bluuebunny/crossref_metadata_2025 huggingface dataset:
Neural rewiring from peripheral to central
Authors: Lu Hao-Yu , Yan Ji-Geng
Published: December 2022

Peripheral nerve injury and reconstruction would lead to alteration of neural pathways. This is regarded as rewiring peripheral nerves, which could also be a trigger for the corresponding neural rewiring process in the brain. Brain plasticity subsequent to peripheral nerve reconstruction plays an important role in the functional recovery of limbs, which has attracted increasing concerns. The present study aimed to overview recent progress in neuroregeneration-related brain plasticity. Nerve transfer is a special technique of nerve reconstruction that usually leads to substantial peripheral neural rewiring and cortical reorganization. Nerve transfer-related shifting of motor representation was particularly discussed. We also emphasized rehabilitation strategies based on the current peripheral-central rewiring theory. Specific strategies based on neural plasticity were proposed for corresponding recovery stages.
A Study to Evaluate the Impact of COVID-19 on the Mental Health of Medical Students
Authors: Das Shouvik , Chaudhuri Arunima , Ray Biman
Published: December 2022

Background and Aim:

The COVID-19 pandemic has imposed huge challenges on medical students and medical educators as they are the frontline workers in health-care management. The present study was conducted to evaluate and compare depression, anxiety, and stress levels and the Impact of Event Scale scores among different phases of undergraduate medical students.

Materials and Methods:

The present study was conducted online at Burdwan Medical College after taking institutional ethical clearance and informed consent from participants. The Depression, Anxiety, and Stress Scale-21 (DASS-21) scores and the Impact of Event Scale-Revised (IES-R) scores of all phases of MBBS students were evaluated during the first and second waves of the pandemic. Jamovi software was used for statistical analysis and ANOVA was used to compare different groups.

Results:

There was no significant difference in the DASS-21 scores among all five groups during the first wave, but significant differences were observed in IES-R scores. On post hoc analysis, significant differences were observed in the Intrusion, Avoidance, and Hyperarousal scores between 1st- and 5th-year, 2nd- and 5th-year, and 4th- and 5th-year students. During the second wave, significant differences in DASS-21 and IES-R parameters were observed between the different phases of MBBS students. There were significant positive correlations between IES-R scores and DASS-21 scores among 1st-year students and a significant negative correlation between IES-R scores and anxiety scores among 2nd-year students during the first evaluation. There were significant positive correlations between IES-R scores and DASS-21 scores among 1st-year students and a significant positive correlation between IES-R scores and stress scores among 5th-year students during the second evaluation.

Conclusion:

Senior batches of MBBS students were more mentally affected by the impact of the pandemic as evaluated by DASS-21 scores and IES-R scores. Levels of depression, stress, and anxiety were also increased during the second wave as compared to the first wave of the present pandemic.
Co-expression of P53 and Ki67 in Premalignant and Malignant Oral/Oropharyngeal Biopsies in Bundelkhand Region, India
Authors: Raj Swati , Vachher Nidhi , Aden Durre , Srivastava Amit , Nath Dwijendra
Published: December 2022

Background and Aim:

India is the third most common country being entitled as “The Oral Cancer Capital of the World.” Around one-third cancer deaths are due to tobacco use. In India, oral cancer ranks first among all cancers in men and second among all cancers in women. p53 over-expression has been widely demonstrated to be a reliable predictor of progression to oral squamous cell carcinoma (OSCC). Ki67 expression is strictly associated with cell proliferation and used as a proliferation marker. Oral cancer was studied in Bundelkhand region with special reference to Gutkha (a form of tobacco) chewing and relative risk. p53 and Ki 67 expression was assessed in premalignant and malignant oral and oropharyngeal lesions and their correlation was evaluated.

Materials and Methods:

A descriptive study including both prospective and retrospective studies carried over a period of 18 months (April 2019–September 2020) at Department of Pathology, Maharani Laxmi Bai Medical College, Jhansi, India. Immunohistochemical evaluation was done by using markers: anti p53 and anti K67 markers with positive control, i.e. p53 – colon and Ki 67 – tonsil) sections stained omitting primary antibody were taken as negative control.

Results:

OSCC and premalignant oral lesions are at high incidence in Bundelkhand region, India. Tobacco is found to be most identifiable risk factor with risk ratio of 0.45.

Conclusion:

The over/co-expression of p53 and Ki67 plays a pivotal role in labeling and predictive marker for malignant transformation as their intensity and pattern of staining increases with increasing grade (highly statistically significant; Pearson's correlation applied).
A Study on the Unusual Course and Branching Patterns of Arteries in the Upper Limb
Authors: Kannappan Senthil Ganesh P. , Srivaram Havila Hasini , Ekambaram Gnanagurudasan
Published: December 2022

Background and Aim:

Human body consists of blood vessels, nerves, and muscles that are not always similar to each one. Anatomical study of abnormal vessels or nerve or muscle arrangements in the body interferes of clinical diagnosis, surgical procedure, and radiological findings. Comprehensive knowledge of anatomical variations present in the body is key for patient management. Arteries of upper limb variations are more common than other variations. Arterial variations may lead to vascular neuropathy. Diagnostic errors can be eliminated by understanding these variations. The aim of the present study is to correlate clinical abnormalities with arterial course variation in the upper limb and contribute some of the previously unknown new variations to medicine.

