bluuebunny/crossref_metadata_2025 huggingface dataset:
Canto 61
Authors: Twitchell-Waas Jeffrey
Published: January 2024

Canto 61 brings the Chinese History Cantos to an appropriate culmination, an ideogrammatic representation of the peaceful and prosperous reign of the Manchu emperor, Yong Tching (1723-35), demonstrating Confucian principles in action. Three primary thematic strands bind the canto together, drawing together the main arguments of the Chinese Cantos overall. First, tradition and continuity, with particular emphasis on filial piety, based on natural affection which socialized becomes the foundation of social cohesion and balance. Secondly, the theme of good governance as manifest in public works, sound economic policies, the proper recognition of civic talent and legal justice. Thirdly, the anti-social forces that oppose good governance are in this canto particularly represented by an alien and imperialistic Christianity. By focusing on a relatively short period of time, in contrast to the historical sweep that characterizes the preceding Chinese Cantos, Canto 61 effectively highlights and balances the key motifs of Pound's ethical view of governance. The Chinese Cantos present the macro historical framework for the following Adams Cantos' presentation of a specific individual actively translating Confucian values into a different time and culture.
Canto 67
Authors: Eyck David Ten
Published: January 2024

The chapter first considers the unique, controversial role of the Adams Cantos (62-71) overall, completed in 1939, citing critics who dismiss them as rushed, opaque, and politically suspect, as well as those who praise their inventive documentary poetics, non-traditional approach to American history, and creative use of textual space. Then Ten Eyck describes Canto 67 as the centrepiece of the Adams Cantos, as it covers John Adams’s activity and writing from 1775 to 1787, essentially from the start of the American Revolution through debates over the U.S. Constitution. The chapter demonstrates why, far from being tangential, the Canto artistically and conceptually serves to build on Pound’s economic and social vision, even as it establishes a poetics for the Pisan Cantos.
Cantos 72–73
Authors: Ricciardi Caterina
Published: January 2024

Cantos 72 and 73 were written in Italian in 1944-45. Pound was addressing an Italian audience to encourage the final resistance of the entrenched Fascist regime in Northern Italy against the advancing Allied troops. Pound reverts to the diction and meter of his favorite authors Dante and Guido Cavalcanti. He tells of meeting the ghost of his associate Marinetti, impresario of Futurism, and discussing their long careers. Marinetti gives way to a Medieval character out of Dante’s Divine Comedy, Ezzelino, who angrily denounces Italy’s enemies. In Canto 73, Cavalcanti’s ghost recounts the fabricated episode of a young woman of Rimini who allegedly perpetrated a suicide attack by leading a group of enemy Canadian soldiers into a mined field, and therefore deserves honor among heroes. Cantos 72-73 are among Pound’s most eloquent and perspicuous; his Italian is peculiar but effective; as always, he joins personal allusions (to his acquaintances and career) with history at large.
Canto 76
Authors: Mead Henry
Published: January 2024

This chapter offers a close reading of Pound’s Canto 76. Noting Pound’s intention to write a modern Paradiso to round off his epic ‘containing history’, the reading traces his efforts to weave multiple historical and mythic references into textual integrity. These include allusions to historical figures like Cunizza da Romana and Caterina Sforza, merged with Pound’s memories of times in Paris and Venice. Pound’s fight to remember moments of symbolic value, representative of a tradition of ‘light-worship’, is manifest in the fragmenting text, completed during Pound’s spell of imprisonment as a traitor at the Disciplinary Training Center in Pisa. The chapter picks out themes of elegy, mourning, hope, and anger at the fascist defeat, and traces Pound’s determination to complete his work in tribute to a seemingly lost European culture, and an ideal city ‘in the mind indestructible’.
Canto 81
Authors: Bush Ronald
Published: January 2024

Canto 81 is not only the most celebrated but also the richest and most textually complicated of all Pound’s Cantos. Descended from a series of Italian drafts that touch on the philosophical paradise Ezra Pound had observed in Cavalcanti’s “Donna mi pregha,” the Canto enacts a crucial moment of illumination in The Pisan Cantos.
Testing He ii Emission from Wolf–Rayet Stars as a Dust Attenuation Measure in Eight Nearby Star-forming Galaxies
Authors: Maschmann Daniel , Leitherer Claus , Faisst Andreas L. , Lee Janice C. , Minsley Rebecca
Published: January 2024

The ability to determine galaxy properties such as masses, ages, and star formation rates robustly is critically limited by the ability to measure dust attenuation accurately. Dust reddening is often characterized by comparing observations to models of either nebular recombination lines or the UV continuum. Here, we use a new technique to measure dust reddening by exploiting the He ii
λ1640 and λ4686 emission lines originating from the stellar winds of Wolf–Rayet stars. The intrinsic line ratio is determined by atomic physics, enabling an estimate of the stellar reddening similar to how the Balmer lines probe gas-emission reddening. The He ii line ratio is measured from UV and optical spectroscopy using the Space Telescope Imaging Spectrograph on board the Hubble Space Telescope for eight nearby galaxies hosting young massive star clusters. We compare our results to dust reddening values estimated from UV spectral slopes and from Balmer line ratios and find tentative evidence for systematic differences. The reddening derived from the He ii lines tends to be higher, whereas that from the UV continuum tends to be lower. A larger sample size is needed to confirm this trend. If confirmed, this may indicate an age sequence probing different stages of dust clearing. Broad He ii lines have also been detected in galaxies more distant than in our sample, providing the opportunity to estimate the dust reddening of the youngest stellar populations out to distances of ∼100 Mpc.
Incidental finding of lung carcinoma invading the left atrium
Authors: Koleva N. , Petkov K. , Takov S. , Angelov K.
Published: January 2024

