sb5+/kg/day during 30 days (n = 456); Intralesional route (IL): MA infiltration in the lesion(s) through subcutaneous injections (n = 90). Statistical analysis was performed through Fisher exact and Pearson Chi-square tests, Kruskal-Wallis, Kaplan-Meier and log-rank tests.

Results

SR, AR and IL showed efficacy of 95.3%, 84.3% and 75.9%, with abandonment rate of 6.5%, 2.4% and 3.4%, respectively. IL patients had more comorbidities (58.9%; p = 0.001), were mostly over 50 years of age (55.6%), and had an evolution time longer than 2 months (65.6%; p = 0.02). Time for epithelialization and complete healing were similar in IL and IM MA groups (p = 0.9 and p = 0.5; respectively). Total AE and moderate to severe AE that frequently led to treatment interruption were more common in SR group, while AR and IL showed less toxicity.

Conclusions/Significance

AR and IL showed less toxicity and may be good options especially in CL cases with comorbidities, although SR treatment was more effective. IL treatment was an effective and safe strategy, and it may be used as first therapy option as well as a rescue scheme in patients initially treated with other drugs.
A gene expression panel for estimating age in males and females of the sleeping sickness vector Glossina morsitans
Authors: Lucas Eric R. , Darby Alistair C. , Torr Stephen J. , Donnelly Martin J.
Published: September 2021

Many vector-borne diseases are controlled by methods that kill the insect vectors responsible for disease transmission. Recording the age structure of vector populations provides information on mortality rates and vectorial capacity, and should form part of the detailed monitoring that occurs in the wake of control programmes, yet tools for obtaining estimates of individual age remain limited. We investigate the potential of using markers of gene expression to predict age in tsetse flies, which are the vectors of deadly and economically damaging African trypanosomiases. We use RNAseq to identify candidate expression markers, and test these markers using qPCR in laboratory-reared Glossina morsitans morsitans of known age. Measuring the expression of six genes was sufficient to obtain a prediction of age with root mean squared error of less than 8 days, while just two genes were sufficient to classify flies into age categories of ≤15 and >15 days old. Further testing of these markers in field-caught samples and in other species will determine the accuracy of these markers in the field.
Predictors of severity and development of critical illness of Egyptian COVID-19 patients: A multicenter study
Authors: Omran Dalia , Al Soda Mohamed , Bahbah Eshak , Esmat Gamal , Shousha Hend , Elgebaly Ahmed , Abdel Ghaffar Muhammad , Alsheikh Mohamed , El Sayed Enass , Afify Shimaa , Abdel Hafez Samah , Elkelany Khaled , Eltayar Ayman , Ali Omnia , Kamal Lamiaa , Heiba Ahmed
Published: September 2021

Objectives

We conducted the present multicenter, retrospective study to assess the epidemiological, clinical, laboratory, and radiological characteristics associated with critical illness among patients with COVID-19 from Egypt.

Methods

The present study was a multicenter, retrospective study that retrieved the data of all Egyptian cases with confirmed COVID-19 admitted to hospitals affiliated to the General Organization for Teaching Hospitals and Institutes (GOTHI) through the period from March to July 2020. The diagnosis of COVID-19 was based on a positive reverse transcription-polymerase chain reaction (RT-PCR) laboratory test.

Results

This retrospective study included 2724 COVID-19 patients, of whom 423 (15.52%) were critically ill. Approximately 45.86% of the critical group aged above 60 years, compared to 39.59% in the non-critical group (p = 0.016). Multivariate analysis showed that many factors were predictors of critically illness, including age >60 years (OR = 1.30, 95% CI [1.05, 1.61], p = 0.014), low oxygen saturation (OR = 0.93, 95% CI [0.91, 0.95], p<0.001), low Glasgow coma scale (OR = 0.75, 95% CI [0.67, 0.84], p<0.001), diabetes (OR = 1.62, 95% CI [1.26, 2.08], p<0.001), cancer (OR = 2.47, 95% CI [1.41, 4.35], p = 0.002), and serum ferritin (OR = 1.004, 95% CI [1.0003, 1.008], p = 0.031).

Conclusion

In the present report, we demonstrated that many factors are associated with COVID-19 critical illness, including older age groups, fatigue, elevated temperature, increased pulse, lower oxygen saturation, the preexistence of diabetes, malignancies, cardiovascular disease, renal diseases, and pulmonary disease. Moreover, elevated serum levels of ALT, AST, and ferritin are associated with worse outcomes. Further studies are required to identify independent predictors of mortality for patients with COVID-19.
Linking cognitive flexibility to entrepreneurial alertness and entrepreneurial intention among medical students with the moderating role of entrepreneurial self-efficacy: A second-order moderated mediation model
Authors: Jiatong Wang , Murad Majid , Li Cai , Gill Shabeeb Ahmad , Ashraf Sheikh Farhan
Published: September 2021