Materials and Methods:

A descriptive study was conducted from 2016 to 2021 in the Department of Anatomy, Apollo Medical College, Chittoor. The study was conducted with 56 upper limbs from 28 cadavers. The arterial course and relations of each region in the upper limb were noted carefully.

Results:

Abnormal arterial courses and variations were considered for data collection. Out of 56 limbs, 6 variations were seen from 5 limbs. Abnormal arterial courses were found in the 2 upper limbs (3%) and abnormal arterial branches were present in the 4 upper limbs (7%). In 51 upper limbs, there were no abnormal arterial courses and branches (90%).

Conclusion:

Study of anatomical arterial variations helps to guide the diagnosis and treatment of patients. Hence, arterial variations present in the upper limbs are more common than in other regions of the body.
Psychological Distress in Pregnant Women
Authors: Lakshmi K. P. , Chandra Subhash , Menon Bindu , Radhamany K. , Rajana P. , Suresh Parvathy
Published: December 2022

Background and Aim:

The morbidity and mortality caused by COVID-19, the economic crisis brought about by the pandemic, and the health policies laid down for the containment of the virus, have a negative effect on the mental health of the people. Pregnant women represent a high-risk group, being particularly susceptible to stress and emotional instability. This study aims to estimate the prevalence of psychological distress in pregnant women during the COVID-19 pandemic.

Materials and Methods:

This is a cross-sectional observational study done in a tertiary care center in Kerala between June and July 2021. All the pregnant women attending the obstetric department, after taking their informed consent were assessed with a pro forma to collect their sociodemographic details and Kessler Psychological Distress Scale was used to assess their psychological distress. The association between sociodemographic variables and distress was assessed using the Chi-square test.

Results:

A total of 66 pregnant women were studied. Fourteen (21.2%) were noted to have psychological distress. Three (4.5%) and 6 (9.1%) were in moderate and severe distress, respectively. None of these women were known to have any psychiatric illness. Psychological distress was more prevalent among homemakers compared to employed pregnant women (P = 0.134), more in primi, compared to second and third gravida (P = 0.825) and more in pregnant women in the second trimester compared to women in the first and third trimesters (P = 0.296).

Conclusion:

Psychological distress is highly prevalent in pregnant women during the COVID-19 pandemic. There is an urgent need for health policies to decrease its negative impact on the health of pregnant women, mothers, and children.
Comparing the Sensitivity of Palm Print Sign and Prayer Sign in Prediction of Difficult Intubation in Diabetic Patients
Authors: Singh Harjot , Dwivedi Deepak , Tandon Urvashi , Bhatnagar Vidhu , Jinjil Kavitha , Tara Swayam
Published: December 2022

Background and Aim:

Palm print and prayer signs are manifestations of “limited joint mobility” syndrome caused by long-standing Type I and Type II diabetes mellitus. This study aims at finding out, which of the two signs is more sensitive for the prediction of difficult intubation in type II diabetes mellitus patients. The secondary objective is to correlate the above two signs with the Cormack–Lehane View during direct laryngoscopy and also to determine whether the duration of Type II diabetes mellitus correlates with difficult intubation in isolation.

Materials and Methods:

A prospective observational study was carried out in a tertiary care hospital. One hundred and fifty patients suffering from Type II diabetes mellitus, undergoing elective general anesthesia with endotracheal intubation, were enrolled in the study. The correlation between Palm print and Prayer sign with Cormack and Lehane grades was studied using the Chi-square test, continuity correction, and Fisher's exact test. The diagnostic efficacy of intubation difficulty for both the signs was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratio.

Results:

The palm print sign was found to be a better indicator of difficult intubation in type II diabetes mellitus patients (P < 0.01). The duration of Type II diabetes mellitus was found to be associated well with difficult intubation (P = 0.007).

Conclusion:

Palm print sign is the single most important test for predicting difficult intubation in Type II diabetes mellitus patients. Duration of Type II diabetes mellitus itself correlates well with difficult intubation.
Autoimmune Hemolytic Anemia Complicating a Non-Severe SARS-COV2 Pneumonia
Authors: Motiaa Youssef , Dwassy Youssef
Published: December 2022

COVID-19 has been associated with a spectrum of hematological complications secondary to excessive activation of the immune system. In this article, we report the case of a 64-year-old patient who developed delayed autoimmune hemolytic anemia following a mild severe acute respiratory syndrome-coronavirus-2 infection. We will discuss its pathophysiological, clinical, and biological aspects as well as the clinical management of this complication.
Role of Aminoglycosides in Management of Ventilator-Associated Pneumonia Caused by Klebsiella Pneumoniae
Authors: Kataria Shaveta , Rajni Ekadashi , Thandi Priyanka , Kumar Mohit , Kulhari Garima
Published: December 2022

Background and Aim:

Ventilator-associated pneumonia (VAP) is considered as a sub-category of healthcare-associated infections and is associated with high morbidity and mortality. Acinetobacter baumannii complex and Klebsiella pneumoniae (K. pneumoniae) are known to be the most important causes. During the last few decades, polymyxins have represented the most commonly used antimicrobial options against multidrug resistant K. pneumoniae. However, in some cases, aminoglycosides were also found to be effective.

Materials and Methods:

This retrospective observational study was conducted in a tertiary care hospital in Jaipur from June' 2020 to June' 2021. All endotracheal (ET) aspirate samples from the clinically suspected cases of VAP received in microbiology laboratory were processed using the standard procedures and relevant medical records were reviewed. VITEK 2 automated system was used for the bacterial identification and antimicrobial susceptibility testing.

