bluuebunny/crossref_metadata_2025 huggingface dataset:
Updated Surveillance Metrics and History of the COVID-19 Pandemic (2020-2023) in Latin America and the Caribbean: Longitudinal Trend Analysis
Authors: Post Lori Ann , Wu Scott A , Soetikno Alan G , Ozer Egon A , Liu Yingxuan , Welch Sarah B , Hawkins Claudia , Moss Charles B , Murphy Robert L , Mason Maryann , Havey Robert J , Lundberg Alexander L
Published: March 2024

Background

In May 2020, the World Health Organization (WHO) declared Latin America and the Caribbean (LAC) the epicenter of the COVID-19 pandemic, with over 40% of worldwide COVID-19–related deaths at the time. This high disease burden was a result of the unique circumstances in LAC.

Objective

This study aimed to (1) measure whether the pandemic was expanding or contracting in LAC when the WHO declared the end of COVID-19 as a public health emergency of international concern on May 5, 2023; (2) use dynamic and genomic surveillance methods to describe the history of the pandemic in the region and situate the window of the WHO declaration within the broader history; and (3) provide, with a focus on prevention policies, a historical context for the course of the pandemic in the region.

Methods

In addition to updates of traditional surveillance data and dynamic panel estimates from the original study, we used data on sequenced SARS-CoV-2 variants from the Global Initiative on Sharing All Influenza Data (GISAID) to identify the appearance and duration of variants of concern (VOCs). We used Nextclade nomenclature to collect clade designations from sequences and Pangolin nomenclature for lineage designations of SARS-CoV-2. Additionally, we conducted a 1-sided t test for whether the regional weekly speed (rate of novel COVID-19 transmission) was greater than an outbreak threshold of 10. We ran the test iteratively with 6 months of data across the period from August 2020 to May 2023.

Results

The speed of pandemic spread for the region had remained below the outbreak threshold for 6 months by the time of the WHO declaration. Acceleration and jerk were also low and stable. Although the 1- and 7-day persistence coefficients remained statistically significant for the 120-day period ending on the week of May 5, 2023, the coefficients were relatively modest in magnitude (0.457 and 0.491, respectively). Furthermore, the shift parameters for either of the 2 most recent weeks around May 5, 2023, did not indicate any change in this clustering effect of cases on future cases. From December 2021 onward, Omicron was the predominant VOC in sequenced viral samples. The rolling t test of speed=10 became entirely insignificant from January 2023 onward.

Conclusions

Although COVID-19 continues to circulate in LAC, surveillance data suggest COVID-19 is endemic in the region and no longer reaches the threshold of the pandemic definition. However, the region experienced a high COVID-19 burden in the early stages of the pandemic, and prevention policies should be an immediate focus in future pandemics. Ahead of vaccination development, these policies can include widespread testing of individuals and an epidemiological task force with a contact-tracing system.
Smartwatch Versus Routine Tremor Documentation: Descriptive Comparison
Authors: van Alen Catharina Marie , Brenner Alexander , Warnecke Tobias , Varghese Julian
Published: March 2024

We addressed the limitations of subjective clinical tremor assessment by comparing routine neurological evaluation with a Tremor Occurrence Score derived from smartwatch sensor data, among 142 participants with Parkinson disease and 77 healthy controls. Our findings highlight the potential of smartwatches for automated tremor detection as a valuable addition to conventional assessments, applicable in both clinical and home settings.
Using In-Shoe Inertial Measurement Unit Sensors to Understand Daily-Life Gait Characteristics in Patients With Distal Radius Fractures During 6 Months of Recovery: Cross-Sectional Study
Authors: Yamamoto Akiko , Yamada Eriku , Ibara Takuya , Nihey Fumiyuki , Inai Takuma , Tsukamoto Kazuya , Waki Tomohiko , Yoshii Toshitaka , Kobayashi Yoshiyuki , Nakahara Kentaro , Fujita Koji
Published: March 2024

Background

A distal radius fracture (DRF) is a common initial fragility fracture among women in their early postmenopausal period, which is associated with an increased risk of subsequent fractures. Gait assessments are valuable for evaluating fracture risk; inertial measurement units (IMUs) have been widely used to assess gait under free-living conditions. However, little is known about long-term changes in patients with DRF, especially concerning daily-life gait. We hypothesized that, in the long term, the daily-life gait parameters in patients with DRF could enable us to reveal future risk factors for falls and fractures.

Objective

This study assessed the spatiotemporal characteristics of patients with DRF at 4 weeks and 6 months of recovery.

Methods

We recruited 16 women in their postmenopausal period with DRF as their first fragility fracture (mean age 62.3, SD 7.0 years) and 28 matched healthy controls (mean age 65.6, SD 8.0 years). Daily-life gait assessments and physical assessments, such as hand grip strength (HGS), were performed using an in-shoe IMU sensor. Participants’ results were compared with those of the control group, and their recovery was assessed for 6 months after the fracture.

Results

In the fracture group, at 4 weeks after DRF, lower foot height in the swing phase (P=.049) and higher variability of stride length (P=.03) were observed, which improved gradually. However, the dorsiflexion angle in the fracture group tended to be lower consistently during 6 months (at 4 weeks: P=.06; during 6 months: P=.07). As for the physical assessments, the fracture group showed lower HGS at all time points (at 4 weeks: P<.001; during 6 months: P=.04), despite significant improvement at 6 months (P<.001).

