bluuebunny/crossref_metadata_2025 huggingface dataset:
Shifting Narratives of the Alternative for Germany.
Authors: Sutterová Dita , Kopeček Vincenc
Published: July 2024

This article examines the evolving narratives of the German political party Alternative for Germany (AfD) and its potential as a hybrid threat. Through narrative manipulation, the AfD has demonstrated its ability to influence public discourse and distort reality via disinformation dissemination. The AfD established in 2013 in response to the financial crisis and dissatisfaction with the European Union, has transitioned into a populist party, and along with this change, it has also changed its narrative. This shift was notably evident during the migrant crisis in 2015, showcasing the party's adeptness at evoking fear and animosity among German voters. The AfD's narratives have been for years similar to those of the Russian Federation, which has used almost identical narratives on some topics. The German party is consequently working with Russian politicians to reshape democratic politics within Europe, and the AfD is accordingly acting as a hybrid threat to the entire European Union. The study is based on a discourse analysis of interviews conducted with German experts on the topic as well as a content analysis of selected German media to explore these narrative dynamics and their broader implications.
Ukrainian Right-Wing Extremists: Exploring Their Involvement in the Ongoing War
and Outlining Potential Threats for Post-War Ukraine
Authors: Zilvar Zilvar
Published: July 2024

As the Russia-Ukraine war constitutes the most severe security challenge Europe has faced since the Cold War's end, many states have realized the fragility of statehood, which an aggressor can destroy overnight. Although this concern is valid, it should not overshadow other security threats. Unlike other authors addressing the phenomenon of foreign fighters in the war, the present article investigates the involvement of Ukrainian right-wing extremists regarding the pre-2022 development, during which the growing sociocultural nationalism, militarism, and tolerance of ultranationalist and ethnonational groups helped shrink their isolation. While they might have played an important role in Ukraine's territorial defence, heavily armed and combat-skilled right-wing extremists might pose a severe threat to Ukraine's post-war restoration. Initially, whereas a literature review indicates the hitherto research and positions the article's inquiry within it, existing theoretical approaches define the observed actors. Based on the open-source intelligence data collection from Telegram and content analysis, the article identified several Ukrainian and also foreign right-wing extremists involved in the war despite its focus on the former. It concludes that the predecessor authors' debated threats associated with the latter, i.e., physical threats, organizational challenges, and wider societal consequences, should be primarily applied to Ukraine.
A Comprehensive review of the Value Relevance of Accounting Information and The Role of Disclosure
Authors: Esfandani Vahab , Ahmadi Reza , Borghei Mohammad Amin , Ramzani Sara
Published: July 2024

This review which presented at The Art and Science of Managing Performance Symposium on February 29, 2024 examines the evolving significance of value relevance of accounting information as a key component for managers and investors when making market decision. The examination of the significance of value relevance of accounting information provides robust analyses concerning the market's perception of accounting information and its role in decision making. Although considerable progress has been made to date in this well established area of research, the literature does not comprehensively elucidate or reach consensus on the fluctuations in value relevance over time. Furthermore, the effect of disclosure on value relevance of accounting information remains relatively an unexplored research topic. This review focuses on value relevance research from the two past decades, also incorporating seminal studies that trace their origins back to the late 1950s. We undertake a review of four streams within the value relevance literature: the significance of earnings and book values, the significance of other accounting information, effect of IFRS and IAS on Value Relevance of accounting information and the role of disclosure on value relevance of accounting information. Moreover, we show the different explanations put forth in the existing literature in an effort to clarify the variation in value relevance over time as well as perspectives for potential future inquiries into the relevance of value. In essence, this review provides readers with a comprehensive understanding of the literature on value relevance and also an introduction to this particular area of empirical accounting and business research.
Is Management by Objectives (MBO) still relevant?
Authors: Kassar George
Published: July 2024

Performance management is “a continuous process of identifying, measuring and developing performance in organizations by linking each individual’s performance and objectives to the organization’s overall mission and goals” (Aguinis 2023). One of the most known strategic approaches within HR and PM practices, is the Management by Objectives (MBO), which can lead to better alignment with organizational goals and improved performance metrics (Schmidt et al. 2017, Farndale and Kelliher 2013).

This communication, a hybrid of a literature overview and position paper, will examine the potential relevance of the MBO model - which was popularized by Peter Drucker back in 1954 - today in 2024; after 70 years after its introduction.

The MBO model is in fact a strategic management approach mostly based on the collaboration between supervisors and employees in defining clear, measurable, and achievable organizational goals (Drucker 1954) .

We will synthesizes various scholarly works to explore how MBO’s fundamental components – goal setting, participatory decision-making, action planning, periodic review, and performance appraisal – continue to positively impact employee behaviour and output in modern performance management practices (George et al. 2021, Starbuck 2017) .

This would includes overviewing studies that examines other approaches designed to enhance organizational effectiveness and employee performance, including the Balanced Scorecard introduced by Kaplan and Norton (1998), the concept of 360-degree feedback widely used for their ability to provide comprehensive evaluations (Garavan et al. 1997, Gruman and Saks 2011), as well as Objectives and Key Results (OKRs) introduced at Intel and popularized by Google (Schleicher et al. 2018), along with and Agile Performance Management which combines principles of agility, flexibility, with frequent feedback, and goal-setting (Poister 2010).