Results:

Out of 705 ET aspirate samples received during the study period, 467 were found culture positive. Majority 304 (98.1%) were Gram-negative isolates, while only 6 (1.9%) were Gram-positive. 156;51.3% isolates belonged to A. baumannii complex, followed by K. pneumoniae (73;24.0%). Antimicrobial susceptibility profile of 73 K. pneumoniae isolates to aminoglycosides was noted. Out of 73 isolates, 42 were found to be resistant to both gentamicin and amikacin, 12 isolates were sensitive to both, while 19 isolates showed variable susceptibility.

Conclusion:

K. pneumoniae is an important causative agent of VAP. While polymyxins have an important role in the management of such cases, aminoglycosides need to be given a careful consideration. They can constitute an effective polymyxin sparing regimen, especially for carbapenem-resistant isolates.
Addressing the Need to Develop Critical Thinking Skills in the New Competency-Based Medical Education Post Graduate Curriculum in Pathology
Authors: Kelkar Anjali J , Bhandary Shital , Chacko Thomas V
Published: December 2022

Background and Aim:

Ability to integrate and apply knowledge to clinical practice is recognized as a core competency under the new CBME curriculum and assessment of critical thinking skills is an essential component. Script Concordance Test (SCT) is recognised as an appropriate assessment tool for measuring critical thinking. Since in India, SCTs for testing critical thinking in the Postgraduate curriculum in Pathology, have not been developed, we worked on developing such test in the setting of a busy referral hospital attached to Medical College in Western India.

The study aimed at

1. Piloting the development of script concordance test to test critical thinking ability and clinical reasoning skills in haematology. 2. Experience sharing of the process of development and validation of the test to enable others to replicate for other topics in pathology.

Materials and Methods:

After obtaining Ethical clearance, SCT for the topic Coagulation was constructed by following the guidelines from AMEE Guide 75. The experts' reactions and their satisfaction about the test were obtained. Pilot testing was done with post graduate students after informed consent. The students' reactions and satisfaction were obtained after taking the test. The analysis was performed using the excel workbook available from a web link maintained by the SCT creators. Item analysis and group comparison was also done.

Results:

Analysis performed with 22 vignettes having 66 items revealed a statistically significant difference between the scores of the experts and the students. Internal consistency reliability (Cronbach's α) was 0.86 whereas Effect size (Cohen's d) was 1.9 with 34% overlap in the items and superiority probability of 91%. Item analysis classified 23 items as “Bad”, 11 items as “Fair” and 32 items as “Good” based on the “item-total correlation” statistic. Re-analysis after removing the bad items, increased Cronbach's α to 0.91 and Cohen's d to 3.9; whereas overlap decreased to 5% and probability of superiority reached 100%.

Conclusion:

Development of a reliable and valid SCT for coagulation was a complex but rewarding process. The analysis of the test required inputs from the statistical experts. Using AMEE Guide 75 and our in-detail description of the process of development, optimisation and validation of script concordance test will enable faculty in many specialities to develop and include it for use in their respective fields.
Using Qualitative Research for Curricular Redesign of Communication Skills Training in a Dental School
Authors: Sriranga Jyotsna , Chacko Thomas V.
Published: December 2022

Background and Aim:

Poor patient-health care provider (HCP) communication skills are a major contributor for noncompliance, lack of trust and sometimes even violence against the HCPs. The students are expected to pick up communication competency through observation and self-learning. In this context, there is a need to bring in the implicit curriculum to the ambit of the explicit curriculum. Here, the focus was on “listening” to the stakeholder's voice to establish the need for explicit communication skills training and justify its importance to professional practice.

Materials and Methods:

A socioconstructivist world-view and qualitative research methodology was adopted. The method of data collection was interviews and focus group discussions. The dean, teaching faculty, students, and patients were interviewed until data saturation. The data were transcribed and a team of 3 coders coded the data manually using inductive methods.

Results:

This study identified the gaps in the existing curricular framework for teaching communication skills. Six major themes emerged from the research. The research process served as a tool to leverage on the gaps identified and build a customized communication skills training program for students.

Conclusion:

The process of qualitative research involves the extensive interviews and discussions with stakeholders to better understand the underlying issues. It initiates dialogs and helps to co-construct solutions to the educational problems. Such self-discovered solutions for change in curriculum that emerges from key stakeholders from within the institution, they are more likely to be accepted, adopted and “institutionalised”.
Neurodevelopmental versus Functional Tics
Authors: Cavanna Andrea E. , Purpura Giulia , Nacinovich Renata
Published: December 2022

