bluuebunny/crossref_metadata_2025 huggingface dataset:
Adrenocortical Carcinoma with Inferior Vena Cava Thrombus
Authors: Nerli Rajendra B , Ghagane Shridhar C , Muzumdar Ameya , Dixit Neeraj S.
Published: May 2023

Adrenocortical carcinomas (ACCs), are rare, with an incidence of <2 per million cases per year. One of three patients with ACC presents with involvement of the venous system and inferior vena cava (IVC) thrombus. Tumors of the right adrenal gland are more likely to involve the IVC, as it drains directly into it. We report on a 70-year-old male who presented with vague abdominal pain and on evaluation with computed tomography of the abdomen showed a well-circumscribed heterogeneously enhancing lesion 4.7 cm × 4.7 cm × 4.1 cm in the right suprarenal region. The lesion was extending into the IVC through the adrenal vein. The tumor and its extension into the IVC were excised following cross clamping of the IVC. Histopathological examination revealed an ACC. The incidence of ACC is low thereby personal experience in managing such tumors is usually limited. An aggressive approach is required in view of the poor prognosis attached to it.
Role of Aloe Vera in the Management of Oral Submucous Fibrosis
Authors: Shah Palak H , Venkatesh Rashmi
Published: May 2023

Oral submucous fibrosis (OSMF) is a potentially malignant disorder of the oral cavity commonly prevalent in India and other southeastern countries where consumption of areca nut is predominated. As it has significant morbidity and mortality, early diagnosis and prompt treatment are essential. At present, none of the treatment modalities offers a complete cure for the diseases. Thus, in the search of newer treatment modalities, various Ayurvedic medicines have been studied in recent years. The present review aims to summarize the role of Aloe vera for the treatment of OSMF.
Trifid Pelvis with Staghorn Calculus Managed by Percutaneous Nephrolithotomy
Authors: Nerli Rajendra B , Chandra Shoubhik , Patil Shashank D , Rotti Nandish
Published: May 2023

A trifid pelvis is an extremely rare anomaly. It represents either a peduncular arrangement or elongation of the major calyces in association with a rudimentary pelvis. This anomaly becomes significant only in the presence of pathological conditions. We report a case of left sided trifid pelvis with a staghorn calculus managed by percutaneous nephrolithotomy.
Coronavirus Disease 2019-associated Mucormycosis of the Head-and-neck Area
Authors: Swain Santosh Kumar , Jena Pragnya Paramita
Published: May 2023

Coronavirus disease 2019 (COVID-19) pandemic is currently evolving and associated with more complications with invasive fungal infection like mucormycosis. Classically, uncontrolled diabetes mellitus (DM) and other immunosuppressive conditions like corticosteroid therapy are known risk factors for causing mucormycosis in COVID-19 patients. Mucormycosis is an invasive fungal infection which rapidly spread to the orbit and brain from the nasal cavity and paranasal sinuses. Mucormycosis in COVID-19 is a fatal to the patient. There is possibility of COVID-19 as a trigger factor for diabetic ketoacidosis which predisposes to invasive fungal infections such as mucormycosis. Patients with poorly controlled DM and immunocompromised conditions increase the risk for development of COVID-19 infections in COVID-19 patients. During the current COVID-19 pandemic, a myriad of clinical manifestations and complications are emerged. Rhino-orbital-cerebral mucormycosis is a fatal clinical entity associated with COVID-19 infections resulting in higher morbidity and mortality. The treatment includes both medical and surgical interventions. It requires early and adequate treatment with amphotericin B and surgical debridement and control of risk factors. A multidisciplinary approach by otorhinolaryngologists, ophthalmologists, neurologists, and dentists is successful for treatment of COVID-19 patients with mucormycosis in the head-and-neck region. Identification of the risk factors and early preventive measures will minimize the incidence of life-threatening mucormycosis in the head-and-neck area of COVID-19 patients.
Success Rate of Reimplantation of Avulsed Primary Anterior Teeth in Children
Authors: Kadam Krishna S. , Gokhale Niraj S. , Hugar Shivayogi M. , Joshi Riddhi , Neha Kohli Nivedita Saxena
Published: May 2023

Background:

Avulsion of tooth is a grave traumatic injury that is associated with complete displacement from its socket. Lack of conclusive solid evidence and discord opinion is the main reason for the dentist to abstain reimplantation of avulsed primary teeth in children and there are hardy few case reports associated with it. A detailed systematic investigation of literature involving several databases is required to obtain additional evidence for the same.

Aim:

This systematic review aimed for emphasizing risks and benefits to guide dentists in implementing the best clinical decision for cases of reimplanting avulsed primary teeth.

Method:

A systematic search was conducted in databases PubMed, Cochrane, and Google Scholar (Embase) for the studies published from January 1, 2010, to December 31, 2021. Cross-references of the selected articles were also done by hand and electronic searching. Gray literature was also searched for the studies according to the relevance.

Results:

Through search strategy, 4623 articles were yielded. After screening through titles and abstracts, 46 articles remained which were further screened for full text. In the end, 8 articles were included in the systematic review according to the eligibility criteria.

Conclusion:

This systematic review concluded that reimplantation can be carried out in primary dentition too by following proper and immediate treatment protocols; however, adequate clinical studies are utmost required with longer follow-up for the establishment of substantial evidence that can usher clinicians regarding elite approach in treatment of primary tooth avulsion.
A Study on Knowledge and Practice of Dispensing Drugs without Prescription by Pharmacists in Belagavi City
Authors: Sharma Shuvam , Patil Sachin , Narasannavar Ashwini , Bhandari Ramesh
Published: May 2023

Background:

The pharmacists were trained mainly to dispense medicines only over prescriptions. Despite guidelines, practice of dispensing medicines without prescription has been widely practiced worldwide. The problem and burden of drug resistance are increasing worldwide due to this practice.

