bluuebunny/crossref_metadata_2025 huggingface dataset:
Coding with Block Programming Languages in Educational Robotics and Mobiles, Improve Problem Solving, Creativity & Critical Thinking Skills
Authors: Moraiti Ioanna , Fotoglou Anestis , Drigas Athanasios
Published: October 2022

The purpose of the article is to highlight how students' computational thinking, which is a critical thinking skill, can be developed through educational robotics and programming. It is a fun and engaging learning activity that encourages students to collaborate, delve into a problem, construct knowledge, and cultivate critical thinking. Educational robotics is therefore an innovative teaching tool, which contributes to the implementation of the above goal and follows the principles of building, specifically the construction of knowledge (Mikropoulos & Bellou, 2010). It develops students' critical thinking, strengthens their mental models, and activates known learning mechanisms leading them to a deeper level of understanding and assimilation of knowledge, which cannot be accomplished with traditional teaching methodologies. It has also been proven to be able to help students solve complex problems as well as contribute to the development of computational thinking skills (Atmatzidou & Demetriadis, 2014), which should characterize the entire literate population and complement the other three basic reading skills, writing, and mathematics (Mavroudis, Petrou & Fesakis, 2014).
Teaching Fire Safety in Schools of Architecture
Authors: Echeverría Juan Bautista , Fernández-Vigil Maria
Published: October 2022

Fire safety teaching in schools of architecture has become more relevant over the last years in Spain due to the influence that it has in the professional architectural project. The introduction of fire safety knowledge in the intermediate courses of architectural studies has important advantages for the student, who quickly perceives the project as a normative discipline. However, fire safety regulations are complex and difficult to understand for the students. The experience along the last years has progressively evolved from an analysis of the legal documents to a more frequent use of graphical representations. A combination of symbols, diagrams, and simple drawings has proven to be quite effective: Symbols act as anchor repeated throughout the learning process. Diagrams are a first approach to the characteristics of the building. And the simple drawings complete the information so the students can work on the proposed exercise.
The Importance of STEM Fields in Higher Education in a Post-Pandemic World
Authors: Günay Aslı , Yüksel Haliloğlu Ebru
Published: October 2022

In today's world, along with the COVID-19 pandemic, the importance of innovation and digitalization for economic growth raises the value of STEM (science, technology, engineering, and mathematics) education due to its contribution to knowledge generation, application, and distribution. Higher education students in STEM fields represent high-quality human capital because they are expertly aware, engage with industry, and incorporate commercial sensibilities into their daily research activity. So, the main goal of this study is to look at the current state of STEM fields in higher education and the labor market for university graduates from STEM fields. Also, the challenges facing STEM fields in higher education during the COVID-19 pandemic are discussed.
Transformative Innovation in Course Design for STEM-Based E-Learning
Authors: Bijlani Vinod Anand
Published: October 2022

Students today are the workers and leaders of tomorrow. It is, therefore, essential to future-proof education against serious disruptions to ensure continued socioeconomic development in the world. The distant learning format is, as yet, largely uncharted in several parts of the world. But it is set to revolutionize teaching and learning in the years to come. By leveraging the pandemic circumstances that disrupted in-person, face-to-face instruction, the author recommends a set of fundamental solutions to bring the complexities of STEM learning back on course. Redefining the strategy to render education remotely, effectively, and at scale, he emphasizes the need for a transformative initiative to improve teaching objectives and learning outcomes. The focus, he believes, should be an integrated approach for a comprehensive experience through the use of immersive technologies, including augmented reality (AR), virtual reality (VR), and the metaverse.
The Use of Culturally Sustaining Practices in Play to Foster Resilience
Authors: Lowry Genevieve
Published: October 2022

Children present in the hospital with an array of previous experiences. Play specialists must learn to help children use experiences as opportunities for growth and coping and be prepared when significant life events emerge as part of a child's play. Ecological models provide a framework for understanding children's lived experiences affecting development and offering insight into children and families responses to stress. Foundational theories of play provide knowledge of children's development, interests, and understanding of themselves and the world. This chapter examines two culturally sustaining models that build on play theories viewing children and families through a strengths-based lens that includes culture, traditions, spiritual, and community support to facilitate assessments and interventions. Converging ecological models and culturally sustaining pedagogies with play deepens the play specialists' understanding and ability to identify strengths, build relationships, and discover family and community support leading to children's meaning making and resilience.
mHealth for Pediatric Patients
Authors: Perasso Giulia
Published: October 2022

The World Health Organization described mHealth as the integration between traditional healthcare assistance and Internet Communication Technologies (ICTs) and devices. mHealth applications are developed by the joined contributions of healthcare researchers and informatic engineers. In pediatric healthcare, these apps can be used to foster the child's distraction through play, but also for psychoeducational and support purposes, according to gamification principles. A growing body of scientific studies points out that mHealth provides fruitful support in surgical practices with pediatric patients and in children's pain management. Research stresses out the core challenge of this field of investigation: the difficulty to develop engaging mHealth applications for pediatric patients that must be, at the same time, effective. In order to deepen the knowledge about pediatric mHealth, the chapter offers a review of N=11 mHealth applications, describing their main features, aims, and scientific outcomes.
Challenges in Implementing Clinical Decision Support Systems for the Management of Infectious Diseases
Authors: Kherabi Yousra , Ming Damien , Rawson Timothy Miles , Peiffer-Smadja Nathan
Published: October 2022