Tic disorders of neurodevelopmental origin are the most common hyperkinetic disorder in childhood. In cases where both multiple motor tics and at least one vocal tic are present, with a chronic course, a diagnosis of Tourette syndrome can be confirmed. Functional movement disorders are a common type of functional neurological disorder, which has previously been referred to as hysteria and conversion, among other diagnostic labels. Functional tics have long been considered a rarer phenotype of functional movement disorder, compared to functional tremor or functional dystonia. However, during the COVID-19 pandemic, there have been multiple reports worldwide of an unexpected increase in the number of adolescents and young adults presenting with acute-onset functional tics. The differential diagnosis between neurodevelopmental and functional tics can be challenging, but a few demographic and clinical features have proven useful in assisting clinicians. Neurodevelopmental tics present with the gradual onset of simple motor and vocal tics in a rostrocaudal evolution, starting in early childhood, more commonly in boys. Conversely, functional tics often have an abrupt and explosive presentation of severe symptoms, with a later age of onset and a female gender predominance. Moreover, it has been reported that a proportion of patients with functional tics developed their symptoms after being exposed to social media content of influencers displaying similar manifestations. The etiology of the recent “pandemic within the pandemic” is likely to be multifactorial, with increased exposure to social media possibly playing a role alongside the psychosocial impact caused by the COVID-19 pandemic.
A Narrative Review of Global Perspective on Illicit Drug Utilization and Substance Use Disorders
Authors: Bhanujirao Paila , Salari Saman , Behzad Paeizi , Salari Tayebeh
Published: December 2022

Drug addiction and abuse are major public health issues across the globe that impact millions of people. Substance abuse and dependence seem to have been relatively high among university students and laborers and comparatively low among school students. Drugs used by the person for nonintended reasons, mainly for their psychoactive effects termed as drug abuse. Continued use of alcohol, illegal drugs, or prescription or over-the-counter medications harms health, employment, family, and law. When it comes to illicit substance usage, possession, and trafficking, every nation has its unique set of laws. The frequency of lifetime drug usage in 2015 was 5%, according to the most current World Drug Report. There is reason to be concerned about the high rates of drug and alcohol addiction among youths because of the substantial problems that have been linked to such use, including higher rates of aggression, suicidal attempts, etc., In this narrative review, we have focused on illicit drugs, substance use, its negative impacts among youths and its prevalence among youths nationally and internationally, and also some prevention strategies to control substance use.
A Retrospective Analysis of Moderate and Severe COVID-19 Pneumonia with Special Reference to the Use of Adjuvant Tocilizumab
Authors: Raval Pratik , Panakkal Benny Jose , Joshi Dinesh , Natrajan Karthik , Shukla Anand , Dubey Gajendra , Sahoo Sibasis , Bajpai Subhendu
Published: December 2022

Background and Aim:

Coronavirus disease 2019 (COVID-19) pneumonia is associated with a hyper-inflammatory syndrome which may cause life-threatening acute respiratory distress syndrome. The aim of this study was to evaluate the safety and efficacy of an anti-inflammatory agent, tocilizumab (TCZ), a monoclonal antibody that targets the interleukin 6 receptor.

Materials and Methods:

We included 53 patients admitted between April and July 2020 with COVID-19 pneumonia who received TCZ. Patients received one intravenous infusion of TCZ, dosed at 8 mg/kg, up to a maximum dose of 800 mg. All patients were evaluated with clinical, laboratory, and radiological parameters.

Results:

Out of 53 patients 28 (52.8%) had severe disease and 25 (47.2%) had the moderate disease. The mean age was 55 years. The most common presenting symptom was fever (73%; n = 39). C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), d-dimer, and ferritin levels were elevated at baseline. After TCZ administration CRP, ferritin and NLR levels reduced significantly whereas d-dimer levels did not fall. Pulmonary fibrosis may be observed later in the course of the disease. All the mortality occurred in patients who had severe disease on presentation. There was no difference in outcomes according to gender, diabetic status, and presence of preexisting cardiac disease.

Conclusion:

Overall, TCZ administration is safe and effective in improving clinical and laboratory parameters with a possible reduction in the need for ventilatory care and duration of intensive care unit stay, particularly in patients with moderate severe acute respiratory syndrome coronavirus- 2 disease. However, our results should be considered preliminary and should be interpreted with caution as they stem from an uncontrolled series.
Pneumomediastinum is a Poor Prognostic Factor in COVID-19 Patients – Case Series and Review
Authors: Ranjan Ashish , Meena Saroj K. , Saini Jitendra Kumar , Gupta Rajnish , Sharma Amit
Published: December 2022

During the second wave of COVID-19, a number of patients requiring invasive or noninvasive pressure support ventilation rose significantly. The cases of pneumomediastinum (PM), pneumothorax (PTX), and subcutaneous emphysema (SCE) were also reported, largely attributed to barotrauma with observation of some spontaneous cases. Here, we present seven moderate-to-severe COVID-19 cases with variable severity developing PM with or without PTX and SCE during the course of hospitalization. Five received noninvasive ventilation, of whom two required invasive mechanical ventilation. The remaining two patients received oxygen therapy alone. Two patients required insertion of intercostal chest drainage tubes for pneumothoraces. Appropriate medical management was given to all patients. Three patients improved and were discharged from the hospital, while four expired. The case series highlights need of early diagnosis, constant monitoring, and judicious use of pressure support ventilation to prevent air leak complications in COVID-19 patients in order to improve their prognostic outcomes.
Prevalence and Predictors of Cyberchondria and Depression Amid COVID-19 Pandemic in Adult Population of Uttar Pradesh, India
Authors: Srivastava Saumya P. , Tiwari Surya Kant , Negi Monika
Published: December 2022

Background and Aim:

COVID-19 pandemic and related measures of containment such as lockdown led to heavy reliance on Internet for education and leisure activities. This study aimed to assess the prevalence and predictors of cyberchondria and depression amid COVID-19 pandemic among adult population of Uttar Pradesh, India.