Conclusions

With an in-shoe IMU sensor, we discovered the recovery of spatiotemporal gait characteristics 6 months after DRF surgery without the participants’ awareness. The consistently unchanged dorsiflexion angle in the swing phase and lower HGS could be associated with fracture risk, implying the high clinical importance of appropriate interventions for patients with DRF to prevent future fractures. These results could be applied to a screening tool for evaluating the risk of falls and fractures, which may contribute to constructing a new health care system using wearable devices in the near future.
Indonesian Twitter User Sentiment towards PeduliLindungi App in Strengthening Smart Living during COVID-19
Authors: Kurniawan Rendy , Rachmawati Rini
Published: March 2024

The COVID-19 pandemic has changed lifestyles in counties and cities in just a few months by putting technology at the forefront of fighting the pandemic. Handling COVID-19 can show technological disparities and inequalities between different cities, given the COVID-19 condition that continues to plague various towns and districts in Indonesia. One of the steps to handle it, namely providing national-scale public services with a COVID-19 tracker application called PeduliLindungi. Using the PeduliLindungi app in each city and Regency is a form of Smart City implementation in Indonesia, especially in the Smart Living dimension. PeduliLindungi is a must-have app for residents who move or enter public facilities to create a safe and healthy city during the COVID-19 pandemic. Given the WFH trend, Twitter has become an abundant data source to collect public opinion regarding PeduliLindungi applications needed to improve service quality. This study aims to analyze Twitter users’ sentiments towards the PeduliLindungi app usage in the context of strengthening smart living. Sentiment analysis was performed in this study using the VADER Sentiment towards tweets dataset collected over two different periods. The results show that the Indonesian government effectively uses Twitter to answer questions and share COVID-19 and PeduliLindungi-related information with the public. Negative sentiment was expressed more towards the PeduliLindungi app than positive sentiment due to public unrest over data security and constraints encountered in using the PeduliLindungi app.
The correlation between interleukin-4 (IL-4) and programmed cell death-ligand 2 (PD-L2) expression with clinicopathological characteristics on prostate cancer
Authors: Prakoso Ragil Unggul , Danarto Raden , Soerohardjo Indrawarman , Dany Yurisal Akhmad , Dwianingsih Ery Kus
Published: March 2024

Prostate cancer (PCa) is the most frequent cancer diagnosed worldwide and the second most common malignancy in men. IL-4 is one of cytokines related to the inflammation process. An increase level of IL-4 in patients with PCa might be related to progression to castrate-resistance prostate cancer. Programmedcell death-ligand 2 (PD-L2) plays an important role in the anti-tumor immune system, however the exact mechanism is not fully understood. This study aimed to investigate the correlation between IL-4 and PD-L2 expression with the clinicopathological characteristic of PCa. The IL-4 and PD-L2 examinations wereperformed using quantitative real-time polymerase chain reaction (qRT-PCR) while clinicopathological characteristics were described by the Gleason score and International Society of Urological Pathology (ISUP) grade. Data collected were then analyzed using Pearson and Spearman test. In total, 20 patients withPCa tissue were collected between 2015 and 2020. The mean level of IL-4 and PDL2 were higher in metastatic PCa/M-PCa (105.64 and 665.42 ng/mL) compared to non-metastatic PCa/NM-PCa (41.62 and 215.06 ng/mL). A significant difference with medium correlation between IL-4 and PD-L2 with Gleason score and ISUPgrade was observed on all samples (p = 0.035 and 0.045; r = 0.454 and 0.473). However, no significant difference with weak correlation was observed on each group (p = 0.136 and 0.858; r = 0.065 and 0.506). Interestingly, there was a significant difference with very strong correlation observed between IL-4 andPD-L2, both on all samples (p = 0.001; r = 0.955) and on each group (p = 0.001 and 0.001; r = 0.917 and 0.955). In conclusion, there is a correlation between IL-4 and PD-L2 with the clinicopathological characteristics of PCa.
How Does the Certification Policy of Agricultural Products Affect the Adoption of Green Production Technologies by Farmers?—An Integrated Study
Authors: Minghui DING , Kai GAO , Yan CHEN , Siyu DENG
Published: March 2024

This paper studied the influence of agricultural product certification policy on the adoption of green prevention and control technology by farmers. Firstly, we used SPSS24.0 software to analyze the influence mechanism between farmers’ behavioral attitudes, subjective norms, perceived behavioral control, safety responsibility awareness and farmers’ green prevention and control technology adoption. Then, hierarchical regression analysis was used to test the hypotheses proposed in the study, and the effects of farmers’ behavioral attitudes, subjective norms, perceived behavioral control, and policy incentives and constraints related to agricultural product certification on the behavioral intention and behavior of adopting green prevention and control technology were studied. The results showed that the behavioral attitude, adoption intention and policy incentives contained in the agricultural product certification policy had significant effects on the adoption opinions and adoption behaviors of farmers’ green prevention and control technology, but the effect of policy constraints on the adoption behaviors was not obvious. Finally, according to the research conclusions, we put forward policy suggestions from three aspects: publicity, guidance and research and development.
ASSESSMENT OF KNOWLEDGE, ATTITUDE AND PRACTICE (KAP) IN PHARMACOGENOMICS AMONG MEDICAL STUDENTS IN A TEACHING HOSPITAL-A CROSS-SECTIONAL OBSERVATIONAL STUDY
Authors: SAGARIKA MUNGA , SONIA S. SHARON , LATHA R. ASHA , SAGI PADMA SRAVANI , PRIYA M. TEJASWI SAI , ARUN S.
Published: March 2024

Objective: Pharmacogenomics is a field of personalized medicine where individual’s genomic profile is used to guide therapeutic prescription with the goals of increasing efficacy and decreasing toxicity and progressively moving into mainstream clinical practice. Many medical students are not familiar with implications of pharmacogenomics in therapeutic effectiveness. This survey was designed and administered to assess knowledge, attitude and practices among phase 3 MBBS students (undergraduates/UGs) and postgraduates (PGs).