The aim is to provide a comprehensive understanding of MBO’s legacy and its potential adaptability to modern business challenges and technological advancements so as it aligns with contemporary organizational performance management practices.
Interim Report NFDI4Chem 2023
Authors: Neumann Steffen , Andres Ann-Christin , Bach Felix , Bender Theo , Bonatto Minella Christian , Eberl Franziska , Fischer Tillmann , Golub Benjamin , Harivyasi Shashank , Herres-Pawlis Sonja , Huang Pei-Chi , Hunold Johannes , Jollife John , Jung Nicole , Liermann Johannes , Nainala Venkata , Razum Matthias , Koepler Oliver , Steinbeck Christoph
Published: July 2024

The progress of the DFG-funded NFDI4Chem consortium (NFDI 4/1 - project number 441958208) in data management in chemistry is outlined in our latest report, highlighting the steps we have taken to integrate a data-centric approach within the chemistry community. This interim report offers a comprehensive overview of our data management activities, covering the reporting period from October 2020 to August 2023.

The shift to digital tools in research documentation is driven by our work with Electronic Laboratory Notebooks (ELNs), such as Chemotion ELN, offering systematic data storage for easy retrieval and sharing. Additionally, we focus on developing repositories, such as Chemotion repository and RADAR4Chem, which fulfil the needs for the storage of chemical data. The NFDI4Chem Search Service ensures easy data access from our repositories. Our efforts extend to community engagement through conference visits and online presence, aimed at creating awareness for (digital) research data management and connecting to chemistry students and researchers. Our training programs have reached over 600 participants to date. Initiatives like the FAIR4Chem award and the Chemistry Data Days promote cultural change towards FAIR data. Our Editors4Chem initiative collaborates with publishers for standardised data management and the Ontologies4Chem workshops organised by our consortium promote the ontology development in the field.

Apart from the consortium's engagement for chemists, NFDI4Chem members played key roles in the development of the NFDI as a whole. Being actively involved in the sections and task forces, NFDI4Chem promotes collaborative solutions across NFDI consortia.
Fresh produce supply chain network design and management using swarm intelligence: A case study of Egypt
Authors: Fahmy Sherif , Gaber Yomna , Zaki Areej , Gaafar Mohamed
Published: July 2024

Purpose: The objective of this work is to fulfil a strategic requirement in Egypt’s agriculture industry by establishing a fresh produce supply chain network (SCN) that manages the collection, processing, packaging, and distribution of products.Design/methodology/approach: A two-phase approach is proposed. In the first, a network of food aggregation hubs is strategically located across the country for the collection, consolidation, and distribution of products. This is accomplished by modeling and solving a cost minimization dynamic facility location-allocation (FLA) problem using a hybrid binary particle swarm optimization (BPSO) algorithm. The second phase of the approach is to complement the hub FLA decision with optimal fleet size, transportation schedules, and routing decisions. This is achieved by solving the split-delivery vehicle routing problem (SDVRP) using a hybrid ant-colony optimization (ACO) algorithm, considering positioning loading constraints, and shelf-lives of products.Findings: There is a strong correlation between the geographical locations and capacities of the established hubs, and the proximity of supply points and the populations in the demand areas. In addition, accounting for spoilage of products has a significant effect on network design, and collection and distribution decisions.Practical implications: Establishment of the intended SCN can reduce the proportion of wasted product during transit, and improve the quality of the delivered product.Social implications: Establishment of the SCN will increase the exposure of small farmers to wider markets, and hence their return and standard of living, and potentially reduce the prices for the final customer.Originality/value: This study is the first attempt to establish an efficient fresh produce supply chain network in Egypt. In addition, the proposed solution approach considered a multitude of problem characteristics, simultaneously for the first time.
Utilization and perceptions of language assistance services by medical trainees: a pathway to language certification
Authors: Avra Tucker , Cordova Daniel , Taira Breena , Torres Jesus R.
Published: July 2024

Background

Access to language assistance is a patient's right under federal law. Despite this, underuse of language services persists.

Objective

The aim of this study was to explore the interest in obtaining bilingual certification and to describe perspectives on language services by resident physicians.

Methods

Between May and August 2021, we conducted a cross-sectional survey of residents at a public, urban hospital serving mostly patients with limited English proficiency (LEP). We assessed resident perspectives on language services, exposure to language-related trainings, non-English language (NEL) skills, and interest in bilingual certification.

Results

A total of 214 residents of 289 completed the survey (a 74% response rate). Of the 95 residents who used their NEL for patient care, 65 (68%) would be interested in bilingual certification. Sixty-nine (33%), 65 (31%), and 95 (45%) residents disagreed or strongly disagreed with being satisfied with the language services available, convenience, and sufficient equipment, respectively. Furthermore, 28 (13%) disagreed or strongly disagreed that they could achieve bi-directional communication with LEP patients.

