bluuebunny/crossref_metadata_2025 huggingface dataset:
Chemical Equilibrium between Cores, Mantles, and Atmospheres of Super-Earths and Sub-Neptunes and Implications for Their Compositions, Interiors, and Evolution
Authors: Schlichting Hilke E. , Young Edward D.
Published: May 2022

We investigate the equilibrium chemistry between molten metal and silicate and a hydrogen-rich envelope using 18 independent reactions among 25 phase components for sub-Neptune-like exoplanets. Both reactive and unreactive metal sequestered in an isolated core are modeled. The overarching effects of equilibration are oxidation of the envelope and reduction of the mantle and core. Hydrogen and oxygen typically comprise significant fractions of metal cores at chemical equilibrium, leading to density deficits that offer a possible alternative explanation for the low densities of the Trappist-1 planets. Reactions with the magma ocean produce significant amounts of SiO and H2O in the envelopes directly above the magma ocean. Molar concentrations in the envelopes of planets with reactive metal are H2 > SiO > CO ∼ Na ∼ Mg > H2O ≫ CO2 ∼ CH4 ≫ O2, while for the unreactive metal case, H2O becomes the second most abundant species, after H2, providing an arbiter for the two scenarios amenable to observation. The water abundances in the atmospheres exceed those in the mantles by at least an order of magnitude in both scenarios. The water concentrations in the silicate mantles are ∼0.01 and ∼0.1 wt% in the reactive and unreactive metal core cases, respectively, limiting the H2O that might be outgassed in a future super-Earth. Less dissolved water in the reactive core case is due to sequestration of H and O in the Fe-rich metal. The total hydrogen budget of most sub-Neptunes can, to first order, be estimated from their atmospheres alone, as the atmospheres typically contain more than 90% of all H.
Dendrocorticiopsis orientalis gen. et sp. nov. of the Punctulariaceae (Corticiales, Basidiomycota) revealed by molecular data
Authors: Wei Chia-Ling , Chen Che-Chih , He Shuang-Hui , Wu Sheng-Hua
Published: May 2022

Dendrocorticiopsis orientalis is presented in this study as a new genus and new species based on morphological and phylogenetic evidence. This new taxon is characterized by resupinate, smooth and membranaceous basidiomata, monomitic hyphal system with clamps, colorless dendrohyphidia, variable presence of cystidia, and ellipsoid to ovoid basidiospores measuring 5–7 × 3.2–5.2 μm. The phylogenetic analyses based on the ITS1-5.8S-ITS2 (ITS) + nuclear 28S rDNA (28S) dataset of Corticiales indicated that the new taxon is nested in Punctulariaceae, separated from other genera with strong support values. Descriptions, specimen photo, and illustrations of the new taxon are provided in this study. A morphological comparison of the four genera of Punctulariaceae is given.
Chapitre 7. Comment engager le citoyen dans les discussions bioéthiques et environnementales ?
Authors: Bréhaux Karine
Published: May 2022

De la problématique de la hausse du prix du gazole de quelques centimes d’euros (cf. le mouvement des Gilets jaunes), nous sommes passés à la question politique de l’impact économique de la transition écologique sur les classes sociales moyennes et surtout vulnérables. Dans ce même débat national en 2018, parmi les 32 questions posées se trouvait celle de la laïcité. La question environnementale est résolument bioéthique couplée à d’autres concepts notamment de la liberté de conscience. Elle rappelle la question rawlsienne du « comment vivre ensemble ? ». Elle fait partie intégrante des programmes politiques en cours des élections présidentielles de 2022. Comment débattre et engager le citoyen dans les discussions bioéthiques et de développement durable ?
Questionnaire MiFID et participation sur les marchés actions
Authors: Broihanne Marie-Hélène , Orkut Hava
Published: May 2022

La Directive sur les marchés d’instruments financiers (MiFID) a pour objectif de protéger les investisseurs européens. Elle impose aux prestataires de services d’investissement de collecter des informations sur leurs clients via un questionnaire. Dans cet article, nous combinons les réponses au questionnaire MiFID et les données bancaires d’environ 50 000 clients d’une grande banque commerciale en France. Nous montrons que les indicateurs MiFID, c’est-à-dire la littératie financière subjective, la tolérance au risque et les attitudes face aux pertes auto-évaluées, affectent significativement la participation sur les marchés actions tout en contrôlant divers déterminants classiques, tels que les caractéristiques sociodémographiques et la richesse nette. Nos résultats sont robustes à une approche par variable instrumentale pour la littératie financière. Classification JEL  : G02, G11, G28.
Global attractor for a partly dissipative reaction-diffusion system with discontinuous nonlinearity
Authors: Zhao Jia-Cheng , Ma Zhong-Xin
Published: May 2022

In this paper, we consider a partly dissipative reaction-diffusion system with discontinuous nonlinearity in the form

   \begin{document}$ \begin{equation*} \left\{\begin{array}{ll} u_t-\Delta u+u+w\in H_0(u-a), \\ w_t-\epsilon(u-\gamma w) = 0, \end{array}\right. \end{equation*} $\end{document}

where \begin{document}$ H_0 $\end{document} is a multi-valued function of Heaviside type. This type of system is used for describing the generation and transmission of electrical signals in neuroscience. We first present an existence result on global solutions. Then, we prove that the system possesses a global attractor having the \begin{document}$ H^r\times H^r $\end{document}-regularity \begin{document}$ (0\leq r<2) $\end{document}. Moreover, by showing the Kneser property for the system, the global attractor is proved to be connected. The main characteristic of the system is that the linear part cannot be represented as the subdifferential of a compact-type function.
The new geography of asylum: digital identity, artificial intelligence and blockchain
Authors: Terranova Giuseppe
Published: May 2022