The increased availability of routine healthcare data collected through electronic medical record (EMR) systems provide opportunities for a much greater data-driven approach to healthcare. In infectious diseases, a number of Clinical Decision Support Systems (CDSSs) have shown promising results to improve quality and safety of healthcare management. However, most CDSSs have not been evaluated in real-world clinical settings and are not implemented into clinical practice. The aim of this chapter is to highlight the major challenges in translating CDSS research in infectious diseases into effective tools suitable for use in the clinical setting. Exemplars of real-world implementations and experience of introducing CDSS in infectious diseases are provided, and discussion on measurable outcomes, integration, and framework for clinical implementation proposed.
Prison
Authors: Lowry Genevieve
Published: October 2022

This chapter focuses on the role of the child life specialist working with families affected by incarceration. Children and families are at increased risk due to trauma exacerbated by arrests, incarceration, and re-entry. This chapter will focus on the ways a child life specialist working in jails, prisons, detention centers, and in communities with schools, non-profits, and faith-based organizations can provide developmentally appropriate explanations, preparation, play, expressive arts, and coping, facilitating opportunities that foster relationships and understanding while promoting resilience.
Brand Attachment and Agile Marketing
Authors: Reis Raissa , Catarino André Paulo , Sousa Bruno Barbosa , Malheiro Alexandra , Santos Vasco
Published: October 2022

This research seeks to understand the impact of the pandemic on online sales of sports brands and their relationship with consumers. The results obtained showed that the brands adapted to the pandemic period, they managed to preserve and even strengthen the relationship and communication with their consumers due to their online platforms, in which their sports products were found due to the high demand during the pandemic, especially in the period of confinement. In addition to realizing the importance of contact with companies during the period of confinement, which helped maintain the connection and loyalty between brand and consumer. The present study represents an important contribution regarding digital and agile marketing and the importance of the relationship between brand-consumer, namely the consumer's attachment to the brand.
The Concept of Sustainability Supported by Green Marketing in Digital Communication Applied to Textile Fashion
Authors: Santos José Duarte , Pereira Inês Veiga , Passos Mariana Cardoso
Published: October 2022

To understand how fashion brands are communicating their sustainability strategies supported in green marketing, a case study was developed with the brands H&M and Levi's. An analysis of the green marketing mix of both brands was carried out with a special focus on digital communication. Their sustainability reports and digital tools were analyzed, namely website, blog, newsletter, and social networks. It was found that both fashion brands are investing significantly in strategies to become more sustainable, seeking to adapt the marketing mix in a green marketing perspective, and are using the online medium to communicate their efforts.
Graphical Password Authentication System for Web and Mobile Applications in JavaScript
Authors: Jha Anand , Bhatele Kirti Raj , Philip Prajeesh , Mishra Khushi
Published: October 2022

RESTful API-based web and mobile applications are cross-platform and can be accessed from anyplace or anytime resulting in a smoother and easier user experience. This ecosystem creates a familiar environment for business applications, especially for small businesses. However, an increasing number of such applications creates opportunities to protect passwords from various attacks. Humans choose weak textual passwords due to easiness, which may lead to the most frangible connections in the chain of authentication. The graphical password offers a better approach of authentication for web and mobile applications in the emerging business world since it uses images as input instead of alphanumeric. It also makes it difficult for the attackers to crack. This study devises a system that allows the user or client application to authenticate by tapping the right cues over a series of images that the user selects while registering in the system. The system is implemented as a web service using JavaScript technology by ReactJS on client applications and NodeJS on server end.
Synthesis of Evidence on Existing and Emerging Social Engineering Ransomware Attack Vectors
Authors: Bello Abubakar , Maurushat Alana
Published: October 2022

As the threat landscape continues to evolve, users are becoming less aware, ignorant, or negligent, putting their confidential data at risk. Users easily fall prey to socially engineered ransomware attacks that encrypt and lock a computer or mobile device, holding it hostage unless a ransom is paid. The cryptoware encrypts data securely, making it almost impossible for anyone except the hacker to unlock the device. This research conducts a systematic review to identify methods for executing socially engineered ransomware attacks. Using a CRI framework, 122 studies were synthesized from 3209 research articles highlighting gaps in identifying and analyzing attack vectors, as well as the need for a holistic approach to ransomware with behavioural control as part of the solution. Human vulnerability was found to be a critical point of entry for miscreants seeking to spread ransomware. This review will be useful in developing control models that will educate organisations and security professionals to focus on adopting human-centered solutions to effectively counter ransomware attacks.
Student Intention to Use Online Library Services of a Locked-Down University
Authors: Manzoor Amir
Published: October 2022

The COVID-19 pandemic had a drastic impact on the teaching and learning practices of universities around the globe. To comply with the new normal, universities shifted their teaching and learning activities online. Academic libraries also shifted their services online. However, in many cases, the students enrolled in universities during COVID-19 era had no prior experience of online library services. This study investigated the factors that drive or inhibit these students' use of online library services. Various recommendations and implications for library management are reported.
Experiences and Challenges of Indigenous Students in Higher Education During the Pandemic
Authors: Arán Sánchez Ana
Published: October 2022