We report a clinical case of a 64-year-old male with known apical hypertrophic cardiomyopathy, who presented to the hospital with new-onset persistent atrial fibrillation. An electrical cardioversion (ECV) was planned after one month of anticoagulation therapy and transesophageal echocardiogram (TEE) was performed beforehand. During the TEE thrombus in the left atrial appendage was detected, as well as a heterogeneous, hyperechoic, vascularized and non-mobile structure in the left atrium (LA). The ECV was cancelled and the patient was sent for computerized tomography (CT) chest scan. It revealed a big mass in the right lung with macromorphology of central lung carcinoma. There was tumor infiltration of the pericardium and the LA, as well as adrenal and liver metastases. The patient was sent for bronchoscopy with biopsy.
Quelle est l’influence du milieu familial d’origine sur le revenu des jeunes adultes ?
Authors: Sicsic Michaël
Published: January 2024

Nous mesurons dans cet article le rôle du contexte familial dans la formation des revenus des individus à partir de deux méthodes complémentaires. Nous montrons d’abord que, si les revenus des parents en sont le principal déterminant observable, seule une faible part (un peu moins de 10 %) de la variabilité des rangs des jeunes adultes d’environ 28 ans est expliquée par les variables observables des parents. À partir des revenus de fratries, on estime ensuite qu’environ 25-30 % de la variation des revenus d’un individu seraient liés à l’influence globale de son milieu familial d’origine. Les variables inobservables comme l’éducation familiale ou le patrimoine culturel et génétique auraient donc plus d’influence que les variables observables des parents comme le revenu. Classification JEL  : J62, D1, D31, H0.
Diversity and antimicrobial activity of the tropical ant-derived actinomycetes isolated from Thailand
Authors: Tunvongvinis Tuangrat , Jaitrong Weeyawat , Samung Yudthana , Tanasupawat Somboon , Phongsopitanun Wongsakorn
Published: January 2024

Antibiotic resistance is one of the most important global healthcare challenges and is responsible for the mortality of millions of people worldwide every year. It is a crisis attributed to misuse of antibiotics and a lack of new drug development. Actinomycetes constitute a group of Gram-positive bacteria known for their distinctive high guanine-cytosine (G+C) content in their genomic DNA. These microorganisms are widely recognized for their capability to generate a wide range of secondary metabolites with diverse biological activities. These versatile microorganisms are ubiquitous in diverse ecosystems, including soil, freshwater, marine sediments, and within the bodies of insects. A recent study has demonstrated that social insects, such as ants, host a diverse array of these bacteria. In this study, we involved the isolation and characterization of a total of 72 actinomycete strains obtained from 18 distinct ant species collected from various regions across Thailand. Utilizing 16S rRNA gene analysis, these isolated actinomycetes were classified into four distinct genera: Amycolatopsis (2 isolates), Micromonospora (1 isolate), Nocardia (8 isolates), and Streptomyces (61 isolates). Among the Streptomyces strains, 23 isolates exhibited antimicrobial activity against a panel of Gram-positive bacteria, including Bacillus subtilis ATCC 6633, Staphylococcus epidermidis ATCC 12228, Staphylococcus aureus ATCC 25923, Kocuria rhizophila ATCC 9341, and Methicillin-resistant Staphylococcus aureus (MRSA) DMST 20646. Additionally, two isolates displayed antifungal activity against Candida albicans TISTR 5554. Based on 16S rRNA gene sequence similarity studies, these two isolates, ODS25 and ODS28, were demonstrated to be closely related to Streptomyces lusitanus NBRC 13464T (98.07%) and Streptomyces haliclonae DSM 41970T (97.28%), respectively. The level of 16S rRNA gene sequence similarity below 98.65% cutoff indicates its potential as a novel actinomycete species. These findings underscore the potential of actinomycetes sourced from ants as a valuable reservoir of novel antimicrobials.
Optimal contests with incomplete information and convex effort costs
Authors: Zhang Mengxi
Published: January 2024

I investigate the design of effort‐maximizing mechanisms when agents have both private information and convex effort costs, and the designer has a fixed prize budget. I first demonstrate that it is always optimal for the designer to utilize a contest with as many participants as possible. Further, I identify a necessary and sufficient condition for the winner‐takes‐all prize structure to be optimal. When this condition fails, the designer may prefer to award multiple prizes of descending sizes. I also provide a characterization of the optimal prize allocation rule for this case. Finally, I illustrate how the optimal prize distribution evolves as the contest size grows.
Worst‐case equilibria in first‐price auctions
Authors: Gretschko Vitali , Mass Helene
Published: January 2024