This study extended the research on the association between cognitive flexibility and entrepreneurial intention by developing a moderated mediation model. This research examined whether entrepreneurial alertness mediates this association. This study also investigated whether entrepreneurial self-efficacy moderates this mediation model by conducting a moderated mediation model. The sample of this study comprised 486 medical university students of Pakistan. Data gathered using a self-report administered questionnaire and hypotheses were tested with SEM structural equation modeling technique through AMOS user-defined estimates and developed a syntax based on Hayes model 15 of process macro. The results revealed that cognitive flexibility is positively related to entrepreneurial alertness and entrepreneurial intentions. Furthermore, findings showed that the indirect relationship of entrepreneurial alertness via entrepreneurial self-efficacy on cognitive flexibility and the entrepreneurial intention was also significant. This study contributes to the emerging research on psychology and entrepreneurship as well as concludes that individuals with a high level of cognitive flexibility, entrepreneurial alertness, and entrepreneurial self-efficacy are more inclined to pursue a career in entrepreneurship.
Curiosity or savouring? Information seeking is modulated by both uncertainty and valence
Authors: van Lieshout Lieke L. F. , Traast Iris J. , de Lange Floris P. , Cools Roshan
Published: September 2021

Curiosity is pervasive in our everyday lives, but we know little about the factors that contribute to this drive. In the current study, we assessed whether curiosity about uncertain outcomes is modulated by the valence of the information, i.e. whether the information is good or bad news. Using a lottery task in which outcome uncertainty, expected value and outcome valence (gain versus loss) were manipulated independently, we found that curiosity is overall higher for gains compared with losses and that curiosity increased with increasing outcome uncertainty for both gains and losses. These effects of uncertainty and valence did not interact, indicating that the motivation to reduce uncertainty and the motivation to maximize positive information represent separate, independent drives.
The impact of the COVID-19 pandemic on Polish orthopedics, in particular on the level of stress among orthopedic surgeons and the education process
Authors: Kołodziej Łukasz , Ciechanowicz Dawid , Rola Hubert , Wołyński Szymon , Wawrzyniak Hanna , Rydzewska Kamila , Podsiadło Konrad
Published: September 2021

The Coronovirus Disease 2019 –(COVID-19) pandemic had a significant impact on the health care system and medical staff around the world. The orthopedic units were also subject to new restrictions and regulations. Therefore, the aim of our research was to assess how the COVID-19 pandemic affected orthopedic wards in the last year in Poland. We created an online survey, which was sent to 273 members of the Polish Society of Orthopedics and Traumatology. The survey contained 51 questions and was divided into main sections: Preparedness, Training, Stress, Reduction, Awareness. A total of 80 responses to the survey were obtained. In Preparedness section the vast majority of respondents (90%) replied, that they used personal protective equipment during the pandemic, however only 50% of the respondents indicated that their facility received a sufficient amount of personal protective equipment. Most of the respondents indicated that the pandemic negatively affected the quality of training of future orthopedists (69.4%) and that pandemic has had a negative impact on their operating skills (66,7%). In Reduction section most of the doctors indicated that the number of patients hospitalized in their departments decreased by 20–60% (61,2% respondents), while the number of operations performed decreased by 60–100% (60% respondents). The negative impact of pandemic on education was noticeable especially in the group of young orthopedic surgeons: 0–5 years of work experience (p = 0,029). Among the respondents, the level of stress increased over the last year from 4.8 to 6.9 (p <0.001). The greatest increase in the level of stress was observed among orthopedists working in country hospitals (p = 0,03). In section Awareness 36,3% of respondents feel well or very well informed about the latest Covid-19 regulations. In addition, most doctors (82.6%) believe that the Polish health care system was not well prepared to fight the pandemic and that the regulations applied so far are not sufficient to effectively fight the pandemic (66.2%). The COVID-19 pandemic has impact on orthopedics departments in Poland and negatively affected the quality of training of orthopedic surgeons and the level of stress.
Predicting fracture outcomes from clinical registry data using artificial intelligence supplemented models for evidence-informed treatment (PRAISE) study protocol
Authors: Dipnall Joanna F. , Page Richard , Du Lan , Costa Matthew , Lyons Ronan A. , Cameron Peter , de Steiger Richard , Hau Raphael , Bucknill Andrew , Oppy Andrew , Edwards Elton , Varma Dinesh , Jung Myong Chol , Gabbe Belinda J.
Published: September 2021

Background

Distal radius (wrist) fractures are the second most common fracture admitted to hospital. The anatomical pattern of these types of injuries is diverse, with variation in clinical management, guidelines for management remain inconclusive, and the uptake of findings from clinical trials into routine practice limited. Robust predictive modelling, which considers both the characteristics of the fracture and patient, provides the best opportunity to reduce variation in care and improve patient outcomes. This type of data is housed in unstructured data sources with no particular format or schema. The “Predicting fracture outcomes from clinical Registry data using Artificial Intelligence (AI) Supplemented models for Evidence-informed treatment (PRAISE)” study aims to use AI methods on unstructured data to describe the fracture characteristics and test if using this information improves identification of key fracture characteristics and prediction of patient-reported outcome measures and clinical outcomes following wrist fractures compared to prediction models based on standard registry data.