Materials and Methods:

A web-based study was conducted among 236 adult participants of Uttar Pradesh during August–November 2021. Standardized tools including Cyberchondria Severity Scale-short version (CSS-SV) and Patient Health Questionnaire-9 were used for eliciting details about cyberchondria and depression.

Results:

The study highlighted that the cyberchondria cluster comprised 45.3% of participants. Subscale score distribution of CSS-SV was found to be the highest (7.53 ± 2.98) for excessiveness and the lowest (6.40 ± 2.93) for compulsion subscale. Furthermore, majority (56.4%) of the participants had depression in various severities. Multivariate logistic regression analysis predicted factors such as female gender, health-care worker, and duration of watching TV and smartphone usage to be influencing cyberchondria. Strong influence of duration spent (>6 h/day) in watching TV, etc., was found on depression.

Conclusion:

Cyberchondria and its association with depression are indeed growing health concerns; efforts should be directed toward controlled Internet usage, which involves adhering to credible sources for authentic health-related information.
Compatible with Conviviality? Exploring African Ecotourism and Sport Hunting for Transformative Conservation
Authors: Ochieng Amos , Koh Niak Sian , Koot Stasja
Published: December 2022

Recent decades have shown the increased popularity of market-based instruments (MBIs) for conservation despite mixed social and ecological outcomes. This paper explores the extent to which two crucial MBIs, namely, ecotourism and sport hunting, are compatible with 'convivial conservation', a novel, integrated approach that explores conservation beyond capitalism. We developed an analytical framework of five key features for transformative change that can potentially contribute to conviviality: access and property rights, benefit-sharing, value operationalisation, institutional arrangements, and decision-making processes. We analysed the use of ecotourism and sport hunting in southern and eastern Africa in relation to the five features. Based on 'radical incremental transformation', we applied these features to analyse if, and if so how, incremental changes to these MBIs can be supportive in transitioning conservation towards (further) conviviality. With insights from our extensive research experiences in eastern and southern Africa, we highlight that the institutional design and contextual factors determining power relations are often more important than the choice of instrument in influencing its social and ecological outcomes. In conclusion, we propose a shift in the dialogue on conservation beyond its infatuation with commodification by integrating convivial elements into the design of conservation policies.
Comparison of Nutrition Risk Screening 2002 and Subjective Global Assessment for Predicting Postoperative Complications Among Patients Undergoing Elective Abdominal Surgery
Authors: Raghuraman Hemamalini , Kavyashree M. , Balakrishnan Gurushankari , Elamurugan T. P. , Shankar Gomathi , Nanda Nivedita , Thulasingam Mahalakshmy , Kate Vikram
Published: December 2022

Introduction:

Malnutrition leads to poor outcomes in surgical patients, leading to negative impact during the postoperative period. Nutrition Risk Screening (NRS) 2002 and Subjective Global Assessment (SGA) are novel tools to assess nutrition risk which have the potential to predict the postoperative complications in surgical patients.

Aim:

This study was carried out to determine the efficiency of the NRS 2002 and SGA in predicting postoperative complications.

Materials and Methods:

A prospective cohort study was conducted to assess the nutritional risk of patients aged 18 years and above who underwent elective abdominal surgery. NRS 2002 and SGA were used for nutritional screening. Univariate analysis was carried out to determine the relative risk (RR) of complications for each variable. Receiver operating characteristic (ROC) and area under curve (AUC) were plotted for NRS 2002 and SGA to identify the score for the former and grade for the latter that predicted complications postoperatively. The correlation of malnutrition with surgical outcomes was performed to determine their association.

Results:

A total of 320 patients were included in the study. Among the patients who underwent elective abdominal surgeries, 39.4% of the total number developed postoperative complications. The most prevalent were Grade 2 complications, which accounted for 69.1% of all such events. Postoperative complications were recorded in 75.5% of the patients identified as at risk by NRS 2002, with a RR of 5.3 (95% confidence interval [CI]: 3.7–7.6; P < 0.001). Complications were found among 68.3% of those who were malnourished by SGA, with a RR of 4.2 (95% CI: 3.0–6.0; P < 0.001). The ROC curve for NRS 2002 to determine the complications had an AUC of 0.80. A score of 3 was the optimal cutoff of NRS 2002 for predicting complications with a maximum sensitivity of 93.6%. Similarly, the ROC curve for SGA grades to determine complications had an AUC of 0.79. Grade B was the best cutoff, with a sensitivity of 77.0%.

Conclusion:

Patients with NRS 2002 scores higher than or equal to 3 and SGA Grades B and above had a higher incidence of postoperative complications in patients undergoing elective abdominal surgeries. Hence, NRS 2002 and SGA are reliable nutrition risk assessment tools for predicting postoperative outcomes.
Review Article on Indwelling Pleural Catheter
Authors: Rajendran Sivanthi Sapna , Ashokan Vignesh , Narasimhan R. Ajay
Published: December 2022

Lymphomas, malignancies of the lung, breast, and ovaries, most frequently give rise to malignant pleural effusions (MPE). The prognosis is often bad when an MPE is present. Malignant cells found in the pleural fluid or tissue can be used to confirm the diagnosis of MPE. Palliative care should emphasize on symptom relief, quality-of-life enhancement, and acceptance of an initial intervention to drain an MPE or prevent recurrence and affordability. Our preferred initial treatment for the majority of patients with recurrent MPE is the placement of an IPC (also known as a tunneled pleural catheter), with intermittent outpatient drainage performed by the patient or attender. Patients with expandable lung are candidates for both IPC drainage and pleurodesis, but those with nonexpandable lung are often only eligible for IPC drainage. IPC requires interventional expertise and may not be available in some institutions. IPC can produce spontaneous pleurodesis and gives good symptom alleviation, according to many randomized trials and one meta-analysis. Effective pleurodesis occurs in up to 70% of patients.
Kartagener's Syndrome Presenting with Secondary Spontaneous Pneumothorax
Authors: Prabhakar Niranjan , Anand R. , Ramesh Preetha
Published: December 2022