The usual analysis of bidding in first‐price auctions assumes that bidders know the distribution of valuations. We analyze first‐price auctions in which bidders do not know the precise distribution of their competitors' valuations, but only the mean of the distribution. We propose a novel equilibrium solution concept based on worst‐case reasoning. We find an essentially unique and efficient worst‐case equilibrium of the first‐price auction that has appealing properties from both the bidders' and the seller's point of view.
Asset bubbles and product market competition
Authors: Queirós Francisco
Published: January 2024

This paper studies the interplay between asset bubbles and product market competition. It offers two main insights. The first is that imperfect competition creates a wedge between interest rates and the marginal product of capital. This makes rational bubbles possible even when there is no overaccumulation of capital. The second is that when providing a production subsidy, bubbles stimulate competition and reduce monopoly rents. I show that bubbles can destroy efficient investment and have ambiguous welfare consequences. However, when they stimulate competition, they can have crowding‐in effects on capital.
Exploiting social influence in networks
Authors: Nora Vladyslav , Winter Eyal
Published: January 2024

We study binary action network games with strategic complementarities. An agent acts if the aggregate social influence of her friends exceeds a transfer levied on the agent by a principal. The principal seeks to maximize her revenue while inducing everyone to act in a unique equilibrium. We characterize optimal transfers showing that agents who are more popular than their friends receive preferential treatment. Our main result is that under mild conditions complete core‐periphery networks deliver the highest revenue to the principal. Furthermore, we show that the revenue is higher in networks where links are allocated unequally across agents. Hence, the principal benefits from creating “influentials” by linking well‐connected hubs to less popular periphery.
Optimal delegation and information transmission under limited awareness
Authors: Auster Sarah , Pavoni Nicola
Published: January 2024

We study the delegation problem between a principal and an agent, who not only has better information about the performance of the available actions but also superior awareness of the set of actions that are actually feasible. We provide conditions under which the agent finds it optimal to leave the principal unaware of relevant options. By doing so, the agent increases the principal's cost of distorting the agent's choices and increases the principal's willingness to grant him higher information rents. We further show that the principal may use the option of renegotiation as a tool to implement actions that are not describable to her at the contracting stage. If the agent renegotiates, his proposal signals information about the payoff state. Due to her limited awareness, the principal makes a coarse inference from the agent's recommendations and, as a result, accepts a large number of the agent's proposals, which ultimately benefits both.
Optimal sequential contests
Authors: Hinnosaar Toomas
Published: January 2024

I study sequential contests where the efforts of earlier players may be disclosed to later players by nature or by design. The model has many applications, including rent seeking, R&D, oligopoly, public goods provision, and tragedy of the commons. I show that information about other players' efforts increases the total effort. Thus, the total effort is maximized with full transparency and minimized with no transparency. I also show that in addition to the first‐mover advantage, there is an earlier‐mover advantage. Finally, I derive the limits for large contests and discuss the limit to perfectly competitive outcomes under different disclosure rules.
Étudier l’immersion en laboratoire : Quand les chercheurs s’interposent entre le jeu et le joueur
Authors: Ludens Homo
Published: January 2024

Depuis deux décennies, on assiste à la multiplication des études en laboratoire cherchant à comprendre l’impact de diverses caractéristiques d’un jeu vidéo sur l’immersion du joueur à l’aide d’appareils de biométrie parfois inconfortables et intimidants. Le groupe de recherche Homo Ludens s’est intéressé aux effets d’une telle médiation sur l’expérience des joueurs et plus particulièrement sur leur concentration, leur engagement et leur immersion. Dans ce chapitre, nous présentons les résultats assez surprenants de notre recherche : le contexte de jeu en laboratoire et le recours à des instruments de biométrie n’ont pas nui à l’immersion des participants, mais ont, au contraire, favorisé la focalisation de leur attention sur le jeu et leur sentiment de transport dans l’environnement vidéoludique. Nous explorons alors différentes pistes d’explications pour éclairer ces résultats en nous appuyant sur des différentes théories en études du jeu. Nous suggérons finalement une série de précautions que les chercheurs peuvent prendre pour minimiser les effets de leur médiation dans le cadre d’une recherche en laboratoire impliquant des joueurs.
Icodologie du métajeu vidéo
Authors: Dalleu Estelle
Published: January 2024

Le jeu vidéo noue une relation particulière au réflexif et au métaleptique. Lorsqu’on examine les diverses manières de se saisir de la problématique du métajeu vidéo, on remarque que l’objet vidéoludique est encore bien souvent cerné entre ludologie et narratologie. Or, il n’est pas question que de mécaniques de gameplay, d’affordance de l’image ou du réinvestissement d’une figure de style littéraire. Le jeu vidéo, c’est aussi une corrélation à la vue, ce qu’indique la présence même du mot vidéo. À quel rapport à l’écran et aux images est-on exposé devant un jeu vidéo dont le propos est la réflexivité ? On souhaite s’attacher ici à une voie moins explorée, qui atténuerait la part du jeu pour mieux s’attacher au voir et plus spécifiquement à une exploration des codes iconologiques du jeu vidéo.
Le jeu vidéo comme espace de réflexivité et de construction discursive : retour sur Gamer Très Accro, un atelier d’expression vidéoludique
Authors: Verbesselt Maxime
Published: January 2024