Objective:

The objective of this study is to assess the knowledge and practice of pharmacists on drug dispensing practices without prescription in Belagavi City.

Materials and Methods:

A cross-sectional study was conducted between January and April 2021 among 80 pharmacists in different areas of Belagavi city. Pharmacists were selected by the simple random technique. Data were collected using the structured questionnaire. The obtained data were tabulated, and the Chi-square test was used to determine the association between the nominal variables.

Results:

Pharmacists had a good knowledge about laws regarding practice of dispensing without prescription. The practice of dispensing nonover-the-counter drugs without prescription was found to be 32.5% in an average. Pharmacists' fear of losing customers was the primary reason for dispensing without prescription. A significant association was found between knowledge score of pharmacists and job status of pharmacist (P = 0.043*) and location of pharmacy (P = 0.05*). The frequency of dispensing medicines without prescription was found to be significantly associated with age of staffs dispensing (P = 0.04*) and with their education status (P = 0.04*).

Conclusion:

Pharmacists had an average level of knowledge regarding the practice of dispensing drugs without prescription in India. However, pharmacists tend to dispense medicines without prescription on request of patients.
Liquid Biopsy
Authors: Chandra Shreya , Chandra Shoubhik , Ghagane Shridhar C. , Nerli Rajendra B.
Published: May 2023

Due to the recent rise in the trend of urological malignancies, noninvasive tumor biomarkers are being researched and used for many different clinical settings. Thus, the identification of specific and effective biomarkers in the form of liquid biopsy has become a major focus, mainly due to the necessity of selecting potentially responsive patients and predicting their outcomes. The rationale for using liquid biopsies instead of solid tissue samples is to avoid unnecessary invasive procedures which will provide the same diagnostic information. The main liquids tackled in patients with urological malignancies are blood and urine. In this review, we provide a detailed discussion on the potential clinical utility of diagnostic materials found in these liquids and will focus on cell-free DNA and other circulating molecules, such as circulating tumor cells, RNAs (microRNAs, long noncoding RNAs, and messenger RNAs), cell-free proteins, peptides, and exosomes as cancer biomarkers.
Fetomaternal Outcome in Epilepsy in Pregnancy in a Tertiary Care Hospital
Authors: Khursheed Rabiya , Ajaz Shaheera , Jeelani Beenish , Wani Saima , Ahmed Abida
Published: May 2023

Introduction:

Epilepsy is one of the most common neurological disorders in obstetrics. Pregnancy with epilepsy is associated with increased risk of complications such as preeclampsia, antepartum hemorrhage, stillbirths, neonatal deaths, intrauterine growth restriction (IUGR), and preterm delivery.

Aims and Objectives:

To study the fetomaternal outcome of pregnancies complicated by epilepsy.

Materials and Methods:

This was a single center retrospective study conducted over a period of 27 months from March 2017 to June 2019. Maternal variables studied included baseline parameters such as age, parity, and mode of delivery. Other variables studied included duration of epilepsy, seizure during pregnancy, antiepileptic drug usage in pregnancy, and maternal complications. Fetal outcome variables analyzed were number of live birth, stillbirth, birth weight, Apgar score, congenital anomalies, and perinatal complications.

Results:

Out of 40 patients with epilepsy in pregnancy, 28 were on antiepileptic drugs (AEDs) during the current pregnancy. The cesarean section rate was 65% in these patients which were higher than in patients without epilepsy. Fourteen patients (35%) delivered vaginally out of which ten were induced. There were six patients who had convulsions four had convulsions in the antepartum period and two had convulsions in the postpartum period. Maternal outcome included gestational hypertension in 6 (15%), postpartum hemorrhage in 1 (2.5%), premature rupture of membranes in 2 (5%), hypothyroidism in 2 (5%), and no maternal death. Prematurity was observed in 10%, low birth weight in 22.5%, and IUGR in 15%. All the neonates received 1 mg of Vitamin K at birth liveborn infants were delivered in 36.

Conclusion:

There was no maternal mortality in our study. The good maternal outcome is because of early booking, regular antenatal visits and regular intake of folic acid, and appropriate number and dose of AEDs. Epilepsy in pregnancy is a high-risk factor which needs thorough evaluation and care from preconception to delivery. These women need delivery at a tertiary care center for the optimum outcome for the perinatal complications.
Endogenous Endophthalmitis Due to Multidrug-Resistant Pseudomonas aeruginosa Treated with Colistin
Authors: Panigrahi Pradeep Kumar , Das Suprava , Sahoo Debasish , Mishra Alpana
Published: May 2023

Multidrug-resistant Pseudomonas aeruginosa is being increasingly recognized as a cause of endogenous endophthalmitis in critically ill patients. Three patients were included in this case series. Antibiogram profile in all three cases showed sensitivity to colistin only. All cases were treated with systemic and intravitreal colistin. Although there was clinical improvement, final visual outcome was poor in all cases. Intravitreal colistin can be tried in multidrug resistance cases. Final prognosis depends on early diagnosis and quick institution of appropriate therapy.
Risk Factors for Cessation of Viral RNA Shedding in COVID-19 Patients
Authors: Dhikale Prasad Tukaram , Chavhan Smita Santosh , Adsul Balkrishna B , Gokhale Chinmay N , Ingale Aniket R , Kinge Kirti V
Published: May 2023

Objectives:

Our study aimed to evaluate the risk factors for the cessation of Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) RNA detection in a cohort of inpatients of laboratory-confirmed coronavirus disease 2019 (COVID-19) cases.