Kartagener's syndrome (KS) is a part of a larger family of diseases classified as primary ciliary dyskinesia (PCD). The triad of KS consists of bronchiectasis, chronic sinusitis, and situs inversus, which is likely underdiagnosed, as a limited amount of centers have resources to provide an accurate diagnosis. Symptoms are more prevalent in children that too in the first decade of life. Pneumothorax might be one of the rare complications of the PCD. A review of literature revealed that few patients are diagnosed with PCD complicated with secondary spontaneous pneumothorax. In this case report, we describe a PCD patient with spontaneous pneumothorax and how we treated him in our institution.
Modeling and Optimization of Process Variables in Turning of Inconel 617 through Criteria Importance through Inter-Criteria and Weighted Aggregated Sum Product Assessment Methodology
Authors: Sundararajan Devendiran
Published: December 2022

Inconel 617 is found in industrial sectors, including chemical, petrochemical, and nuclear. This work mainly concentrates on the analysis and the input-parameters optimization that minimizes the surface roughness, tool wear, and force in turning Inconel 617. Then, the chip and inserts are morphologically characterized using optical images. The residual plots showed that the accomplished investigational data are reliable and suitable for further study. Abrasion is accountable for tool wear mechanisms, and a rise in cutting speed affects the tool wear profile. Chip burr adhering to the flank surface is responsible for the surface roughness increase. Optimum cutting parameters are determined as 0.3mm depth of cut, 0.1mm/rev feed rate, and 220m/min cutting speed. Feed rate is the most influential parameter for process variables through Criteria Importance through Inter Criteria and weighted aggregated sum product assessment methodology.
Investigation of Machining Nimonic 75 with Hexagonal Boron Nitride Nanofluids: Tool Wear, Cutting Forces, Roughness, Residual Stress, and Chip Morphology
Authors: Kannan Venkatesan , Sundararajan Devendiran
Published: December 2022

The present paper examined the machining of Nimonic 75 experimentally with hexagonal boron nitride-based cutting fluid. Three different types of hexagonal boron nitride (hBN) nanofluids with various hBN concentrations and cutting variables (cutting speed and feed rate) are applied in turning experiments. Tool wear, cutting forces, roughness, residual stress, and chip morphology in machining Nimonic 75 alloy with the hBN nanofluids are analyzed. The effects caused by the variation of hBN concentration and cutting variables are discussed. The results show that cutting speed decrease the force, surface roughness, specific energy consumption, and chip reduction coefficient except for shear angle, friction coefficient, and residual stress. The increase in feed rate increases the machining characteristics and chip-tool interface indices parameters except for flank wear and specific energy consumption. Finally, the optimal weight concentration to minimize machining and chip-tool parameters is 0.50 wt.% of hBN in cutting fluid. The weighted desirability approach is applied to determine the optimal parameters for both characteristics.
Experimental Analysis on Machining Properties of Aluminum Hybrid Composite Materials
Authors: RA Hari Baalaaji , K Balasubramanian , R Soundararajan
Published: December 2022

Hybrid Composite materials meet a major demand in current industrial market through mixture of various percentages of metal compositions at different levels. One such material, which is most widely employed, is aluminum. Aluminum hybrid metal matrix composites is substituted with conventional alloys in order to meet the rigid, high-end requirements at major industries. In this work, it is reinforced with Aluminum-Tungsten Carbide-Graphite composite and fabricated using the stir casting process. Die sinking electric discharge machining (EDM) process is preferred over conventional process for the purpose of machining complex shaped materials with accuracy. The optimization of minimizing surface roughness and maximize material removal rate is essential to increase the effective and efficient usage of hybrid composites. In this experimental work, the sensitivity of various parameters of EDM on the output responses is found using Taguchi experimental design, Multi response optimization and Analysis of variance (ANOVA) to generate the mathematical model. From the experiment, it is found that %WC = 6 %, %Gr = 3 %, I= 5A, V=50V, TOFF=50μs, is the most optimal value among others due to its meta stable bonding in improving the machining parameters to achieve optimization of minimizing surface roughness and maximizing material removal rate
Preparation and Characterization of Lanthanum Ferrite Nanopowders Using Igepal CO 520 as a Surfactant
Authors: J Chandradass , N.V. Rengasamy , M AMUTHA SURABI , kim Ki Hyeon , Rajendran R
Published: December 2022