Cet article décrit et analyse le déroulement et les résultats d’un atelier de création de jeu vidéo dans le cadre d’un projet d’éducation aux médias porté par Action Médias Jeunes et l’AMO Passages en 2017 avec un groupe d’adolescents. Le projet Je vis des hauts et débats proposait aux participants d’utiliser le médium vidéoludique comme moyen d’expression sur l’image que leur environnement leur renvoie de leurs identité et pratiques en tant que joueurs. Au terme d’une semaine d’ateliers créatifs, analytiques et ludiques est apparu un jeu collectif dans lequel les clichés répertoriés sur le jeu vidéo et celles et ceux qui le pratiquent ont été mis en scène en utilisant les codes propres au gameplay de différents types de jeux. L’article transcrit et analyse les observations récoltées durant les ateliers et présentées au colloque Entre le jeu et le joueur : écarts et médiations le 28 octobre 2018 à l’Université de Liège et met celles-ci en perspective avec le travail de chercheurs et chercheuses sur d’autres projets antérieurs articulant création vidéoludique et éducation.
La médiation ludique : un nouvel écart entre le musée et ses publics ?
Authors: Doduik Nicolas
Published: January 2024

Dans le champ des musées, professionnels et observateurs considèrent généralement qu’un contenu culturel n’est jamais accessible immédiatement. C’est précisément le rôle de la « médiation culturelle » d’ajouter un élément médian entre un contenu culturel et ses récepteurs pour accompagner sa réception. Pourtant, un certain discours sur l’immédiateté de l’expérience ludique trouve des échos dans le monde muséal : les jeux y sont parfois promus comme une manière de s’approprier immédiatement des contenus culturels. Cet article s’intéresse à deux jeux créés au Mucem (Musée des Civilisations de l’Europe et de la Méditerranée), musée public national situé à Marseille. À partir d’une observation participante et d’entretiens avec des professionnels de ce musée, il cherche à s’interroger sur la pertinence du choix d’objets ludiques comme objets de médiation. Il montre que, paradoxalement, les jeux censés faciliter l’appropriation de contenus muséaux par des publics non pratiquants du musée peuvent la complexifier, en nécessitant de nouvelles médiations dues aux codes ludiques et muséaux qu’il faut maitriser pour utiliser ces objets. Cette conclusion nuance le caractère supposé immédiat de l’expérience ludique, et la capacité des jeux de musée à combler l’écart entre le musée et ses publics.
Quelle place pour l’engagement professionnel des enseignants en Tunisie ?
Authors: Barouni Manel , Naceur Abdelmajid
Published: January 2024

L’enseignant est l’acteur principal et un chaînon essentiel de la réussite d’un système éducatif, notamment pour l’amélioration de la qualité du processus d’enseignement-apprentissage. Cet article s’intéresse à l’engagement professionnel des enseignants tunisiens, en proposant un éclairage sur le contexte dans lequel ils évoluent, ainsi que sur les défis qu’ils ont à relever. Après un aperçu des contraintes et opportunités de leur réalité professionnelle, puis de travaux de recherche, il analyse l’état actuel de cet engagement professionnel avant de proposer des pistes pour développer leur autonomisation et leur motivation.
Formation des enseignants : une troisième révolution ?
Authors: Nóvoa António
Published: January 2024

Cet article suggère la possibilité d’une troisième révolution en matière de formation des enseignants. Dans une première partie, après avoir évoqué l’époque des écoles normales et de l’universitarisation au vingtième siècle, il soutient que la formation des enseignants doit être pensée comme une formation professionnelle de niveau supérieur. Dans la deuxième partie, les dichotomies sont évitées et une synthèse est proposée autour de la valorisation de la connaissance professionnelle enseignante (un troisième genre de connaissance), de la reconnaissance des enseignants comme formateurs des nouveaux enseignants (un troisième acteur) et de la construction d’une maison commune pour la formation et la profession (un troisième lieu). Ces éléments jettent les bases d’une troisième révolution dans la formation des enseignants.
A Study on the Operational Efficiency of National Supercomputer Resources Based on DEA Model
Authors: Shim Hyungwook , Hahm Jaegyoon
Published: January 2024

As a measure to improve the operational efficiency of the Korean supercomputer joint utilization resources, an efficiency analysis using DEA was conducted to derive the improvement level of the input and output factors of the operation plans of seven specialized centers. The factors that constitute the objective function of efficiency were identified through the operation plans submitted by the specialized centers, and DEA analyzed the improvement factors and levels of inefficient specialized centers through the CCR and BCC models, and then conducted an additional super-efficiency analysis to compare the relative efficiency levels among the efficiency groups. As a result of the analysis, the inefficiency of specialized centers in the meteorological/climate/environmental fields was identified from the reference group, and the need for improvement and the level of improvement of input and output variables were identified. In addition, the authors suggested ways to improve the establishment of resources and operational targets, such as a joint utilization ratio to secure financial efficiency at the government level in establishing a joint utilization resource.
Alignment of University Competencies With Global Skill Measures
Authors: Al Khateeb Ahmed Abdulateef , Aldosemani Tahani I. , Abu-Dawood Sumayah , Algarni Sameera
Published: January 2024