This chapter describes and analyzes the experiences of indigenous students of higher education during the COVID-19 pandemic. They are undergraduates of the bachelor's degree of elementary education who attend a public university located in the north of Mexico, as part of an affirmative action policy that began in 2017. Through the phenomenological method, with an interpretative framework and qualitative approach, this research examines the testimonies of 15 key informants using in-depth interviews, in order to convey the academic challenges they went through during the school lockdown and isolation period of the health emergency caused by the SARS-COV-2 virus, including the development of their dissertation to obtain their degree. The chapter reveals the extreme difficulties they experienced due to the lack of suitable computer equipment, internet connection, and absence of an adequate digital competence. For the ones that had to do their thesis report in order to graduate, having to write their theses in a second language meant an additional obstacle as well.
A Numerical Study on Increasing the Cavity Temperature in Injection Molds
Authors: Minh Pham Son , Trung Do Thanh
Published: October 2022

In the injection molding process, the filling process will be easier and, in most cases, the surface quality will be significantly improved if the mold surface temperature is high. However, as the temperature of the mold plates rises, the cooling process takes longer, the injection molding cycle takes longer, and the cost of production rises. The most important thing is to keep the mold temperature under control, which means heating the mold surface to the required temperature while keeping the injection cycle time to a minimum. In this research, hot air was used as the heat source for raising the cavity temperature to over 200 °C with a heating time of 20 s. At the end of heating process, the temperature was collected at 10 points for comparison. In addition, the temperature distribution was also discussed.
Effect of Air Cooling on Tool Wear in Drilling CFRP
Authors: Kesmanee Kamonlak , Chanpariyavatevong Amarin , Boongsood Wanwanut
Published: October 2022

Carbon fiber reinforced polymer (CFRP) is commonly used in many industries such as sports equipment, aerospace and automotive industries because of its particular properties of low weight and high strength. When penetrating the plastic with a large amount of fiber, problems such as fiber pull-out, delamination and matrix smearing exist. Delamination is a major problem in drilling the components/parts and assembling composite materials. Cutting CFRP without cooling enhances cutting temperature, leading to an increase in delamination. This paper investigates the effect of the difference between with and without air cooling on the drilling of bidirectional CFRP laminates using carbide tools. The cutting parameters studied were cutting speed and feed rate, while tool wear was the response of this study.
Design and Analysis of Electric Bike Chassis Using Glass Fibre Composites
Authors: Sudharson L.S. , Prabakaran Prabakaran , Arjun C.A.
Published: October 2022

Electric motorcycles and scooters are alternates for the existing Internal combustion engine which eliminates emissions and greenhouse gases. The frame is a critical part of any vehicle bolsters an objective in its construction and protection for integrated parts within the vehicle. The weight of the frame contributes to 40% of the total curb weight of the vehicle. Hence, the main objective of this paper is to design, analyze and validate an electric bike frame to decrease the weight and replace the existing conventional material which will also lead to an increase in efficiency of an E-bike. Glass Fibre with Epoxy resin is reinforced individually with Eggshell and sugarcane as these materials are quite economical and easily accessible. A three-dimensional model of a Naked sports bike frame is made using Catia V5 software. Structural analysis is performed for static boundary conditions using Ansys 18.2 software. Based on the analysis results, GFRP and GFRP with Eggshell has less deformation and strain other than steel. GFRP and GFRP with Eggshell are fabricated and experimented for Tensile, flexural strength, and impact test. On the outcome of results, GFRP has better Tensile strength of 288 N/mm2, flexural strength of 15 N/mm2, and Impact energy of 12 joules whereas GFRP with Eggshell has a Tensile strength of 139 N/mm2, flexural strength of 6 N/mm2 and Impact energy of 4 joules. Theoretical simulation and experimental results suggest for alternate replacement of steel which reduces the weight of the frame by 45% for the modelled structure.
Chitosan/PVA Nanofibrous Membranes as Air Filter Material
Authors: Sosiati Harini , Suhandra Izon , Ramadhan Muhammad , Yuda F.A. Kusuma , Yusmaniar Yusmaniar , Iriani Yofentina
Published: October 2022

Nanofiber membranes made of polymer materials are being extensively investigated and developed as air filter materials. This research aims to make and characterize the nanofiber membranes as filter materials capable of filtering gaseous pollutants from cigarette smoke. The electrospinning method manufactured the chitosan (CS)/PVA blend nanofiber membranes with CS/PVA ratios of (0/100, 20/80, 30/70, and 40/60 w/w) using low molecular weight (LMw) PVA and the ratios of (0/100, 10/90, 20/80, and 30/70 w/w) with high Mw (HMw) PVA. The CS concentration increased the CS-PVA solution‘s electrical conductivity and decreased the membrane‘s average fiber diameter and tensile properties. The filtration test on neat PVA and CS/LMw PVA (20/80) membranes set on the metallic substrate with a 0.08 mm hole size was conducted by varying membrane thickness (20, 35, and 45 µm). The filtration efficiency increased with the membrane thickness because membrane pores tend to be smaller, indicating that reducing the fiber diameter by adding CS increases pore size. The filtration test on CS/HMw PVA (20/80) membranes with 45 µm thickness on different substrate¢s hole sizes of (0.08, 1.19, and 1.41 mm) showed that the larger the hole size, the lower the filtration efficiency. By similar CS/PVA ratio, membrane thickness, and substrate size hole, the CS/HMw PVA's filtration efficiency (87.15%) is higher than CS/LMw PVA (85.79%). However, the CS/LMw PVA membrane showed higher tensile strength, low stiffness, and more economical air filtration material than CS/HMw PVA.
Wear Evaluation Results from a Practical Trial of Laser-Coated Pump Parts in the Mineral Processing Industry
Authors: Purvee Ariunbolor , Stehr Gunther C. , Baatar Battsengel , Narmandakh Dulguun
Published: October 2022