Materials and Methods:

This was a hospital-based, cross-sectional study. All COVID-19 patients positive on the reverse transcription polymerase chain reaction (RTPCR) test of nasopharyngeal samples who were admitted in this Dedicated COVID Hospital (DCH) from April to June 2020 were included in this study. The deceased patients were excluded. Cessation of Viral RNA Shedding (CVS) was considered to have been achieved on the date of the first negative SARS-CoV-2 RTPCR result out of the two consecutive negative SARS-CoV-2 PCR results on nasopharyngeal swabs taken 24 h apart.

Results:

Of the 4632 COVID-19 patients, 3307 (71.4%) patients achieved CVS. Patients had a median (IQR) time from positive to negative PCR of 16 (11–23) days. In multivariate cox regression analysis, age group 41 − 60 years (hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.63–0.91), age >60 years (HR [CI] = 0.63 [0.53–0.78]), female sex (HR [CI] = 1.08 [1.01-1.16]), cancer (HR [CI] = 1.87 [1.03–3.41]) were the independent risk factors for cessation of viral shedding.

Conclusion:

Patients older than 40 years, male patients were shedding viral RNA for more duration and can be considered for the isolation for a longer duration.
Clinical Presentation and Infection Prevention Control Practices in Health-care Workers Diagnosed with COVID-19 in a Dedicated COVID Hospital, Mumbai
Authors: Adsul Balkrishna B. , Chavhan Smita Santosh , Dhikale Prasad Tukaram , Kinge Kirti V. , Gokhale Chinmay N. , Ingale Aniket R. , Jadhav Nilam
Published: May 2023

Objectives:

The objective of this study was to study the clinical presentation and infection prevention and control (IPC) measures in health-care workers (HCWs) diagnosed with COVID-19 in a Dedicated COVID Hospital (DCH).

Materials and Methods:

It was a prospective cohort study of HCWs in a DCH. The new cases found in HCWs from December 1, 2020, to January 31, 2021, were interviewed and followed up for 1 month. The study was part of an international multicenter study by the World Health Organization (WHO). The doctors, nurses, housekeeping, and other staff working in this DCH were considered as HCWs. WANTAI severe acute respiratory syndrome coronavirus 2 Ab ELISA provided by the WHO was used for qualitative testing antibody (IgM + IgG). Paired serology samples from cases were collected for serology testing – comprising one baseline serum sample taken during week 1 and another taken in the 6th week.

Results:

Out of the 1340 HCWs, 25 HCWs (including 15 doctors) developed COVID-19 in 60 days. Most (17, 68%) of the HCWs were from the age group of 21 to 30 years. All the HCWs reported receiving training in IPC. Most (21, 84%) of the HCWs reported following hand hygiene always, as recommended. Most (22, 88%) of the HCWs reported being using recommended personal protective equipment (PPE) always, as recommended. The duration of hospital stay was 10 ± 3.6 days (mean ± standard deviation) and the range was 4–18 days. There was no significant difference between infection prevention and control practices of doctors and other HCWs. In our study, all the patients had mild disease and the antibody titer was positive in 7 (28%) patients in the 1st week of illness and in 20 (80%) patients in the 6th week of illness. The most common symptoms were respiratory symptoms (60%), sore throat (52%), fever (48%), cough (44%), and joint ache (20%). Two (8%) HCWs were asymptomatic.

Conclusion:

The incidence of COVID-19 among HCWs can be kept low by proper IPC measures such as availability of PPE and training of HCWs in IPC.
Jigsaw Technique
Authors: Dnyanesh Suma , Pattanshetti Sheetal Vishwanath , Bhimalli Shilpa M , Dixit Daksha
Published: May 2023

Objectives:

(1) To motivate students for self-directed learning and to enhance their communication skills. (2) To investigate jigsaw technique for its effectiveness in learning anatomy. Cooperative education is the prime aim of this teaching–learning intervention. The students rely on each other for a collective or combined learning experience. The onus of responsibility of the work done by the student and his/her team will be evaluated by the facilitator. We would like to know whether jigsaw cooperative learning would be considered as effective interventional teaching-learning measure compared to the traditional lecture method.

Materials and Methods:

Sixty students of first MBBS were involved in a jigsaw session to learn anatomy. The students were divided into groups of five and a total of 12 such groups were made. The study material was also divided into five topics. The students read the study material and after becoming well versed with their topic, they taught their topic to other students. The students were asked to give feedback on the session. A surprise MCQ test was also conducted between this group and a control group of students to assess their knowledge. The results of the MCQ test were statistically analyzed.

Results:

The students found the jigsaw session to be more engaging than traditional classes. MCQ scores were more in the study group than in the control group.

Conclusion:

The jigsaw technique is both an educational and enjoyable way of teaching. Due to its immense benefits, both students and teachers resolved to use this technique in the future as well.
Pulmonary function abnormality in patients recovered from Covid 19 pneumonia, in a tertiary care hospital in India
Authors: Lawrence Ria , Singh Raj B. , Prakash A Keerthi
Published: May 2023

Background:

One of the most dreaded complications of COVID pneumonia is post-COVID residual lung fibrosis and lung function impairment.

Objectives:

To find out the extent and type of pulmonary function abnormality using spirometry, diffusion capacity, and 6-minute walk test and to co-relate with the clinical severity at the time of infection, in patients who have recovered from COVID19 pneumonia, in a tertiary care hospital in India.