Conclusions

Over a quarter of the residents expressed interest in bilingual certification and were likely to pass the certification exam. Many reported using their own NEL skills without certification and held negative views on services and trainings.
Trois régimes de l’objet mathématique
Authors: Salanskis Jean-Michel
Published: July 2024

L’article décrit trois statuts que l’on peut envisager en philosophie pour l’objet mathématique : le statut de point d’appui pour un discours que l’on tient par avance pour vrai (l’objet enfant de la vérité), le statut d’objet qui se présente et que l’on connaît en tant qu’il se présente (l’objet se présentant), et finalement le statut métaphysique d’objet se répétant, donnant lieu à de la différence sans concept (l’objet idéal, faisant défaut à son identité). Les trois statuts sont pris au sérieux et considérés comme correspondant à des intérêts légitimes. Dans le cours de la discussion, on croise le dilemme de Benacerraf, le débat Brouwer-Hilbert et diverses conceptions kantiennes ou husserliennes.
Truffaut et le polar : la série noire de l’imprimerie
Authors: Aubron Hervé
Published: July 2024

Le genre policier fut l’une des rares passions communes de la Nouvelle Vague. Après Claude Chabrol, celui qui s’est le plus mesuré au genre stricto sensu est François Truffaut. Cela reste bizarrement sous-estimé, comme si ces adaptations n’étaient que des intermèdes ou des exercices de style : il s’y exprime là, pourtant, son rapport le plus direct à l’écrit et au stéréotype.
Le Notre Père en langue amérindienne dans le Brésil des XVIe et XVIIe siècles : interactions, circulations, usages
Authors: Castelnau L’Estoile Charlotte de
Published: July 2024

Le texte s’attache à montrer l’agency des Amérindiens dans la composition et la diffusion du Notre Père en langue autochtone dans le Brésil des xvie et xviie siècles. Partant des sources françaises, portugaises et hollandaises, l’article montre qu’on peut retrouver la mention des Indiens, identifiés ou anonymes, qui ont un rôle dans la diffusion de la prière telle qu’elle a été finalement consignée dans des textes, puis parfois imprimée d’abord par des Français puis par les Portugais. Dans le contexte des guerres indigènes et coloniales de l’époque, savoir par cœur le Notre Père de la part des Amérindiens, était un signe de leur alliance passée avec les Blancs et pouvait les protéger d’une captivité injuste. C’était la marque intangible de leur statut d’Indiens chrétiens. La question d’une connaissance purement formelle du texte revient comme un leitmotiv dans les sources coloniales. Changeant d’alliances européennes, entre Portugais, Français et même Hollandais, les Amérindiens chrétiens ont été ainsi d’importants vecteurs de la circulation du texte du Notre Père dans le Brésil colonial.
Rigidity or fluidity? Does variety-seeking vary based on perceived threat during the COVID-19 pandemic?
Authors: Ashrafi Dewan Mehrab , Chowdhury S.M. Mukit , Habiba Wardha , Chowdhury Shafayat Hossain , Alam M. Sayeed , Zabeen Mashruha , Sarker Md. Atiqur Rahman
Published: July 2024

The COVID-19 outbreak has significantly changed modern lifestyles and consumption patterns, prompting an increasing focus within consumer behavior research on exploring the impact of perceived threats and the quest for variety. In response to this exigency, our investigation endeavors to ascertain the correlation between the perceived threat posed by the coronavirus and the inclination towards seeking variety. Drawing upon established theoretical frameworks such as reactance theory and terror management theory, we aim to investigate if perceived threat of COVID- 19 heightens individuals’ propensity to seek greater variety in scenarios involving multiple choices. Our initial empirical investigations, conducted across two distinct studies, reveal an evident increase in individual tendency for variety-seeking in both stationery supplies and food items as their perceived threat from the disease intensifies. Furthermore, our third study underscores the nuanced nature of variety-seeking behavior under the influence of perceived threat, highlighting its modulation within predefined decision-making boundaries. Specifically, in situations characterised by heightened perceived threat, consumers exhibit a heightened tendency to seek variety among choices offered by different brands. Conversely, when presented with options within the same brand, their behavior diverges. Notably, this study highlights the intricate interplay between the perceived threat of COVID-19 and alterations in the pursuit of variety.
Knowledge co-creation in the digital age: Social Science research as a catalyst
Authors: Editor The
Published: July 2024

The rapid transformation into the digital age has radically  altered and redefined the ways in which we access, create, share, and use knowledge. Paradigm shifts that have resulted from the impacts of industrialization, modern sciences, technological advancements, and globalization, have significantly affected our educational processes (UNESCO, 2023). Digital transformation has accelerated knowledge sharing and helped advancing towards achieving the Sustainable Development Goals (SDGs), especially SDG4, which aims at ensuring inclusive and equitable quality education (United Nations, 2015). Further, digital competence allows quick access to, and responsible use of information for learning, work, and effective participation in society. Nevertheless, the success of individuals in a society depends not only on the accumulation of knowledge but also on their ability to harness the information effectively, creatively, and collaboratively.
Awake intubation in a patient with morbid obesity in the emergency department: our experience
Authors: Chicone Gianmaria , Miccichè Viviana , Gallo Rosa , Maiarota Francesco , Toto Roberta , Fittipaldi Ciro , Iannuzzi Michele
Published: July 2024

