bluuebunny/crossref_metadata_2025 huggingface dataset:
An Innovative Management Perspective for Organizations through a Reputation Intelligence Management Model
Authors: Ramos Célia Maria Quitério , Casado-Molina Ana Maria , Ignácio-Peláez José
Published: September 2019

Banking companies aiming to maintain their sustainability in financial markets need to develop an integrated management based on the most important intangibles assets of relational capital. Decision- makers need to analyze and understand a huge volume of opinions continuously generated in digital ecosystems about emotions and feelings that their stakeholders associate with the performance and communication of the brand. Current tools of management fail to consider transversal and holistic models, which study the frequency and value of existing relationships between the relational capital and intangible assets. In this research, an innovative management model based on reputation intelligence is proposed. This model incorporates methodology from business intelligence models, through OLAP and data mining techniques, to analyses the complex relationships among intangible assets experience, emotion and attitude. The proposed model was applied to companies in the banking sector and the results obtained permit a conclusion about the kinds of relationships for these intangibles in each bank.
Understanding an Effect of Technology Between the Relationships of the Five-Factor Model and Sales Performance Technology as a Moderating Tool
Authors: Kimixay Litinthong , Cheng Liu , Waheed Abdul , Kathid Lidinthong
Published: September 2019

Over the past decades, numerous experts have been investigated the correlation among distinct personality traits and job performance. However, relatively less attention was paid examining the significance of technological tools in sales management, especially in developing countries. This article explores the relationship among the five-factor model (FFM) of personality traits and sales performance (SP) with a moderating role of the technology. To this end, structural equation modeling and Fisher's Z transformation analysis were employed to analyze the hypotheses. The findings revealed that extraversion, conscientiousness, openness to experience, and emotional stability traits are positively correlated to SP. In contrast, agreeableness is not highly correlated with SP relatively than the remainder traits. Additionally, results revealed the significant effect of technology as a moderator which strengthens the association of FFM and SP. This study proposes diverse managerial implications and future directions for practitioners and academicians across the nations.
Benefits and Adoption of Integrated Reporting
Authors: Joshi Prem Lal , Sallehhuddin Abdullah , Munusamy Predeeban , Deshmukh Ashutosh
Published: September 2019

Integrated reporting (IR) combines financial and other value relevant information of an organization into one report, innovative development in corporate reporting. This study reports the perceptions of accountants regarding benefits and possible adoption of IR in the Malaysian context. The authors used a survey method and received responses from 50 companies listed on the Bursa Malaysia. The statistical analyses provide the following results. IR is not adopted widely but 56% of companies are currently thinking of adopting IR. The top three perceived potential benefits include increased communication, transparency, and the breaking of functional silos. Statistical tests further indicate that large companies show more willingness to adopt IR and are also more aware of the potential benefits. The accountants from large organizations also believe that the quality of financial reporting and compliance practices will improve due to IR adoption. Furthermore, the results suggest that accountants expect Malaysian Institute of Accountants to be a lead agency for the enforcement of IR in Malaysia and also IR to be eventually made a mandatory requirement for corporate reporting. These results should be of interest to the policymakers in countries similar to Malaysia.
Exploring the Preferences for Anticipated Use of Head-Mounted Displays
Authors: Zuidhof Niek , Ben Allouch Somaya
Published: September 2019

Head-mounted displays (HMDs) have been available for several years now, but uptake has been slow so far. The objective of this study was to gain insight into preferences on anticipated use in the early phase of HMDs with augmented reality. A survey was conducted among Dutch students following a nursing or social work education (N=100). Results showed that almost nobody had ever used a HMD. The areas of high interest of anticipated use of HMDs lies especially in receiving information regarding emergencies via the HMD if something is happening close to people's physical location and news and general information about physical location. For potential use functionalities, the most interesting functions reported by respondents were using HMDs for hands-free calling and receiving information about their behavioral patterns with regard to movement. The attitudes towards receiving non-visible cues in social interaction such as detecting stress levels or mood were all reported with a negative attitude. More than half of the respondents reported to have an intention to use a HMD in the future.
Factors Influencing International Students Behavioral Intention to Order Online Food Delivery Services
Authors: Mensah Isaac Kofi
Published: September 2019

This study integrated culture (language) and perceived service quality into the UTAUT model to explore the intention of international students to order food online in China. The results have demonstrated that performance expectancy, effort expectancy, culture (language), and perceived service quality were all significant predictors of the intention of international students to order food online. Also, culture (language) was determined to influence the perceived service quality, effort expectancy, and performance expectancy of ordering food online. Performance expectancy, and effort expectancy were revealed to be significant predictors of perceived service quality. Furthermore, the intention to order food online was a determinant of the intention to recommend. The implications of these findings are discussed.
A Hint of Primitive Mucosal Immunity in Shrimp through Marsupenaeus japonicus Gill C-Type Lectin
Authors: Alenton Rod Russel R. , Koiwai Keiichiro , Nakamura Rika , Thawonsuwan Jumroensri , Kondo Hidehiro , Hirono Ikuo
Published: September 2019