Materials and Methods:

This is a prospective, cross-sectional study with a total 100 patients. Patients who have recovered from COVID pneumonia after one month of onset of symptoms and before 3 months who come for follow-up and have respiratory complaints undergo pulmonary function test will be recruited in the study.

Results:

In our study, the most common lung function abnormality detected was restrictive pattern in 55% of the patients (N = 55) followed by mixed pattern in 9% of patients (N = 9), obstructive in 5% of patients (N = 5), and normal in 31% of patients (N = 31). In our study, total lung capacity was reduced in 62% of the patients and normal in 38% of the patients and diffusion capacity of lung was reduced in 52% of the patients recovered from 52% of the individuals. Also, a 6-minute walk test was reduced in 15% of the patients and normal in 85% of the patients.

Conclusion:

Pulmonary function test can serve as an important tool in both diagnosis and follow-up of post-COVID lung fibrosis and pulmonary sequalae.
A study on clinicodemographic profile, severity, and outcome of Covid-19 in hospitalized vaccinated individuals at tertiary care centre
Authors: Gali Jayasri Helen , Shah Chirali , Keerthi B. Y , Thomas Vimala
Published: May 2023

Objective:

To evaluate the demographic profile, clinical severity, and outcome of Covid-19 infection in hospitalised vaccinated individuals.

Methods:

An observational, cross-sectional study was conducted among Covid-19 infected hospitalised patients. Clinicodemographic profile, severity, and outcome of Covid-19 infection among the vaccinated group (VG) were recorded. These patients were also compared with unvaccinated group (UVG) with Covid-19 infection admitted during the study period. Cox proportional hazards models was used to estimate hazard ratios for mortality risk in both groups.

Results:

Out of 580 participants, 48.2% were vaccinated with either one (71%) or two doses (28.9%). In both, VG and UVG, majority 55.8% belonged to 51–75 years. Males were predominant with 62.9% in both VG and UVGs. Day of illness at admission from symptom onset (DOI), progression of disease, ICU stay, oxygen requirement, mortality was significantly higher in UVG than in VG (p < 0.05). Steroid duration (p < 0.001) and anti-coagulation time (p < 0.001) were significantly higher in UVG than in VG. D dimer levels were significantly higher in UVG than in VG (p < 0.05). Increased age, (p < 0.0004), severity of disease, (p < 0.0052), increased oxygen requirement (p < 0.001), elevated C-reactive protein levels (Moderate: P < 0.0013; Severe P < 0.0082), and elevated IL-6 levels (p < 0.001) were the significant determinants of Covid-19-related mortality in both VG and UVGs.

Conclusion:

Vaccinated individuals have shown milder severity, had reduced hospital stay and better outcomes as compared to unvaccinated individuals suggesting a potential vaccine efficacy against Covid-19.
Secondary infections in critically ill patients with COVID-19: A retrospective single-center study
Authors: Haque Obaid I. , Shameem Mohammad , Hashim Wamin
Published: May 2023

Background:

Patients infected with COVID-19 admitted to the intensive care unit (ICU) may have a higher incidence of developing secondary infections. These infections can further deteriorate the hospital course and increase mortality. Therefore, the objectives of this study were to investigate the incidence, associated risk factors, outcomes, and pathogens associated with secondary bacterial infections in critically ill patients with COVID-19.

Methods:

All adult COVID-19 patients admitted to the intensive care unit requiring mechanical ventilation from October 1, 2020 until December 31, 2021 were screened for inclusion in the study. A total of 86 patients were screened and 65 who met the inclusion criteria were prospectively entered into a customized electronic database. The database was then retrospectively analyzed to investigate secondary bacterial infections.

Results:

Of the 65 patients included, 41.54% acquired at least one of the studied secondary bacterial infections during the course of their ICU stay. The most common secondary infection (59.26%) seen was hospital-acquired pneumonia followed by acquired bacteremia of unknown origin (25.92%) and catheter-related sepsis (14.81%). Diabetes mellitus (P = <.001), cumulative dose of corticosteroids (P = 0.001), were associated with an increased risk of secondary bacterial infection. The most commonly isolated pathogen in patients with secondary pneumonia was Acinetobacter baumannii. Staphylococcus aureus was the most common organism associated with a bloodstream infection and catheter-related sepsis.

Conclusion:

The incidence of secondary bacterial infections was high in critically ill patients with COVID-19 and was associated with a longer duration of admission to the hospital and ICU and a higher mortality. Diabetes mellitus and cumulative dose of corticosteroids were associated with significantly increased risk of secondary bacterial infection.
Cystic lung lesion following transbronchial lung cryobiopsy: Case report and systematic review
Authors: Malegaonkar Srikant Kashinath , Sehgal Inderpaul Singh , Muthu Valliappan , Agarwal Ritesh , Bal Amanjit , Dhooria Sahajal
Published: May 2023

Transbronchial lung cryobiopsy (TBLC) is a technique used to sample the lungs for diagnosing diffuse lung diseases. A sizeable tissue is sheared off the lung parenchyma during TBLC leading to a defect in the lung, which might result in a cystic lesion on imaging. Computed tomography (CT) performed for other reasons might incidentally reveal such a cyst. We report a 75-year-old patient who underwent TBLC and developed significant intraprocedural bleeding. Chest CT performed for worsening breathlessness revealed an acute exacerbation (AE) of the underlying interstitial lung disease, and incidentally showed a new cyst in the biopsied lung lobe. The patient recovered clinically after the administration of high-dose methylprednisolone. A chest CT performed nine months later showed resolution of the lung cyst. A systematic review of the literature revealed that cysts/pneumatoceles/cavities may appear in 50% of patients following TBLC. About 90% are due to biopsy trauma and mostly resolve spontaneously. Rarely, a cavity may be due to infection; antimicrobial agents should be administered in such cases.
Scourge of tuberculosis: A rare case of simultaneous chylothorax and chylous ascites
Authors: Gada Parth B. , Sachdev Rupali R. , Ansari Waqar A. , Jadhav Akash A.
Published: May 2023