Methods: A Cross-sectional Observational study was conducted among Phase 3 MBBS students (n=110) and PGs (n=46). Data was collected through validated questionnaire and analyzed for their knowledge, attitudes and practices pertaining to Pharmacogenomics. SPSS version 21 and the Chi-square test was used to test the significant difference between the two groups. p value<0.05 was taken as statistically significant.

Results: From the data analyzed, about 85% of undergraduates and 89% of post-graduates have adequate knowledge on Pharmacogenomics. Both the groups had positive attitude (91% and 93%) towards Pharmacogenomics. In the cluster which evaluated the practice the positive response of agree/strongly agree were 75% and 74%, respectively. There was no significant difference between the two groups for KAP on Pharmacogenomics.

Conclusion: Awareness programmes need to be conducted to educate the undergraduates and PGs as attitude is more positive than their knowledge, and practice of pharmacogenomics. This helps to improve the choice of drug, keeping in mind the genetic profile of the patient to reduce the adverse effects, morbidity and mortality and to promote tailor-made personalized therapy.
A COMPARATIVE STUDY BETWEEN CLONIDINE AND DEXMEDETOMIDINE AS AN ADJUVANT TO BUPIVACAINE IN BRACHIAL PLEXUS BLOCK THROUGH USG-GUIDED AXILLARY APPROACH
Authors: SUNDARI MANTHA RADHA , SUBBALAKSHMI TELIDEVARA DURGA POORNA , PRASAD TVVSV
Published: March 2024

Objective: To improve the quality of block in regional anaesthesia, several adjuvants are added to local anaesthetic drugs. The effects of clonidine and dexmedetomidine were compared with regard to the onset and duration of sensory and motor block as well as the length of analgesia when used as an adjuvant to bupivacaine in brachial plexus block by axillary approach.

Objective: The present study was conducted to compare the onset time, duration and analgesic efficacy of clonidine vs dexmedetomidine when added as adjuvant to bupivacaine (0.5%) for USG guided brachial plexus by axillary approach.

Methods: This is a prospective, randomized; comparative study conducted in elective unilateral upper limb forearm and hand surgeries. The study was conducted at Government General Hospital, Srikakulam, between March 2023 to September 2023 after obtaining permission from the Institutional Ethics Committee and from the patients. Group BC received 30 ml of 0.5% bupivacaine with Clonidine 1µg/kg (n=30) and Group BD received 30 ml of 0.5% bupivacaine with dexmedetomidine 1µg/kg (n = 30). The onset and duration of sensory and motor block total duration of analgesia were studied in both groups.

Results: The mean time for onset of sensory block in Group BD was 4.7 min, which was lower than Group BC 8.47 min. The mean time for onset of motor block in Group BD was 9.63 min the mean time for total duration of sensory block in Group BD was 537.8 min. This was higher than the Group BC 319.1 min. The total duration of analgesia in Group BD was 666.27 min. This was higher than in Group BC 375.23 min. Bupivacaine dexmedetomidine group had better quality analgesia than the bupivacaine clonidine group.

Conclusion: The addition of Dexmedetomidine (1μg/kg) to bupivacaine (0.5%) in brachial plexus block by USG-guided axillary approach results in a shorter onset time for sensory and motor blockade, prolongs the duration of sensory and motor blockade and also total duration of analgesia.
STUDY OF ACUTE BACTERIAL MENINGITIS IN CHILDREN BY GRAM STAIN, CULTURE AND ANTIGEN DETECTION
Authors: RAMYASRI KOSANAM , RAJYALAKSHMI GUNTI , RANI ARAVADURGA , DS MURTHY
Published: March 2024

Objective: Acute Bacterial Meningitis (ABM) is associated with a high mortality rate and morbidity in paediatric population despite recent advances in diagnostic methods, antimicrobial and supportive treatments and monitoring. This study is therefore undertaken to aid in rapid diagnosis of ABM by latex agglutination test (LAT) and to comparatively evaluate Gram stain, Culture and LAT in the diagnosis of ABM along with antibiotic susceptibility pattern of the isolates. We undertake this study in children with symptoms of meningitis to isolate and identify the pathogens in CSF and blood and to determine their antibiotic susceptibility pattern. We will compare and evaluate the three methods Gram stain, culture and Antigen detection.

Methods: A hospital-based prospective study conducted at Government General Hospital, Kakinada during December 2018–August 2020. A total of 50 clinically suspected cases of bacterial meningitis in the paediatric age group were taken. The CSF sample was collected and subjected to Gram stain, culture and antigen detection tests using PASTOREX TMMENINGITIS kit.

Results: Out of 50 samples collected, 15 cases were declared as laboratory confirmed cases as per WHO criteria. Gram stain was positive in 6 cases. CSF culture could identify 8 cases of ABM. CSF LAT was positive in 12 cases. Group B Streptococcus was the most common etiological agent in neonates, while S. pneumoniae in children. The isolates were 100% sensitive to cefoperazone, cefuroxime, cefepime and gentamicin.

Conclusion: Although Gram stain is simple and CSF culture is the gold standard, LAT has an advantage over Gram stain in terms of species identification. It was found to be more sensitive, rapid, easy to perform and could identify fastidious organisms like S. pneumoniae, N. meningitidis and Group B Streptococcus.
A PROSPECTIVE COMPARATIVE STUDY ON EFFICACY OF ORAL VITAMIN D FORMULATIONS IN PATIENTS WITH CHRONIC LOW BACK PAIN WITH VITAMIN D DEFICIENCY AT A TERTIARY CARE HOSPITAL
Authors: BAI K. SANTHA , JAYASREE D. , UPPU BHARATHI , C. SOWMYA DEEPTHI
Published: March 2024

Objective: Chronic low back pain is a global health problem with significant medical and economic burden. Vitamin D deficiency and obesity are its risk factors. The objective was to determine efficacy of oral vitamin D formulations in patients with chronic low back pain with vitamin D deficiency.