Awake intubation is considered the standard of care for the management of the anticipated difficult airway. For its pharmacological properties, remifentanil is ideal for managing difficult endotracheal insertions. This process is augmented by the use of transtracheal injection of lidocaine as it disperses evenly around the area and facilitates the action of remifentanil further. A 48-year-old male patient, weight 200 kg, 184cm tall (BMI>40) came into the emergency room for severe hypercapnic hypoxic respiratory failure. Awake fiberoptic intubation was the option to secure the airway. Successful airway management is critical to the practice of emergency medicine. All anesthesiologists should be familiar with the airway management of obese patients.
Dermoscopy of Riehl’s melanosis: a case report and a short review of the literature
Authors: Sonego Benedetta , Bazzacco Giulia , Zelin Enrico , Conforti Claudio , Zalaudek Iris , Di Meo Nicola
Published: July 2024

Riehl’s melanosis (RM) is a pigmentary disorder, more common in individuals with dark skin phototypes, considered a form of pigmented contact dermatitis. In this paper we present a case of RM due to the rubber component of a work facial mask in which dermoscopy and patch test were the most important tools to help physicians in diagnosis. In addition, we reviewed the main dermoscopic clues that may be useful in differential diagnosis with others facial pigmentary disorders.
A rare case of multiple myeloma with several atypical manifestations
Authors: Nasti Clelia , Natale Raffaele , Morena Annadora , Della Pepa Roberta , Pasanisi Fabrizio , Santarpia Lidia
Published: July 2024

A 75-year-old woman presented asthenia and anemia after recurrent intestinal bleeding. Colonoscopy showed the presence of blood clots in the ascending colon, without active bleeding. During hospitalization, right toe cyanosis progressed to ischemic necrosis and was resistant to analgesics and vasodilators. The positron emission tomography-computed tomography scan showed a nodular thickening in the midfield of the right lung. Blood chemistry evidenced an Immunoglobulin (Ig) G-λ monoclonal peak. Multiple myeloma (MM) was diagnosed by bone marrow biopsy and serum/urine Ig-free chain dosage. The patient no longer had intestinal bleeding after the first MM chemotherapy (CHT). After 6 months of CHT, a partial hematological response and peripheral vascular improvement occurred. Extremely rare conditions may result in MM. In this case report, seemingly unrelated atypical manifestations co-existed and responded to hematological CHT for MM, confirming their association with the disease.
Are the complications after laparo-assisted endo-rectal pull-through for Hirschsprung disease related to the change of the anal tone?
Authors: Noviello Carmine , Romano Mercedes , Trotta Letizia , Umano Giuseppina Rosaria , Papparella Alfonso
Published: July 2024

The main advantage of the laparo-assisted transanal endorectal pull-through technique (LA - TERPT) for Hirschsprung Disease (HD) is the respect to the rectal-anal anatomy. Postoperative complications have been observed recently. The present study aims to determine how often these postoperative complications occur in these patients. From January 2009 to December 2018, a retrospective analysis was conducted on 36 children (25 males) with HD who underwent LA-TERPT. Data were collected on the age of diagnosis and surgery, sex, the presence of other pathologies, and cases of enterocolitis. In all cases, anorectal manometry (ARM) was performed to evaluate the anal tone. The median age at diagnosis was 2 months and the mean age at surgery was 5 months. Nine related pathologies were identified: five cases of Down syndrome, one case of hypertrophic stenosis of the pylorus, atresia of the esophagus, polydactyly, and anorectal malformation. A patient with total colonic aganglionosis was identified through laparoscopic serummuscular biopsies. Enterocolitis was diagnosed in 7 cases before and 6 after surgery. At follow-up, the complications recorded were: 5 cases of constipation (treated with fecal softeners), one case of anal stenosis (patient with anorectal malformation), 16 cases of soiling (treated with enemas) and 1 child with fecal incontinence (treated with a transanal irrigation system). The ARM was performed in all 36 cases and showed normal anal tone, except for one case with anal hypotonia. LA-TERPT is an important surgical technique for HD. According to the literature, soiling is the most main complication after HD surgery, probably due to “pseudo-incontinence” with normal anal sphincter tone.
Healthcare providers’ narratives about interactionally troubling patient exchanges: Accounting for and against an active patient role
Authors: Weiste Elina , Stevanovic Melisa , Ranta Nanette , Nevalainen Henri
Published: July 2024

The current trend in healthcare is to actively involve patients in their own treatment; however, in practice, healthcare providers may adhere to paternalistic views, which may not align with ideals related to patient involvement. This tension may become visible when providers talk about service encounters that they experienced as being interactionally troubling. In this empirical qualitative study, we utilize Bamberg’s narrative positioning analysis to explore how healthcare providers construct patients’ roles in narratives about such troubling exchanges. Data consist of 20 audio-recorded interviews with healthcare providers. We found two types of narratives in which healthcare providers’ perceptions of interactionally troubling patient exchanges were consistently related to their implicit evaluations of patients along a continuum of activeness versus passiveness. In the first, an active patient was considered ideal, and the problematic patient was one who is passive. In the second, a patient’s over-activeness was thought to interfere with the healthcare delivery. While providers’ complaints about patient passiveness were unproblematically presented from the perspective of the patient participation ideal, complaints about patient over-activeness were difficult to account for due to their inherent connotations with paternalism. Thus, we conclude that there is a need for training and interventions aiming to develop healthcare providers’ critical awareness of shifting cultural models, including patient involvement ideals and providers’ capacity to reflect paternalistic tendencies.
Boerepioniers van die Sandveld
Authors: De Wet G.C.
Published: July 2024