Slurry pumps in the mineral processing industry are parts that erode very quickly. Erosion is predominantly caused by abrasion from fine particles of the ores. Because of this, the erosion process takes place on impeller blades and cover plates that directly contact the slurry. This paper evaluates the wear of laser-coated pump parts in the mineral processing industry. Building upon previous research conducted by the authors, we aimed to determine the best laser coating powder system to extend the useful life of specific laser-coated pump parts. Four blades of a slurry pump impeller were each treated with a different laser powder coating, then assessed for wear after 19 days of operation. During this real-life trial, each powder system performed differently. The laser coatings were worn away in two general directions. The first direction was along with the blade pattern, and the second wear direction was from the center of the impeller to the direct blade surface. Partial surface cladding led the material to wear away faster than complete surface cladding due to perpendicular force. Based on these results, in order to use material hardness and wear resistance to higher efficiency, we need to cover all surfaces with different thicknesses depending on the wear rate of the part. This study also showed that Powder System 2 was the most suitable coating material for this type of slurry pump.
DETECTION OF ANTINUCLEAR ANTIBODIES TARGETING INTRACELLULAR SIGNAL TRANSDUCTION, METABOLISM, APOPTOTIC PROCESSES AND CELL DEATH IN CRITICAL COVID-19 PATIENTS
Authors: YASSINE HADI
Published: October 2022

Background: The heterogeneity of coronavirus disease of 2019 (COVID-19) lies within its diverse symptoms and severity, ranging from mild to lethal. Acute respiratory distress syndrome (ARDS) has been shown to be a leading cause of mortality in COVID-19 patients, characterized by a hyper cytokine storm. Autoimmunity is proposed to occur as a result of COVID-19, given the high similarity of the immune responses observed in COVID-19 and autoimmune diseases. Here, we investigate the level of autoimmune antibodies in COVID-19 patients with different severities. Results: Initial screening for antinuclear antibodies (ANA) IgG using ELISA revealed that 1.58% (2/126) and 4% (5/126) of intensive care unit (ICU) COVID-19 cases expressed strong and moderate ANA levels, respectively. An additional sample was positive with immunofluorescence assays (IFA) screening. However, all the non-ICU cases (n=273) were ANA negative using both assays. Samples positive for ANA were further confirmed with large-scale autoantibody screening by phage immunoprecipitation-sequencing (PhIP-Seq). The majority of the ANA-positive samples showed "speckled" ANA pattern by microscopy, and revealed autoantibody specificities that predominantly targeted proteins involved in intracellular signal transduction, metabolism, apoptotic processes, and cell death by PhIP-Seq; further denoting reactivity to nuclear and cytoplasmic antigens. Conclusion: Our results further support the notion of routine screening for autoimmune responses in COVID-19 patients, which might help improve disease prognosis and patient management. Further, results provide compelling evidence that ANA-positive individuals should be excluded from being donors for convalescent plasma therapy in the context of COVID-19.
Covid-19; Cholera and Crimean-Congo hemorrhagic fever in Iraq: A country with three outbreaks
Authors: Hussein Nawfal R
Published: October 2022

NA
Monocyte HLA-Dr Expression to Monitor Immune Response and Potential Infection Risks Following Vaso-Occlusive Crises in Patients with Sickle Cell Anemia
Authors: Fort Romain , Monneret Guillaume , Nader Elie , Cannas Giovanna , Connes Philippe , Venet Fabienne , Hot Arnaud
Published: October 2022

No abstract required for a scientific letter
Impact of obesity on double-lumen endobronchial tube displacement after lateral decubitus positioning
Authors: Lee Kyuho , Park Jin Soo , Kim Min-Soo , Tae Nayoung , Lee Dongwoo , Oh Young Jun
Published: October 2022