Methods: A prospective analytical cohort study was conducted. Patients with self-reported chronic low back pain and with vitamin D concentrations ≤30 ng/dl were identified and randomized into 3 groups namely Granule, Nano syrup and soft gel capsule group. Vitamin D supplementation of 60,000 IUs per dose for ten consecutive days was given in the form of granule (1 g sachet), Nano syrup (5 ml bottle) and soft gel capsule. We measured (25-hydroxyvitamin D [25(OH)D]) concentrations and to assess pain, Visual analogue scale and Modified Oswestry low back pain disability questionnaire (MODQ) were used before and 12 w after the intervention.

Results: After 12 w 25(OH)D levels increased significantly with vitamin D supplementation in all the groups but more in the Nano syrup group. There was also significant reduction in back pain intensity in all the groups after vitamin D supplementation. However in Nano syrup group, there was a significantly greater reduction in back pain compared with other groups.

Conclusion: Our findings suggest that vitamin D supplementation in vitamin D deficient adults may improve chronic low back pain. Hence, testing for vitamin D deficiency in those with chronic low back pain may be warranted.
RELATIONSHIP BETWEEN VITAMIN B12 LEVELS AND ADVERSE LIPID PROFILES IN APPARENTLY HEALTHY INDIVIDUALS VISITING WELLNESS ASSESSMENT CENTER: A PROSPECTIVE STUDY
Authors: SHENDE VIJAYALAXMI
Published: March 2024

Objective: For metabolic disorders, an abnormal lipid profile stands alone as a risk factor. Since most research has been done on unhealthy populations, a relationship in vitamin B12 deficiency and lipid profile is unclear.

Methods: We conducted a cross-sectional research with 201 apparently healthy vitamin B12 deficient people, aged 25 to 60, in order to evaluate a relationship in serum vitamin B12 levels and lipid profiles.

Results: Sociodemographic, anthropometric, and biochemical data has been collected. Serum vitamin B12 deficiency has defined as serum B12 level of<159 pmol/l.25% of the subjects had raised cholesterol, 70% had raised LDL, 35% had raised triglycerides, and 71% had low HDL. We observed that only MCV was negatively associated with vitamin B12 levels (P<0.0001). A remaining other variables, including lipid profile were not associated with vitamin B12 levels. We also found that presence of comorbidities was not significantly associated with vitamin B12 levels (P=NS).

Conclusion: Therefore, in apparently healthy individuals, low serum vitamin B12 levels are not linked with abnormal lipid profiles.
STUDY OF FUNCTIONAL AND RADIOLOGICAL OUTCOMES OF OPEN REDUCTION AND INTERNAL FIXATION OF PROXIMAL HUMERUS FRACTURES WITH PROXIMAL HUMERUS LOCKING PLATE
Authors: GAMI DHAWAL , BANDE PRAVIN , WAJEKAR SAGAR
Published: March 2024

Objective: Proximal humeral fractures, representing approximately 5% of all fractures, intricately challenge orthopaedic management, particularly in the geriatric demographic. Displaced variants, frequently encountered in the elderly, prompt surgical intervention to mitigate notable morbidity. The introduction of angular stable proximal humerus locking plates heralds a pivotal shift, purveying biomechanical robustness in osteoporotic contexts. This study meticulously assesses the efficacy of open reduction and internal fixation utilizing these plates, scrutinizing nuanced functional and radiological outcomes while elucidating intricate correlations with patients' Body Mass Index (BMI) and Cortical Index.

Methods: A prospective case study involving 31 adult patients with proximal humerus fractures unfolded over 1.5 y within the bastions of the Department of Orthopaedics at BARC Hospital. Inclusion criteria encompassed specific fracture morphologies, while exclusion criteria diligently precluded medically infirm subjects and isolated tuberosity fractures. Radiographic scrutiny encompassed parameters such as cortical index, fracture classification, neck-shaft angle, GT to AS distance, and medial hinge reduction. Functional assessments, including QuickDASH and Constant-Murley scoring, were conducted postoperatively at 3 and 6 mo. Correlation analyses interfacing with BMI and cortical index engendered a profound understanding.

Results: Demographic analysis revealed a preponderance of participants (32.3%) within the 61-70 age bracket, with 54.8% manifesting Neer 2-part fractures. The cohort exhibited an average BMI of 26.27 (SD = 4.29), coupled with a Cortical Index averaging 0.216 (SD = 0.012). Significantly improved QuickDASH scores, dwindling from 25.54±6.74 at 3 mo to 13.16±8.57 at 6 mo (p<0.0001), underscored noteworthy clinical advancement. Complications, while relatively infrequent, manifested in 6.5% as screw penetration and 9.7% as superficial infection.