No abstract available.
Johannesburg: Ontstaan en eerste bestuursreëlings 1886-1899
Authors: Grundlingh L.W.F.
Published: July 2024

No abstract available.
Pietersburg: Die eerste eeu 1886-1986
Authors: Tempelhoff Johann W.N.
Published: July 2024

No abstract available.
Carolina 1886-1986.
Authors: Van Breda P.
Published: July 2024

No abstract available.
Graaf-Reinet's water problems
Authors: Minnaar A. de V.
Published: July 2024

Since its establishment in 1786 Graaff-Reinet has been plagued by persistent water shortages. This article traces the often controversial problem from the time of open furrows and branddamme, through the waterworks period when the municipality was forced to declare itself bankrupt, to the Van Ryneveld's Pass Dam era. The building of the latter seemed to ensure a permanent supply of water. But periodic droughts, which caused the town's water supply to become impregnated with salts, and the water rights of irrigators lower down the Sundays River, proved to be almost insurmountable problems. These difficulties led the town council to launch investigations into various alternative water supply schemes. Unfortunately these were unsuccessful and Graaff-Reinet enters its third century no nearer to solving its ever-vexing water problems.
Perioperative Management of an Obstetric Patient with Eisenmenger Syndrome and Pre-Eclampsia Using Milrinone
Authors: Deepak Chakravarthy C.D. , Thangaswamy Chitra Rajeswari , Balachander Hemavathi
Published: July 2024

Pregnancy in a patient with pulmonary hypertension carries a high risk of mortality. It poses multiple problems in the management of pregnancy, labor, and postpartum, thereby emphasizing the need for a multidisciplinary team for a successful outcome. We describe the successful management of a case of Eisenmenger syndrome who developed pre-eclampsia during her 28 weeks of pregnancy. As far as our knowledge, this is the first case report that describes the use of milrinone in a parturient for a successful outcome.
Effects of Dexmedetomidine on Perioperative Glycemic Control in Adult Diabetic Patients Undergoing Cardiac Surgery
Authors: Panidapu Nagarjuna , Babu Saravana , Gadhinglajkar Shrinivas V. , Thomas Diana , Aspari Azeez Mahammad , Sen Barsha
Published: July 2024

Background and Objective:

To study the effects of dexmedetomidine (DEX) on perioperative blood glucose levels in adult diabetes mellitus (DM) patients undergoing cardiac surgery.

Methods and Material:

A prospective, observational study was conducted on 100 adult diabetic patients aged between 18 and 75 years undergoing cardiac surgery with cardiopulmonary bypass (CPB). The patients were divided into two groups (group D and group C) of 50 each. Group D patients received DEX infusion, whereas the group C patients received 0.9% normal saline infusion.

Results:

The blood glucose levels, heart rate, mean arterial pressure, and serum potassium levels at different time points were comparable between the two groups (P > 0.05). The mean dose of insulin required in the combined population as well as in both controlled and uncontrolled DM patients was significantly less in group D than in group C (combined population - 36.03 ± 22.71 vs 47.82 ± 30.19 IU, P = 0.0297; uncontrolled DM - 37.36 ± 23.9 IU vs 48.16 ± 25.15 IU, P = 0.0301; controlled DM - 34.7 ± 21.5 IU vs 47.63 ± 35.25 IU, P = 0.0291). Duration of mechanical ventilation and VIS were comparable between the two groups. The incidence of arrhythmias (20% vs 46%, P = 0.0059) and delirium (6% vs 20%, P = 0.0384) was significantly less in group D than in group C. None of the patients in either group had stroke, myocardial ischemia, and mortality.

Conclusion:

The results suggested that DEX infusion during the intraoperative period was very effective for perioperative glycemic control and reduction of insulin requirement in DM patients undergoing cardiac surgery.
Association of Neutrophil-Lymphocyte Ratio and Red Blood Cell Distribution Width with Poor Outcome in Pediatric Cardiac Surgery − A Retrospective Observational Study
Authors: Kumar Alok , Aggarwal Monika , Mohapatra Akash , Ameta Nihar
Published: July 2024

Background:

Neutrophil–lymphocyte ratio (NLR) is a valuable indicator for evaluating inflammatory response and red blood cell distribution width (RBDW), a routinely available biomarker of likely erythropoietic dysfunction, which may be associated with adverse outcomes after cardiac surgery. This study aimed to investigate the association between these two readily available haematological parameters, with the poor outcomes in paediatric patients undergoing cardiac surgery.

Methods:

A comprehensive review of medical records for paediatric patients who underwent cardiac surgery at our tertiary care centre between April 2022 and June 2023 was carried out. RBDW and NLR values were collected from complete blood count reports obtained on admission to the ICU. Demographic data, surgical details, and postoperative complications were also recorded. A receiver operating characteristic (ROC) curve and multivariable logistic regression were applied to identify the prognosis performance of preoperative NLR and RBDW for poor outcomes.

Results:

The study included 219 patients meeting the inclusion criteria of which a total of 90 (41%) children experienced at least one of the poor outcomes. Preoperative NLR (AUC=0.88, 95%CI 0.36–0.70, cut off- 4.2) and RBDW (AUC=0.88, 95%CI 0.39–0.73, cut off- 18.5%) showed prognostic significance in the perioperative period.