For several years, the United Nations High Commissioner for Refugees (UNHCR) has insisted on the need to invest in new technologies to improve the procedures for the identification, reception and redistribution of asylum seekers around the world. United Nations experts have promoted new forms of digital inclusion aimed at both asylum seekers and displaced persons. They consider digital tools to be essential for achieving one of the UN Sustainable Development Goals: Target 16.9, which by 2030 intends to provide legal identity for all, including birth registration. Biometrics have been used on an experimental basis since the early 2000s to create digital identities in the humanitarian space for those vulnerable persons without traditional identity documents. It is a divisive subject. The aim of this article is to consider, from a geopolitical perspective, if following the acceleration of the digital revolution caused by the pandemic it is possible to invest in technological tools to improve the processes of identification, redistribution and reception of asylum seekers and displaced persons while at the same time respecting their privacy and freedoms. This hypothesis would signal the emergence of a geography of receiving asylum seekers on a global scale based not only on the governance of territory and borders, but also on platform governance.
A new class of ratio type estimators in single- and two-phase sampling
Authors: Dar Amber Yousaf , Saeed Nadia , Abu-Shawiesh Moustafa Omar Ahmed , Shahbaz Saman Hanif , Shahbaz Muhammad Qaiser
Published: May 2022

The estimation of a certain population characteristics is required for several situations. The estimates are built so that the error of estimation is minimized. In several situations estimation of the population mean is required. Different estimators for the mean are available but, there is still room for improvement. In this paper, a new class of ratio-type estimators is proposed for the estimation of the population mean. The estimators are proposed for single- and two-phase sampling schemes. The expressions for bias and mean square error are obtained for single-phase and two-phase sampling estimators. Mathematical comparison of the proposed estimators has been achieved by using some existing single-phase and two-phase sampling estimators. Extensive simulations have been conducted to compare the proposed estimators with some available single- and two-phase sampling estimators. It has been observed that the proposed estimators are better than the existing estimators. Consequently, the proposed ratio estimators are recommended for use by the practitioners in various fields of industry, engineering and medical and physical sciences.
Modified generalized neo-fuzzy system with combined online fast learning in medical diagnostic task for situations of information deficit
Authors: Bodyanskiy Yevgeniy , Chala Olha , Kasatkina Natalia , Pliss Iryna
Published: May 2022

In the paper, we propose the modified generalized neo-fuzzy system. It is designed to solve the pattern-image recognition task by working with data that are fed to the system in the image form. The neo-fuzzy system can work with small training datasets, where classes can overlap in a features space. The core of the system under consideration is a modification of multidimensional generalized neuro-fuzzy neuron with an additional softmax activation function in the output layer instead of the defuzzification layer and quartic-kernel functions as membership ones. The learning procedure of the system combined cross-entropy criterion optimization using a matrix version of the optimal by speed Kaczmarz-Widrow-Hoff algorithm with the additional filtering (smoothing) properties. In comparison to the well-known systems, the modified neo-fuzzy one provides both numerical and computational implementation simplicity. The computational experiments have proved the effectiveness of the modified generalized neo-fuzzy-neuron, including the situation with shot training datasets.
OBILJEŽJA VISOKOKONFLIKTNIH RAZVODA RODITELJA S MALOLJETNOM DJECOM
Authors: Majnarić Ines
Published: May 2022

CHARACTERISTICS OF HIGH-CONFLICT DIVORCES OF PARENTS WITH MINOR CHILDREN ABSTRACT Researches dealing with divorce from a psychosocial perspective highlight the child’s exposure to parental conflicts during the divorce process and the quality of co-parenting as the two most powerful factors influencing the adjustment of children to the process of divorce. Thus, the adjustment of children is particularly vulnerable in high-conflict divorces. Having this in mind, the emphasis in this paper is on an overview of the definitions of high-conflict divorce and the factors that contribute to it. A better understanding of ongoing conflict between parents can help facilitate risk assessment for developing high-conflict divorces, as well as create evidence-based prevention programs for that matter. The purpose is to undertake preventive and treatment activities to reduce the level of conflict between parents and prevent consequences for children. In addition, the need for the development of such programs is emphasized, as well as their balanced implementation in the social welfare system, through family centers and other authorized social services providers. Key words: high-conflict divorce; consequences for children; predictors; prevention
The effects of medical students’ self-oriented perfectionism on academic procrastination: the mediating effect of fear of failure
Authors: Cho Mina , Lee Yoon-Seon
Published: May 2022