Lectins are found in most living organisms, providing immune surveillance by binding to carbohydrate ligands. In fishes, C-type lectins were isolated from mucus of respiratory organs (skin and gills), where they aid the mucosal immune response in regulating microbiota and suppressing pathogens. In shrimp, however, no mucosal immunity or any form of gill-specific immune defense has been reported, and most identified C-type lectins are associated with hemocyte cellular and humoral responses. Interestingly, our microarray analysis revealed the localization of highly expressed novel biodefense genes in gills, among which is Marsupenaeus japonicus gill C-type lectin (MjGCTL), which we previously reported. Gill mucus collected from M. japonicus displayed similar bacterial agglutination ability as observed with recombinant MjGCTL. This agglutinating ability can be attributed to endogenous MjGCTL (nMjGCTL) detected in gill mucus, which was confirmed with an agglutination assay using purified nMjGCTL from gills. In addition, nMjGCTL also promoted in vivo bacterial phagocytosis by hemocytes. In vivo knockdown of MjGCTL resulted in a compromised immune system, which was manifested by impaired agglutination capacity of gill mucus and downregulation of the gill antimicrobial peptides, crustin and penaeidin. Shrimp immunocompromised by MjCGTL knockdown, apparently lost the ability to respond to attaching and penetrating bacteria. This was evident as increased total bacteria and Vibrio counts in both gills and hemolymph, which were correlated with low survival during a bacterial challenge. These results reveal immune defense by shrimp gills resembling a primitive form of mucosal immunity.
Lymphatic Cannulation for Lymph Sampling and Molecular Delivery
Authors: Zawieja David C. , Thangaswamy Sangeetha , Wang Wei , Furtado Raquel , Clement Cristina C. , Papadopoulos Zachary , Vigano Marco , Bridenbaugh Eric A. , Zolla Lello , Gashev Anatoliy A. , Kipnis Jonathan , Lauvau Gregoire , Santambrogio Laura
Published: September 2019

Unlike the blood, the interstitial fluid and the deriving lymph are directly bathing the cellular layer of each organ. As such, composition analysis of the lymphatic fluid can provide more precise biochemical and cellular information on an organ's health and be a valuable resource for biomarker discovery. In this study, we describe a protocol for cannulation of mouse and rat lymphatic collectors that is suitable for the following: the “omic” sampling of pre- and postnodal lymph, collected from different anatomical districts; the phenotyping of immune cells circulating between parenchymal organs and draining lymph nodes; injection of known amounts of molecules for quantitative immunological studies of nodal trafficking and/or clearance; and monitoring an organ’s biochemical omic changes in pathological conditions. Our data indicate that probing the lymphatic fluid can provide an accurate snapshot of an organ’s physiology/pathology, making it an ideal target for liquid biopsy.
KIR Polymorphism Modulates the Size of the Adaptive NK Cell Pool in Human Cytomegalovirus–Infected Individuals
Authors: Manser Angela R. , Scherenschlich Nadine , Thöns Christine , Hengel Hartmut , Timm Jörg , Uhrberg Markus
Published: September 2019

Acute infection with human CMV (HCMV) induces the development of adaptive NKG2C+ NK cells. In some cases, large expansions of this subset, characterized by coexpression of HLA-C–specific KIR, are stably maintained during the life-long latent phase of infection. The factors that control these unusual expansions in vivo are currently unknown. In this study, the role of KIR polymorphism and expression in this process was analyzed. It is shown that strong NKG2C+ NK cell expansions are dominated by single KIR clones, whereas moderate expansions are frequently polyclonal (p < 0.0001). Importantly, the choice of KIR was not arbitrary but biased toward usage of HLA-C–specific KIR encoded by the centromeric part of group A (cenA) haplotypes. Consideration of KIR allelic variation and gene copy number revealed that the cenA effect was predominantly due to the HLA-C2–specific KIR2DL1 receptor; presence of KIR2DL1 on NKG2C+ NK cells led to significantly larger clonal expansions than the cenB-encoded KIR2DL2 (p = 0.002). Expansion of NKG2C+KIR2DL1+ NK cells was always accompanied by the cognate ligand HLA-C2. Moreover, in these donors the frequency of NKG2C+ NK cells correlated with the concentration of anti-HCMV IgG (r = 0.62, p = 0.008), suggesting direct relevance of NKG2C+KIR2DL1+ NK cells for virus control. Altogether, the study suggests that the homeostasis of NKG2C+ NK cells in HCMV infection is at least partly controlled by coexpression of cognate inhibitory KIR. In particular, the strong interaction of KIR2DL1 and HLA-C2 ligands seems to promote large and stable expansion of adaptive NK cells in HCMV infection.
The influence of absorptive capacity and networking capabilities on small and medium enterprises
Authors: Munyanyi Watson , Pooe David
Published: September 2019

Background: In response to the ever-growing complexity in the business environment that has resulted from the dramatic technological transformation, businesses have altered the way they conduct business. The influence of the external business environment is increasing in significance, rendering traditional methods of operating business outdated and forcing the adoption of new methods.Objective: The aim of this study is to investigate how organisational capabilities influence small and medium enterprises’ (SMEs) operational performance (OP), by specifically looking at absorptive capacity (ACAP), networking capabilities (NCs) and customer relational capabilities (CRCs).Setting: This study was conducted in Zimbabwe and was spread across the 10 provinces, focusing on 388 randomly selected SMEs.Methods: Data were collected through self-administering questionnaires to respondents, using the drop-off or pickup technique and making telephonic follow-ups to increase the response rate. Analysis of the data in this study was largely quantitative in nature and it was performed using a two-step structural equation modelling approach.Results: The results of the study indicate that CRCs lead both ACAP and NCs to improve OP.Conclusion: This study enlightens both SMEs’ managers and policymakers on the significance of capabilities, as opposed to resources, in the growth of the SMEs sector. In light of the results, it is imperative that firms orientate themselves to embrace networking and ACAP as central tenets of their day-to-day operations while attending to customers timely and innovatively.
Epidemiology of Breast Cancer in Indian Women: Population and Hospital Based study
Authors: Kumar Deepika , Batra Usha
Published: September 2019