Tuberculosis (TB) is a rare cause of chylothorax and chylous ascites. This is a case of simultaneous TB-chylothorax and chylous ascites in a 20-year-old patient who had been diagnosed with disseminated Multi-Drug Resistant (MDR) Tuberculosis two years ago. Abdominal distention with horseshoe-shaped dullness was found on examination. Abdominal ultrasound revealed gross ascites and bilateral gross pleural effusion. Pleural fluid analysis was positive for chylomicrons and revealed elevated Protein, Albumin, ADA, and Triglyceride. GeneXpert was negative and no growth was seen on culture. Lymphoscintigraphy showed a normal ascent of radio tracer along bilateral lower limb. Lymphangiogram and thoracic ductogram showed multiple dilated lymphatic ducts in the bilateral internal iliac region with obstruction of lymphatic flow in the iliac group of nodes. Low-fat diet was given. No interventional radiological approach or surgical correction could be done for the patient. He died after one and half years with progressive swelling and emaciation.
Endobronchial chondroid hamartoma of left main bronchus and its bronchoscopic management
Authors: Prasad Virender Pratibh , Vaddepally Chetan Rao , Rao Chikyala Dheeraj , Narasimha M. Penchala , Sethi Shweta , Maturu Venkata Nagarjuna
Published: May 2023

Most tumours of the tracheobronchial tree are malignant. Benign tumours such as hamartoma are infrequent and generally intra-parenchymal. Here we present a case of a 65-year-old male patient who presented with a purely endobronchial lobulated mass lesion in the left main bronchus. This central airway obstruction was managed by a complete endobronchial resection using an electrocautery snare and cryo-recanalisation techniques. A diagnosis of endobronchial chondroid hamartoma was made on histopathological examination. Such endobronchial lesions are rare and constitute less than 2% of all hamartomas.
Analysis of Plasma Circulating Tumor DNA in Borderline Resectable Pancreatic Cancer Treated with Neoadjuvant Modified FOLFIRINOX: Clinical Relevance of DNA Damage Repair Gene Alteration Detection
Authors: Lim Dong-Hoon , Yoon Hyunseok , Kim Kyu-pyo , Ryoo Baek-Yeol , Lee Sang Soo , Park Do Hyun , Song Tae Jun , Hwang Dae Wook , Lee Jae Hoon , Song Ki Byung , Kim Song Cheol , Hong Seung-Mo , Hyung Jaewon , Yoo Changhoon
Published: May 2023

Purpose There are no reliable biomarkers to guide treatment for patients with borderline resectable pancreatic cancer (BRPC) in the neoadjuvant setting. We used plasma circulating tumor DNA (ctDNA) sequencing to search biomarkers for patients with BRPC receiving neoadjuvant mFOLFIRINOX in our phase 2 clinical trial (NCT02749136).Materials and Methods Among the 44 patients enrolled in the trial, patients with plasma ctDNA sequencing at baseline or post-operation were included in this analysis. Plasma cell-free DNA isolation and sequencing were performed using the Guardant 360 assay. Detection of genomic alterations, including DNA damage repair (DDR) genes, were examined for correlations with survival.Results Among the 44 patients, 28 patients had ctDNA sequencing data qualified for the analysis and were included in this study. Among the 25 patients with baseline plasma ctDNA data, 10 patients (40%) had alterations of DDR genes detected at baseline, inclu-ding ATM, BRCA1, BRCA2 and MLH1, and showed significantly better progression-free survival than those without such DDR gene alterations detected (median, 26.6 vs. 13.5 months; log-rank p=0.004). Patients with somatic KRAS mutations detected at baseline (n=6) had significantly worse overall survival (median, 8.5 months vs. not applicable; log-rank p=0.003) than those without. Among 13 patients with post-operative plasma ctDNA data, eight patients (61.5%) had detectable somatic alterations.Conclusion Detection of DDR gene mutations from plasma ctDNA at baseline was associated with better survival outcomes of pati-ents with borderline resectable pancreatic ductal adenocarcinoma treated with neoadjuvant mFOLFIRINOX and may be a prognostic biomarker.
The generalized Binet formula for $k$-bonacci numbers
Authors: Parks Harold R. , Wills Dean C.
Published: May 2023

Using Vandermonde determinants, we give a simple proof of the generalization
of the Binet formula to the

k

-bonacci numbers.
Universal reflective-hierarchical structure of quasiperiodic eigenfunctions and sharp spectral transition in phase
Authors: Jitomirskaya Svetlana , Liu Wencai
Published: May 2023

We prove sharp spectral transition in the arithmetics of phase between localization and singular continuous spectrum for Diophantine almost Mathieu operators. We also determine exact exponential asymptotics of eigenfunctions and of corresponding transfer matrices throughout the localization region. This uncovers a universal structure in their behavior governed by the exponential phase resonances. The structure features a new type of hierarchy, where self-similarity holds upon alternating reflections.
Who Left the Dog Out (of the History)? -
Authors: Holtzapple Zachary
Published: May 2023

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Nosocomial vs Healthcare Associated vs Community Acquired SBP –
Authors: Iqbal Amna
Published: May 2023