Purpose: Based on the logic that self-oriented perfectionism (SOP) is one of the most well-established predictors of academic procrastination (AP), we predicted that fear of failure (FF) would mediate the association between SOP and AP. The purpose of this study is to investigate the mediating effect of FF on the influence of SOP on AP in medical students.Methods: A total of 156 undergraduate medical students completed a battery of questionnaires. This study is an analysis of cross-sectional data obtained through an offline survey. The self-report questionnaires assessed demographics and psychological scales, including the Multidimensional Perfectionism Scale, Performance Failure Appraisal Inventory, and Aitken Procrastination Inventory. The data were analyzed by descriptive statistics, correlations analysis, and multiple regression analyses using IBM SPSS ver. 22.0 (IBM Corp., Armonk, USA).Results: SOP had a direct negative influence on AP (β=-0.420, p<0.001). Also, SOP had a significant indirect effect on AP through FF (β=0.0393; 95% confidence interval, 0.040–0.0936). These results indicated that the FF partially mediates the relationship between SOP and AP.Conclusion: Although SOP among medical students might play an adaptive role to lessen AP, in cases FF gets higher, SOP could have opposing effects via the mediating effect of FF, leading to an actual increase in AP. Attempts to deal with the FF among medical students should be made for better academic achievements.
Effective online large-group teaching in health professions education
Authors: Fong Jie Ming Nigel , Tsang Li Ping Marianne , Tan Nigel Choon Kiat , Salcedo Daniel , Tan Kevin
Published: May 2022

Online large-group teaching (OLGT), employed to reach a large group of learners in separate physical locations, allows asynchronous learning and facilitates social distancing. While online large-groups can be a powerful and resource-lean means of health professions education, it has challenges and potential pitfalls that may affect the learning process and outcomes. Through a sociomateriality framework, this article describes strategies for effective online large-group teaching in health professions education in three key strands. Firstly, to optimize learning, OLGT sessions should match learning needs with appropriate OLGT platforms, incorporate strategies to sustain learner attention, and accommodate learners of different abilities. Secondly, to develop a learning culture, OLGT must not only focus on cognitive aspects of learning but also build a community of practice, nurture digital professionalism and professional identity. Thirdly, we discuss the avoidance of pitfalls such as cognitive overload of both tutors and learners, technical issues and security risks, mitigating inequities in access to online learning, and the use of program evaluation to plan for sustained improvements. We conclude with a case vignette that discusses the challenges of OLGT and the application of the above strategies in a teaching scenario.
Anselm Hüttenbrenner in Lower Styria (1853–1858)
Authors: Motnik Marko
Published: May 2022

After the Styrian composer Anselm Hüttenbrenner had largely withdrawn from public life, he spent most of his time between the autumn of 1853 and the autumn of 1858 in Maribor (Marburg). In Maribor and its surroundings he found peace of mind and a closeness to nature, devoting himself intensively to compositional and pedagogical activities. He composed numerous lieder on texts by his host Ferdinand von Rast (Hilarius) plus many piano pieces, in addition to orchestral overtures and church music. The article attempts to shed light on this period in Hüttenbrenner’s life, which has not been previously studied.
Alfred Khom in njegovo delovanje v Ljubljani
Authors: Barbo Matjaž
Published: May 2022

Alfred Khom (1825–1893), rojen v Linzu, je deloval v Celovcu, Gradcu, Volšperku, Innsbrucku in na Dunaju. V obdobju 1849–1861 se je uveljavil v Ljubljani kot dirigent, skladatelj, organist, zborovodja in glasbeni učitelj. Sodobne kritike poudarjajo njegovo umetniško občutljivost, idejno ga zaznamuje uveljavitev nadnacionalne biti avstrijske kulturne enovitosti, ki presega jezikovne meje.
Publish or Perish: A Scientific Blueprint for a Journal Article
Authors: Gottlieb Matthias , Utesch Matthias Christoph
Published: May 2022

Contributions perish due to a lack of structure and clarity. The time for framing and market is low, or knowledge about a feasible structure is missing. This article aids a framework suggestion of structuring an article to provide writers a scien-tific blueprint for most contributions to the International Journal of Engineering Pedagogy (iJEP). Therefore, we investigated to write down our expertise and knowledge on contributions in practice over many years. We look at typical mis-takes and present knowledge nuggets to avoid these. Besides, we shed light on the specific parts of an article to present editors’ expectations and present a light weighted approach for authors to quickly dive into the writing theme. Writers can apply this blueprint to sort their minds, write the structure of the contribution publishable, and shorten the time to market.
Protée au royaume de Fierabras
Authors: Deruelle Benjamin
Published: May 2022

L’imaginaire de la chevalerie est au cœur de l’identité et de l’éthos nobiliaire au début de l’époque moderne. Des cours princières européennes aux résidences nobiliaires dans les provinces, l’idéal chevaleresque est promu et présenté comme le champ d’expérience et l’horizon d’attente des gentilshommes. Ceux qui dénoncent leurs mœurs et leurs exactions usent, eux aussi, de ce référent pour mieux mettre en avant les perversions du second ordre. Mais que sait-on de cette culture de la guerre ? Elle est encore bien souvent présentée comme un bloc monolithique, enferrée dans des valeurs médiévales, désuètes et déconnectées des réalités sociales, politiques et militaires. Pourtant, l’idéal chevaleresque n’est pas un objet figé qui s’imposerait à la noblesse de la Renaissance. Ceux qui le revendiquent, s’approprient son héritage, le restaurent suivant les normes et les valeurs de leur temps, et le modèlent selon leurs intérêts et l’usage qu’ils comptent en faire. La culture chevaleresque apparaît alors dans toute sa diversité et dans toute sa complexité.
Quand l’homme devint un numéro
Authors: Belmas Élisabeth
Published: May 2022