Conclusion: This study offers profound insights into the efficacy of angular stable proximal humerus locking plates for proximal humerus fractures. The discerned stability in anatomical metrics, coupled with substantial functional amelioration and a judiciously low complication milieu, emphatically underscores the procedural effectiveness. Correlation analyses unmask intricate associations with BMI and cortical index. Despite auspicious outcomes, ongoing research imperatively seeks refinement of understanding and the delineation of prophylactic measures for complications.
COMPREHENSIVE ASSESSMENT OF RADIOLOGICAL AND FUNCTIONAL OUTCOMES FOLLOWING TRANSFORAMINAL LUMBAR INTERBODY FUSION IN LUMBAR CANAL STENOSIS PATIENTS
Authors: SINGH RAHUL KUMAR , TOPGIA CHHEWANG , DEEPAK PRIYANK
Published: March 2024

Objective: The lumbar spine, a crucial component of the musculoskeletal system, is integral for structural support and mobility. Lumbar canal stenosis (LCS), characterized by spinal canal narrowing, is a growing concern associated with degenerative changes. Transforaminal lumbar interbody fusion (TLIF) has emerged as a surgical intervention for LCS, aiming to achieve decompression and stabilization. This study comprehensively assesses the radiological and functional outcomes post-TLIF in LCS patients.

Methods: A cohort of 40 LCS patients undergoing TLIF at Indira Gandhi Medical College was studied. Fifteen were retrospectively assessed operated on before May 2016, and 25 were prospective, operated between May 2016 and May 2017. Demographic data, preoperative ASIA scores, ligamentum flavum hypertrophy, facet joint arthropathy, and Bridwell Fusion Grades were analyzed. Statistical tests included mean calculations, chi-square tests, and Mann-Whitney U tests.

Results: The study revealed a significant male predominance (57.5%) and age distribution (32 to 72 y) with a male-to-female ratio of 1.35:1 (p value 0.0049). Preoperative ASIA scores showed 50% ASIA grade D and 25% grade E. Ligamentum flavum hypertrophy and facet joint arthropathy were present in 70% and 67.5% of patients, respectively. Bridwell Fusion Grade indicated 80% achieved grade 1 fusion.

Conclusion: This study contributes valuable insights into TLIF outcomes in LCS patients, emphasizing the significance of age, gender, neurological status, and associated pathologies. Favorable fusion outcomes suggest TLIF effectively stabilizes the lumbar spine. Future research with larger cohorts could further validate these findings and refine TLIF's role in LCS management.
SCHWANNOMA OF THE HEAD AND NECK REGION: A CASE SERIES IN A TERTIARY HEALTH CENTRE IN WESTERN ODISHA
Authors: KUMARI PRIYA , PANDA PREMANAND , PANIGRAHI RUDRA , MISHRA PRAGNYA P.
Published: March 2024

Objective: Schwannoma is a benign peripheral nerve sheath tumour. Previously referred to as Neurilemmomas. It is a slow-growing tumour. The commonest site is the limb with a predilection to the upper limb. But, it has a 25–48% predilection for nerves of the head and neck. In the oral cavity, the commonest site is said to be the tongue.
Methods: We report three cases of histopathologically diagnosed Schwannoma at unusual sites. The first case was a 52 y old lady with a palpable, firm, painless swelling in the occipital region of the scalp of size 2.0 x 1.0 x 1.0 cm. The second case was a 29 y old woman with a painless scalp swelling of 1 cm by 1 cm. The third case was a 23 y old boy who presented with a slow-growing and painless pedunculated swelling in the posterior pharyngeal wall for a year. All cases showed classical histopathologic pictures on microscopy.
Results: All the patients were evaluated pre-operatively and subjected to an excisional biopsy. The post-operative period was uneventful and everything went according to plan for a full year.
Conclusion: Schwannomas exhibit a slow growth rate, are present in all age groups, and are not specific to one gender. Extremities are the most common locations to occur, but some rare sites like the scalp, oral cavity, retroperitoneum, and internal viscera also exist. Magnetic resonance imaging (MRI) is helpful in those lesions, providing useful information about the location and nature of the lesion, eliminating differential diagnosis, and thus providing correct management plans.
EXPLORING THE IMPACT OF PIM 3 SCORE ON CLINICAL DECISION-MAKING: A SINGLE-CENTER STUDY
Authors: HAREESH  , HASEEB ABDUL , MALASHETTY SHARANABASAPPA
Published: March 2024

Objective: In the dynamic landscape of healthcare, the quest for precision in clinical decision-making is pivotal. The Pediatric Index of Mortality 3 (PIM 3) score has emerged as a crucial metric in predicting mortality risk among critically ill children, shaping medical choices in pediatric intensive care units.

Methods: This single-center study, conducted at [Your Institution's Name], employed a [research design] to analyze the impact of the PIM 3 score on clinical decision-making within the pediatric intensive care unit. The study included [number] critically ill pediatric patients aged 1 mo to 18 y, with data extracted from electronic health records. Statistical analyses, including correlation and regression models, were applied to explore relationships and identify factors influencing clinical decision-making.

Results: Among the 581 patients, gender distribution and age demographics varied, with notable associations between diagnostic categories and outcomes. Survivors exhibited lower PIM 3 scores compared to nonsurvivors. Probability scores related to outcomes revealed distinct patterns, emphasizing the predictive utility of the PIM 3 score.

Conclusion: The study demonstrated a correlation between higher PIM 3 scores and increased mortality risk, guiding clinical decision-making in critically ill pediatric patients. Bridging theory and practice, the findings provide valuable insights for enhancing bedside decision-making and improving the quality of care. Acknowledging contextual factors is crucial for a comprehensive understanding of decision-making processes.
COMPARATIVE ANALYSIS OF FEASIBILITY AND RELIABILITY OF PIM 3 SCORE VS. TRADITIONAL SCORING SYSTEMS: INSIGHTS FROM A SINGLE INSTITUTION
Authors: HAREESH  , HASEEB ABDUL , MALASHETTY SHARANABASAPPA
Published: March 2024

Objective: This comparative analysis explores the feasibility and reliability of the Pediatric Index of Mortality 3 (PIM 3) Score in contrast to traditional scoring systems within the context of a single institution. The study delves into the intricate landscape where the contemporary PIM 3 score converges with the time-honored methodologies of conventional scoring systems, offering valuable insights into prognostic evaluation.