Background: Double-lumen endobronchial tube (DLT) displacement, defined as migration of the DLT > 15 mm from optimal position, may threaten patient safety. Lateral decubitus positioning (LDP) of the patient can induce DLT displacement; however, little is known regarding the predictors for DLT displacement after this maneuver. Obesity may further aggravate DLT displacement by distorting mediastinal anatomy, but no comprehensive data exist concerning the impact of obesity on DLT displacement after LDP. Therefore, we evaluated the predictive value of preoperative risk factors, including obesity, for DLT displacement after LDP in patients who underwent pulmonary resection.Methods: Data of patients who underwent pulmonary resection between July 2020 and July 2021 were retrospectively reviewed. Age, sex, height, weight, body mass index, left main bronchus diameter, DLT size, lateral decubitus direction, DLT depth, patient height divided by the DLT depths in supine and lateral decubitus positions (H/Dsupine and H/Dlateral, respectively), and extent of DLT dislocation were assessed. Logistic regression analysis identified risk factors, and the optimal cutoff values for continuous variables were determined using receiver operating characteristic curve analysis.Results: Data from 428 patients were analyzed. DLT displacement was observed in 52 patients (12.1%). Obesity and H/Dsupine were independent predictors for DLT displacement after LDP (odds ratio [OR]: 5.69, 95% CI [2.89, 11.23], P < 0.001 and OR: 8.28, 95% CI [2.92, 23.48], P < 0.001, respectively).Conclusions: Obesity was significantly associated with DLT displacement after LDP. Pre-emptively advancing the DLT from its optimal position before LDP may be advantageous in patients with obesity.
Neurological paradox during treatment in a non-HIV patient with pulmonary tuberculosis
Authors: Amornpojnimman Thanyalak , Srisilpa Song , Sathirapanya Pornchai
Published: October 2022

Rationale:

To report neurological paradox in a non-HIV patient with pulmonary tuberculosis.

Patient concerns:

A 26-year-old non-human immunodeficiency virus immunosuppressed female patient presented with diffused headache, diplopia, ascending paraparesis with loss of bowel and bladder control.

Diagnosis:

Disseminated neurological paradoxical reaction developed during tuberculosis treatment in a non-human immunodeficiency virus patient.

Intervention:

High-dose intravenous corticosteroid was added to the anti-tuberculous drugs, followed by tapered dose of oral prednisolone in 3 months.

Outcome:

A favorable neurological outcome was obtained 6 months later.

Lessons:

Neurological paradoxical reaction cannot be overlooked among the tuberculosis-treated cases who present with newly emerged neurological disorders.
Posttraumatic stress symptom trajectories of Chinese university students during the first eight months of the COVID-19 pandemic and their association with cognitive reappraisal, expressive suppression, and posttraumatic growth
Authors: Jiang Hong-juan , Nan Jiang , Lv Zhi-yue , Yang Juan
Published: October 2022

Objective:

To identify the moderating effects of cognitive reappraisal (CR) and expressive suppression (ES) on the relationship between posttraumatic stress (PTS) symptoms and posttraumatic growth (PTG) in university students.

Methods:

The survey included 1 987 Chinese university students who completed questionnaires on PTS symptoms in February 2020, with three follow-up surveys at two-month intervals until August 2020. We assessed CR and ES at February 2020 and PTG at August 2020. Growth mixture modeling was used to classify the PTS symptom trajectories. Multinomial logistic regression was used to recognize the predictors of class membership. The relationships among PTS symptoms, CR, ES, and PTG were examined using multi-group path analysis.

Results:

Sex, SARS-CoV-2 infection of a family member or friend, number of siblings, CR, and ES were significantly associated with PTS symptoms. Three latent classes were identified: ‘Increasing PTS’ (n=205, 10.0%) who had rapid deterioration of PTS symptoms, ‘Moderate PTS’ (n=149, 8.0%) who had a high level of PTS symptoms at the beginning and slightly increasing, and ‘Persistent Minimal PTS’ (n=1 633, 82.0%), who had slow resolution of PTS symptoms over time. Male, SARS-CoV-2 infection of a family member or friend, and having a lower CR and a higher ES, were more likely to have ‘Increasing PTS’. PTS at February 2020 predicted PTG only in ‘Increasing PTS’ class, and both CR and ES had moderating effects on the conversion between them.

Conclusions:

Most students recovered from posttraumatic stress of COVID-19 pandemic, but a small proportion expeienced increasing PTS symptoms, and those with this condition may benefit from emotional regulation intervention.
Gas Chromatography–Mass Spectrometry Analysis of Anbarnesa Smoke and Its Antiviral Activity
Authors: Iravani Siavash , Sajjadi Seyed Ebrahim , Rafieian-Kopaei Mahmoud , Zolfaghari Behzad
Published: October 2022

Background:

Anbarnesa is the female donkey dung typically collected after the labor and in early springtime.

Materials and Methods:

The chemical composition of the smoke collected from Anbarnesa was evaluated by gas chromatography–mass spectrometry (GC/MS), and its antiviral activity was analyzed based on 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) assay.

Results:

As a result, twenty-two constituents representing 97.1% of the Anbarnesa smoke could be identified. Hexadecanoic acid (29.4%), cis-9-octadecenoic acid (17.7%), and octadecanoic acid (10.8%) were the smoke's main constituents, respectively. Antiviral activity was evaluated using MTT assay. The CC50 value of the compound on Hep2 and Verro cells was 2271.2 μg/mL and 5077.5 μg/mL, respectively. Furthermore, the 50% inhibitory concentration value on adenovirus and herpes simplex type-1 was 802.55 μg/mL and >5077.5, respectively.