Exceptionnels par leur richesse et leur continuité, puisqu’ils se succèdent, presque sans lacune, de 1670 au lendemain de la Première Guerre mondiale, les registres d’admission à l’Hôtel royal des Invalides ont permis d’entreprendre une enquête d’épidémiologie historique d’envergure : 47 registres, réunissant plus de 110 000 notices consignées de 1670 à 1791, ont été soumis à un sondage aléatoire au 1/10e. Les 11 528 signalements ainsi rassemblés ont permis de mieux connaître l’état de santé d’une partie de la population adulte masculine dans la France moderne. Chemin faisant, leur étude a livré également une foule d’informations de nature diverse. Ainsi l’analyse de l’organisation interne des registres a-t-elle montré comment se sont mis en place les outils administratifs d’identification des individus à l’époque moderne. En l’espace d’une dizaine d’années - de 1670 à 1680 -, les secrétaires gardes des archives sont passés d’une identification par le prénom et le patronyme à l’attribution d’un numéro matricule. C’est aux Invalides que l’homme est, semble-t-il, devenu un numéro.
150 mm SiC Engineered Substrates for High-Voltage Power Devices
Authors: Rouchier Séverin , Gaudin Gweltaz , Widiez Julie , Allibert Frédéric , Rolland Emmanuel , Vladimirova Kremena , Gelineau Guillaume , Troutot Nicolas , Navone Christelle , Berre Guillaume , Bosch Daphnée , Leow Yen Lin , Duboust Alain , Drouin Alexis , Bethoux Jean Marc , Boulet Romain , Chapelle Audrey , Cela Enrica , Lavaitte Guillaume , Bouville-Lallart Adeline , Viravaux Laurent , Servant Florence , Bhargava Shivan , Thomas Shawn , Radu Ionut , Maleville Christophe , Schwarzenbach Walter
Published: May 2022

Silicon Carbide (SiC) Power Devices have emerged as a breakthrough technology for a wide range of applications in the frame of high power electronics. Despite the continuously improving quality and supply of 4H-SiC substrates, the availability of such wafers is still insufficient. An advantageous opportunity is offered by the Smart CutTM technology with the integration of a very high quality SiC layer transferred to a low resistivity handle wafer. This bi-layer material enables a significant yield optimization and improvement of the device’s electrical performance. Moreover, an additional key feature of the Smart CutTM technology is the possibility to re-use multiple times the donor wafer, leading to reduced manufacturing costs and enabling the high volume production of SiC wafers. In this paper we report the latest advances in the development of such so called SmartSiCTM substrates.
Performance Comparison of 6.5 kV SiC PiN Diode with 6.5 kV SiC JBS and Si Diodes
Authors: Sundaramoorthy Vinoth , Mihaila Andrei , Spejo Lucas , Minamisawa Renato Amaral , Knoll Lars
Published: May 2022

6.5 kV SiC PiN diode with JTE and p+ rings termination was fabricated and characterized. The static and dynamic performance of SiC PiN diode were compared with that of SiC JBS diode and silicon diode, while switched in combination with a silicon IGBT. SiC PiN provides clear advantage while operating at higher current densities (above 100 A/cm2) and had lower leakage current. When switched together with a silicon IGBT, they contribute to losses similar to that of a SiC JBS diode.
Antigen and Immunogen: An Investigation into the Heterogeneity of Immunology Terminology in Learning Resources
Authors: Pandey Sumali , Bruns Heather A , Condry Danielle L J , Kleinschmit Adam J , Lal Archana , Sletten Sarah , Sparks-Thissen Rebecca L , Vanniasinkam Thiru , Taylor Rebekah T , Justement Louis B , Elliott Samantha L
Published: May 2022

The need to focus on immunology education has never been greater. The coronavirus disease 2019 pandemic has revealed that a significant proportion of our society is vaccine hesitant. Some of this hesitancy may stem from a general lack of understanding of how the immune system and immunological interventions work. In addition, social media platforms undercut public health efforts by quickly propagating a multitude of misconceptions and erroneous information surrounding the science behind these interventions. The responsibility to be advocates for science is well recognized by immunology researchers, educators, and public health professionals, as evidenced by the rich body of resources developed to communicate science to the lay audience. Scientific jargon, however, can be a barrier to effective communication and can negatively impact learning and comprehension. The field of immunology is especially laden with discipline-specific terminology, which can hamper educators’ efforts to convey key concepts to learners. Furthermore, a lack of consistency in accepted definitions can complicate students’ conceptual understanding. Learning resources, including textbooks, published in print or available online, and exclusively digital resources, continue to serve as the primary sources of information for both educators and students. In this article, we describe a vast heterogeneity in learning resource glossary descriptions of two key conceptual terms: antigen and immunogen. We provide a perspective on pedagogical strategies to address these critical terms. Using current knowledge, we recommend an approach to standardize the definitions of the terms antigen and immunogen within the immunology educator community.
Endoplasmic reticulum stress contributed to inflammatory bowel disease by activating p38 MAPK pathway
Authors: Long Yan , Zhao Yan , Ma Xiaoqing , Zeng Ya , Hu Tian , Wu Weijie , Deng Chongtian , Hu Jinyue , Shen Yueming
Published: May 2022