In the present study, a reverse micelle method is used to fabricate Lanthanum ferrite nanopowders. Toluene (oil phase), Igepal CO 520 (non-ionic surfactant), and mixed aqueous solutions of Lanthanum (III) nitrate hydrate and Iron (III) nitrate nonohydrate are used to make the microreactor (water phase). The precipitate is formed by introducing ammonium hydroxide to microemulsion. The deposit is then centrifuged, dried, and calcined to prepare LaFeO3 nanopowders. The prepared LaFeO3 nanopowders were subjected to X-ray diffraction (XRD), and Transmission electron microscopy (TEM). XRD confirms the presence of LaFeO3 with cubic spinel structure annealed at 600°C. The size of the crystallites grows as the water to surfactant ratio rises. TEM shows the particle size at water to surfactant ratio of about 11.4 nm. Weak ferromagnetic behavior and reduced magnetic moments are revealed by magnetic measurements. When the water-to-surfactant ratio rises, the absorption band at R=12 shifts to a longer wavelength, as shown by UV-NIR spectroscopy.
Privlačnost onkraj groba in kača kot varuhinja devištva
Authors: Božič Blaž
Published: December 2022

V pričujočem prispevku skušam strniti nekaj misli o specifičnih elementih erotičnega imaginarija epizode o Moreju in Halkomedeji v Nonosovem Epu o Dionizu, to sta motiv kače, varuhinje devištva, in motiv nekrofilije. Najprej podajam shematičen prikaz zgradbe obeh motivov z ozirom na proleptično Nonosovo poetiko. Pri motivu kače gre predpostaviti tročleno zgradbo (prefiguracija v 15. knjigi, prerokba v 33. knjigi in osrednji prizor v 35. knjigi), pri nekrofiliji pa dvočleno (prefiguracija in osrednji prizor v 35. knjigi). Že v poprejšnjih raziskavah izrečena predpostavka, da gre tudi pri prizoru nekrofilije v resnici za prefiguracijo (Moreja) ocenjujem za smiselno zaradi podobnosti likov (anonimni vojščak, anonimnost kot značilnost »tipa«) in v kompozicijskem oziru. V pragmatičnem oziru je, če želimo ta prizor razumeti kot prefiguracijo, nujno predpostaviti bralčevo poznavanje epizode o Kalimahu in Druzijani iz Janezovih del, ki, kot je bilo ugotovljeno že v drugih raziskavah, gotovo predstavlja intertekst k Nonosovi epizodi. Motiv kače v vsebinskem in simbolnem smislu berem kot značilen primer Nonosove literarne sinteze krščanskega in klasičnega elementa, pri čemer je funkcija kače (varuhinja vhoda v sveti okraj) del klasičnega izročila, idejno ozadje epizode pa izvira iz krščanskega konteksta (idealizacija devištva in čistosti). Implicitne metafore v tem branju so eni strani razumevanje ženskega telesa kot svetega (okraja) in spolovila kot vhoda, ki ga varuje kača, ter na drugi strani – z ozirom na htonično naravo kače – razumevanje človeškega telesa kot zemeljskega elementa (v nasprotju z dušo, ki se povezuje z nebeškim).
Je Ptolemajev Serbinon antično srbsko mesto?
Authors: Veljković Žarko B. , Ilić-Pisum Dragan
Published: December 2022

V zadnjih treh desetletjih se v Srbiji ponovno pojavlja romantična, paraznanstvena, tako imenovana nacionalna zgodovina. Ta v svoji najnovejši pojavni obliki trdi, da so Srbi avtohtoni prebivalci Podonavja in Balkana, tako rekoč Praindoevropejci v svoji pradomovini, srbščina pa naj bi bila indoevropski prajezik. Ti kvazizgodovinarji brez znanstvenih argumentov so, naslanjajoč se na glasoslovne asociacije, obenem tudi kvazietimologi in trdijo, da Ptolemajevo mesto Serbinon v Panoniji dokazuje, da so že v antiki Srbi živeli v Podonavju in na Balkanu. Resni znanstveni in etimološki dokazi pa to »prasrbsko« etimologijo v celoti zavržejo in razkrijejo, da gre za panonski ilirski toponim *Sérbinom, ki približno pomeni »mesto z žrelom/vodno sotesko, iz katere(ga) bruha voda, z vodno globeljo« ali »kraj, kjer je žrelo jame ali votline, brezno«; ali še bolje, »kraj z vodnim virom/izvirom ali (?) rečnim izvirom« oz. »kraj z virom termalne vode«. Toponim sestavlja indoevropski koren *serbh- »srkati, goltati; kapljati, curljati; žrelo; žrelo jame ali votline, brezno« in ilirska pripona za tvorbo toponimov -inom, ta se denimo najde v poimenovanju *Altinom (*Altinon, Altinum) ipd. Sodeč po Ptolemajevi Geografiji bi se koordinate tega toponima lahko približno ujemale z današnjim madžarskim krajem Villánykövesd oz. z današnjo hrvaško Cabuno ali s hrvaškim krajem Gradina, obe lokaciji pa se nahajata v bližini Virovitice ob madžarski meji.
Isotta Nogarola
Authors: Nogarola Isotta , Tadel Alex
Published: December 2022

Elegija v slavo cianskega podeželja, edino ohranjeno delo v verzih avtorice Isotte Nogarole, opeva posest, ki jo je imela plemiška družina Nogarola v bližini Verone. Pesnica bukoličnim motivom idiličnega podeželja doda ajtiološki mit o zgodovini jezera, ki se je nahajalo na omenjeni družinski posesti. Jezero po nimfi Ciane, ki jo poznamo predvsem iz Ovidovih Metamorfoze (5.409–470), poimenuje Cianum ter okoliško pokrajino povzdigne v domovanje mitološkega bitja in vir pesniškega navdiha.
The Modernizing Jewish Family as a Negative Role Model in Polish Popular Novels at the Turn of 19th and 20th Century
Authors: Domagalska Małgorzata
Published: December 2022

In Poland at the turn of 19th and 20th century a modernizing Jewish family appears quite frequently in anti-Semitic and non-anti-Semitic “Jewish novels”. In both cases a Jewish family is presented in rather pejorative light as a point of reference to a Polish family. In such comparison Polish culture and Poles are presented as a more attractive, more civilized and that is why their way of living is followed by the Jews. Jewish families try to undergo the process of assimilation but their effort are depicted in rather pejorative or even ridiculous way.