This study analysed two internationally recognised measurements of professional skills: the Programme for the International Assessment of Adult Competencies (PIAAC) and the Digital Competence Framework for Citizens (DigComp 2.2). This analysis aimed to establish a baseline and reference point for a comprehensive understanding of these two scales with the objective of exploring the most relevant competencies and assessing their potential benefits in fostering a technology-driven environment in higher education institutions in Saudi Arabia. The research yielded significant findings regarding the essential competencies that university students should possess, drawing insights from the two assessments and identifying gaps in existing manuals. The research outcomes include valuable insights and best practices that can empower a new generation of university learners to effectively engage with the requirements of Education 4.0.
SSVEP-Enhanced Threat Detection and Its Impact on Image Segmentation
Authors: Gao Shouwei , Cheng Yi , Mao Shujun , Fan Xiangyu , Deng Xingyang
Published: January 2024

Selective attention, essential in discerning visual stimuli, enables the identification of threats such as snakes—a prime evolutionary influence on the human visual system. This phenomenon is encapsulated in snake detection theory (SDT), which posits that our ancestors' need to recognize these predators led to specialized perceptual abilities. This investigation utilizes steady-state visual evoked potentials (SSVEP) alongside the random image structure evolution technique, which systematically increases visual clarity through the interpolation of random noise, to probe the neural mechanisms underpinning selective attention, with a focus on serpentine forms. These findings underscore snakes' unique perceptual impact due to their curved forms and scaled textures, crucial for quick recognition—advancing image semantic segmentation and recognition tech.. This is particularly relevant for security and wildlife management, showcasing the evolutionary progression and cognitive prowess of the human visual apparatus.
Envelhecimento populacional: diferenças demográficas dos países da América do Sul
Authors: Petrus Júlia Kátia Borgneth , Pereira Junior Magno Vasconcelos
Published: January 2024

Este artigo analisa o envelhecimento populacional de doze países da América do Sul, com o propósito de conhecer a expectativa de vida dos idosos maiores de 65 anos e discutir as consequências da falta de atenção para a qualidade de vida dessa população, tendo como base os dados demográficos da Comissão Econômica para a América Latina e Caribe – CEPAL, com ênfase nos anos 1990 e 2015, os quais foram ilustrados em forma de tabelas, gráficos, pirâmides etárias e mapas para melhor visualização e análise. Perguntas como: quantos são os idosos? Onde há maior concentração de idosos no sul da América? Qual a relação entre a taxa de fecundidade e o envelhecimento? Qual a conexão das faixas etárias de jovens e adultos com o topo da pirâmide? Foram respondidas por meio das variáveis representadas por porcentagens: % de pessoas com 65 anos a mais, % de jovens de 0 e 14 anos, % de adultos de 15 a 64 anos, Taxa de Fecundidade, Esperança de vida ao nascer e Índice de Envelhecimento. Ademais, foi produzido um breve recorrido teórico sobre o tema. Os países com a melhor esperança de vida ao nascer são Chile, Uruguai e Argentina, bem como são esses os países que mais têm % de idosos, invertendo algumas posições. As menores taxas de fecundidade ficaram para o Chile e Brasil. Ainda, o Chile é o país com maior índice de envelhecimento. Bolívia e Guiana são os países com a menor expectativa de vida. No entanto, Bolívia foi o país em que mais aumentou a esperança de vida em 25 anos (1990 a 2015), passando de 56,5 para uma expectativa de vida de 67,8 anos.
Epidemiology of deaths due to suicide in the southeast of Iran: a retrospective study from 2010 to 2017
Authors: Ghiasi Zahra , Abdi Reza , Jafari Sadegh
Published: January 2024

Suicide is the most real life-threatening challenge for populations worldwide; therefore, it is important to identify its risk factors. This study comprised an epidemiological survey of suicide deaths referred to the forensic setting of Zahedan, Iran, between 2010 and 2017 (a total of 214 completed suicide cases). The research method was descriptive-analytical with a retrospective approach. The research tool was a questionnaire prepared based on the information form about the suicide deaths at the Zahedan Forensic Medicine Center. A frequency distribution in descriptive statistics was used to analyze the data. The findings showed that hanging was the main method of suicide in the southeast of Iran. The highest suicidal rates were also related to adults with the following conditions: aged between 20 and 30, males, married individuals, employed people, urban dwellers, people without a history of suicidal behavior, and people with an elementary education. The results obtained by the current study can be useful for identifying suicide risk groups among attempted suicides and designing suicide prevention programs.
Incidence of urinary incontinence following endoscopic laser enucleation of the prostate by en-bloc and non-en-bloc techniques: a multicenter, real-world experience of 5068 patients
Authors: Castellani Daniele , Gauhar Vineet , Fong Khi Yung , Sofer Mario , Socarrás Moisés Rodríguez , Tursunkulov Azimdjon N , Ying Lie Kwok , Biligere Sarvajit , Tiong Ho Yee , Elterman Dean , Mahajan Abhay , Taratkin Mark , Ivanovich Sorokin Nikolai , Bhatia Tanuj Pal , Enikeev Dmitry , Gadzhiev Nariman , Bendigeri Mohammed Taif , Teoh Jeremy Yuen-Chun , Dellabella Marco , Sancha Fernando Gómez , Somani Bhaskar Kumar , Herrmann Thomas Reinhard William
Published: January 2024