Methods and design

Adult (16+ years) patients presenting to the emergency department, treated in a short stay unit, or admitted to hospital for >24h for management of a wrist fracture in four Victorian hospitals will be included in this study. The study will use routine registry data from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR), and electronic medical record (EMR) information (e.g. X-rays, surgical reports, radiology reports, images). A multimodal deep learning fracture reasoning system (DLFRS) will be developed that reasons on EMR information. Machine learning prediction models will test the performance with/without output from the DLFRS.

Discussion

The PRAISE study will establish the use of AI techniques to provide enhanced information about fracture characteristics in people with wrist fractures. Prediction models using AI derived characteristics are expected to provide better prediction of clinical and patient-reported outcomes following distal radius fracture.
“Withstanding ambivalence is of particular importance”—Controversies among experts on dealing with desire to die in palliative care
Authors: Kremeike Kerstin , Dojan Thomas , Rosendahl Carolin , Jünger Saskia , Romotzky Vanessa , Boström Kathleen , Frerich Gerrit , Voltz Raymond
Published: September 2021

In order to investigate controversies surrounding the desire to die phenomenon in palliative care by analyzing expert opinions on the topic, we carried out a secondary qualitative data analysis of free text comments collected during a Delphi survey that was designed to develop a conversation aid for dealing with desire to die in everyday clinical practice. Between 01/2018 and 03/2018, a two-round Delphi survey was carried out with national (German) and international palliative care experts. Free text comments were reinvestigated to identify controversies surrounding the desire to die phenomenon. An additional in-depth analysis focused on statements expressing attitudes towards proactively addressing (potential) desires to die. Within the Delphi survey, 103 of 149 multi-professional participants (almost all of them with practical and only six with exclusively theoretical expertise in palliative care) generated 444 free text comments. Thereof, we identified three main categories related to dealing with desire to die: “outer framework“, “extended care system” and “health-professional-patient-relationship”. Ambivalences, taboos and uncertainties surrounding desire to die in palliative care became apparent. Experts are divided concerning the practice of proactively addressing desire to die. Even if these conversations–especially the proactive approach–are also viewed critically, we conclude that open-ended and respectful communication about desire to die between health professionals and patients can be understood as an eligible intervention in palliative care. Proactively addressing the topic is a possible way to open up such conversations.
Infant and young child feeding practice among mothers of children age 6 to 23 months in Debrelibanos district, North Showa zone, Oromia region, Ethiopia
Authors: Mekonnen Mathewos , Kinati Tadele , Bekele Kumera , Tesfa Bikila , Hailu Dejene , Jemal Kemal
Published: September 2021

Background

Inappropriate infant and young child feeding (IYCF) practice is the leading cause of malnutrition in children. Data is needed to identify children at risk of poor feeding practice and to target interventions to improve IYCF practices. Therefore, this study aimed to assess IYCF practice and associated factors among mothers of children age 6 to 23 months in Debrelibanos district, north Showa zone, Oromia region, Ethiopia.

Method

A community-based cross-sectional study design was conducted among 380 mothers of children age 6 to 23 months from March 1 to April 5, 2019. A simple random sampling technique was used to select the respondents. Data was collected using a structured interviewer-administered questionnaire that had been pretested. The data was entered into Epi-Data 3.1 and then transferred to SPSS 21 for analysis. Descriptive statistical analysis was done, and an association between an outcome variable and independent variables was examined in logistic regression models.

Result

Overall, 65.8% of mothers practiced appropriate IYCF practice. The study revealed that 70.5% of children started breastfeeding within one hour of birth, and 61.6% were breastfed exclusively for six months. Among studied mothers, 79.5% continued to breastfeed their children until 2 years, and 69.2% of the participants started complementary feeding timely at six months. Minimum dietary diversity was observed in 19.2% of children, while minimum meal frequency was found in 79.2%. The majority of mothers (77.6%) fed their babies with bottles. Mother’s educational status of primary school [AOR = 4.50, 95% CI: (1.38,14.61)], husband’s occupation being merchant [AOR = 6.45, 95% CI: (1.51, 27.59)]; antenatal care follows up [AOR = 3.15, % CI: (1.22, 8.12)], radio/television ownership [AOR = 7.41, 95% CI: (2.86, 19.20)], child’s sex being female [AOR = 4.78, 95% CI: (2.26, 10.064) and sufficient knowledge on child feeding [AOR = 2.82, 95% CI: (1.27, 26.26)] were independent predictors for appropriate IYCF practice.