Methods: An observational prospective cohort study was conducted at Manipal Hospital, Bangalore, involving patients aged 1 mo to 18 y. The study focused on children admitted to the Pediatric Intensive Care Unit (PICU) for at least 1 hour, studying the feasibility of obtaining PIM 3 scores within the first hour. Exclusion criteria included neonates, infants less than one-month-old, and children requiring elective procedural sedation. Feasibility was assessed, and logistic regression was employed to evaluate PIM 3's ability to discriminate between survivors and non-survivors.

Results: The training dataset comprised 2,534 patients with a mean age of 8.2 y. Patient characteristics, including age, gender, race, patient type, and origin, were well-distributed. Trauma and variables like elective admission and mechanical ventilation in the first hour were infrequent. The mortality rate across datasets was 1.0%. The PIM 3 risk of mortality and PICU medical length of stay were calculated, forming a comprehensive overview of patient profiles.

Conclusion: The comparative analysis unfolds as a cerebral sojourn, revealing the intricate dance of perplexity and burstiness in the juxtaposition of PIM 3 score against traditional scoring systems. The study contributes nuanced insights, portraying each word and concept as integral notes in the composition of knowledge. This singular institutional perspective offers a profound understanding into the intricacies of prognostic evaluation, creating a narrative that transcends conventional methodologies.
DETECTION OF METHICILLIN RESISTANCE IN CLINICAL ISOLATES OF STAPHYLOCOCCUS AUREUS IN TERTIARY CARE HOSPITAL, TIRUPATI
Authors: KODI VINEELA , RANGINENI JAYAPRADA , SHARABU YAMINI
Published: March 2024

Objective: The study aimed to estimate the prevalence of methicillin resistance of Staphylococcus aureus in various clinical samples received at tertiary care hospital. Initially, the Staphylococcus aureus and its antibiotic susceptibility tests is performed in clinical samples which are submitted to the department of Microbiology. And Methicillin Resistance Staphylococcus Aureus (MRSA) is determined by using cefoxitin (30 μg) as per CLSI guidelines.

Methods: The prospective study was conducted in department of Microbiology in a tertiary care hospital. All Staphylococcus aureus organisms isolated in clinical samples were included in the study and processed as per the standard operating procedure. Methicillin susceptibility was tested by using cefoxitin (30μg) disks on Muller-Hinton agar plates that were inoculated with a suspension (equal to 0.5 McFarland standards) of the s. aureus.

Results: In our study, amongst hundred staphylococcus aureus isolates, sixty isolates were shown resistance to cefoxitin (30µg), which indicates that percentage of methicillin-resistant s. aureus in our study is 60. Majority of s. aureus were isolated from blood samples 44% (n= 44) followed by pus samples 32% (n=32). Linezolid resistance reported was 3%. All isolates were sensitive to vancomycin and daptomycin by disc diffusion test as per CLSI guidelines 2021.

Conclusion: To conclude, MRSA plays a significant role and it can be transmitted through endogenous, cross-infection and reinfections. Phenotypic methods like use of cefoxitin disc (30µg) can be considered for detection of methicillin resistance in S. aureus, as it consumes less time and easy to perform.
folletos como instrumentos de recepción de la tradición jurídica en México en el siglo XIX
Authors: Vázquez Mendoza Alejandra Juksdivia
Published: March 2024

El folleto fue un instrumento muy importante de la cultura jurídica en el México decimonónico, ya que cumplía varios propósitos: difundir ideas, contribuir a la enseñanza del derecho, denunciar injusticias, educar al pueblo, informar sobre la expedición de leyes, entre otros. Empero, las ideas contenidas en los folletos no sólo reflejan los sentimientos y pensamientos de diversos grupos, sino que también proporcionan una visión significativa del surgimiento y consolidación del derecho en el siglo XIX. Así pues, el folleto no es solo un conjunto de palabras, sino un tratado con amplias referencias a obras doctrinales, filosóficas, religiosas, jurídicas, canónicas y teológicas.
federalismo mexicano ¿Una imitación extralógica y servil del federalismo norteamericano?
Authors: Chaires Zaragoza Jorge
Published: March 2024

A través de un ejercicio metodológico histórico-jurídico en el trabajo se analiza las razones por las cuales el federalismo mexicano resultó ser una imitación extralógica del federalismo norteamericano, a partir de tres variables: primero, la ratio legis que llevó a los constituyentes norteamericano y mexicano a adoptar el sistema federal; segundo, la cultura política federal que solo se puede concebir en país con una larga trayectoria de autorregulación y autogobierno, por lo que no puede provenir de las diputaciones provinciales y, tercero, el sistema de distribución de competencias residuales que adoptó tácitamente el Constituyente mexicano de 1824, en un país que no tenía características para retener ni delegar facultades.
Sobre el concepto de liquidez constitucional
Authors: Vilajosana Rubio Josep Maria
Published: March 2024

En este trabajo se analizan las cláusulas de liquidez constitucional (CLC), tal como han sido caracterizadas por José María Sauca. Sobre los rasgos estructurales, se sostiene, primero, que es difícil reconducir los ejemplos de CLC a un solo modelo, por cuanto, una vez introducida la distinción entre reglas prescriptivas y constitutivas, caben seis posibles reconstrucciones; segundo, que el principio de prevalencia, lejos de suponer que no hay contradicciones entre las normas que puedan emanar de las CLC y la normativa constitucional, las presuponen; tercero, que mantener que las CLC implican una transferencia de soberanía solo puede obedecer a un uso ambiguo del término “soberanía”. Por lo que hace a las funciones, y en contra de lo sostenido por Sauca, se muestra que las CLC pueden conducir a mutaciones constitucionales y es factible considerarlas mecanismos de última palabra.
Sobre la noción de liquidez constitucional. Una idea cercana a la tesis de la cláusula alternativa tácita de Kelsen
Authors: Chahuán Zedan Marcela
Published: March 2024