Conclusion:

This retrospective observational study highlights a significant association between elevated Red Blood Cell Distribution Width (RBDW) and Neutrophil Lymphocyte Ratio (NLR) values and poor outcomes in paediatric patients undergoing cardiac surgery. These readily available haematological parameters could serve as potential prognostic indicators for identifying patients at risk of poor outcomes.
Fulminant Giant Cell Arteritis with Tongue Autoamputation
Authors: Baburaj Karthik , Thekkedath Manojan , Bhasi Remesh
Published: July 2024

Giant cell arteritis (GCA) is a systemic vasculitis predominantly affecting large and medium-sized arteries. While headache, scalp tenderness, jaw claudication, and visual disturbances are common presentations in patients over 50 years old, rare manifestations such as tongue necrosis can pose diagnostic challenges. We present an 86-year-old female who initially presented with visual disturbances, jaw claudication, and constitutional symptoms. She was diagnosed with GCA based on clinical features, elevated inflammatory markers, and ultrasound findings of thickened temporal arteries. Despite treatment with high-dose corticosteroids, she subsequently developed spontaneous amputation of the anterior one-third of her tongue due to bilateral lingual artery occlusion, a rare complication occurring in approximately 1% of GCA cases. Despite treatment, the patient’s condition rapidly deteriorated, and she succumbed to the illness within 3 weeks of the initial presentation. This case highlights an atypical and fulminant presentation of GCA with tongue autoamputation, emphasizing the need for early recognition and aggressive management to prevent devastating ischemic complications.
The adherence to asthma medication for hospitalized children with asthma: A cross-sectional study in a tertiary hospital in Riyadh, Saudi Arabia
Authors: Alghamdi Nawaf Abdullah , Alshammari Elaf A. , Alsahli Afnan A. , Abuhaimed Alanoud A. , Alyousef Bader Y. , Othman Fatmah , Abusido Tamer A. , Alkhalaf Hamad Abdullah
Published: July 2024

AIM:

The aim of the study was to assess adherence to asthma controller therapy and factors that influence asthma control and to determine the association between asthma knowledge of the caregiver and asthma control among admitted children with asthma.

SETTINGS AND DESIGN:

A cross-sectional study was conducted between November 2022 and May 2023 in a tertiary care hospital. Children with a diagnosis of asthma aged 2–14 years, who were admitted to the hospital with an exacerbation of asthma were identified.

METHODS:

Caregivers of the admitted children were interviewed using the Asthma Knowledge Questionnaire and Pediatric Inhaler Adherence Questionnaire.

STATISTICAL ANALYSIS USED:

Demographic and clinical data were described using descriptive analyses, where mean and standard deviation were used for normally distributed continuous variables, median and interquartile range (IQR), if otherwise. A P < 0.05 was set as a cutoff for statistical significance.

RESULTS:

A total of 144 caregivers completed the survey. Median score for parents’ knowledge of asthma was 64%, with an IQR of 59–67. Both mother’s and father’s educational levels were associated with a good level of knowledge: odds ratio (OR) = 2.48, 95% confidence interval (CI) = 1.1–5.6, and OR = 5.33, 95% CI = 2.23–12.7, respectively. Median adherence to metered dose inhaler (MDI) was 4 (IQR = 2–6). Children who had been admitted to the general ward in the last 6 months were three times more likely to be nonadherent to MDI (OR = 3.03, 95% CI = 1.18–7.82). Forty-three percent of children who were nonadherent to MDI were less likely to have their asthma controlled (OR = 0.43, 95% CI = 0.17–1.06).

CONCLUSION:

This study revealed that a low level of knowledge among caregivers of asthma patients is linked to inadequate adherence to asthma controller therapy. As medication adherence is crucial for achieving desirable asthma control and improving the quality of life for this population, efforts need to be made to enhance the knowledge level of parents of children with asthma.
Genotoxicity and mutagenicity assessment of electronic cigarette liquids
Authors: Al-Otaibi Hajed M. , Baqasi Aisha MS. , Alhadrami Hani A.
Published: July 2024

INTRODUCTION:

Electronic cigarettes (e-cigarettes) are often advertised as a safer alternative to traditional smoking. However, recent data suggest they may not be as safe as previously believed. This study aims to evaluate the genotoxicity and mutagenicity of e-cigarette liquids.

METHODS:

We randomly selected eight varieties of e-cigarette liquids from the local market in Jeddah, Saudi Arabia. We evaluated their genotoxicity using the Genotoxicity SOS-Chromo Test™ Kit. In this investigation, a rat liver S9 fraction was utilized to emulate liver metabolic function to measure any chemical substance’s mutagenic potential. The SOS-Chromo Test was performed by recording the β-galactosidase and alkaline phosphatase activity with and without the metabolic activation enzyme (S-9).

RESULTS:

All samples, except for the first two dilutions of sample 2, were nongenotoxic in the absence of the S9 activation enzyme, according to the genotoxicity analysis. However, when tested in the presence of the S9 enzyme, samples 2, 4, and 7 exhibited mutagenic activity at varying concentrations.