Conclusion

The prevalence of appropriate infant and young child feeding practice indicators was found to be rather high among the mothers in this study. The use of a bottle to feed babies, in particular is very common among the mothers who were studied. To address child malnutrition, it is critical to educate families about proper IYCF practices. This study suggests that mothers be properly educated about IYCF recommendations at health care facilities during their visits, as well as the promotion of appropriate IYCF through various media.
Individual differences in thinking style and dealing with contradiction: The mediating role of mixed emotions
Authors: Santos David , Requero Blanca , Martín-Fernández Manuel
Published: September 2021

The present research examined how individuals’ thinking style (holistic vs. analytic) is associated with the way they deal with contradictory information and whether experiencing mixed emotions can mediate this relationship. Participants first completed the thinking style measure and then were exposed to two contradictory pieces of information (Studies 1 and 2). In study 2, we also measured the experience of mixed emotions to test the mediating role of this variable. Across two studies, we found that individuals with a holistic thinking style were more able to reconcile contradictory information compared to individuals with an analytic thinking style. Study 2 showed that the relationship between thinking style and dealing with contradiction was mediated by the experience of mixed emotions. This research extends previous findings on confrontation of contradiction and mixed emotions by using an individual-differences rather than a cultural-differences approach, and establishes mixed emotions as a plausible mediating variable.
Chronique d’une écologie décoloniale dans C’est ma terre de Fabrice Bouckat
Authors: Naudillon Françoise
Published: September 2021

The documentary film C’est ma terre by Fabrice Bouckat screened during the 2019 edition of Terrafestival is one of the first large-scale films produced locally on the crisis of the chlordecone molecule. This article will examine from a decolonial perspective, how its director, a Martinican with Gabonese origins who lives and works in Guadeloupe, develops a synthetic and universal vision of environmental crises, and thus demonstrates that destruction of ecosystems crosses time and space, cultures and lands, languages and peoples by bringing ecological crisis in the West Indies closer to the one experienced by the Vietnamese victims of Agent Orange.
Afrofuture ecosystems
Authors: Macdonald Marie-Paule , Petty Sheila
Published: September 2021

Recently, there has been a surge of African screen media representations of environmental awareness and solutions for sustainable communities as the Global South experiences increasing urban migration and climate change. Much of the focus in this work is on the precarity of daily life for those on the margins of large urban agglomerations. This article brings together theories and practices from the disciplines of urbanism, architecture and documentary cinema studies to examine some examples of how African artists are bringing attention to issues of urban precarity, climate change, survival and growth on the continent.
Methodological elements for the comparative analysis of the first wave of the Covid-19 epidemic in France, Italy, and Spain
Authors: Aldea-Ramos Néstor
Published: September 2021

The three European countries included in the northwest littoral of the Mediterranean region – Italy, France and Spain – reported their first cases of the SARS-CoV-2 coronavirus early in 2020. The subsequent epidemic strongly impacted these countries, challenging the healthcare systems efficiency, and the capacity and transparency of their public statistics structures. Because public statistics were not fully adapted to such a new health situation, the available official data could not wholly describe the epidemic correctly. This paper developed an indicator derived from the prevalence of SARS-CoV-2 aiming to describe the time and spatial dynamics of the epidemic. Although the analysis was not applied to France due to the lack of data available, the comparative analysis among Spain and Italy highlighted some similarities and certain divergences, partially attributable to the features of each country‘s national demographic patterns and the peculiarities of applied health protocols. Finally, mortality during the first wave of the epidemic has been analysed for the three countries, demonstrating higher mortality index in Spain, although the reported number of SARS-CoV-2 declared deaths does not explain a portion of this mortality excess.
Follicle-stimulating hormone mediates the consumption of serum-derived glycogen by bovine cumulus-oocyte complexes during in vitro maturation
Authors: Cantanhêde Ludymila F. , Santos-Silva Cristiane T. , Moura Marcelo T. , Ferreira-Silva José C. , Oliveira Júnior M. B. , Gonçalves Daniel N. A. , Teixeira Álvaro A. C. , Wanderley-Teixeira Valéria , Oliveira Marcos A. L.
Published: September 2021

Background and Aim: Oocyte in vitro maturation (IVM) is an appealing approach for several assisted reproductive technologies and dissecting oocyte maturation. Nonetheless, IVM leads to lower developmental competence and usually relies on undefined, serum-containing media. Therefore, biochemical profiling aimed to explore fluctuations in IVM media content during the acquisition of oocyte developmental competence.

Materials and Methods: Bovine cumulus-oocyte complexes (COCs) underwent IVM in TCM199 medium with Earle's salts, supplemented with 2.0 mM L-glutamine, 10% fetal bovine serum, antibiotics, and 0.05 IU/mL porcine follicle-stimulating hormone (FSH+) or vehicle control (CTL) medium for 22 h.

Results: FSH withdrawal (CTL) diminished several processes associated with the acquisition of oocyte developmental competence, such as reduced cumulus cell expansion, diminished estradiol synthesis (FSH+: 116.0±0.0 pg/mL vs. CTL: 97.6±18.0 pg/mL), and lower oocyte nuclear maturation rate (FSH+: 96.47% vs. CTL: 88.76%). Fresh media formulations (i.e., TCM199 with FSH or vehicle) were indistinguishable under biochemical profiling threshold conditions. Biochemical profiling showed similar total protein and lipid concentrations between groups. Further, total sugar concentrations diminished from fresh media to their post-IVM counterparts, albeit in an FSH-independent manner. Glycogen concentrations remained unaltered after IVM within CTL media, albeit were substantially lower after IVM under FSH+ conditions.