Conclusions:

it was revealed that Anbarnesa was nontoxic in 1/64, 1/128, and 1/256 dilutions, while the toxicity was detected in 1/32 dilution after 72 h. In addition, in 1/8 and 1/16 dilutions, cell toxicity was identified in the first hour.
Successful Recovery of a Critically Ill Pregnant Covid-19 Patient Treated with Extracorporeal Membrane Oxygenation (ECMO) in Sanglah General Hospital, Bali, Indonesia
Authors: Utama I Made Susila , Purnamasidhi Cokorda Agung Wahyu , Panji Putu Agus Surya , Aryana Made Bagus Dwi , Harta Komang Adhi Parama
Published: October 2022

Extracorporeal membrane oxygenation (ECMO) has been shown to be effective as a form of a life-sustaining modality in previous outbreaks such as Middle East respiratory syndromes covariant and H1N1. A 28-year-old woman was referred from a military hospital after experiencing prolonged dyspnea and a loss of consciousness. At the time of admission, the patient was pregnant with a gestational age of 24–25 weeks and has a history of hypertension and a caesarian section. Respiratory failure forced a caesarean section, which was followed by an intensive care unit admission. Five days after admission, the patient was placed on ECMO with a heparin drip. The patient suffered coinfections identified in the patient’s sputum, blood, and urine samples. Significant clinical improvement observed after the second ECMO weaning and was followed by successful discharge. The successful treatment of a critically ill COVID-19 pregnant patient with ECMO as a life-sustaining critical-care modality is uncommon. However, potential coinfections must be considered, and physicians must prepare for waves of clinical worsening and improvement.
An Anesthetic Management of Patient with Hemophilia A Undergoing Recurrent Perianal Abscesses
Authors: Nurumbetova Oktom , Tuç Özer , Çekmen Nedim
Published: October 2022

Hemophilia A is an x-linked recessive disorder characterized by an absent or reduced factor VIII (FVIII). It is a genetic deficiency that causes increased bleeding. It can be challenging for anesthesiologists to discover it in the perioperative management. This case report represents the successful management of a 25-year-old male patient having severe hemophilia A. We managed a 25-year-old man, 89 kg, 180 cm, with a recurring history of perianal abscesses. Previously at 13 years old, he experienced prolonged and excessive bleeding after a minor cut and injury. Following clinical and laboratory investigation, he was diagnosed with severe hemophilia A. Ever since, he used to take antihemophilic factor (AHF) VIII transfusion therapy and revealed severe disease with a positive inhibitor. No other coexisting disease was revealed during history-taking. We managed this case with general anesthesia because of the fact that he was hemophilic. We administered 2000 International Unit (IU) of recombinant Factor VIII (rFVIII) preoperatively as per the hematologist’s recommendation. We continued with 2000 IU of AHF FVIII transfusion after the surgery, but unfortunately, he redeveloped the abscess again. Another careful anesthesia and surgery were then conducted with a satisfactory result. The multidisciplinary team approach was provided to a positive outcome in these patients. Perioperative transfusion of AHF FVIII is essential for patients with hemophilia.
Childhood-onset systemic lupus erythematosus, probably triggered by severe acute respiratory syndrome coronavirus 2 infection, presenting with autoimmune haemolytic anaemia
Authors: Rauf Abdul , Thekkudan Shinto Francis , Mampilly Neena , Vijayan Ajay
Published: October 2022

Systemic lupus erythematosus (SLE) is a multisystemic and chronic autoimmune disease with varying clinical manifestations. The role of various infectious agents in triggering the disease onset in genetically predisposed patients has been implicated in the pathogenesis of SLE. The severe acute respiratory syndrome coronavirus 2 has been reported to trigger various autoimmune diseases including SLE in few adults. Herein, we report the case of a previously well 12-year-old girl who presented with warm antibody Coombs-positive autoimmune haemolytic anaemia, 3 weeks after testing positive for COVID-19. COVID IgG antibody test was positive. During the hospital stay, she developed multisystem involvement in the form of neurological manifestations and arthritis. She was managed with steroids, intravenous (IV) immunoglobulins and supportive measures. Her anti-nuclear antibody and anti-dsDNA antibodies were positive and complement levels were low, confirming a diagnosis of SLE. Her clinical condition improved rapidly and remained neurologically normal, and serial haemoglobin showed an improving trend. IV steroids were changed to oral form, and hydroxychloroquine was also added. She remained well on 3-week follow-up.
Solitary neurofibroma of the psoas muscle
Authors: Chaturvedi Chandrashekher , Chaturvedi Himani-Tiwari
Published: October 2022

Neurofibroma is a benign peripheral nerve sheath tumour usually present on superficial tissues of the head and trunk. Retroperitoneal location is extremely rare for neurofibroma and comprises only 1% of all retroperitoneal tumours. It can be solitary or associated with the genetic disorder, von Recklinghausen's disease or neurofibromatosis type-1. Magnetic resonance imaging (MRI) is the gold standard modality for imaging retroperitoneal tumours because it provides a better definition and specificity in the evaluation of the location, extension, and composition of the lesion. Here, we report the case of a 30-year-old man affected by retroperitoneal solitary neurofibroma of the psoas muscle, but not associated with von Recklinghausen's disease. MRI showed a well-defined lobulated retroperitoneal lesion noted within the right psoas muscle. Complete surgical excision of the tumour was performed, and the diagnosis of neurofibroma was made through histological and immunohistochemical examination.
The laboratory and hypertension - Novel approach for diagnosis and management
Authors: Bhargava Seema , Manocha Anjali , Kankra Mamta , Singla Parul , Sharma Anisha , Datta Rashmi Rasi
Published: October 2022

