bluuebunny/crossref_metadata_2025 huggingface dataset:
Magnetar Flare-driven Bumpy Declining Light Curves in Hydrogen-poor Superluminous Supernovae
Authors: Dong 董 Xiao-Fei 晓菲 , Liu 刘 Liang-Duan 良端 , Gao 高 He 鹤 , Yang 杨 Sheng 圣
Published: July 2023

Recent observations indicate that hydrogen-poor superluminous supernovae (SLSNe-I) often display bumpy declining light curves. However, the cause of these undulations remains unclear. In this paper, we have improved the magnetar model, which includes flare activities. We present a systematic analysis of a well-observed SLSN-I sample with bumpy light curves in their late phase. These SLSNe-I were identified from multiple transient surveys, such as the Pan-STARRS1 Medium Deep Survey and the Zwicky Transient Facility. Our study provides a set of magnetar-powered model light curve fits for five SLSNe-I, which accurately reproduce the observed light curves using reasonable physical parameters. By extracting the essential characteristics of both the explosions and central engines, these fits provide valuable insights into investigating their potential association with gamma-ray burst engines. We found that the SLSN flares tend to be the dim and long extension of GRB flares in the peak luminosity versus peak time plane. Conducting large-scale, high-cadence surveys in the near future could enhance our comprehension of both SLSN undulating light curve properties and their potential relationship with GRBs by modeling their light curve characteristics.
Relapse of Evans syndrome following BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine: case report and literature review
Authors: Cvetković Mirjana , Pantić Nikola , Virijević Marijana , Pravdić Zlatko , Sabljić Nikica , Mitrović Mirjana , Suvajdžić-Vuković Nada
Published: July 2023

Introduction: Coronavirus disease 2019 (COVID-19) vaccines are considered to be safe. Only few cases of vaccine-induced immune thrombocytopenia or immune hemolysis have been reported so far. Evans syndrome (ES) is a very rare syndrome characterized mainly by warm autoimmune hemolytic anemia (wAIHA) and immune thrombocytopenia (ITP).
Case presentation: We present a case of a 47‐year‐old male with a history of wAIHA, diagnosed in 1995 and successfully treated with glucocorticoids, with sustained remission. ITP was diagnosed in May 2016. Due to refractoriness to glucocorticoids, intravenous immunoglobulins (IVIGs), azathioprine and vinblastine, he was splenectomised in April 2017, resulting in complete remission. In May 2021, eight days after the second dose of BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine, he experienced mucocutaneous bleeding. Blood tests showed platelet count (PC) of 8×109/L, while his hemoglobin (Hb) was normal (153 g/L). He was treated with prednisone and azathioprine, without response. On day 28 after vaccine administration, weakness, jaundice and dark brown urine occurred. His laboratory tests: PC 27×109/L, Hb 45 g/L, reticulocytes 10.4%, total bilirubin 106.6 μmol/L, direct bilirubin 19.8 μmol/L, lactate dehydrogenase 633 U/L, haptoglobin ˂0.08 g/L, and positive Coombs test were consistent with ES relapse. After treatment with glucocorticoids, azathioprine and IVIGs, his blood count finally improved (PC 490×109/L, Hb 109 g/L) and remained stable on day 40 of hospitalization.
Conclusions: Although it is unclear whether the relationship between COVID-19 vaccination and relapse of ES in our patient is coincidental or causal, it highlights the need for monitoring of serious outcomes following vaccination.
Karyotype and genome size variation in Delphinium subg. Anthriscifolium (Ranunculaceae)
Authors: Luo Xiaoyu , Nie Tang-Jie , Liu Heng , Ding Xue-Fei , Huang Ying , Guo Chunce , Zhang WenGen
Published: July 2023