BACKGROUND: Breast Cancer is a leading cause of mortality and ranked apex among females all over the world. Early detection and diagnosis of breast cancer may reduce the increasing burden of the disease. With this background, a Population and Hospital based cancer registries have been studied to understand the epidemiology of breast cancer trends in India.OBJECTIVE: The objective of this study is to gather information provided in different cancer registries and analyze the epidemiology of breast cancer statistics in India.METHODS: Age Adjusted Rate, Age Specific Rate and Mortality Incidence Ratio has been considered as evaluation metric.RESULTS: In this study it has been observed that the Age Adjusted Rate and Mortality rate of Breast Cancer has been reported as 25.8 and 12.7 per 100,000 women respectively.CONCLUSION: Additional awareness & screening programs early diagnosis and treatment facilities can only significantly improve the breast cancer’s clinical picture in India.
Impact of Antibiotic Resistance on Treatment of Pneumococcal Disease in Ethiopia: An Agent-Based Modeling Simulation
Authors: Chen Hui-Han , Stringer Andrew , Eguale Tadesse , Rao Gauri G. , Ozawa Sachiko
Published: September 2019

Antimicrobial resistance (AMR) is a growing threat to global health. Although AMR endangers continued effectiveness of antibiotics, the impact of AMR has been poorly estimated in low-income countries. This study sought to quantify the effect of AMR on treatments for pediatric pneumococcal disease in Ethiopia. We developed the DREAMR (Dynamic Representation of the Economics of AMR) model that simulate children younger than 5 years who acquire pneumococcal disease (pneumonia, meningitis, and acute otitis media) and seek treatment from various health facilities in Ethiopia over a year. We examined the AMR levels of three antibiotics (penicillin, amoxicillin, and ceftriaxone), treatment failures, and attributable deaths. We used the cost-of-illness method to assess the resulting economic impact of AMR from a societal perspective by estimating the direct and indirect treatment costs and productivity losses. Findings showed that AMR against antibiotics that were used to treat pneumococcal disease led to 195,763 treatment failures per year, which contributed to 2,925 child deaths annually in Ethiopia. Antimicrobial resistance resulted in a first-line treatment failure rate of 29.4%. In 1 year, the proportion of nonsusceptible Streptococcus pneumoniae bacteria increased by 2.1% and 0.5% for amoxicillin and penicillin, and reduced by 0.3% for less commonly used ceftriaxone. Annual costs of AMR to treat pneumococcal disease were around US$15.8 million, including US$3.3 million for ineffective first-line treatments, US$3.7 million for second-line treatments, and US$8.9 million for long-term productivity losses. Antibiotic stewardship to reduce misuse and overuse of antibiotics is essential to maintain the effectiveness of antibiotics, and lessen the health and economic burden of AMR.
Case Report: Concurrent Rheumatic Fever and Acute Post-Streptococcal Glomerulonephritis in a High-Burden Setting
Authors: Nakauyaca Anna V. , Ralph Anna P. , Majoni William S. , Kangaharan Nadarajah
Published: September 2019

We report a case of acute rheumatic fever with severe pancarditis occurring simultaneously with probable acute post-streptococcal glomerulonephritis in a previously well, Australian Aboriginal, 29-year-old male. These autoimmune streptococcal sequelae are usually considered pathogenetically distinct, and concurrence has not previously been reported from this high-burden setting. We hypothesize that a single type of infecting group A Streptococcus (Strep A) triggered both autoimmune sequelae. Salient features included mitral and aortic regurgitation that worsened during the acute illness, painful pericarditis, and high troponin; severe acute kidney injury with oliguria, hematuria, and macroalbuminuria; reduced complement (C3); and elevated streptococcal serology. The case highlights important diagnostic and management challenges. It also illustrates the serious morbidity impact of the complications of Strep A.
Case Report: Paracoccidioidomycosis in Solid Organ Transplantation: Disseminated Disease in a Liver Recipient and Literature Review
Authors: Peçanha-Pietrobom Paula M. , Falqueto Aloisio , Rodrigues Gandarella Anna Danielle , Moyzés Júlia Vieira , Rangel Karoline Almeida , Miranda Letícia Balarini , Hemerly Matheus Compart , Careta Renata Scarpa , Peçanha Paulo Mendes
Published: September 2019

Paracoccidioidomycosis (PCM) is an endemic systemic mycosis that is of great importance in Latin America. Its occurrence in solid organ transplantation (SOT) is rare, but with high mortality rate. In this report, we describe a case of PCM in a liver transplant recipient 19 months after transplantation. The patient presented with multiple skin abscesses, arthritis, osteolytic lesions, and pulmonary and adrenal involvement. Despite the presence of disseminated disease and the patient’s immunosuppressed condition, the patient responded well to prolonged antifungal treatment with no sequelae, thus suggesting that early diagnosis and correct treatment may lead to favorable outcomes in SOT recipients with PCM.
Bacillus thuringiensis Cry5B is Active against Strongyloides stercoralis in vitro
Authors: Charuchaibovorn Sarit , Sanprasert Vivornpun , Sutthanont Nataya , Hu Yan , Abraham Ambily , Ostroff Gary R. , Aroian Raffi V. , Jaleta Tegegn G. , Lok James B. , Nuchprayoon Surang
Published: September 2019