Conclusion: FSH mediates the consumption of serum-derived glycogen by bovine COCs during IVM and implies that serum-free media should contain increased glucose concentrations to facilitate the acquisition of oocyte developmental competence.
A PRELIMINARY STUDY OF IN VIVO INJECTION OF AUXIN AND CYTOKININ INTO Rafflesia patma Blume FLOWER BUDS
Authors: Mursidawati Sofi , Wicaksono Adhityo
Published: September 2021

The controlling mechanisms for the growth and differentiation of Rafflesia from a flower bud into the anthesis stage is currently unknown, particularly if any plant growth regulator (PGR) physiological pathways play some type of roles. In the wild, the number of flower buds available to study are extremely limited. In this study, we grouped six flower buds of Rafflesia patma Blume into three different treatments: two buds injected with auxin (indoleacetic acid, IAA), two buds injected with cytokinin (kinetin), and two buds injected with sterile distilled water as a control. Buds enlarged with both IAA and kinetin treatments compared to the control, but only buds injected with IAA showed a transition stage with the bract revealed (cupule-bract stage from previously cupule stage) within two weeks of five weeks of observation. These results raise further questions whether Rafflesia development is more likely due to auxin exposure when in flower bud as compared to cytokinin. Future studies should include increased sample size for treatments, enhanced PGR administration to allow exposure to the tissue and less tissue damage, injection of other PGRs such as gibberellin (GA) and jasmonic acid (JA), and histological tissue analysis to investigate PGR effects in depth.
Effectiveness of Modified Alvarado Scoring System for Diagnosis of Acute Appendicitis
Authors: Devanathan Suhas , Tote Darshana , Shinde Sandip
Published: September 2021

BACKGROUND Acute appendicitis is very commonly diagnosed when a patient presents with acute abdomen. This is more commonly seen in the young and middle-aged individuals. The clinical signs and symptoms determine the diagnosis and management. Scoring systems are in plenty to diagnose acute appendicitis and mainly include the presenting signs and symptoms, but are not acceptable for all populations with different age groups. Modified Alvarado scoring system is a timed tested scoring system used in different populations and age groups with good efficacy and to provide a bedside clinical diagnosis of acute appendicitis. The purpose of this study was to assess effectiveness of modified Alvarado score in the early diagnosis of acute appendicitis. METHODS A prospective observational study was done which incorporated 50 patients presenting with the signs and symptoms pointing out to acute appendicitis, clinically. The patients were evaluated by Modified Alvarado score during admission and based on the treating surgeon’s decision, were operated. Finally, the score was compared with the diagnosis achieved with a histopathological examination of the operated specimen. RESULTS The sensitivity of raja isteri penigran anak saleha appendicitis (RIPASA) score was 70.58 %, specificity was 68.75 %, positive predictive value (PPV) was 82.75 %, negative predictive value (NPV) of RIPASA score was 52.38 % and the diagnostic accuracy of RIPASA score was 70 %. CONCLUSIONS Modified Alvarado scoring system is simple scoring system which can be used in a bedside manner but uses specific and limited features for the diagnosis of acute appendicitis which limits the effectiveness of this scoring system. KEY WORDS Acute Abdomen, Clinical Scoring System, Modified Alvarado Scoring System
A Study of Clinicopathological Association in Chronic Liver Disease - A Cross Sectional Study from a Tertiary Referral Hospital of South India
Authors: Naidu Adapa Ramakrishnam , Gandhi Manchu Venkata Viswanadh , Sivakumar Lotheti , Ramana Murthy Sreepada Venkata
Published: September 2021

BACKGROUND Chronic liver disease is a liver disorder of varying causes and severity with variable clinical, biochemical and histological findings with severity lasting for 6 months or more. The spectrum of chronic inflammatory diseases of the liver extends from acute hepatitis to chronic hepatitis and finally to cirrhosis. Whatever the aetiology, the same basic underlying histological changes may be seen in the liver. The objective of the study was to see the association of clinical diagnosis with the histopathological diagnosis among chronic liver disease patients. METHODS It is a cross-sectional study that included analysis of clinicopathological data of 40 patients with clinically suspected chronic liver disease who were admitted to the medical wards of government general hospital, Kakinada between March 2003 and May 2005. RESULTS Total number of patients (N = 40) of suspected chronic liver disease were included in the study in which 25 were males (62.5 %) and 15 were females (37.5 %). Most of the cases (36) were found in the age group of 30 - 69 years, a majority of 12 was in the age group of 50 - 59 years. The most common symptoms in this study were abdominal distension and loss of appetite in 28 (70 %) patients, followed by pain in abdomen 22 (55 %), jaundice 17 (42.5 %), loss of weight 16 (40 %), pedal oedema 11 (27.5 %). A total of 7 cases (41.7 %) of cirrhosis were seen in the age group of 40 - 49 years, 5 cases (45.45 %) with chronic hepatitis were in the age group of 50 - 59 years, 5 (45.45 %) hepatocellular carcinoma cases were in the age group of 60 - 69 years, hepatoblastoma was seen in a 60-year-old female. Clinical diagnosis was strongly associated with histopathology (Pearson chi-square value = 19.583, P = 0.021) and also showed fair agreement between clinical diagnosis and histopathology (P = 0.002). CONCLUSIONS Chronic liver disease is more in males, most commonly seen in the age group of 30 - 69 years and the majority of them are in the age group of 50 - 59 years. Cirrhosis is the most common chronic liver disease seen in North and Coastal Andhra, part of South India, followed by chronic hepatitis, hepatocellular carcinoma. The most common etiological factor is alcoholic abuse (35 %) followed by HBsAg positivity (15 %), native medicine in 5 % and unknown in 45 %. Clinical diagnosis of chronic liver disease should be confirmed with histopathological examination. In appropriate clinical settings, the clinical diagnosis of chronic liver disease made by experts is fairly associated with histopathological diagnosis. KEY WORDS Chronic Liver Disease, Clinical Diagnosis of Liver Disease, Histopathological Association
An Update on Dentinal Hypersensitivity - Aetiology to Management – A Review
Authors: Mrinalini Mrinalini , Sodvadiya Urvashi B. , Hegde Mithra N. , Bhat Gowrish S.
Published: September 2021