Five taxa of Delphinium subg. Anthriscifolium have been karyologically studied through chromosome counting, chromosomal measurement, and karyotype symmetry. All studied specimens had a basic chromosome number of x = 8, D. anthriscifolium var. savatieri, D. anthriscifolium var. majus, D. ecalcaratum, and D. callichromum were diploid with 2n = 16, while D. anthriscifolium var. anthriscifolium was tetraploid with 2n = 32. Monoploid chromosome sets of the investigated diploid taxa contained 1 metacentric chromosome, 3 submetacentric chromosomes, and 4 subtelocentric chromosomes. Higher interchromosomal asymmetry (CVCL) was present in D. ecalcaratum and D. callichromum than in other taxa. The highest levels of intrachromosomal asymmetry (MCA) and heterogeneity in centromere position (CVCI) were found in D. anthriscifolium var. majus. Diploid and tetraploid genome sizes varied by 3.02–3.92 pg and 6.04–6.60 pg, respectively. Karyotype and genome size of D. anthriscifolium var. savatieri, D. anthriscifolium var. majus, D. callichromum, and D. ecalcaratum were reported for the first time.
Beetles (Coleoptera) in deciduous dead wood tree species trunks in Lithuania
Authors: Lekoveckaitė Aistė , Podėnienė Virginija , Ferenca Romas
Published: July 2023

We present a list of beetles that emerged from wind-felled tree trunks of several tree species, including European ash (Fraxinus excelsior), aspen (Populus tremula), common oak (Quercus robur), birch (Betulasp.), small-leaved linden (Tilia cordata) and black alder (Alnus glutinosa). Four hundred and ninety species and 60 families of beetles were collected using trunk-emergence type traps. We found 440 beetle species that had previously been recorded from dead wood; the remaining 50 were newly discovered and all were considered as not directly associated with dead wood. Common oak trunks had the highest diversity of beetles, with approximately 42% of the identified beetle species found in our research. Of all the beetle species identified in the study, about half are saproxylic, while the remaining are considered as not having direct association with dead wood. The results of the study emphasise the importance of dead wood in maintaining beetle diversity in Lithuanian forests. This study provides a valuable baseline for future research on beetles in dead wood in Lithuania and may help to provide information for conservation efforts to protect these important habitats.
First record of the non-native Osbornellus auronitens (Provancher, 1889) (Hemiptera, Cicadellidae, Deltocephalinae) in Italy
Authors: Ruzzier Enrico , Lessio Federico , Cinquatti Francesca , Poggi Francesco , Alma Alberto , Galli Andrea , Bani Luciano , Sanna Francesco
Published: July 2023

Globalisation and international trade, in particular, are the major drivers of introduction and the spread of non-native species. To date, more than 30 species of non-native Hemiptera Auchenorrhyncha have been accidentally introduced into Europe. Some species are invasive with important repercussions primarily for agricultural activities, while almost no information exists on their impacts within natural ecosystems. Therefore, early detection of non-native species and their subsequent monitoring are extremely important actions to undertake.

The North American Osbornellus auronitens (Provancher, 1889), firstly recorded for the Palearctic and Europe in Switzerland in 2016, is recorded in Italy for the first time on the basis of 77 specimens collected between August 2015 and October 2022.
A new species of the Cyrtodactylus quadrivirgatus complex (Chordata, Reptilia, Squamata, Gekkonidae) from Sumatra Barat, Indonesia
Authors: Ahda Yuni , Nugraha Fitra Arya Dwi , Hon Tjong Djong , Kurniawan Nia , Amardi Yunico , Fauzi Muhammad Alif , Lin Si-Min
Published: July 2023