Recent evidence suggests that endoplasmic reticulum (ER) stress plays a vital role in inflammatory bowel disease (IBD). Therefore, the aim of this study was to investigate the mechanism by which ER stress promotes inflammatory response in IBD. The expression of Gro-α, IL-8 and ER stress indicator Grp78 in colon tissues from patients with Crohn’s disease (CD) and colonic carcinoma was analyzed by immunohistochemistry staining. Colitis mouse model was established by the induction of trinitrobenzene sulphonic acid (TNBS), and the mice were treated with ER stress inhibitor tauroursodeoxycholic acid (TUDCA). Then the body weight, colon length and colon inflammation were evaluated, and Grp78 and Gro-α in colon tissues were detected by immunohistochemistry. Epithelial cells of colon cancer HCT116 cells were treated with tunicamycin to induce ER stress. Grp78 was detected by Western blot, and chemokines were measured by PCR and ELISA. The expression levels of Grp78, Gro-α and IL-8 were significantly upregulated in intestinal tissues of CD patients. Mice with TNBS induced colitis had increased expression of Grp78 and Gro-α in colonic epithelia. TUDCA reduced the severity of TNBS-induced colitis. In HCT116 cells, tunicamycin increased the expression of Grp78, Gro-α and IL-8 in a concentration-dependent manner. Furthermore, p38 MAPK inhibitor significantly inhibited the upregulation of Gro-α and IL-8 induced by tunicamycin. In conclusion, ER stress promotes inflammatory response in IBD, and the effects may be mediated by the activation of p38 MAPK signaling pathway.
Randomized controlled trial of multidisciplinary rehabilitation therapy using mobile applications in cases of ankle fractures
Authors: Kasnakova Petya , Mihaylova Anna , Djurdjev Boris , Tornyova Biyanka
Published: May 2022

A multidisciplinary approach to rehabilitation in patients with ankle fractures is needed to return to their daily activities. Mobile health applications can improve or optimize the rehabilitation process. The purpose of this study is to monitor the efficiency of a modified and validated rehabilitation scheme for the functional rehabilitation of the lower limbs. The subjects of the study are patients in the post-immobilization and post-operative period. The algorithm of procedures administered to the patients were performed by physiotherapists and monitored via mobile apps. The results show a reduction of the swelling and the pain, overcoming the muscular imbalance, enhanced stabilization, correct way of walking, and an improved quality of life of the patients with ankle fractures. Despite a certain trend towards residual deficit, the implementation of kinesitherapeutic means creates the necessary background on the basis of which specialized methods can be applied – joint-mobilizing techniques and passive stretching, for the purpose of the full recovery of the functions of the lower extremity. The application of mobile apps optimizes the recovery process and increases access to rehabilitation.
Evaluation of the Family Liaison Officer role during the COVID-19 pandemic
Authors: Hughes Luke , Anderton Lisa , Taylor Rachel
Published: May 2022

Communication within healthcare settings is often a subject of contention for patients’ families at the best of times; however, contention was greatly magnified in the United Kingdom by restrictions on hospital visitations during the early stage of the COVID-19 pandemic. To support communication between families and patients, a central London hospital introduced the role of the family liaison officer (FLO). This study was designed to evaluate the rapid implementation of the FLO and to explore potential for it to become a standard role. Semi-structured interviews were conducted with five FLOs and seven colleagues who had worked alongside them between April and June, 2020. Two versions of the role emerged based on FLOs’ previous background: clinical (primarily nurses) and pastoral (primarily play specialists). The FLO became a key role during the pandemic in facilitating communication between patients, clinical teams, and families. Challenges associated with the role reflect the speed in which it was implemented. It was evident to those in the role, and clinicians who the role was supporting, that it had potential to help improve hospital communication and the work of healthcare staff beyond the pandemic.
The Lay knowledge regarding the prevention of complications related to childbirth: Perceptions of Congolese pregnant women
Authors: Tshiama Claudine , Bongo Gédéon , Nsutier Oscar , Babintu Mukandu Basua
Published: May 2022

During pregnancy, women sometimes choose certain practices based upon the experience of their family and/or their vicinity to anticipate complications that may occur during childbirth. The main objective of this study is to understand the motivations and perceptions of pregnant women on lay knowledge in the prevention of complications related to childbirth among a sample of Congolese women. We conducted this study at N’djili Referral Hospital in Kinshasa, Democratic Republic of Congo, using a qualitative phenomenological survey and indepth face-to-face interviews. We interviewed seven women on the phenomenon of lay knowledge practice in the prevention of maternal difficulties and analyzed the data using thematic coding. We provided a consent form to the participants and were careful not to include identifying information. Three main themes emerged: i) discussion of complications related to pregnancy and delivery, ii) perceptions about lay knowledge in preventing complications related to childbirth, and iii) suggestions from participants about using lay knowledge in healthcare settings. Based upon data collected, we argue that lay knowledge about pregnancy can be integrated into formal antenatal training when appropriate and, in doing so, we can build trust among pregnant women toward professional medical instruction.
Total Metabolic Regression after Everolimus in an Adult Patient with Pseudomyogenic Hemangioendothelioma
Authors: Huang Derek De-Rui , Liao Yi-Hua , Lee Jen-Chieh , Chen Tom Wei-Wu
Published: May 2022

Pseudomyogenic hemangioendothelioma (PHE) is a rare vascular tumor harboring the pathognomonic SERPINE1-FOSB fusion. Most patients are treated primarily with surgical resection, but some patients require systemic therapy due to multiple metastases at initial presentation or multifocal recurrence after definitive resection. The most optimal treatment strategy for the disease has yet to be clearly defined; however, mammalian target of rapamycin inhibitors show promise-given–reported anecdotal responses from case reports of pediatric patients. We present an adult patient with multifocal PHE who was successfully treated with everolimus with a significant clinical response.
A Comparative Study of Sodium Bicarbonate and Hyaluronidase on Pain Perception, Anesthesia, and Akinesia during Peribulbar Anesthesia for Cataract Surgery
Authors: Sodani Priyanka , Dogra Sandeepika , Raj Dev , Bhagat Vabita
Published: May 2022

Background:

An ideal anesthetic solution should provide good anesthesia and akinesia with minimal pain on injection.