Strongyloidiasis, caused by Strongyloides stercoralis infection, is an important neglected tropical disease that causes significant public health problems in the tropics and subtropics. The disease can persist in hosts for decades and may be life-threatening because of hyperinfection and dissemination. Ivermectin (mostly) and albendazole are the most common anthelmintics used for treatment. Albendazole is suboptimal for this parasite, and although ivermectin is quite effective in immunocompromised patients, a multiple-course regimen is required. Furthermore, reliance on a single drug class for treating intestinal nematodes is a recipe for future failure. Therefore, it is important to discover new anthelmintics to treat or prevent human strongyloidiasis. One promising candidate is the Bacillus thuringiensis crystal protein Cry5B. Cry5B is highly potent against parasitic nematodes, for example, hookworms and Ascaris suum. Here, we investigated the potential of Cry5B against S. stercoralis. Multiple stages of S. stercoralis, including the first larval stage (L1s), infective stage (iL3s), free-living adult stage, and parasitic female stage, were all susceptible to Cry5B as indicated by impairment of motility and decreased viability in vitro. In summary, Cry5B demonstrated strong potential as an effective anthelmintic for treatment and transmission control of human strongyloidiasis, justifying further experiments to investigate in vivo therapeutic efficacy.
Pooled Deep Sequencing of Drug Resistance Loci from Plasmodium falciparum Parasites across Ethiopia
Authors: Brazeau Nicholas F. , Assefa Ashenafi , Mohammed Hussein , Seme Heven , Tsadik Abeba G. , Parr Jonathan B. , Keeler Corinna , Hathaway Nicholas J. , Meshnick Steven R. , Bailey Jeffrey A. , Kassa Moges , Juliano Jonathan J. , Woyessa Adugna
Published: September 2019

Although Ethiopia has an overall lower prevalence of Plasmodium falciparum among countries in Africa, the emergence of drug resistance could seriously hinder elimination efforts. Using samples collected from five therapeutic efficacy studies conducted in 2007–11, we evaluated the prevalence of putative drug resistance mutations in the pfcrt, pfmdr1, and kelch13 genes at the time of those studies, as well as the ama1 gene for genetic relatedness using a pooled amplicon deep sequencing approach. Among all sites, the kelch13 gene showed no mutations, whereas the pfcrt CVIET genotype was fixed in all populations. By contrast, the mdr1 gene demonstrated frequencies of resistant genotypes ranging from 10 to 100% at amino acid position 86 and from 0% to 57.8% at amino acid position 1246. Although we observed a low degree of haplotype sharing between sites, we did observe considerable haplotype sharing within sites over time. This suggests that P. falciparum populations in Ethiopia are isolated and able to persist through time.
Prevalence of Virulence Genes in Enteroaggregative Escherichia coli Isolates from Young Children from Rural South Africa
Authors: Tanih Nicoline F. , Bolick David T. , Samie Amidou , Nyathi Emanuel , Dillingham Rebecca , Pinkerton Relana C. , Guerrant Richard L. , Bessong Pascal O.
Published: September 2019

In this study, we report on the prevalence of 19 virulence genes in enteroaggregative Escherichia coli (EAEC) isolates from northern South Africa. Stool samples obtained prospectively from 97 children from 1 to 12 months of age were analyzed, and EAEC isolates were confirmed based on the presence of aaiC or aatA genes. We investigated 177 enteroaggregative Escherichia coli isolates for the prevalence of virulence genes using multiplex polymerase chain reaction. The chromosomal gene aaiC was detected at higher frequency (48.0%) compared with aatA (26.0%). The gene encoding the open reading frame Orf61 was the most prevalent putative virulence trait detected among the isolates (150/177; 84.7%). None of the genes was statistically associated with diarrhea (P > 0.05). Detection rates were higher during 7–12 month of life with an association observed for the pic gene and the age group 7–12 months (P = 0.04). Winter was the season with the highest detection rates. Our data reveal a high prevalence of Orf61, Orf3, and astA in South African EAEC isolates. Specific genes may provide additional markers for the study of disease associations with age and season of sample collection.
Temporal Pattern of Mutations in the Knockdown Resistance (kdr) Gene of Aedes aegypti Mosquitoes Sampled from Southern Taiwan
Authors: Biduda Sandrine , Lin Chia-Hsien , Saleh Fatma , Konradsen Flemming , Hansson Helle , Schiøler Karin L. , Alifrangis Michael
Published: September 2019