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Predictors of 6-Month Mortality in Hospitalized COVID-19 Patients,
Authors: Kaur Jasskiran
Published: May 2023

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Cellulosimicrobium Bacteremia in a Patient With Small Cell Lung Cancer:
Authors: Soewarna Victoria
Published: May 2023

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Streptococcus intermedius -
Authors: Al-Tkrit Amna
Published: May 2023

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The Future of Animal Feed
Authors: Pexas Georgios , Kyriazakis Ilias , Doherty Bob
Published: May 2023

The feed-food competition for environmental and economic resources raises increasing concerns about the production and supply of protein for the global livestock sector. Risks to food-security and approaching deadlines for global sustainable development, means exploring the potential for alternative protein feeds is imperative. However, as the use of alternative feeds for livestock production is still at its infancy, it is critical that potential direct or indirect food safety risks are evaluated before implementation at commercial scales. This Rapid Evidence Assessment (REA) offers a lens that focuses on the potential opportunities and threats of such alternatives for the sustainability and food safety of the global livestock sector. Four potential alternative protein sources for livestock feeds are identified and evaluated through this REA: genetically modified / engineered protein crops and alternative cultivation methods cellular agriculture former foods, food waste and industry by-products and waste streams animal by-products and insects Through this analysis, a strategic policy roadmap and research agenda are synthesised to facilitate higher-level policy making, supporting local solutions for global sustainable development and a more food-secure future. The four broad directions for policy making and research the REA proposes are: decoupling protein production from fossil fuel developing sustainable economic strategies for alternative proteins at a subnational level supporting circular livestock feed solutions further enhancing the feed and food regulatory system
A compreensão do conhecimento social de lugar
Authors: Godoi Guilherme Aparecido de , Olivieira Francismara Neves
Published: May 2023

No contexto educacional, o lugar é um conteúdo da Geografia Escolar, assim como uma escala de análise para se conduzir o processo de ensino dos saberes geográficos. Contudo, simplesmente trabalhar os conceitos na escala local, não garante por si só que os saberes sejam construídos e que a compreensão de lugar seja alcançada. Assim sendo, o presente artigo objetivou verificar se uma proposta pedagógica, pautada nos princípios da metodologia ativa sob enfoque piagetiano, com uso de fotografias e discussões coletivas acerca do espaço vivido, favorece a elaboração do conhecimento de lugar. Para tanto, adotou-se a Epistemologia Genética de Jean Piaget sobre a construção do conhecimento e em especial seu estudo sobre a construção do espaço. Participaram 8 estudantes do 6º ano do Ensino Fundamental II de uma escola pública da cidade de Londrina. O método clínico crítico piagetiano fundamentou a coleta dos dados, desenvolvida por meio de uma sequência didática que teve como tema o conceito de lugar e envolveu atividades com fotografias, discussão em grupo e produção de texto. Os resultados indicaram que a metodologia ativa foi uma proposta rica e integradora, que permitiu a retirada de ênfase do conteúdo escolar para a forma de estruturação e leitura do espaço, permitindo o desenvolvimento e compreensão das noções de modo a integrar tais saberes.
Palavras-chave
Lugar, Conhecimento social, Ensino de Geografia, Metodologia ativa, Teoria piagetiana.
 
Understanding the social knowledge of place: contributions from the active methodology under a piagetian focus
Abstract
In the educational context, place is a content of School Geography, as well as an analysis scale to conduct the process of teaching geographic knowledge. However, simply working the concepts at the local scale does not in itself guarantee that knowledge is built and that an understanding of place is achieved. Therefore, this article aimed to verify whether a pedagogical proposal, based on the principles of active methodology under a Piagetian approach, using photographs and collective discussions about the lived space, favors the development of knowledge of place. Therefore, Jean Piaget's Genetic Epistemology was adopted on the construction of knowledge and in particular his study on the construction of space. Eight students from the 6th year of Elementary School II from a public school in the city of Londrina participated. The Piagetian critical clinical method was the basis for data collect, developed through a didactic sequence whose theme was the concept of place and involved activities with photographs, group discussion and text production. The results indicated that the active methodology was a rich and integrative proposal, which allowed the removal of emphasis from school content to the way of structuring and reading the space, allowing the development and understanding of notions in order to integrate such knowledge.
Keywords
Place, Social knowledge, Teaching Geography, Active methodology, Piagetian theory.
THE "PHOTOSYNTHESIS–GROWTH–STRESS MEMORY" RELATIONSHIP IN PLANTS UNDER CONDITIONS OF MOISTURE FLUCTUATION AND RECURRENT DROUGHT: MANAGEMENT OPTIONS
Authors: Anastasia ŞTEFÎRŢĂ Anastasia , BULHAC Ion , BRÎNZĂ Lilia , VOLOȘCIUC Leonid , COROPCEANU Eduard , COCU Maria
Published: May 2023

The effect of co-activation of the stress-memory formation potential under repeated drought of Glycine max (Merr.) L. plants was recorded using cytokinin (CK), thiourea (TH) and, especially, complex preparation Polyel. Glycine max plants (Merr.) L. of Moldovitsa, Nadejda and Magia varieties, exposed to two cycles of "drought–rehydration" at the "first trifoliate leaf" and "flowering - pods formation” phases served as test subjects. The tolerance-inducing effect manifests itself by maintaining the content of assimilatory pigments, photosynthesis and growth processes at a significantly higher level. After the restoration of the optimal moisture background, plants pre-treated with CK, TH and the preparation Polyel, which endured moderate stress in the initial stages of ontogenesis, had restored functional processes. The information obtained in this work certainly opens the management perspective of the ability to form stress memory, adaptation and tolerance of plants to the unfavourable fluctuation of humidity and recurrent drought. The management possibilities of plant adaptation and tolerance are discussed.
La Plataforma Moodle y rendimiento académico en los estudiantes universitarios de una Universidad Pública peruana
Authors: MALPARTIDA YAPIAS RAFAEL JULIAN
Published: May 2023