BACKGROUND Dentinal hypersensitivity is a common clinical disease that occurs as a result of dentin exposure. Though the term dentin hypersensitivity and dentin sensitivity is used interchangeably, dentin hypersensitivity is an exaggerated form of dentinal sensitivity which arises due to localized pulpal inflammation, pulpal nerve sprouting, and development of inflammatory sodium channels. It is characterised by short sharp pain emerging from exposed dentinal tubules in reaction to various stimuli. Such dentin exposure could be due to either enamel loss or cemental loss. This is followed by removal of smear layer by mechanical or chemical means. At present, the hydrodynamic theory, which describes fluid movement in response to stimuli within exposed dentinal tubules, is a commonly recognized explanation for dentin hypersensitivity. It is more common in premolars and canines, and it affects the facial surfaces of the teeth towards the cervical aspect. Studies suggested microscopic changes in the structure of sensitive dentin compared with normal dentin. The diagnosis of dentinal hypersensitivity requires careful clinical examination and eliciting the response using various stimuli. Dentinal hypersensitivity is usually managed by the use of physical or chemical agents. They work either by disturbing the neural response to pain stimulus or block fluid flow by occluding the tubule. The desirable features of a desensitising agent include the ability to give instant and longlasting pain relief, being simple to use, well accepted, not harmful to the pulp. It is recommended that the desensitizing agent is used for at least two weeks. Some of the newer agents used for management includes CPP-ACP, proarginine, nanomaterials, herbal products, propolis etc. In cases where there is tooth structure loss, appropriate restorative material is used to cover the exposed dentin. Root canal therapy is considered the last resort for pain relief after all other options have failed to provide relief. The present article outlines the etiopathogenesis, risk factors, diagnosis, prevention and treatment of dentinal hypersensitivity. KEY WORDS Dentinal Hypersensitivity; Dentin Sensitivity; Desensitizing Agents; Iontophoresis
Essential Notions Concerning the Integration of Refugees
Authors: Decmann Bertalan
Published: September 2021

The latest wave of refugees, which peaked in 2015, raises the question of what we mean by integration, not only in terms of the rules adopted in the EU, but also in terms of the social inclusion of individual refugees and their families. This is because the concepts in the literature, in EU documents on asylum, and in individual sectoral policies (e.g. social, employment, housing, health and public education) are not necessarily harmonized. Therefore, the aim of the study is not only to review integration outcomes, but also to distinguish concepts related to migration, asylum, and refugee discourse, such as exclusion, disintegration, acculturation, and assimilation. Only clarification will bring us closer to selecting the most important social policy and asylum measures. This clarification is also urgent because a coherent integration policy must comply with both cultural diversity and non-discrimination requirements in the EU.
Voluntary Social Insurance Policy Through the Evaluation of Workers in Tay Ho District, Hanoi City, Vietnam
Authors: Mai Linh , Nguyen Thi Kim Hoa
Published: September 2021

Vietnam’s voluntary social insurance (VSI) policy has been in force since 2008 and by 2018 included 270,000 participants (accounting for 0.79% of
the labor force). Hanoi City is the capital of Vietnam, with 21,156 participants (0.56%). The proportion of people participating in VSI is still very low. Workers who have at least 20 years of participation will receive a monthly pension and their beneficiaries will receive a death benefit in case of their demise. The opinions of workers about VSI policies are presented in the report through interviews with 170 voluntary social insurance participants and 168 non-participants in Tay Ho District, Hanoi City. The research results in new findings using comparison between participants and non-participants. In addition, in-depth interviews were conducted with 40 people, including social insurance officials in Tay Ho District, ward officials, and workers, to clarify why the number of VSI participants is low. Based on the research and evaluation of workers concerning VSI policies and regulations, we identify the main causes of this situation, as well as the policy- and communication-related shortcomings, and suggest solutions for improving the social insurance participation rate of individuals in Hanoi City in particular, and Vietnam in general.
Very poor prognosis after a conservatively treated hip fracture in the most frail nursing home residents
Authors: Broekman M.M.T.J. , de Vos J. , de Vijlder L. , Brundel M.
Published: September 2021