Aedes mosquitoes are the principal dengue vector in Taiwan, where the use of insecticides is a key element in the national control strategy. However, control efforts are constrained by the development of resistance to most insecticides, including pyrethroids. In this study, mutations in the voltage-gated sodium channel (VGSC) gene resulting in knockdown resistance (kdr) were examined in Aedes aegypti. Fragments of the VGSC gene were polymerase chain reaction (PCR)-amplified followed by restriction fragment length polymorphism analysis in samples from various settings in Southern Taiwan covering dry and wet seasons from 2013 to 2015. Three kdr mutations were identified: V1023G, D1794Y, and F1534C, with observed frequencies of 0.36, 0.55, and 0.33, respectively, in the dry season of 2013–2014. Exploring for temporal changes, the most important observation was the 1534C allele frequency increment in the following season to 0.60 (P < 0.05). This study suggests that continued insecticide pressure is driving the mutational changes, although the selection is ambiguous in the mosquito population.
A Path to Ending Hepatitis C in Ethiopia: A Phased Public Health Approach to Achieve Micro-Elimination
Authors: Taye Belaynew Wasie
Published: September 2019

Ethiopia’s hepatitis C virus (HCV) prevalence is predicted to rise by 2030. To halt this increasing trend, a suitable approach to the elimination of HCV is needed. This review explores the current status, challenges, and opportunities and outlines a strategy for the micro-elimination approach in Ethiopia. I searched PubMed and EMBASE using combined Medical Subject Heading databases for the literature on HCV micro-elimination. A phased public health approach to HCV micro-elimination, including preparation/capacity building (phase I), implementation (phase II), and rollout and scale-up (phase III), targeting people living with HIV, prisoners, chronic hepatitis and cancer patients, blood donors, and pregnant women is a pragmatic strategy to Ethiopia. This can be implemented at general and tertiary care referral hospitals with a future scale-up to district hospitals through task-shifting by training general practitioners, nurses, laboratory technologists, and pharmacists. Availability of the highly effective direct-acting antivirals (DAAs) can be ensured by expanding the existing program that provides highly subsidized DAAs through an agreement with Gilead Sciences, Inc. and eventually aiming at domestic generic manufacturing. The significant enablers to HCV micro-elimination in Ethiopia include the control of healthcare–associated HCV infection, blood safety, access to affordable testing and pan-genotypic DAAs, task-shifting, multisectoral partnership, and regulatory support. General population-based HCV screening and treatment are not cost-effective for Ethiopia because of high cost, program complexity, and disease epidemiology.
Intravenous Steroid Days and Predictors of Early Oral Steroid Administration in Tuberculous Meningitis: A Retrospective Study
Authors: Paliwal Vimal Kumar , Das Animesh , Anand Sucharita , Mishra Prabhakar
Published: September 2019

Intravenous (IV) dexamethasone is recommended for 14 days in stage 1 and 28 days in stage 2/3 tuberculous meningitis (TBM). We used a different steroid protocol. We shifted TBM patients to oral steroids after 48 hours of sustained improvement on IV steroids (oral group). Patients who worsened after shifting to oral steroids were reinitiated on IV steroids. Once they showed a consistent improvement for 48 hours, the IV steroids were overlapped with oral steroids for 7–10 days to taper off IV steroids (overlap group). We compared total IV steroid days in our patients with the recommended treatment and identified predictors that favored the oral group. This was a retrospective study. We included 98 patients with TBM (66 in the overlap group and 32 in the oral group) from January 2013 to July 2018. The median IV steroid days were 9 days (interquartile range of 4–12; 2–3.5 days in the oral group and 10–11.5 days in the overlap group). The mortality rate was 6.1%. The logistic regression model showed that TBM patients with basal exudate, tuberculoma, and modified Rankin scale (mRS) < 3 had a higher probability for going to the oral group. We conclude that total IV steroid days can be reduced in TBM patients by our method of steroid use. Presence of basal exudates and tuberculoma may favor early shifting from IV to oral steroid, whereas higher mRS may require a relatively longer course of IV steroid.
Susceptibility of Rickettsia rickettsii to Tigecycline in a Cell Culture Assay and Animal Model for Rocky Mountain Spotted Fever
Authors: Blanton Lucas S. , Wilson Nicholas M. , Quade Bethany R. , Walker David H.
Published: September 2019

Rocky Mountain spotted fever (RMSF), caused by Rickettsia rickettsii, is a severe tick-borne infection endemic to the Americas. Oral doxycycline is effective, but during severe life-threatening disease, intravenous therapy is recommended. Unfortunately, intravenous formulations of doxycycline are not always available. Therefore, we aimed to determine the susceptibility of R. rickettsii to an alternative parenteral agent, tigecycline, in vitro and in vivo. To determine the minimum inhibitory concentration of tigecycline, R. rickettsii–inoculated Vero cells were incubated with medium containing tigecycline. At various time points, monolayers were collected and R. rickettsii was quantified via real-time polymerase chain reaction (PCR). The growth of R. rickettsii was inhibited in the presence of ≥ 0.5 µg/mL of tigecycline. To determine the effectiveness of tigecycline in vivo, guinea pigs were inoculated with R. rickettsii. Five days after inoculation, they were treated twice daily with subcutaneous tigecycline 3.75 mg/kg or subcutaneous doxycycline 5 mg/kg. Treated animals improved, whereas untreated controls remained ill. Tissues were collected for quantitative PCR–determined bacterial loads on day 8. Median bacterial loads in the tigecycline group were less than those in untreated animals: liver (0 versus 2.9 × 104 copies/mg), lung (0 versus 8.3 × 103 copies/mg), skin (2.6 × 102 versus 2.2 × 105 copies/mg), spleen (0 versus 1.3 × 104 copies/mg), and testes (0 versus 1.0 × 105 copies/mg, respectively). There were no significant differences in the bacterial loads between doxycycline-treated versus tigecycline-treated guinea pigs. These data indicate that tigecycline is effective against R. rickettsii in cell culture and in an animal model of RMSF.
Family Medicine Residency Graduates' Preparation for Quality Improvement Leadership
Authors: Lichkus Jonathan , Fang Bo , Peterson Lars E.
Published: September 2019

Background

Training in quality improvement (QI) is a standard component of family medicine residency education. Graduating family medicine residents' ability to lead QI initiatives is unknown.