Esta investigación tuvo como objetivo demostrar la influencia de la plataforma Moodle en el rendimiento académico del curso de gestión de proyectos productivos en los estudiantes del décimo ciclo de Ingeniería agroindustrial de la Facultad de Ciencias Agrarias de la Universidad Nacional de Huancavelica. La muestra poblacional estuvo constituida por 19 estudiantes. Para la variable plataforma Moodle se utilizó un instrumento tipo encuesta, valorándose dimensiones (ambientes virtuales, foros de debate y material digital) y para la variable rendimiento académico, se utilizó las notas de la asignatura gestión de proyectos productivos. La investigación demuestra que la aplicación de la plataforma Moodle y el rendimiento académico tiene una correlación positiva considerable (r = 0,698). Existe evidencia estadística de que la plataforma Moodle influye significativamente en el rendimiento académico del curso de gestión de proyectos productivos; aseveramos que es importante complementar las clases presenciales con ambientes virtuales de aprendizaje, debido a su influencia positiva en los estudiantes.
Uso del Marketing digital innovando la Oferta formativa y demanda educativa para el nivel superior, en los colegios públicos de la provincia de Satipo 2020-2021.
Authors: Vila Hiojo Bernabe Teodoro , Castillo Mendoza Helsides Leandro , Vílchez Casas Ludy Rossana
Published: May 2023

El propósito es determinar la relación entre “uso del marketing digital y la Oferta formativa y demanda educativa para el nivel superior, de los colegios públicos de la provincia de Satipo 2020 – 2021”.

La investigación obedece al enfoque cuantitativo, de diseño no experimental, de tipo aplicada, en un nivel descriptivo, por su carácter correlacional, por naturaleza cuantitativa, según el alcance temporal transversal. Se consideró una muestra de tipo censal de forma no probabilístico, de 68 alumnos, utilizando la técnica de encuesta virtual y como instrumento el cuestionario digital.

Los resultados obtenidos indica una correlación del 0.409, que significa una correlación moderada, asimismo señalaron que el 1,5 % nunca realizan promoción digital, y que el 86,6 % manifiesta, que a veces realizan promoción digital, por último, el 17,9% siempre realizan la promoción digital. De tal manera incidir en el empleo de estudios virtuales a nivel universitario de docentes y educandos, para responder a los cambios en el sistema educativo.
Programa de ejercicios propioceptivos para la prevención de caídas en el adulto mayor (Proprioceptive exercise program for the prevention of falls in the elderly)
Authors: Chalapud Narváez Luz Marina , Molano Toba Nancy Janeth
Published: May 2023

Objetivo: determinar la efectividad de un programa de ejercicios propioceptivos en el equilibrio estático y dinámico para prevenir las caídas en la población adulta mayor del Centro Vida Norte de la Fundación EMTEL Popayán. Materiales y mé-todos: el estudio tuvo un diseño cuasi experimental no controlado, con una muestra de 16 personas de la tercera edad, a quienes se les aplicó un programa de ejercicios propioceptivos de 10 semanas de duración, dos días a la semana con dos sesiones de entre-namiento, consistente en ejercicios de postura, fortalecimiento muscular, propiocepción, equilibrio estático y dinámico. Para el análisis de datos se utilizó el programa PSPP 23.0. Se realizó análisis univariado aplicando medidas de tendencia central y un análisis estadístico con pruebas paramétricas para dos muestras relacionadas T-Student. Resultados: edad promedio de 73,13 años, 50% de la población presenta sobrepeso, y el 68,75% ha sufrido caídas. Se encontró una significancia estadística de p=0,002 entre la evaluación inicial y final del riesgo de caídas. Conclusión: el programa de ejercicios propioceptivos en el equili-brio estático y dinámico, sí es efectivo para prevenir caídas en la población adulta mayor de Popayán.Palabras clave: Ejercicios, Propiocepción, Equilibrio estático y dinámico, Adulto mayor.
Abstract. Objective: To determine the effectiveness of a proprioceptive exercise program in static and dynamic balance to prevent falls in the elderly population of the Vida Norte Center of the EMTEL Popayán Foundation. Materials and methods: The study had an uncontrolled quasi-experimental design, with a sample of 16 elderly people, who were applied a program of propri-oceptive exercises of 10 weeks duration, two days a week with two training sessions, consisting of posture exercises, muscle strengthening, proprioception, static and dynamic balance. The PSPP 23.0 program was used for data analysis. Univariate analy-sis was performed applying measures of central tendency and a statistical analysis with parametric tests for two related T-Student samples. Results: average age of 73.13 years, 50% of the population is overweight, and 68.75% has suffered falls. A statistical significance of p=0.002 was found between the initial and final assessment of the risk of falls. Conclusion: the program of propri-oceptive exercises in the static and dynamic balance, yes, it is effective to prevent falls in the elderly population of PopayánKeywords: Exercises, Proprioception, Static and dynamic balance, older adult.
Influencia de la altitud sobre la condición física de futbolistas en situaciones de entrenamiento y competición: una revisión sistemática (Influence of altitude on the physical condition of soccer players in training and competition situations: a systematic review)
Authors: Montañez Rojas Fabian Humberto
Published: May 2023