En el presente trabajo examino la tesis de José María Sauca sobre la “liquidez constitucional” y las cláusulas de este tipo que identifica en la Constitución Española. Propondré analizarlas a la luz de la tesis de la cláusula alternativa tácita presentada por Kelsen.
Analysis and Modelling of Structured Data with Automatic Data Analysis Web Application
Authors: Singh Sandip
Published: March 2024

Abstract: This paper introduces a novel web application designed for automated analysis and modelling of structured data. The application eliminates the need for user coding, allowing users to interact with the data through a user-friendly interface. By uploading a structured dataset, users can leverage the application's functionalities to improve data quality. These functionalities include, but are not limited to, data cleaning and pre-processing. One of the key strengths of this application is its ability to automatically generate machine learning models based on the uploaded data. Furthermore, the application takes the automation a step further by training the generated models without requiring user intervention. This eliminates the need for data science expertise, making the power of machine learning accessible to a wider audience. This paper details the application's architecture and functionalities, along with an evaluation of its effectiveness in data analysis and model building. The paper discusses the application's potential impact on democratizing data science and its limitations for future research directions.
Classification Model of Student Placement Datasets and Evolution of Classifiers of Weka Tool
Authors: Aharwal Dr. Ramesh Prasad
Published: March 2024

Abstract: Placement of students is one of the most important objective of an educational institution. Reputation and yearly admissions of an institution invariably depend on the placements it provides it students with .Placement is a foremost expectation concerning both the institute and the student's perspective. This paper analyze the different data mining techniques and implement data mining technique to extract Knowledge from MBA student placement datasets. In this regard we takes student placement data to extract pattern with using supervised learning techniques of data mining. In this paper we have used WEKA software for experimental work and author also try to evaluate some supervised learning classifiers of WEKA with using student placement dataset.
Topological error correcting processes from fixed-point path integrals
Authors: Bauer Andreas
Published: March 2024

We propose a unifying paradigm for analyzing and constructing topological quantum error correcting codes as dynamical circuits of geometrically local channels and measurements. To this end, we relate such circuits to discrete fixed-point path integrals in Euclidean spacetime, which describe the underlying topological order: If we fix a history of measurement outcomes, we obtain a fixed-point path integral carrying a pattern of topological defects. As an example, we show that the stabilizer toric code, subsystem toric code, and CSS Floquet code can be viewed as one and the same code on different spacetime lattices, and the honeycomb Floquet code is equivalent to the CSS Floquet code under a change of basis. We also use our formalism to derive two new error-correcting codes, namely a Floquet version of the 3+1-dimensional toric code using only 2-body measurements, as well as a dynamic code based on the double-semion string-net path integral.
MODEL UNTUK MENINGKATKAN KINERJA ORGANISASI DI LEMBAGA NON PROFIT
Authors: Soelton Dr. Mochamad , Baihaqi Muhammad , Arief Harefan , Nugrahati Tati , Saputro Fit Eko
Published: March 2024

Penelitian ini bertujuan untuk menguji dan menganalisa Organizational Learning, Organizational Commitment dan Organizational Citizenship Behavior terhadap Organizational Performance pada Lembaga Kesejahteraan Sosial (LKS) Kabupaten Cianjur Jawa Barat, metode yang di gunakan dalam penelitian ini adalah adalah metode kuantitatif. Objek penelitian adalah pengasuh di Lembaga Kesejahteraan Sosial (LKS) di Kabupaten Cianjur Jawa Barat, dengan jumlah populasi sebanyak 30 pengasuh. Teknik pengambilan sampel menggunakan nonprobability sampling dengan ukuran sampel 30 pengasuh yang merupakan seluruh jumlah populasi.Analisi data yang di gunakan dalam penelitian ini adalah alat analisis Struktural Equation Model (SEM) dengan menggunakan Software Smart-PLS Versi 3.0. Hasil dari penelitian ini adalah bahwa Organizational Learning, dan Organizational Citizenship Behavior memiliki pengaruh yang positif dan signifikan terhadap Organizational Performance, dan Organizational Commitment memiliki pengaruh yang positif dan signifikan terhadap Organizational Performance.
PENGARUH TARIF ANGKUTAN DAN BRAND IMAGE TERHADAP LOYALITAS PELANGGAN GRABBIKE PADA PERUSAHAAN GRAB INDONESIA
Authors: Setiawan Tjipto
Published: March 2024