Objective

We assessed the preparedness of graduating family medicine residents to lead QI projects and to identify factors that may increase such readiness.

Methods

Milestone data for all graduating family medicine residents were linked to a practice demographic questionnaire completed by the same residents who registered for the American Board of Family Medicine certification examination between 2014 and 2017. The change in self-assessed QI preparedness over time and its association with faculty-assigned milestone ratings were examined using descriptive and regression analyses.

Results

The questionnaire had a 100% response rate (12 208 responded). Between 2014 and 2017, the percentage of residents who self-reported being “extremely” or “moderately” prepared to lead QI projects increased from 72.7% (2208 of 3038) to 75.8% (2434 of 3210, P = .009). Self-reported QI team leadership was associated with 93% higher odds of feeling extremely prepared compared to moderately prepared (odds ratio 1.93, 95% CI 1.58–2.35). The average midyear faculty-assigned milestone rating for QI among residents who felt “extremely” prepared was 3.28 compared to 3.14 among those who felt “not at all” prepared.

Conclusions

Over the past 4 years, family medicine residents' self-assessed preparedness to lead QI projects has barely increased. There was no correlation between self-assessed preparation and faculty-assigned milestone rating. However, we found a small association between self-reported QI leadership and self-assessed QI preparedness.
Uncinate Preserving Procedures: A Leading Step toward Conservation in Functional Endoscopic Sinus Surgery
Authors: Patro Sourabha K
Published: September 2019

Uncinate process is thought to be having role in controlling airflow dynamics at the osteo meatal complex. Excision of uncinate process during traditional functional endoscopic sinus surgery (FESS) affects these airflow patterns increasing the flow in the sinuses in inspiration and decreasing it during expiration. Conventional way of performing a FESS always includes uncinectomy. However, preservation of uncinate process during surgery leads to the protection of the opened sinuses and avoid the attack of direct airflow to the sinus along with maintaining the normal nasal drainage from the sinus cavities. There is no clear evidence or consensus in the issue and regarding the feasibility of successful access in the ethmoids and sphenoids and beyond by preserving this immensely important land mark.

In this study, we have tried to see that whether it is feasible to conserve uncinate as a future eland mark and preserve more normal nasal physiology compared with the resection of uncinate process.

How to cite this article

Gupta AK, Patro SK. Uncinate Preserving Procedures: A Leading Step toward Conservation in Functional Endoscopic Sinus Surgery. Clin Rhinol An Int J 2015;8(1):12-14.
Role of Tracheostomy in Respiratory Distress: A Study of 50 Cases
Authors: Sahni Dimple
Published: September 2019

Tracheostomy plays a vital role in respiratory distress caused by different conditions, like respiratory passage of obstruction, head and neck tumor, surgeries, trauma patients and inflammatory conditions. Timing of the operation and postoperative care deserves more emphasis. Delay in the performance of this operation defeats the purpose of tracheostomy and if managed properly, it is a life saving procedure. The aim of the study was not only to give immediate relief to the patients of respiratory distress. But also to study age and sex distribution indication and evaluate factors associated with morbidity and mortality, intraoperative and postoperative complications associated with this procedure. This study was done on 50 cases of respiratory distress admitted in different department of Rajindra Hospital, Patiala, who underwent tracheostomy as an emergency or elective procedure. Most of the patients (24%) were of 50 to 60 years of age of which 60% were males. Emergency tracheostomy was done in most of the cases (64%). Most common complication was wound infection and granuloma formation (16%). Mortality due to primary disease (tumors of head and neck) was 34%. Followed by head injury (29%). Only one patient died of tracheostomy due to excessive bleeding.

How to cite this article

Sahni D. Role of Tracheostomy in Respiratory Distress: A Study of 50 Cases. Clin Rhinol An Int J 2015;8(1):20-23.
Glial Heterotopia over the Nasal Septum: A Case Report and Review of the Literature
Authors: Swain Santosh Kumar , Dash Satyabrata , Baisakh Manash Ranjan , Samal Rankanidhi
Published: September 2019

Nasal gliomas are rare congenital lesions arising from defective embryonic development, often termed as Nasal glial heterotopias. It manifests as a mass of extra-cranial cerebral tissue unconnected with the brain. Clinically, these masses are firm and incompressible. Histopathologically, they consist of neuroglial cells and astrocytes embedded in fibrous and vascular connective tissue. Radiological investigations, such as computed tomography (CT) or magnetic resonance imaging (MRI) should be done to rule out intracranial extension. The mass was completely resected endoscopically which was attached to the anterior part of the nasal septum. Endoscopic technique provides excellent visualization. We report one case of nasal glial heterotopia in a baby from southern part of Odisha which has an unusual attachment over the septum. A review of the literatures regarding nasal glioma is also presented.