Aims:

The aim of this study is to determine the effect on pain perception and efficacy of sodium bicarbonate over hyaluronidase in the local anesthetic mixture during peribulbar anesthesia.

Settings and Design:

A prospective, randomized, double-blind study.

Materials and Methods:

An independent observer labeled two injections as A (hyaluronidase 1500 IU in 30 mL of lignocaine) and B (7.5% sodium bicarbonate 1 mL in 30 mL of lignocaine). Group 1 was injected with injection A while Group 2 was injected with injection B. The visual analog scale (VAS) was used to determine the intensity of pain. Onset and degree of anesthesia and akinesia were recorded.

Statistical Analysis:

Computer software Microsoft Excel SPSS version 26 (Chicago Inc) for windows was used. The qualitative data and quantitative data were reported as proportions and mean ± (standard deviation), respectively. Chi-square test for proportions was used for the comparison of qualitative variables and unpaired Student's t-test was used to test the significance between quantitative variables. P < 0.05 was considered statistically significant. All P were two-tailed.

Results:

Out of 123 patients, 23 were excluded from the study. Hundred patients were divided into Group 1 and Group 2. The mean age in Group 1 was 64.92 ± 10.77 years while in Group 2 was 62.86 ± 11.17 years. The mean heart rate and mean systolic blood pressure in both groups were statistically insignificant. Group 2 experienced very less pain (mean pain score VAS = 5.12 ± 1.17) as compared to Group 1 (mean pain score was 7.16 ± 1.09) and the difference between both the groups was found to be statistically significant. There was a significant difference in the onset of anesthesia in both groups (P = 0.001). In the sodium bicarbonate group, the onset was faster. The onset of akinesia was better in Group 1 (4.76 ± 2.06 min). Grading of akinesia was better in Group 1.

Conclusion:

Sodium bicarbonate reduces pain on injection in peribulbar anesthesia and also results in a quicker onset of anesthesia.
Early versus Late Tracheostomy in Patients with Acute Brain Injury
Authors: Shekhar Saurav , Singh Raj Bahadur , De Ranjeet Rana , Singh Ritu , Akhileshwar  , Kumar Nitin
Published: May 2022

Introduction:

Patients with acute brain injury presents are unique subset of neurocritical care patients with its long-term functional prognosis difficult to determine. They often have long intensive care unit (ICU) stay and presents as challenge to decide when to transfer out of ICU. This prospective study aims to assess the benefits of early tracheostomy in terms of ICU-length of stay (ICU-LOS), number of days on ventilator (ventilator days), incidence of ventilator-associated pneumonia (VAP), and mortality rates.

Materials and Methods:

After institutional ethical clearance, 80 patients were randomized into two groups: Group A, early tracheostomy group (tracheostomy within 3 days of intubation) and Group B, standard of care group (tracheostomy after 10 days of intubation: late tracheostomy). A cutoff of 10 in the SET score was used in predicting need of early tracheostomy; both groups were compared with respect to ICU-LOS, number of ventilator days (ventilation time), need of analgesia and sedation, incidence of VAP, and mortality data.

Results:

Both the groups were comparable in terms of demographic profile and various disease severity scores. ICU-LOS was 14.9 ± 3.6 days in Group A and 17.2 ± 4.6 in Group B. The number of days on ventilator and incidence of VAP was significantly lower in Group A as compared to Group B. There was significantly lower mortality in Group A subset of patients in ICU.

Conclusion:

SET score is a simple and reliable score with fair accuracy and high sensitivity and specificity in predicting need of tracheostomy in neurocritical patients. A cutoff of 10 in the score can be reliably used in predicting need of early tracheostomy as in few other studies. Early tracheostomy is clearly advantageous in neurocritical patients, but has no advantage in terms of long-term mortality rates.
RHCE*E and RHCE*e genotype incompatibility in a southern Thai Muslim population
Authors: Tanwarawutthikul Poonyapa , Intharanut Kamphon , Mitundee Supattra , Nathalang Oytip
Published: May 2022

CONTEXT:

The formation of red cell alloantibodies resulting from both transfusion and pregnancy can cause adverse effects from allogeneic blood transfusions. Alloanti-E is commonly detected among Thai and Asian populations.

AIMS:

This study aimed to determine RHCE*E and RHCE*e genotype incompatibility in a southern Thai Muslim population and to compare it with those previously reported for other populations.

SUBJECTS AND METHODS:

Nine hundred and twenty-seven DNA samples obtained from 427 unrelated healthy blood donors from southern Thai Muslims and 500 samples from Central Thais were included. Samples were genotyped for RHCE*E and RHCE*e using an in-house polymerase chain reaction with the sequence-specific primer technique.

RESULTS:

Significant differences were found when we compared the allele frequencies of the RHCE*E and RHCE*e between southern Thai Muslims and Central Thais: RHCE*E 0.162 versus 0.197 and RHCE*e 0.838 versus 0.803 and also found in Chinese, American native, Japanese, Korean, Alaskan native, Hawaiian, South Asian, Brazilian Japanese-descendant, and Malay Malaysian populations (P < 0.05). In addition, the E/e incompatibilities among southern Thai Muslims and Central Thais were 24.23% and 26.71%, respectively.