We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate (EEP) comparing en-bloc (Group 1) versus 2-lobe/3-lobe techniques (Group 2). We performed a retrospective review of patients undergoing EEP for benign prostatic enlargement in 12 centers between January 2020 and January 2022. Data were presented as median and interquartile range (IQR). Univariable and multivariable logistic regression analysis was performed to evaluate factors associated with stress urinary incontinence (SUI) and mixed urinary incontinence (MUI). There were 1711 patients in Group 1 and 3357 patients in Group 2. Patients in Group 2 were significantly younger (68 [62–73] years vs 69 [63–74] years, P = 0.002). Median (interquartile range) prostate volume (PV) was similar between the groups (70 [52–92] ml in Group 1 vs 70 [54–90] ml in Group 2, P = 0.774). There was no difference in preoperative International Prostate Symptom Score, quality of life, or maximum flow rate. Enucleation, morcellation, and total surgical time were significantly shorter in Group 1. Within 1 month, overall incontinence rate was 6.3% in Group 1 versus 5.3% in Group 2 (P = 0.12), and urge incontinence was significantly higher in Group 1 (55.1% vs 37.3% in Group 2, P < 0.001). After 3 months, the overall rate of incontinence was 1.7% in Group 1 versus 2.3% in Group 2 (P = 0.06), and SUI was significantly higher in Group 2 (55.6% vs 24.1% in Group 1, P = 0.002). At multivariable analysis, PV and IPSS were factors significantly associated with higher odds of transient SUI/MUI. PV, surgical time, and no early apical release technique were factors associated with higher odds of persistent SUI/MUI.
Comparative Study between Modified Millard and White Roll Vermilion Flap Techniques in Unilateral Lip Repair: A Randomised Controlled Study
Authors: Mabrouk Mohamed M. , Abdullateef Khaled Salah , Abdelsattar Ayman Hussein , Elbarbary Mohamed , Kaddah Sherif , Mohamed Wesam
Published: January 2024

Background:

Cleft lip and palate, which affects 0.5–1.6 out of every 1000 live births, is the most prevalent congenital defect of the head and neck. Several approaches, including quadrangular flaps, triangular flaps and rotation-advancement procedures, White Roll Vermilion Turn Down Flap (WRV flap) from the lateral lip element were employed by Mishra to modify Millard’s technique to create the vermilion and white roll on the medial lip segment. This study aimed to use the anthropometric measurements taken pre- and post-operation to evaluate quantitative assessment of modified Millard technique compared with WRV flap technique in unilateral cleft lip (UCL) repair.

Materials and Methods:

Prospective, randomised controlled study recruited infants scheduled for UCL repair. Infants aged 3–6 months, either complete or incomplete deformity. A total of 42 patients were randomized in 1:1 ratio to undergo either WRV flap technique (group A) or modified Millard technique (group B) and another control included 21 age-matched healthy children. We compared WRV flap procedure to Modified Millard’s procedure in terms of both qualitative (another surgeon’s opinion) and quantitative (anthropometric) evaluation.

Results:

Vertical lip length and philtral lip height significantly longer in Millard group (B) than WRV flap group (A) in immediate postoperative assessment and nasal width was significantly wider in WRV flap group (A) than Millard group (B) in 3-month post-operative assessment. The lip shape, the vermilion shape was better in Millard technique than WRV flap technique; however, this was statistically insignificant. However, no major difference in the overall results between the WRV flap and Millard rotation-advancement repairs.

Conclusion:

Anthropometric measurement of surgical outcome evaluates the surgical technique used and helps to compare between cleft and non-cleft side showing the degree of deformity and we used subjective assessment to analyse facial aesthetics. Overall results demonstrate no significant differences between modified Millard technique and WRV flap technique.
Outcome of Biliary-enteric Reconstruction with Hepaticoduodenostomy Following Choledochal Cyst Resection: A Prospective Study
Authors: Goyal Ashok Kumar , Gupta Rahul , Meena Neelam
Published: January 2024

Background:

The two most commonly performed methods of biliary-enteric reconstruction following choledochal cyst resection are Roux-en-Y hepaticojejunostomy (HJ) and hepaticoduodenostomy (HD). There is a lack of consensus regarding the better technique between them. This study aimed to evaluate the outcomes, efficacy and early complications of HD as a mode of biliary reconstruction after surgical resection of a choledochal cyst.

Materials and Methods:

This was a multi-institutional prospective study carried out in high-volume tertiary care teaching institutes from January 2010 to December 2022. All children managed with HD following choledochal cyst resection were analysed for their early complications and outcomes.

Results:

A total of 74 patients were included in this study. There were 59 (79.73%) females and 15 (20.27%) males. Thirty-nine (52.70%) patients had jaundice at the time of presentation. Magnetic resonance cholangiopancreatography was performed in 57 (77.03%) patients following ultrasonography. Intraoperatively, malrotation was present in 2 (2.70%) patients. In our study, operating time ranged from 60 to 195 min (mean: 118 min). Hospital stays ranged from 8 to 17 days (mean: 11.5 days). The post-operative biliary leak was seen in 7 (9.50%) patients, out of which 6 (8.11%) minor leaks were managed conservatively. Roux-en-Y HJ was performed on 1 (1.35%) patient with a major leak. In our series, 4 (5.40%) patients developed cholangitis; post-operative haemorrhagic nasogastric aspirate 5 (6.76%), post-operative pancreatitis 3 (4.05%) and wound infection 4 (5.40%) were observed and managed conservatively. None of the patients in our study developed an anastomotic stricture, bile gastritis and adhesive small bowel obstruction.