Purpose: In very frail nursing home residents transport to the hospital for diagnostics in case of a suspected hip fracture might be considered too burdensome or not desirable. We aimed to elucidate the prognosis and disease course for this group. Methods: We performed a retrospective cohort study between 2017 and 2020 in a nursing home in the Netherlands. All patients with a suspected hip fracture were eligible. The main exclusion criteria was transport to the hospital for diagnostics. Our primary outcome is survival after one month. Results: 23 patients fulfilled the inclusion criteria. Median age was 84 years. Almost all patients had severe dementia. After one month 20 patients (87%) had died. Median survival was 5 days (interquartile range 3-8). Conclusion: In the most frail nursing home residents with a suspected hip fracture the prognosis is very poor with a median survival of only 5 days.
Dystopia: Queer Sex and the Unbearable in Grasshopper Jungle
Authors: Mason Derritt
Published: September 2021

This chapter draws on Andrew Smith’s 2014 novel Grasshopper Jungle to explore the representation of queerness as a locus of dystopian adolescent experiences and, by hyperbolic extension, the cause of the apocalypse. Smith’s novel satirically amplifies the idea that adolescence is itself a kind of dystopia, and simultaneously points to how queer sex is a kind of darkness—or invisibility—often “experienced as unbearable,” in Lauren Berlant and Lee Edelman’s words, by critics of queer young adult literature. Austin, Grasshopper Jungle’s history-obsessed narrator, records in astonishing detail the world’s destruction by mutant bugs, yet Austin’s moment of sexual intimacy with his male best friend remains a striking silence in his otherwise scrupulous account. This chapter concludes that Grasshopper Jungle’s excessive rendering of YA’s storm, stress, darkness, and violence ironically makes visible the novel’s unwillingness to confront the unbearability associated with queer sex.
Horror and Camp: Monsters and Wizards and Ghosts (Oh My!) in Big Mouth
Authors: Mason Derritt
Published: September 2021

This chapter moves readers from Andrew Smith’s adolescence-as-dystopia to the popular animated Netflix series Big Mouth, which represents adolescence as a horror show. Like Grasshopper Jungle, Big Mouth provides audiences with monstrous avatars for the storm and stress of adolescence. Instead of horny, rampaging mutant mantises, however, Big Mouth offers viewers Hormone Monsters, haunted houses, ghosts, and other Gothic tropes as embodiments of those anxieties that surround puberty and its horrifying humiliations. Unlike Grasshopper Jungle, Big Mouth universalizes queerness, celebrates the polymorphous perversity of childhood, and uses camp to defuse many of the anxieties that attend other representations of adolescent sexuality. Big Mouth offers us a kind of camp with strong ties to shame—what Kathryn Bond Stockton calls “dark camp”—and illustrates how shame and debasement can function as a powerful model of relationality, one that unites the show’s young protagonists through shared queer feelings.
Puerto Rican Engagement With Jazz And Its Effects On Latin Music
Authors: Lapidus Benjamin
Published: September 2021

This chapter explores how Puerto Rican and Nuyorican (New York-born Puerto Rican) musicians in New York City used jazz harmony, arranging, improvisation, and musical aesthetics to broaden the sound of Latin popular music from the postwar period into the 1990s and beyond. It argues that the Puerto Rican connection to jazz was extensive and encompassed a variety of styles and eras. The chapter challenges the debate over salsa's patrimony and development, by demonstrating how particular Puerto Rican musicians in New York City were fluent in jazz and incorporated it into Latin music. Much discourse has unfortunately centered on pitting Puerto Rican against Cuban musicians or looking only at commercial or sociocultural considerations when considering Latin music in New York. Proficiency in both jazz and Latin music allowed Puerto Rican musicians to innovate in ways that did not happen in Puerto Rico or elsewhere. The chapter also explores other themes discussed in the introduction, such as the importance of clave, the impact and extent of music education among Puerto Rican musicians, family lineages, the importance of folklore, and inter-ethnic collaboration.
George Trenholm Sees the Future
Authors: Ross Charles D.
Published: September 2021

This chapter tells the story of George Trenholm, one of the savviest businessmen in the United States and probably the richest man in the South when the Civil War began. It describes Trenholm's international powerhouse firm that was highly respected by the powerful in New York and Europe. The chapter then turns to review the impact of Abraham Lincoln's election as president on the slaveholding Southern states and the more industrial Northern states. Three days later George Trenholm introduced a measure in the South Carolina General Assembly denouncing the election and stating that South Carolina should preserve her sovereignty by securing supplies and weapons to arm the state. As South Carolina joined Alabama, Mississippi, Louisiana, Georgia, and Florida in establishing the Confederate States of America, Trenholm started a trend that would be rapidly copied by others: he began to change the registry of his ships to British and obscuring the names of the true owners. The chapter then introduces Captain Sam Whiting, the person who paid the courtesy of dipping his US flag to the Union defenders of the fort. It investigates how both the Union and Confederate governments scrambled to put people in the right places to win the war.
“This Remote Western Maritime Colony”
Authors: Ross Charles D.
Published: September 2021