How to cite this article

Swain SK, Dash S, Baisakh MR, Samal R. Glial Heterotopia over the Nasal Septum: A Case Report and Review of the Literature. Clin Rhinol An Int J 2015;8(1):34-37.
Rare Nasal Mass: Inflammatory Myofibroblastic Tumor of Nose and Paranasal Sinuses
Authors: Sura Jafferhusein , Rathore Praveen Kumar , Sharma Divya , Bhargava Eishaan
Published: September 2019

Inflammatory myofibroblastic tumor (IMFT) also known as pseudotumor is a condition of unknown etiology, that mimmicks a neoplastic process clinically and radiologically. They occur all over the body with few exceptions. In the head and neck region, they are rare. The orbit, maxilla, nasopharynx and skull base are sites where they have been reported. We present a case of a 32-year-old male having a mass in the cheek, which presented a diagnostic challenge.

How to cite this article

Sura J, Raj A, Rathore PK, Sharma D, Khurana N, Wadhwa V, Bhargava E. Rare Nasal Mass: Inflammatory Myofibroblastic Tumor of Nose and Paranasal Sinuses. Clin Rhinol An Int J 2015;8(1):38-40.
Rhinolith Causing Oronasal Fistula: A Rare Complication
Authors: Singh Ishwar , Gupta Divya , Gulati Achal
Published: September 2019

Rhinolith is an uncommon nasal mass and it is rare to find it causing complication. Most of the rhinoliths are asymptomatic and are incidentally diagnosed, although some may present with unilateral foul smelling nasal discharge and obstruction. We report an unusual case of rhinolithiasis in 50-year-old male causing palatal erosion forming an oronasal fistula.

How to cite this article

Gupta D, Singh I, Gulati A. Rhinolith Causing Oronasal Fistula: A Rare Complication. Clin Rhinol An Int J 2015;8(1):41-42.
Sinonasal Manifestation of Rosai-Dorfman Syndrome
Authors: Mishra Kiran , Vaid Lakshmi , Gogia Vivek
Published: September 2019

Sinus histiocytosis with massive lymphadenopathy (SHML) (also known as Rosai-Dorfman syndrome) is a rare, idiopathic, benign and self-limiting histiocytic proliferative disorder. It most commonly involves the cervical lymph nodes. The disease has a benign course and involvement of the nasal cavity as an extranodal site is exceptional. Here, we report a case of bilateral sinonasal mass with subsequent involvement of cervical lymph nodes in 22-year-old lady. Histological examination of the cervical lymph nodes and nasal mass biopsy demonstrated evidences of Rosai-Dorfman disease (RDD). The clinical presentation, histologic characteristics, radiographic findings and treatment of the disease are discussed.

How to cite this article

Vaid L, Jain N, Gogia V, Mishra K. Sinonasal Manifestation of Rosai-Dorfman Syndrome. Clin Rhinol An Int J 2015;8(1):43-45.
A Descriptive Study of Length of Stay at an Intensive Care Unit
Authors: Shukla Kasturi , Chandrashekhar Priyadarshini , Kumar Nirmal , Devade Pradnya K
Published: September 2019

Background and aims

As intensive care units (ICUs) are very resource intensive, length of stay (LOS) is of prime importance. This study was done to analyze the LOS in different ICUs and analyze it against a set benchmark.

Materials and methods

This retrospective study was conducted from April to June 2013 on patients admitted during January to March 2013 in the neurosurgery ICU (NICU), medical ICU (MICU), high dependency unit (HDU) and isolation ICU of a large multispecialty hospital in Pune (India). As per the quality manual of the hospital, benchmark LOS was considered as 3.08 days for ICU. Mean and median LOS was analyzed through Student's t and Chi-square test; proportion of short (<2 days) and long stay (>4 days) patients was also computed.

Results

Out of 835 patients admitted to the NICU, MICU, HDU and Isolation ICU, the overall mean LOS was 3.37 ± 5.54 days which was statistically significant at a p-value <0.001 (t = 17.58, 95% CI 3-3.75). The overall mean LOS was higher than the benchmarked 3.08 days but still within the optimal range of 2 to 4 days. Mean LOS was statistically significant when tested for department-wise variations with a Chi-value of 173.56 (p-value < 0.001, LR = 113.75). Highest mean LOS was observed for isolation ICU and lowest for MICU. 360 (43.1%) were short stay, 141(16.8%) were long stay and remaining were optimal stay patients.

Conclusion

The mean LOS for the ICUs varied significantly across the type of ICUs which needs to be continuously monitored. Mean LOS variation across ICU type indicates need for separate benchmarks.

How to cite this article

Shukla K, Chandrashekhar P, Kumar N, Devade PK. A Descriptive Study of Length of Stay at an Intensive Care Unit. Int J Res Foundation Hosp Healthc Adm 2015;3(1):29-32.
Adverse Drug Reaction Policy in a Tertiary Care Hospital
Authors: Aggarwal V , Gupta Shakti Kumar , Sharma DK , Arya S , Singh S
Published: September 2019

Adverse drug reactions (ADRs) are a significant cause of morbidity and mortality and contribute to the incidence of adverse events, resulting in increased healthcare costs. Healthcare providers need to understand their role and responsibility in the detection, management, documentation, and reporting of ADRs. The purpose of this study is to provide guidelines regarding the procedure of reporting ADRs to hospital authority. It was a descriptive cross-sectional study carried out between April and August 2013. The study population included doctors, nursing personnel, paramedical staff and quality managers of tertiary care hospital from one public and two private hospitals. Interaction was done with study population against the back drop of the checklist and ADR policy was formulated.