Conclusion:

Resection of choledochal cyst with HD reconstruction is safe and feasible with short operative time. HD is a viable option for operative management of choledochal cyst with low complication rates and faster recovery.
Congenital Urethrocutaneous Fistula
Authors: Suman Bijay Kumar , Singh Ram Jeewan , Sinha Amit Kumar , Kumar Bindey
Published: January 2024

Male congenital urethrocutaneous fistula is an extremely rare anomaly that is commonly associated with chordee or anorectal malformations. It is characterised by an abnormal urethral opening on the ventral aspect of the penis with well-formed distal urethra and meatus at the tip of the glans. The treatment is individualised according to the site of the fistula, associated anomalies and condition of the distal urethra. The principles of hypospadias surgery should be strictly followed.
Community Pharmacist’s Awareness, Knowledge and Attitude Towards use of Vitamin Supplements in Pimpri-Chinchwad Municipal Corporation (PCMC) Area of Pune, India: A Descriptive Cross Sectional Study
Authors: Patil Pravin J. , Patil Vilas S. , Malu Jayesh S. , Aswale Divya M.
Published: January 2024

Background:

US FDA defines: dietary supplements is a product that intended to supplement a person’s diet, it’s generally consist of at least one or more of the following dietary ingredients, vitamin, minerals, a herb or other botanical and amino acid by increasing the daily consumptions of an extract metabolite concentration, constitute or combinations of these medication. Excessive and inappropriate use of medicines has been recognised as a public health problem resulting in increased likelihood of adverse drug event, drug interaction, and inappropriate drug prescribing and increased cost.

Material and Methods:

This was the cross-sectional study conducted in year 2022 at Pimpri Chinchwad (Pune). The total 250 questionaires are distributed and from that 226 response were received. Target population consist of community pharmacists working in the drug store in this area (n=226).

Results:

Data was represented in three domains of study i. e. awareness, knowledge and attitude. Correlation coefficient using Pearson’s method were determined to evaluate strength of correlation between awareness-knowledge, Knowledge-attitude and awareness-attitude. Correlation coefficient were calculated by comparing most relevant and equal number of questions.

Conclusion:

The study demonstrated positive attitude among surveyed community pharmacists in Pune, India. There is lacuna in accurate and adequate awareness, knowledge and attitude of vitamin deficiency, efficiency, recommended daily allowance (RDA), toxicity and interactions among pharmacist as one of the stakeholders of healthcare in India. Few of the remedies viz. framing of guidelines, inclusion in formal education syllabus, continuous education, updation exams etc. may be of use.
Utilization of Untied Fund and Factors Affecting the Utilization at Sub-Centers of Rural Odisha: A Mixed-Method Study
Authors: Antony Annu , Singh Arvind K. , Sahu Dinesh P. , Mishra Abhisek , Parida Swayam P.
Published: January 2024

Introduction:

The untied funds at sub-centers provided flexibility for local action at block and down below levels. Effective utilization of untied fund can strengthen the healthcare. So, our study aims at assessing the knowledge of health workers, male/female (HWF/M), and effectiveness of utilization of untied funds at the sub-center (SC) level.

Material and Methods:

A mixed method (cross-sectional study and qualitative study) was conducted at Tangi Block, Khordha district, Odisha, in the year 2020. Health workers, male and female in sub-centers, and local stakeholders were interviewed using a structured interview schedule. The tool comprises financial records, a semi-structured questionnaire, and an in-depth interview guide. Universal sampling was adopted. For the cross-sectional study, 24 health workers were male/female, and for the qualitative study, all local stakeholders and 24 health workers female/male were interviewed. The study was conducted as a part of an academic program, and ethics approval was approved by AIIMS Bhubaneswar Institute Ethics Committee.

Results:

Seven out of 24 sub-centers did not spend any money, with a median unspent amount of 4260 INR (Q1-0, Q3-17300). As many as 36.8% of sub-centers had a delay of 9 months to get the untied fund, which significantly affected the utilization of funds. 37% of HWF/M utilized the fund inappropriately. None of the health workers had complete knowledge regarding the appropriate usage of untied fund. Communication gap, multiple engagements, non-cooperation from officials, delay in technical processing, and irregular Garam Sabha meetings were found to be barriers.

Conclusion:

Our study found out under-utilization of money in untied fund. Communication gap, non-cooperation form village leaders, poor knowledge, overburdened health workers, improper reporting, and lack of felt need were found to be barriers for prompt utilization.
Manipur’s Journey Towards the Health SDGS: What’s Achieved and what more is Needed?
Authors: Yumnam Veda
Published: January 2024

India and its constituent states are committed to achieving universal health coverage (UHC) as a part of the Sustainable Development Goals (SDGs) 2030 by strengthening primary healthcare (PHC). The National Health Mission (NHM) has been a landmark effort at health systems strengthening, aiming to reboot both the architecture and service delivery. Manipur ranks fourth out of the eight states in the North East Region in the National Institution for Transforming India (NITI) Aayog’s ranking for SDGs. The available evidence, drawing upon secondary datasets and available primary data, aims to unpack the progress made in health systems strengthening to interpret the journey toward achieving UHCs and SDGs. The progress made and the gaps in terms of human resources, infrastructure, service utilization, and reduction of out-of-pocket expenditure are interpreted in terms of critical social determinants such as geographic and ethnic divides. Newer policies, such as the Act East Policy and medical tourism, are examined in the context of current disparities and the potential to accelerate the journey towards achieving SDGs.
A Preliminary Study on the Impact of Household Air Pollution on Adult Respiratory Health in Urban and Rural Settings of Jaipur, India
Authors: Sharma Arun Kumar , Dhabahi Anukrati , Mohanty S. S.
Published: January 2024

Background:

This study aimed to investigate the association between household air pollution and chronic respiratory illness (CRI) in Jaipur, India.