Perkembangan ilmu pengetahuan dan teknologi yang sangat pesat membawa perubahan padakehidupan manusia, khususnya dalam bidang sarana transportasi. Grab Indonesia bertekat untuk menjadi perusahaan berbasis online nomor satu di Indonesia. Tarif angkutan dan Brand Image merupakan salah satu faktor yang dapat mempengaruhi loyalitas pelanggan Grabbike. Tujuan penelitian adalah untuk mengetahui pengaruh tarif angkutan dan brand image baik secaraparsial maupun simultan terhadap loyalitas pelanggan Grabbike pada perusahaan Grab Indonesia. Penelitianini merupakan penelitian asosiatif kausal dengan menggunakan pendekatan kuantitatif. Analisis data kualitatif yang digunakan melalui perhitungan statistik yaitu: Uji Instrumen (Uji Validitas dan Realibilitas), Uji Statistik (Uji T Parsial, Uji F Simultan, Uji Normalitas, Uji Linearitas, Uji Regresi Linear Berganda),dan Uji Asumsi Klasik (Uji Heteroskedastisitas dan Multikolinearitas).Hasil penelitian menemukan bahwa: hasil uji t secara parsial (X1 terhadap Y) menunjukkan hasil yangpositif dengan nilai koefisien 0,110 sedangkan hasil uji t secara parsial (X2 terhadap Y) menunjukkan hasilyang positif dengan nilai koefisien 0,136. Hasil analisis uji F secara simultan terdapat hasil dengan nilai signifikan sebesar 0,187 > 0,05 yang artinya variabel tarif angkutan dan brand image secara bersama-sama tidak berpengaruh signifikan terhadap loyalitas pelanggan. Diantara variabel bebas (X1 dan X2) ditemukanvariabel yang paling dominan terhadap loyalitas pelanggan (Y), yaitu variabel tarif angkutan (X1). Haltersebut dibuktikan dengan kontribusi dari variabel tersebut merupakan yang paling positif terhadap loyalitaspelanggan.
Schier, S. E., & Eberly, T. E. (Eds.). (2022). The Trump Effect: Disruption and Its Consequences in US Politics and Government. Rowman & Littlefield, 181pp.
Authors: Fitrie Innayathul , Viartasiwi Nino
Published: March 2024

This book review aims to help readers examining the merit and demerit of the book edited by Schier and Eberly titled “The Trump Effect: Disruption and Its Consequences in US Politics and Government,” that was published in 2022. Trump’s administration had brought back the behavioural analysis in the International Relations study. The articles presented in the book illustrate how a leader’s agency can turned the course of domestic politics in democratic settings, as well as the global politics. How well the book convince its readers is the focus of our review.
The Re-emergence of Parang Sabil: A Foucauldian Discourse Analysis on Suicide Terrorism Phenomenon in the Philippine
Authors: Licayan Kebart , Esteban Francis
Published: March 2024

Terrorists and the threat of terrorism know no pandemic, as the 2020 Jolo suicide bomber incident vividly demonstrates. One of the signs of the new age of Philippine terrorism is the emergence of suicide terrorism. However, the lack of adequate explanations for the phenomenon shows that suicide terrorism is still a poorly researched topic in Philippine terrorism studies. This paper aims to contribute to the literature by investigating the power dynamics, specifically looking at how the phenomenon is interpreted by scholars using the Foucauldian Discourse Analysis. This study presents several scholarly arguments, examines how these arguments are created, and looks into the implications of their understandings. We argue that scholars hold the power to interpret the phenomenon. Their interpretations are crucial in policymaking. The results reveal that the limited information available allowed for such a diverse range of hypotheses. Yet, despite the limitations, their initial interpretations are crucial in addressing the issue at this time. This highlights the importance of scholars in this setting. The truths revealed here may or may not have an impact on unique community conditions.
Unravelling President Obama’s Myanmar Policy: Pragmatic Liberalism at Play
Authors: Liew Wui Chern , Rogers Roy Anthony , S. Sidhu Jatswan
Published: March 2024

This study aims to examine the US’s Myanmar policy from the perspective of pragmatic liberalism and explore the primary factors behind the policy shift in 2009. It fills a gap in the literature by offering a rare analysis of US-Myanmar policy through the lens of pragmatic liberalism. The research methodology employs document search and elite interviews to gather comprehensive insights. The research questions focus on understanding how pragmatic liberalism manifested in Obama’s Myanmar policy and identifying the objectives he aimed to achieve. The findings reveal that Obama’s Myanmar policy aligns with the principles of pragmatic liberalism. It can be analysed through two dimensions: modelling creation and hegemony maintenance. Within the context of Sino-US competition, the primary factor driving the US's policy change in Myanmar is China. Consequently, the US’s policy shift aims to establish a new strategic partner to contain Chinese influence in Southeast Asia, thereby maintaining US hegemony in the region. This study contributes to the understanding of US-Myanmar relations and sheds light on the underlying motivations and dynamics of the US’s policy shift. By adopting a pragmatic liberalist approach, the US seeks to shape Myanmar’s trajectory while safeguarding its strategic interests in the region.
The 21st Century Israel-Palestine Conflict Over Jerusalem and its Peace Processes
Authors: Ezugwu Olileanya
Published: March 2024

Jerusalem is a depiction of the Israeli-Palestinian conflict's national politics and contrasting identities. The continuous rise in violence, with its devastating effect on peace and security prompts the examination of the conflict, various peace processes and the status of Jerusalem. The major objectives of this paper are to examine the Israel-Palestine conflict over Jerusalem in the 21st century and analyse the status of Jerusalem and different peace talks through external mediation and intervention. The theory of structural realism was adopted for this study; which, concerning the conflict over Jerusalem, emphasises that war is a significant, and fundamental instrument of change in international affairs. Secondary data was used in this paper, by reviewing and analysing data gathered from scholarly publications, journals, articles, and online materials. The paper finds an intensified increase of violence between Israel and Palestine, especially regarding the status of Jerusalem and Palestine as an independent state. The paper concludes that despite numerous peace processes and diplomatic efforts, a lasting resolution has remained elusive. The failure to achieve a comprehensive agreement stems from a combination of factors, including conflicting narratives, incompatibility of goals, deep-rooted mistrust, geopolitical complexities, and the influence of external actors. Peace, stability, and acceptable status of Jerusalem can only be initiated and resolved solemnly between Israel and Palestine, but until then, neither the status of Jerusalem nor Palestine would be defined.