Objetivo: Analizar la influencia de la altitud sobre la condición física de los futbolistas en situaciones de entrenamiento y competición. Metodología: Esta revisión sistemática corresponde a la literatura disponible en bases de datos Scopus, Ebsco Host, Science Direct, y PubMed, desarrollada mediante la metodología PRISMA, en un rango de 6 años (2014 – 2020), usando las palabras (Soccer) y (altitud) y (condición física) y (entrenamiento) o (competencia). Resultados: Se crearon categorías de análisis en el software QDA Miner Lite v 2.0.7. para descripcion de las variables. Se recuperaron 1887 registros, de los cuales 10 artículos fueron elegibles. La calidad metodológica de los documentos se hizo de acuerdo a Law (1998). Conclusión: Los beneficios de la altitud son verificables en el entrenamiento y la competición en deportes intermitentes, pero aún requieren la creación de planes más específicos en el fútbol.
Palabras clave: Fútbol, ​​altitud, entrenamiento, competición, condición física.
Abstract. Objective: To analyze the influence of altitude on the physical condition of soccer players in training and competition situations. Methodology: This systematic review corresponds to the literature available in the Scopus, Ebsco Host, Science Direct and PubMed databases, developed with the PRISMA methodology, in a range of 6 years (2014 - 2020), using the keywords (Soc- cer) and (altitude) and (physical condition) and (training) or (competition). Results: Analysis categories were created in QDA Miner Lite v 2.0.7 software. for the description of the variables. 1887 records were retrieved, of which 10 articles were eligible. The methodological quality of the documents was carried out according to Law (1998). Conclusion: the benefits of height are verifiable in training and competition in intermittent sports, but still require the creation of more specific plans in soccer.
Keywords: Soccer, altitude, training, competition, physical condition.
Composition of Stand and Growth Dynamics of Black Cardamom (Amomum subulatum) in Different Agroforestry Habitats in Bhutan
Authors: Koirala Bhakti Sharma , Suberi Bhagat , Chhetri Rekha , Gyeltshen Thubten
Published: May 2023

The composition and arrangement of tree species at different altitudes play a vital environmental role in the growth of Black Cardamom (Amomum subulatum) in Bhutan. The present study assesses agroforestry tree species composition and factors affecting the growth of A. subulatum in different habitat types. Altitudes were sorted into three different altitudinal bands (low, mid, and high) and each altitudinal band in three different habitats (timber tree, fodder tree, and mixed tree habitat) was assessed. The sampling of 48 plots was made for each habitat and the plot size was 20×20 m. In total, 144 plots were sampled systematically within the selected altitudinal bands in three different habitats. The 56 ecologically important agroforestry shade tree species were used for growing A. subulatum. Tree species preference of A. subulatumchanged based on different altitudes and habitat types [F(2, 33) = 45.672, P = .001]. Critical factors affecting the growth are tree canopy cover (r = –0.461) and infested A. subulatum stems (r = –0.765). The increasing number of infested stems retarded the growth and dense canopy cover or open canopy reduces the growth rate of A. subulatum. Overall, growth was suitable in timber tree habitat at mid altitudes, where Alnus nepalensis was the dominating species having 41.40% canopy cover with low pest and disease-infested A. subulatum stems. Significantly, the lower altitudinal band and the fodder tree habitats were found to be unsuitable for growth (p < 0.05).  Thus, appropriate site selection, canopy cover and altitude could provide optimum growth.
Историографический обзор изучения вопроса истории улуса Джучи
Authors: Нарымбет Гүлнур , Жакаш Досмухамбет
Published: May 2023

В данной статье автор на основе письменных источников проанализировал историографический обзор изучения вопроса истории образования и развития улуса Джучи. На сегодняшний день изучение первоисточников является актуальной проблемой исследователей, позволяющие раскрыть новые страницы из истории улуса Джучи, а именно политическое, экономическое и культурное развитие государства. Исследование проводилось на основе исторических, последовательных принципов, статистического, сравнительного и проблемно-хронологического анализа, систематического и объективного подходов. Основные результаты исследования позволили раскрыть этнополитическую историю улуса, позволяющие на основе изучения письменных источников определить значимые этапы этногенеза улуса Джучи.
Boshlang‘ich sinflarda matematika o‘qitishda kompetensiyaviy yondashuv
Authors: Jo‘lanov Doniyor , Ulug‘berdiyeva Gulchehra
Published: May 2023

Ushbu maqolada matematika o‘qitishda kompetensiyaviy yondashuvning samaradorligi xususida so‘z borgan.
Ўзбекистон республикасида аҳолини ижтимоий ҳимоя қилишнинг асосий йўналишлари
Authors: Кутбитдинва Мухайёхон
Published: May 2023

Мақолада меҳнат бозорининг ривожланиши аҳоли фаровонлиги ва турмуш сифати ошишини таъминловчи, меҳнат унумдорлиги, ялпи ички маҳсулотнинг юқори ўсиш суръатлари ва инвестициялар самарадорлигининг омиллари, ижтимоий ҳимоянинг асосий йўналишлари, камбағалликни қисқартириш ечимини кутаётган долзарб масалалар кўриб чиқилган.
About the French experience of constitutional reforms
Authors: Ergashev Shukhrat
Published: May 2023

Large-scale constitutional reforms implemented in Uzbekistan require studying the constitutional experience of advanced countries along with the long history of national statehood. The experience of France as a country with a long history of constitutionalism, which created one of the first examples of modern bourgeois statehood is of great importance.