Materials and Methods:

A total of 147 participants over 18 years of age from 45 households were randomly included in the study, and follow-up visits were conducted once every fortnight over a three-month period. Spirometry tests were conducted using a portable hand-held digital spirometer. A self-designed, pretested, semi-structured questionnaire was utilized to collect socio-demographic information from the participants. Statistical tests, such as t-tests were used to analyze the association between household air pollution and CRI.

Results:

The prevalence of COPD and bronchial asthma was 2% and 4%, respectively. Various risk factors for CRI were identified within households, and only 4 episodes of acute exacerbation of chronic respiratory illness were observed, resulting in no incidence density calculation. The mean values of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were significantly lower in females (P < 0.001) Also, the mean values of FVC and FEV1 were significantly lower in rural areas (P < 0.005) than urban areas.

Conclusion:

Our findings highlight the importance of government and stakeholder action to implement clean air policies and protect respiratory health. Further studies are needed to expand on these findings and delve deeper into understanding the complex interactions between various risk factors and respiratory health in this population.
Prevalence of Physical Nicotine Dependence and its Determinants among Tobacco users in the Rural Field Practice Area of a Tertiary Care Hospital in Tamil Nadu, India
Authors: Sharmila Jamine , Anugraha J , Umadevi R , Easwar Anantha
Published: January 2024

Background:

Tobacco is the major cause of preventable death globally, which kills one person prematurely every six seconds. In India, around 46.9% of men and women aged 15 years and above use any kind of tobacco, according to NFHS-5. Tobacco use for longer duration with increased frequency is often addictive. Nicotine in tobacco is often associated with dependence, which is recognized as a public health menace and the single most significant factor for premature death. Hence, assessment of nicotine dependence among tobacco users is essential to implement tobacco control measures effectively. To estimate the prevalence of nicotine dependence among tobacco users and to study the factors associated with nicotine dependence among those tobacco users in a rural area of Kancheepuram district, Tamil Nadu.

Material and Methods:

A community-based descriptive cross-sectional study was conducted among 375 tobacco users aged 18 years and above residing permanently in the rural field practice area of the Rural Health and Training Centre (RHTC) attached to a Tertiary Care Hospital in Tamil Nadu. The study has been conducted for 6 months. A systematic random sampling technique was used to recruit the study participants. Data was collected by conducting personal interviews using a pre-tested semi-structured questionnaire. The data obtained was subjected to statistical analysis using SPSS version 23.

Result:

About 48.7% of the study participants had high dependence, 25% had moderate dependence, and 26.3% had low physical dependence on nicotine. The duration of tobacco use (P < 0.0000) and age of initiation of tobacco use (mean age was 28 ± 7.1 years) (P < 0.0001) was found as a significant risk indicator for nicotine dependence.

Conclusion:

The high nicotine dependence (48.7%) among the study participants is quite alarming and warrants more visible and aggressive anti-tobacco campaigns and targeted preventive strategies.
Immunization Status of Children 12–36 Months Age of Migrant Workers and Factors Associated with it in Urban Areas of Bangalore East
Authors: Kurkuri Shweta Neminath , Subramanian Mangala
Published: January 2024

Background:

Immunization is a cost-effective weapon against vaccine preventable diseases. Children of migrant workers suffer from lack of immunization because of frequent shift of places, poor knowledge, and low socioeconomic status. To assess the immunization status of children 12–36 months of age of migrant workers and factors associated it. To identify the reasons for non-immunization or partial immunization among these children.

Material and Methods:

A cross-sectional study was conducted among 500 migrant workers’ children aged 12–36 months residing in Urban Bangalore east from February 2019 to August 2020. A cluster sampling method was incorporated. The data were collected using pre-tested semi-structured questionnaire. Data were analyzed using Epi-info™ Version 7.2.1 and SPSS version-21. Data were summarized in percentages, mean, standard deviation, and logistic regression.

Results:

The mean age of the children was 25.2340 ± 8.42 months. Out of 500 children, 88.60% were fully immunized, 11.40% were partially immunized, and no child was unimmunized. Significant predictors of immunization status of children were education of father and immunization card. Common reasons for dropout were inconvenient time (80.70%), unaware of need (77.19%), and busy schedule of parents (75.44%). The dropout rate of BCG to MR-1, Penta-1 to Penta-3, and Penta1to MR-1 was 6.49%, 0.85%, and 2.12%, respectively.

Conclusions:

Immunization coverage in the present study was 88.60%. Inconvenient time was the main reason behind partial immunization.