CONCLUSIONS:

This study was the first to determine the RHCE*E and RHCE*e genotype incompatibility among southern Thai Muslims, enabling the estimation of their potential alloimmunization risk. These data could be useful to provide safe blood transfusions across ethnic populations.
Is the curriculum of transfusion medicine in MBBS aligned with practical needs: A point of view of fresh graduates
Authors: Saleem Umera , Naveed Muhammad Asif , Samiullah Muhammad , Tanveer Urwah , Alam Shahroz , Zafar Ahmed Faraz , Safdar Sohail
Published: May 2022

OBJECTIVE:

The objective of the study is to assess the satisfaction level of doctors regarding their competence in the blood transfusion process and their reflection on training at the undergraduate level.

BACKGROUND:

Transfusion errors due to suboptimal knowledge and lack of training can lead to grave outcomes. Therefore, to optimize patient care, a thorough understanding of transfusion medicine basics is highly imperative for all medical graduates.

METHODOLOGY:

This survey was conducted online through Google forms with a questionnaire consisting of 15 questions. 8 medical colleges (4 government and 4 private) were selected by random cluster sampling technique. Data were analyzed with SPSS version 23.

RESULTS:

Of 502 participants, 53.8% were females and 69.9% were graduates of public medical colleges. About 84.6% did not receive any formal training on transfusion during graduation. Almost 82% felt that the current curriculum is not designed to meet their practical needs of blood transfusion and 52% agreed that knowledge of transfusion medicine is required for undergraduates. The survey also revealed that 70.5% of participants believed that whole blood is required for most patients and 49.8% did not feel confident to manage transfusion-related complications by themselves.

CONCLUSION:

Our survey showed that our undergraduate curriculum is not aligned with the practical transfusion needs of a young doctor. As transfusions are being carried out by these young doctors, this needs to be addressed by revising the current curriculum and incorporating teaching and hands-on training to our medical graduates.
Alterations in blood component utilization in a tertiary care hospital in eastern India in the COVID-19 pandemic
Authors: Das Sudipta Sekhar , Biswas Rathindra Nath
Published: May 2022

BACKGROUND:

With shortages of blood globally in the COVID-19 pandemic, many hospitals and blood centers have successfully implemented blood conservation strategies and strategies to maintain blood donations and blood inventory. Here, we reported our experience of utilization of blood components for transfusion in the current COVID-19 pandemic and discussed the patient blood management (PBM) methods and importance of judicious blood usage in any pandemic.

MATERIALS AND METHODS:

The retrospective study of 8 months was divided into pre-COVID and COVID periods. Parameters that included number of blood requisitions, blood components reserved and transfused, clinical speciality wise blood usage in both the periods were analysed. Blood utilization indices were computed using recommended equations.

RESULTS:

We observed an unusual pattern of blood utilization with significant disruption on blood supply and demand chain in this pandemic. A mean drop of 50.7% blood requisitions was observed in the COVID period. The period observed transfusion of 3608 units of blood components with a mean drop of 49.7% when compared to pre-COVID period. Mean drop of 46.6%, 54.4%, 53.4% and 52.7% were observed in packed red blood cell, fresh frozen plasma, platelet concentrate and cryoprecipitate transfusions in the COVID period. Blood component utilization was significantly reduced in most clinical specialities. The mean cross match to transfusion ratio in the COVID period was 1.28 with a mean increase in transfusion probability and transfusion index by 18.2% and 22.2% respectively.

CONCLUSION:

Although a constant transfusion support was needed in few clinical specialities throughout the pandemic, strict adherence to PBM protocols and practice of first in, first out method of blood dispensing helped the blood centre to support all patients needing blood transfusion.
Comparison of efficacy of filter paper cyanmethemoglobin method with automated hematology analyzer for estimation of hemoglobin
Authors: Kumar Lalit , Kangle Ranjit
Published: May 2022

BACKGROUND:

Screening of hemoglobin (Hb) before blood donation is one among the vital tests. It is performed to select a blood donor to prevent the collection of blood from an anemic person. However, no accurate, cost-effective, reliable, and standardized method is available to estimate Hb.

OBJECTIVE:

The aim is to evaluate the efficacy of filter paper cyanmethemoglobin (FPCH) method with the automated hematology analyzer in the estimation of Hb concentration for screening of a suitable donor.

METHODOLOGY:

This was a cross-sectional study in which the blood samples of 2000 patients visiting KLE's Dr. Prabhakar Kore Charitable Hospital, Belagavi, were collected in vials and directly estimated for Hb using automated hematology analyzer. To evaluate the efficacy of FPCH, 20 μL of blood sample was transferred onto Whatman filter paper and dried at room temperature. After drying, it was placed in 5 mL of Drabkin's solution for 30 min. Optical density was estimated by measuring the absorbance. Data were analyzed using SPSS version 20. The correlation coefficient, paired t-test, and difference between the means of both the methods were calculated.

RESULTS:

The mean Hb estimated by FPCH was 11.25 g/dL and automated hematology analyzer gave 11.35 g/dL. The difference in the means of both the methods was 0.1 g/dL. Paired t-test was done to test the level of significance and the result was 8.151 (95% confidence interval: 0.08–0.13 g/dL, P < 0.001). The correlation coefficient was found to be 0.976 (P < 0.001).