How to cite this article

Singh S, Gupta SK, Arya S, Sharma DK, Aggarwal V. Adverse Drug Reaction Policy in a Tertiary Care Hospital. Int J Res Foundation Hosp Healthc Adm 2015; 3(1):41-47.
Incidence Rates of Healthcare-associated Infections in Hospitals: A Multicenter, Pooled Patient Data Analysis in India
Authors: Chakravarthy Murali , Sengupta Sharmila , Singh Sanjeev , Munshi Neeta , Jose Tency , Chhaya Vatsal
Published: September 2019

Aim

The aim of this study was to collect the multicenter data of healthcare-associated infections (HAIs) to assess the infection control scenario in India in context with CDC/NHSN and INICC database.

Materials and methods

Four National Accreditation Board for Hospitals and Health Care Providers (NABH) accredited hospitals were selected on random basis and raw data on healthcare-associated infections—number of days and number of infections in all intensive care patients was obtained as per the CDC-NHSN definitions and formula. Three major device related infections were considered for analysis based on the prevalence of HAIs and discussions with subject matter experts. All nodal champions from each hospital were trained and common data collection sheet for surveillance in accordance to CDC-NHSN was formed. The pooled means for HAI rates and average of the pooled means for all were calculated using data from four hospitals and were compared with CDC/NHSN and international nosocomial infection control consortium (INICC) percentiles of HAIs rates.

Results

The Indian pooled mean HAI rates for all infections were above CDC/NHSN percentile threshold but below INICC percentile. Ventilator-associated pneumonia (VAP) was considered as matter of prime concern, crossing P90 line of CDC/NHSN threshold. However, no HAI rate was in limit of P25.

Conclusion

Indian HAI rates were higher when mapped with CDC threshold. This promotes the need for more standardized and evidence-based protocols been adhered to so as to bring HAI within CDC/NHSN thresholds. However, the four hospitals have better HAI rates as compared to pooled INICC database.

How to cite this article

Singh S, Chakravarthy M, Sengupta S, Munshi N, Jose T, Chhaya V. Incidence Rates of Healthcareassociated Infections in Hospitals: A Multicenter, Pooled Patient Data Analysis in India. Int J Res Foundation Hosp Healthc Adm 2015;3(2):86-90.
Hand Hygiene Policy for a Tertiary Care Hospital
Authors: Gupta Shakti Kumar , Arya Sanjay , Singh Sheetal , Aggarwal Vijay , Thuilephy T
Published: September 2019

Hand hygiene diminishes the carriage of potential pathogens on the hands. It results in reduction in patient morbidity and mortality from nosocomial infection. Eighty percent of nosocomial disease transmission is thought to be via hands. The purpose of this study is to provide policy with regard to hand hygiene which can be followed in tertiary care hospitals. It was a descriptive cross-sectional study carried out between April and August 2013. The study population included doctors, nursing personnel, paramedical staff and quality managers of tertiary care hospital from public and private hospitals. Checklist was made after an exhaustive review of literature which was then improvised. Validation of the checklist was done by experts in infection control in various private and public hospitals. Subsequently, interaction was done with study population against the back drop of the checklist and hand hygiene policy was formulated.

How to cite this article

Singh S, Gupta SK, Arya S, Aggarwal V, Thuilephy T. Hand Hygiene Policy for a Tertiary Care Hospital. Int J Res Foundation Hosp Healthc Adm 2015;3(2):103-109.
Study of the Traffic Management System at an Apex Tertiary Care Teaching Hospital and Recommendations for Improvement
Authors: Gupta Shakti Kumar , Sharma DK , Lathwal Amit , Arya Sanjay Kumar , Sahoo Mukunda Chandra
Published: September 2019

Introduction

Hospital parking services often represent the very first contact patients and visitors have with our hospital and to make a positive perception of our hospital, we need ample patient and visitor parking. Over last decade, there has been a quantum increase in workload by 6 to 7 times and a corresponding increase in the number of vehicles entering the tertiary care teaching hospital premises. Aim of traffic management at tertiary care hospital is to decongest, improve and smoothen traffic by advocating lane discipline, platooning, signal lights, parking, footpaths, reducing the number of private vehicles, efficient public transport, car pooling, etc.

Aims and objective

To study vehicular traffic management system at a Apex Tertiary Care Teaching Hospital.

Methodology

This was done by survey of the area and observation of traffic flow and its measurement. The data, thus, collected were analyzed and based on the analysis an action plan was drawn.

Conclusion

As regards parking arrangements at the tertiary care teaching hospital are concerned, there is a need to create integrated parking lots on surface as well as basement of the buildings for parking of approximately 7600 vehicles which will also take into account the future needs. These parking lots should also include multilevel intelligent parking system with a computerized system of lifts stacking each car in a berth, and thus reducing the need for parking and service personnel.

How to cite this article

Sahoo MC, Gupta SK, Sharma DK, Arya SK, Lathwal A. Study of the Traffic Management System at an Apex Tertiary Care Teaching Hospital and Recommendations for Improvement. Int J Res Foundation Hosp Healthc Adm 2015;3(2):110-113.