Hypertension remains one of the most significant causes of mortality, affecting more than 1 billion people worldwide. It is a significant public health concern and a major risk factor for renal disease, heart failure, stroke, coronary artery disease and peripheral vascular disease. In more than 90% of hypertensive patients, the cause of blood pressure elevation is unknown. Therefore, early diagnosis and timely interventions are crucial to prevent complications. Over the last four decades, various blood biomarkers have been identified, which can help in understanding the cause of the underlying processes involved in the onset, development and progression of hypertension (HT). It is our attempt, in this review, to suggest a more robust use of circulating biomarkers that may prove to be beneficial in better elucidating the pathophysiology, development, progression and therapeutic efficacy in the management of HT.
Monkeypox virus infection – Evolution, molecular biology, epidemiology, clinical features and management aspects
Authors: Kaul Dinesh , Yadav Kavita , Bansal Akanksha
Published: October 2022

Monkeypox virus (MPXV) infection has lately emerged as a new public health problem across 100 countries. Surging cases of MPXV infection in non-endemic countries prompted the World Health Organization to declare it a public health emergency in July 2022. The virological and clinical resemblance to eradicated smallpox disease has generated new scientific interest. This DNA orthopoxvirus primarily harbouring in squirrels, rats and non-human primates has led to infection in the human population. A recent surge of cases has been seen across 16 countries, with a clustering of cases in bisexual/homosexual men. The virus spreads through close contact with infected individuals with prodromal symptoms of fever and myalgia. A rash appears after 1–3 days of fever. There is presence of vesicular rash over the face, hands, feet and genital areas, and associated lymphadenopathy. Although no specific antiviral drugs directed against MPXV are available, tecovirimat developed against smallpox infection can be used and is effective. A synthetic analogue drug of cidofovir, i.e., brincidofovir has been evaluated for MPX patients in United Kingdom. A preventive strategy in close contacts may be offered through smallpox vaccines such as ACAM2000 and JYNNEOS. Epidemiological data from Africa suggest that smallpox vaccines provide 85% efficacy in preventing MPXV cases. Vaccinia immunoglobulin intravenous (VIGIV) has been used in immunocompromised patients with T-cell defects as prophylaxis where the use of vaccines is contraindicated. VIGIV can be used as a treatment modality for smallpox or non-variola infections like monkeypox in an outbreak, although the efficacy data are lacking.
Chronic Pancreatitis Associated with Pancreatic Stone Impaction at the Ampulla and Subsequent Gallbladder Perforation
Authors: Shaikh Oseen Hajilal , Kumbhar Uday Shamrao , Vijayakumar Chellappa , Chakkalakkoombil Sunitha V , Gaur Naveen Kumar
Published: October 2022

Obstructive jaundice due to pancreatic stone is very rare. We report a case of obstructive jaundice in a patient with chronic pancreatitis, occurring due to the pancreatic stone getting impacted at the ampulla and subsequently, leading to gallbladder perforation, without any dilatation of the biliary tree. This could be explained due to the lower insertion of the cystic duct. Such instances can be managed with percutaneous tube cholecystostomy, endoscopic retrograde cholangiopancreatography, pancreatic stone extraction, and stenting of both the main pancreatic duct and the common bile duct.
Anatomy in a Virtual Small-group Learning Setting
Authors: Mathew John Kandam Kulathu , Daniel Priyanka , Shanthi Pauline , Srivatsava Supraja , Charles Aby S. , Jacob Jenny , Gowri Mahasampath , Rabi Suganthy
Published: October 2022

Background:

The benefits of small-group learning (SGL) in anatomy are well documented; however, the COVID-19 pandemic has seen the dynamics of SGL change in the online environment. In this study, we aimed to study the effects of the online platform and the content created on students' perception in the delivery of virtual SGL (VrSGL) in anatomy for 1-year medical students.

Materials and Methods:

VrSGL in anatomy was conducted for 6 weeks on Microsoft Teams as a meeting platform. Each group consisted of 10–12 1st-year medical students. Various aspects of VrSGL were analyzed with respect to technological factors, online content, online small-group teaching, and assessment modalities such as online viva, digital spotters, clinical cases, and short answer writing, through validated online feedback forms.

Results:

Of the 97 students (46 males and 51 females), 86% found the frequency of VrSGL optimal. There was a substantial positive correlation between connectivity issues and the quality of SGL. Majority of the students reported that VrSGL enabled them to learn anatomy well (72%), at their own pace (90%), and increased their accountability (85%). There was a significant positive correlation between the effectiveness of VrSGL sessions and quality of specimen demonstration videos (P < 0.001), assignments (P < 0.001), and online assessment (P < 0.001). A significant drawback of VrSGL was the lack of handling of cadaveric specimens as reported by 91% of the students.