CONCLUSION:

FPCH is an efficient method, which is comparable to the automated hematology analyzers for Hb estimation. It could be used as an alternative screening tool for detection of Hb in a blood donation camp.
Comparative study between isolated medial meniscus root repair versus open-wedge high tibial osteotomy versus combined approach in patients with root tears, 2-year follow-up
Authors: Waly Ahmed H.T.
Published: May 2022

Background

Medial meniscus root tears usually lead to loss of hoop tension of the meniscus and result in high-contact pressure in the medial compartment of the knee. Surgical management of those types of tears is mandatory to restore hope tension and to save medial compartment. This study was done to evaluate the necessity of medial root repair with high tibial osteotomy (HTO) for treatment of medial meniscus root tears.

Patients and methods

This is a prospective comparative study over 60 patients with medial meniscal root tears. The patients were classified randomly into three groups. The first group (group A) was treated with isolated medial meniscus posterior root tear repair (n=20). The second group (group B) was treated with isolated open-wedge high HTO (n=20). The third group (group C) was treated using combined medial meniscal root repair with high tibial open-wedge osteotomy (n=20). A clinical evaluation was made using range of motion (ROM) and pain assessment. Functional evaluation was done using Lysholm score and Hospital for Special Surgery score. Radiological evaluation was done using follow-up standing Lyon–Schuss films.

Results

Regarding the patients’ reported outcome measures, one-way analysis of variance was calculated to compare means between the three groups. The results of isolated root repair were the worst and there was no statistically significant difference between groups B and C.

Conclusion

Results recommend isolated HTO as a solo fast-attack procedure with reliable durable clinical and radiological outcomes for the treatment of root tears of the posterior horn of the medial meniscus.
Marked Response to Chemoimmunotherapy in a Patient with Follicular Lymphoma of Huge Mesenteric Lymphadenopathy
Authors: Li Chia-Chen , Yu Shan-Chi , Kuo Sung-Hsin
Published: May 2022

Follicular lymphoma (FL) is the most common subtype of indolent non-Hodgkin's lymphomas. We present the case of a 57-year-old woman who initially complained of abdominal fullness and unintentional weight loss. A computerized tomography scan disclosed a huge mesenteric mass and confluent lymphadenopathy in the paraaortic area, and the pathological diagnosis of a paraaortic lymph node biopsy showed histological Grade 1–2 FL. She received chemoimmunotherapy, including rituximab plus cyclophosphamide, vincristine, and prednisolone, for Ann Arbor Stage III FL disease accompanied by compression symptoms, and achieved a nearly complete remission after completing eight cycles of chemoimmunotherapy. She is currently receiving maintenance rituximab therapy.
Utility of the annular closure device in the treatment of degenerative disc disease
Authors: Ganeshkumar Akshay , Narwal Priya , Phalak Manoj , Katiyar Varidh , Sharma Ravi , Borkar Sachin Anil , Kale Shashank Sharad
Published: May 2022

Lumbar degenerative disc disease is a common etiology of lower backache and resulting morbidity, severe disease can even result in neurological deficits. Recurrence occurs even after surgical treatment and results in poor prognosis, loss of productivity, and increased healthcare costs. Novel methods to tackle this based on countering plausible biomechanical reasons for recurrence have emerged including the recently investigated Annular Closure Device (ACD). Few RCTs and numerous comparative studies and post-hoc analyses have evaluated its safety, efficacy, and health economics; this review aims to provide an objective overview of the ACD. It was observed that ACD use was associated with significantly lower reoperations and re-herniations while having comparable or slightly higher complication rates and significantly saving direct and indirect costs. Leg pain and Back pain at follow-up were comparable between ACD and control groups. TSA objectively reveals the need for more data to ascertain ACD safety and efficacy. ACD usage has been shown to reduce re-herniations, reoperations while having comparable back pain and complication rates; thus having a positive health economics benefit. This should encourage more widespread adoption of ACD which would function to reduce the data gap.
Delayed C5 palsy following anterior cervical discectomy and arthroplasty – Rare presentation of two cases by an unusual phenomenon of “flosealoma”
Authors: Srikantha Umesh , Hari Akshay , Lokanath Yadhu K , Somasundar Deepak , Rao Shilpa
Published: May 2022

Hemostatic agents are commonly used in neurosurgical procedures with often exceptionally low complication rates. Rarely, they may cause neurological deficits secondary to pressure effect on neurologic structures, especially when applied within narrow bony cavities. We would like to report two cases of delayed unilateral C5 palsy following anterior cervical discectomy and arthroplasty for a C5–C6 cervical disc herniation. Clinical presentation was identical in both cases, with left deltoid and bicep weakness and left-arm pain without myelopathy symptoms, although with the unusual imaging findings of a new left C4–C5 foraminal lesion. An additional emergency posterior minimally invasive cervical laminoforaminotomy was carried out to decompress the nerve. The weakness improved fully within 2 months after the second surgery. This case report highlights the importance of strong clinical suspicion for a possible lesion as a cause of postoperative C5 palsy. In this case, it was due to an unusual phenomenon where flowable hemostatic agent used in the first surgery had migrated superiorly leading to nerve compression away from the primary level.
Bloch’s theorem for heat mappings
Authors: Cortissoz Jean C.
Published: May 2022

In this paper we give a proof via the contraction mapping principle of a Bloch-type theorem for (normalised) heat Bochner–Takahashi

K

-mappings, that is, mappings that are solutions of the heat equation, and which also satisfy a weak form of

K

-quasiregularity. We also provide estimates from below for the radius of the univalent balls covered by this family of functions.