This chapter describes the steamship service of the two cities after the British mail steamer Karnak made its way from New York to Nassau for the first time. It argues that the establishment of such a regular link with the outside world had been a high priority for the British officials and the contract meant that Bahamians would finally have a regular connection to both North America and Europe. When Prince Alfred paid his visit to New Providence in December 1861, Acting Governor Charles Rogers Nesbitt wrote an official welcome in which he referred to the Bahamas as “this remote western maritime colony.” The chapter offers a glance at the Bahamas' place in world history, and investigates how Bahamians were displayed as opportunistic people of the sea who embraced everything associated with a maritime lifestyle. But unless there were goods on a wrecked ship to pilfer, there was not much to do.
Putting the Pieces in Place
Authors: Ross Charles D.
Published: September 2021

This chapter details the standoff between Gladiator and Flambeau. It reviews Sam Whiting's decision to acquire a stockpile of coal so that any Union cruisers that came to port would be ready to move on blockade runners when necessary. Blockade runners had a serious advantage in that they chose the time to make their move, while blockading ships had to always keep their steam up to have any chance of catching their prey. The chapter then examines the technology and technique of blockade running and how coal became a strategic material and came into high demand. By the end of 1861, dozens of ships had evaded the blockade to make their way back and forth from Nassau to the Confederacy. The chapter analyzes the impact of the arrivals of Prince of Wales, Ella Warley, Theodora, and Gladiator on astute businessmen like George Trenholm and Henry Adderley. With the blockade running trade about to erupt, the chapter unveils how Henry Adderley's son Augustus Adderley and his son-in-law George Harris became partners in his firm. Ultimately, the chapter discusses the importance of Baptiste Laffite, an agent for John Fraser and Company, and his role in facilitating the flow of material through Nassau.
The Progressives, Ida Bell Wells-Barnett, and the Multiple Racisms That Marked Jim Crow Segregation
Authors: Hasian Marouf A. , Paliewicz Nicholas S.
Published: September 2021

In this chapter, the authors focus on the genealogical dimensions of the anti-lynching efforts of those nineteenth-century progressive advocates who joined Ida B. Wells-Barnett during her anti-lynching crusades. Extending the work of post-structural theorists, who focus on larger discursive formations, the authors comment on the enduring texts and visualities that swirled around Wells-Barnett and those who critiqued her work as she put together her famed “Red Record” of lynchings.
“By Parties Unknown”
Authors: Hasian Marouf A. , Paliewicz Nicholas S.
Published: September 2021

This chapter explains the myriad reasons why so many members of the NAACP
and other anti-lynching communities failed to muster enough support to pass U.S. federal anti-lynching legislation before World War II. During this period, all sorts of “states’ rights” arguments were used to critique the efforts of organizations like the NAACP and the International Labor Defense (ILD) during the Jim Crow years.
Bryan Stevenson, the Formation of the Equal Justice Initiative, and the Fight against the “Stepchild of Lynching”
Authors: Hasian Marouf A. , Paliewicz Nicholas S.
Published: September 2021

This chapter explains the motivations of Bryan Stevenson and the rise of the EJI. We study how Stevenson’s legal work, his involvement with America’s justice system, and his best-selling book, Just Mercy, contributed to the formation of the EJI. Through a close reading of Just Mercy, we argue that Stevenson and his EJI garnered international attention as a response to the believed complacency of civil rights activism and its forgetting of the legacy of racial terrorism.
EJI Critiques of Confederate Statuary, Dixie Monumentalization, and Charlottesville Legacies
Authors: Hasian Marouf A. , Paliewicz Nicholas S.
Published: September 2021

This chapter analyzes the presences of lynching historiographies that Stevenson and the EJI challenge at the National Memorial for Peace and Justice and the Legacy Museum. From a critical genealogical standpoint, the authors draw out the multi-directionality and competitive nature of Dixie monumentalization and the “narrative wars” in the South. This part of the book also specifically explains how the 2017 Unite the Right rally had everything to do with the living legacy, and iconography, of racial terrorism even though many had thought we were in a “post-racial” moment.
Billy Higgins in the Zone: Brushwork, Breath, and Imagination
Authors: Williams James Gordon
Published: September 2021

This Chapter presents an analysis of the late drummer and community leader Billy Higgins’s improvised brushwork and breathing strategies in his performance on Hoagy Carmichael’s “Georgia on My Mind” on his frequent collaborator’s Charles Lloyd’s recording The Water Is Wide (2000). Connecting with the book’s theme of political and cultural considerations of what it means to create Black musical space, Ashon Crawley’s “black pneuma” interpretive frame is used to help understand Higgins’s breathing strategies relative to his drumming as an orchestration of individual and community sound. Higgins’s breathing strategies during improvisation are theorized as a way to cross bar lines, accessing all colors of the human condition while creating a Black sense of musical place. Higgins’s values of musical place-making thrive through his ego-denying philosophy for the benefit of group sound throughout his career and within the social movement of Leimert Park.