CONCLUSION:

Contrary to common belief, e-cigarettes are not safe. The present investigation confirms the presence of both toxicants and carcinogens in some e-cigarette liquids. This exposure could increase users’ risk of various health complications.
Saudi Initiative of Bronchiolitis Diagnosis, Management, and Prevention 2024 updated consensus on the prevention of respiratory syncytial virus
Authors: Alharbi Adel S. , Al-Hindi Mohammed Y , Alqwaiee Mansour , Al-Shamrani Abdullah , Alharbi Saleh , Yousef Abdullah , Alshammary Aisha , Miqdad Abeer , Said Yazan , Alnemri Abdulrahman , Alahmadi Turki , Almudeer Ali Husein
Published: July 2024

Respiratory syncytial virus (RSV) is the major cause of bronchiolitis among children under 5 years of age worldwide, accounting for a prevalence of 25%–88% in Saudi Arabia. Although no effective treatment for the virus exists, passive immunoprophylaxis reduced RSV hospitalizations in high-risk children. With recent advances in immunization, the Saudi Initiative of Bronchiolitis Diagnosis, Management, and Prevention panel screened recent relevant international guidelines, locally published data, and expert consensus to update guidelines for RSV prevention, taking into consideration the resources, timing, varying health profiles, and RSV burden in Saudi Arabia. The panel updated its recommendations to include immunization of infants, mothers, and older adults. Practical guidelines were prepared to facilitate the administration of the short-acting and newly developed long-acting RSV monoclonal antibodies (mAb) during the regular follow-ups of high-risk infants in specialized clinics. In addition, long-acting mAb was highlighted as all-infant protection in the routine immunization calendar.
Effect of cheese and casein phosphopeptide-amorphous calcium phosphate on erosive lesions of primary teeth enamel following exposure to amoxicillin and ibuprofen syrups: An in vitro study
Authors: Yousefi Bahareh , Mehran Majid , Sadabadi Yoones , Banakar Morteza , Haghgoo Roza
Published: July 2024

Background:

The acidic component of liquid medicinal syrups used by pediatric patients may cause erosion and partial demineralization. This study aimed to evaluate the effect of cheese and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on erosive lesions of primary teeth enamel following exposure to amoxicillin and ibuprofen syrups.

Materials and Methods:

In this in vitro study, 60 noncarious deciduous molars were used. After measuring the surface microhardness of the samples, they were randomly separated into two groups and immersed in either amoxicillin or ibuprofen for 1 min three times per day. CPP-ACP, cheese, and artificial saliva were then applied to each of the three subgroups (n = 10). After each immersion time, 10 min of therapy was given. Between treatment intervals, the samples were kept in artificial saliva. The microhardness was remeasured after 1 week. Data were analyzed using SPSS software through repeated-measures ANOVA (α = 0.05).

Results:

All samples’ microhardness reduced considerably after immersion in liquid pharmaceuticals (amoxicillin [84.9 kgf/mm2] and ibuprofen [75.1 kgf/mm2]), but increased significantly following exposure to therapeutic solutions. There was no difference between the amoxicillin-cheese and amoxicillin-CPP-ACP subgroups (P = 0.975). A statistically insignificant difference was found between the ibuprofen group and the ibuprofen-CPP-ACP subgroup (P = 0.499).

Conclusion:

As a result, cheese and CPP-ACP can be utilized to remineralize erosive lesions caused by amoxicillin or ibuprofen exposure.
Surgical Challenges of Bilateral Duplex Kidney with Ectopic Ureters
Authors: Paul Sabyasachi , Mandal Ananya , Mandal Prithwis , Halder Pankaj K.
Published: July 2024

The bilateral duplex system is extremely uncommon, and only a few cases have been documented in the literature. It may manifest as a bifid renal pelvis and partial or complete ureteric duplication, with or without ectopic insertion of the ureter. An ectopic ureter is more problematic when there is significant vesicoureteral reflux, incontinence, and/or blockage. The optimal course of treatment is considered to be ureteral reimplantation rather than heminephrectomy. We describe the management strategy for a case of bilateral duplex kidneys with bilateral ectopic ureters in a growing female child.
Agriculture-Related Occupational Hazards Reporting to Health Facility in Tribal Area: A Retrospective Record-Based Observational Study
Authors: Kumar Niku , Kumar Ankit , Phalke D. B. , Kapoor Suraj
Published: July 2024

Introduction:

India being a country of agriculture, most of its population is engaged in agriculture-based activities in a varied manner either directly or indirectly. This sector of activity being most unorganized, very little attention has been given to the occupational health problems of these workers.

Objectives:

To evaluate the socioeconomic profile of agriculture-related occupational health hazards like physical, chemical, biological, mechanical, respiratory, and dermatological, agriculture-related occupational health hazards.

Materials and Methods:

The present study was a retrospective record-based observational study conducted in 3 health centers (2 PHCs and 01 Tertiary care Health center) of tribal area of western Maharashtra over a period of 12 months with a sample size of 274 cases.