Conclusion:

The most impactful factors on VrSGL were quality of specimen demonstration videos, frequency of the SGL sessions, assignments, and online assessment modalities.
Corneal endothelial protection during manual small-incision cataract surgery
Authors: Singh Mamta , Mishra Deepak , Sinha Bibhuti P , Anand Abhishek , Singhal Shubha
Published: October 2022

Cataract causes bilateral blindness in 20 million people globally, the vast majority of whom live in developing countries. Manual small-incision cataract surgery (MSICS) has emerged as an efficient and economical alternative to phacoemulsification, giving comparable results in terms of final visual gain. One of the important determinants of postoperative visual gain is the status of the corneal endothelium. Multiple factors such as corneal distortion, irrigation solution turbulence, mechanical trauma by instruments, nuclear fragments, intraocular lens contact, and free oxygen radicals, all have been implicated in causing corneal damage during cataract surgery. MSICS with posterior chamber intraocular lens implantation has been reported to cause an endothelial cell loss of 15.83%, which is comparable with other modes of cataract surgery like extracapsular cataract extraction and phacoemulsification. Thorough preoperative assessment of endothelial status and taking necessary steps for endothelial protection during surgery can decrease the endothelial cell loss and overall burden of pseudophakic bullous keratopathy. In addition to surgical techniques, the type of irrigating solutions, ocular viscoelastic devices, intracameral dyes, and drugs all affect the endothelial cell status. This review presents a summary of available literature on the protection of endothelial cells during different steps of MSICS. This is especially relevant for developing countries where large-scale MSICS cataract surgeries are performed to decrease the cataract blindness burden.
Immediately sequential bilateral cataract surgery in Down syndrome
Authors: Sharma Rishi , Shankar Sandeep , Kumar Nitesh , Vichhare Nitin
Published: October 2022

The exponential increase in world population and average human lifespan is expected to result in geriatric population globally. The problem of preventable blindness due to cataract will increase manifold. Simultaneous Bilateral cataract surgery (SBCS) is a viable option in such subset of patients. Despite faster visual recovery, economic benefits to patients and health care providers, decreased risk of complications associated with General anaesthesia, there is significant resistance in accepting SBCS as a routine procedure. Bilateral endophthalmitis is the main deterrent in performing ISBCS. This case highlights successful ISBCS in 36 years old female patient with Down’s syndrome.
Manual small-incision cataract surgery and glaucoma – A dilemma of the duo
Authors: Bhagat Purvi Raj , Prajapati Kamini Mukeshkumar
Published: October 2022

Both cataract and glaucoma significantly affect the quality of life of an individual and they are often found to coexist, either primarily or secondary to one another. Clear-cut guidelines are not available for this subgroup of coexistent morbidities. Through this article, we attempt to discuss the risks and benefits of staged and combined surgery, their short- and long-term effects on the intraocular pressure and pre and postoperative management. The indication and type of surgery will depend on the type, severity and control of glaucoma, and the clinical significance of cataract; and the surgical outcome on the surgical technique used, site of surgery, use of anti-fibrotic agents, and most importantly, the surgeon’s skill and experience.
Minimal anesthetic manual small-incision cataract surgery (MSICS)
Authors: Dev Suvir , Bali Jatinder , Narang Surinder , Miglani Sundeep , Arneja Jaswant
Published: October 2022

Ever-evolving modern day cataract extraction techniques have been accompanied by the use of smaller quantities and less invasive methods of anesthesia. Topical anesthesia is routinely used for phacoemulsification. However, peribulbar block or some modification of it is used for anesthesia in manual small-incision cataract surgery (MSICS) by most practitioners. The authors describe a technique using a combination of 1.5–2 milliliters of anesthetic mixture given subconjunctivally and supplemented with commercially available intracameral anesthetic and mydriatic for MSICS. It is possible to get high level of anesthetic effect and ease of surgery with this technique though there is a small learning curve. Several modifications from topical phacoemulsification like two side ports six o’clock hours apart make this surgery easy to adapt to. No special instrumentation is required. It gives adequate analgesia and anesthesia to complete the surgery. a minimalistic anesthetic approach in MSICS can be used with enhanced safety and by avoiding usual complications of traditional peribulbar and retrobulbar anesthesia.
Architectural analysis of subconjunctival oblique limbus incision techniques in manual cataract extraction surgery by optical coherence tomography imaging
Authors: Yang Jun , Han Fang , Song Liming , Huang Xin , Jiang Yijing , Lai Pinghong
Published: October 2022

The purpose was to assess the profile of subconjunctival oblique limbus incision (SCOLI) design by using anterior-segment optical coherence tomography (AS-OCT) and try to emphasize the proper technique of wound construction. The structural dimensions and integrity of the wound were acquired from the patients, who had undergone manual small-incision cataract surgery with SCOLI techniques, using a Canon OCT anterior-segment imaging system on the first postoperative day. The use of AS-OCT allowed for an in vivo evaluation of SCOLI in high definition. The radial OCT scan image showed three staggered incisions, including conjunctiva incision, scleral entrance, and inner corneal lip. A tangential scan demonstrated that the internal lip is parallel to the curvature of the peripheral cornea. The en face image showed an asymmetric 4 arc-shaped configuration rather than a symmetrical one. In conclusion, AS-OCT could be used to analyze SCOLI to determine optimal wound construction and geometry. The results of this study indicated that an asymmetric 4 arc-shaped limbus tunnel incision was superior to the conventional linear equivalent in stability and nucleus delivery.