There are some Jewish heroes presented as a role model, but they only prove the role. There is a huge gap between Poles and Jews who have to make an effort to change their personality and behaviour according to Polish expectations.

In anti-Semitic novels a description of the process of modernization and assimilation of Jews had to prove its negative consequences. Jews were treated as enemies and novels’ plot revealed their main goal – the conquest of Poland. This kind of writing can be also seen as a warning against mix marriages to prevent Polish society from the integration with Jews, who are presented as the main threat of homogeneity of Polish nation.
“Childhood Left the Brightest Memories”: Early Years Described in the Autobiographies of Jewish Female Students in the Early 20th Century
Authors: Drach Oksana
Published: December 2022

The article presents the childhood years of Jewish female students of the medical department of the Kyiv Higher Courses for Women, as described in their own autobiographies. The study of their autobiographical images of childhood reveals transformations in the relationships between parents and daughters in Jewish families in the modern period, the variability of the home upbringing of girls, and the obligatory component of their education. The admission of daughters to the educational institutions determined by their parents symbolized the end of childhood.
Da Capital ao Interior: os usos do espaço público por crianças e jovens de periferia em perspectiva comparada
Authors: Greicy Bittencourt Cunha Mirila
Published: December 2022

O presente trabalho, originado de pesquisas de mestrado, constitui-se em descrição e análise da circulação e uso de espaços públicos por crianças e jovens de regiões de periferia do Rio de Janeiro e de Campos dos Goytacazes. Foram utilizadas as técnicas da observação e de entrevistas entre os meses de março de 2017 e março de 2019. Através da comparação, buscou-se perceber as semelhanças e diferenças nos usos e circulação em espaços públicos. Entre os resultados, destacam-se as tensões e negociações entre as crianças e jovens e os administradores desses locais e os processos de ressignificação do uso e circulação no MAM–RJ e na UENF–RJ. Na ausência de aparelhos públicos nas periferias, esses espaços funcionam como ponto de encontro e lazer.
Editorial
Authors: Editorial Conselho
Published: December 2022

É com satisfação e esmero que lançamos o segundo número da Revista Áskesis – Revista dos Discentes do Programa de Pós-Graduação em Sociologia da UFSCar. Essa segunda edição teve como principal característica a continuidade, pois a revista tem como intenção, a circulação e a renovação de seus membros do Comitê Editorial, para que o maior número de discentes do programa possam aprender todas as minúcias de uma revista de cunho acadêmico. Os objetivos dos novos integrantes da revista foram o rápido aprendizado para a realização dos aspectos burocráticos, acadêmicos, intelectuais e políticos que contêm a editoração de uma revista. Assim é de suma importância, esse espaço conquistado pelos “antigos” e atuais membros do comitê como local para o exercício e expressão intelectual – e político – dos futuros discentes.
Anatomska zbirka pisca / Anatomy Collection of a Writer
Authors: Duraković Irma
Published: December 2022

In his novel Mensch gegen Mensch (1919), the Austrian writer Ernst Weiß opens the door to the figure of a doctor for the first time. The diseases that Weiß works with here are not only the fruit of the “writer’s imagination” but almost clearly mapped images from the conventional medicine books as well as the very experiences that Weiß acquired during his education and later practice as a surgeon in Vienna and Prague. In the novel Mensch gegen Mensch, the writer introduces the hero Alfred to the world of the Second Viennese Medical School, which on the one hand stands in the service of humans, and on the other excludes all that is not material: sensitivity and ultimately the very “soul”. While the clinical view focuses on the human body as the subject of research, the literary text puts humans at the centre of events and tries to expose what is invisible to the naked eye: the human psyche. Questions arise as to how Weiß portrays the early 20th-century medical discourse in the novel and what role he attributes to medicine in the research and understanding of a human.
Negativna kritika suvremenih interpretacija Aristotelove Metafizike / Negative Critique of Contemporary Interpretations of Aristotle’s Metaphysics
Authors: Grbić Safer
Published: December 2022

The history of Aristotle’s writings, posthumously collected, edited, published and named Metaphysics, is the history of its interpretations. From the first commentaries on Aristotle’s Metaphysics to its contemporary interpretations, there is a two-thousand-year-long tradition. However, the tradition of interpreting Aristotle’s search for the sought-after science is such that in modern times it is reduced to a discussion of the relationship between E and Λ books of Metaphysics through the relationship between ontology and theology in Aristotle’s system. In this paper, we will present the sought-after science as a fundamental issue in Metaphysics, a brief sketch of Metaphysics and the historical problems of the E and Λ books. This paper aims to prove the negative teachings of posthumously published Aristotle’s writings through a critique of their modern interpretations that present the sought-after science in Aristotle’s project as negative i.e. unfinishable and as evidently unfinished.
Uvodna riječ / Foreword
Authors: Editorial
Published: December 2022

Foreword.