Results:

We found an increased incidence of occupational hazards among males of age group 21–60 years and illiterate individuals mainly during rainy and winter seasons. Out of the 274 cases, 22.99% were illiterate. Biological occupational hazards were the most prevalent form of occupational hazard contributing 81.02% of total cases, the majority of cases (64%) arising due to snake bites followed by scorpion bites (19%). Of total 274 cases of occupational hazards 10.21% cases were of mechanical hazards and 6.93% cases of chemical hazards. Another prevalent factor associated was addiction to some substances like alcohol or tobacco in about 74% of cases. This suggests that addiction may be one of the important contributory factors related to occupational hazards.

Conclusion:

There is high burden of agricultural related occupational hazard especially the biological hazard and addictions like substance abuse may be a contributory factor for mechanical injury as well as biological hazard. We Suggest ways to minimize incidences of occupational hazards which may include Awareness and education to target population about various hazards and their prevention, Periodic medical examination based on hazard. Vocational training and rehabilitation may also be given due attention by health policymakers and government at all levels.
Farmers’ Suicides in India: A Qualitative Study of Andhra Pradesh (AP) and Telangana States of India
Authors: Memdani Laila , Memdani Azim , Memdani Anisha
Published: July 2024

Suicides by the farmers’ is increasing in India. From 2005 to 2020, 319,598 famers committed suicide and in states of AP and Telangana this number was 319,598 which is 28% of the total. It implies that more than one quarter of the total number of farmers’ who committed suicide in the ountry were from Telangana and AP. Worldwide farming is considered as a high risk occupation for mental diseases. May be because of the nature of farming and the risk of natural calamities. The study aims to identify the factors that contribute to farmer suicides in Telangana andAndhra Pradesh (AP) and to propose preventive solutions for the problem. In this research in-depth interviews were done with the close relatives ofthe person who committed suicide and qualitative methodology is used. We find that the main causes of farmers suicides are economic and not themental health of the farmers.
Analysis of Age Appropriate Measles Immunisation among the Eligible Children in India: A Cross-Sectional Analysis of National Family Health Survey–5
Authors: Debnath Avijit , Roy Niranjan , Roy Dipankar , Sarma Munmi , Roy Dipanjan , Das Kinnor , Deb Deepmala
Published: July 2024

Background:

Measles continues to pose a significant health threat to children in India, contributing significantly to the global burden of measles-related fatalities. Moreover, a considerable number of children did not even receive their first dose of the measles vaccine, and those who did generally did not receive it at the recommended age. Additionally, there is limited information available in India about age-appropriate measles immunization coverage. Hence, a modest attempt was made to evaluate the extent of timeliness of measles immunization and identify factors associated with the administration of the same among children aged 12 to 23 months in India.

Materials and Methods:

Data from the most recent National Family Health Survey (NFHS 5, 2019–2021) were used in the present study. The sample comprised 48,928 children aged 12 to 23 months. Cox Proportional Hazard regression analysis was used to determine the significant influencing factors on age-appropriate measles immunization in India.

Results:

Despite fairly up-to-date measles immunization coverage in India, more than 55% of immunized children received their immunization after the recommended age. Significant percentages of untimely immunization were observed for a substantial number of States and Union Territories across India. From the regression analysis, maternal age and education, religious affiliation, access to media, and healthcare-seeking behaviors such as institutional delivery and utilization of antenatal checkup were identified as the prominent factors related to age-appropriate immunization in India.

Conclusion:

Untimely immunization is a crucial issue in India. Addressing the timeliness of measles immunization requires a comprehensive strategy that includes healthcare delivery, family planning, immunization perception, and general education. Efforts should be prioritized to improve awareness and accessibility for ensuring timely immunization, thereby safeguarding the health of children across India.
Comparison of Ultrasonography and Cone-beam Computed Tomography for Quantitative Assessment of Midpalatal Suture Opening after Rapid Palatal Expansion: A Pilot Study
Authors: Selvaraj Madhanraj , Duggal Ritu , Manchanda Smita , Chaudhari Prabhat Kumar , Bhalla Ashu Seith
Published: July 2024

Background:

The study was to compare the ultrasonographic (USG) and cone-beam computed tomographic (CBCT) measurements of the width of anterior midpalatal suture (MPS) opening following rapid palatal expansion (RPE).

Methods:

The study included 13 patients (boys: 6; girls: 7) with a mean age of 11.85 ± 1.82 years who underwent RPE therapy for maxillary transverse deficiency. The width of the anterior MPS opening was measured in real-time USG, postscan USG image, and CBCT that were obtained immediately after maxillary expansion. The postscan USG and CBCT measurements were performed twice by two examiners at different times. The intraclass correlation coefficient (ICC), Bland–Altman plot, and paired t-test were performed to evaluate intra- and inter-examiner reliability, level of agreement, and systematic error between different measurements.

Results:

On serial USG evaluation, the MPS opening was seen as the discontinuity in the margins of the maxillary cortical bone, which was not evident before expansion or after the retention period. The intra- and inter-examiner reliability was high (ICC >0.9) for all the measurements. The Bland–Altman plot showed considerable agreement between the different methods, with maximum observations having a mean difference which was within the 95% limits of agreement (real-time vs. postscan USG: ±0.75 mm; CBCT vs. real-time USG: ±0.93 mm; and CBCT vs. postscan USG image: ±1.09 mm). The systematic differences were not statistically significant (P < 0.05) for all the computed measurements.

Conclusion:

USG can be used as a reliable nonionizing imaging modality to assess the anterior MPS opening following RPE.