Among the six species of Cyrtodactylus occurring in Sumatra, two species were described based on non-Sumatran type series, C. consobrinus and C. quadrivirgatus. The latter species was described originally from Thailand thus the wider distribution in Sumatra should be clarified taxonomically. Cyrtodactylus quadrivirgatus from Sumatra Barat was examined using both morphology and the Natrium Dehydrogenase Subunit 2 (ND2) gene to clarify its taxonomic status and phylogenetic placement. It was found that these specimens form a sister clade to all other species of the sworderi group from Peninsular Malaysia and the genetic distance ranges from 20–24.3%. This subset is herein described as a new species. The new species is readily distinguished from C. quadrivirgatus and other Sumatran species by a combination of characters: small size SVL 37.5–53.78 mm; longitudinal rows of dorsal tubercles 16–19; paravertebral tubercles 31–41; ventral scales 32–43; 24–49 enlarged precloacal and femoral scales; precloacal pores rarely present; no precloacal depression; two postcloacal tubercles on each side; 14–19 subdigital lamellae on forth toe; 9–15 supralabial scales; 9–12 infralabial scales; three or four internasal scales; and 3–6 gular scales that border the first pair of postmental scales. This work underscores the importance of clarifying widely distributed species for taxonomic validation.
Knowledge Organisers for learning: Examples, non-examples and concept maps in university mathematics
Authors: Jeong Inae , Evans Tanya
Published: July 2023

Finding effective ways to engage students in sense-making while learning is one of the central challenges discussed in mathematics education literature. One of the big issues is the prevalence of summative assessment tasks prompting students to demonstrate procedural knowledge only, which is a common problem at the tertiary level. In this study, in a large university classroom setting (N = 355), an instructional innovation was designed, developed, implemented and evaluated involving novel tasks–Knowledge Organisers. The tasks comprised prompts for students to generate examples/non-examples and construct a concept map of the key mathematical concepts in the course. The initiative's design was based on the current understanding of human cognitive architecture. A concept map is a visualisation of a group of related abstract concepts with their relationships identified by connections using directed arrows, which can be viewed as an externalisation of a schema stored in a learner's long-term memory. As such, we argue for a distinction between a local conceptual understanding (e.g., example space) versus a global conceptual understanding, manifesting through a high-quality concept map linking a group of related concepts. By utilising a mixed-methods approach and triangulation of the findings from qualitative and quantitative analyses, we were able to discern critical aspects pertaining to the feasibility of implementation and evaluate learners' perceptions. Students' performance on concept mapping is positively correlated with their perceptions of the novel tasks and the time spent completing them. Qualitative analysis showed that students' perceptions are demonstrably insightful about the key mechanisms that supposedly make the tasks beneficial to their learning. Based on the results of the data analyses and their theoretical interpretations, we propose pedagogical strategies for the effective use of Knowledge Organisers.
Improving English Vocabulary Through Quizizz in Practice Tests for Gamification and Google Forms with AutoProctor in Assessment tests for the Preclusion of Malpractice
Authors: Manipatruni Venkata Ramana , Kumar Nannapaneni Siva , Karim Mohammad Rezaul , Banu Sameena
Published: July 2023

Research on Vocabulary is prominent, and it helps learners find many diverse ways to learn vocabulary to a greater extent. However, the research on vocabulary in recent years gradually diminishes as students age and get to higher education [1]. Many researchers recommend the effective use of digital tools to motivate students to participate actively in learning [9], and digital gamification makes quite an impact by creating student interest in word learning [1] [12]. At this juncture, our research serves the need for improving the vocabulary of Engineering students through digital gamification using 'Quizizz' in their Practice tests and Google Forms with 'AutoProctor' to preclude their malpractice during their assessment test-taking. This study was carried out based on quantitative research by collecting and analyzing numerical data of a couple of research groups, the control group (n1=45) and experimental group (n2=69), and also through a closed-ended questionnaire using a Likert Scale. The findings demonstrate how this research culminated in the results that brought a subtle difference in the two groups; the control and experimental groups that pursued the traditional and blended methods. The Pooled Standard Deviation (Spooled) (Weighted average of Standard Deviations from both the groups) statistically demonstrated that it had deviated from the control group's Standard Deviation (s1) by 0.286 and from the experimental group's Standard Deviation (s2) by 0.2. This weighted average vindicated the study that the experimental group could perform better than the control group in the post-test.
Role of Digital Story in Promoting Preventive Health Concepts among Primary Stage Students
Authors: Alomoush Reem AbdElkareem
Published: July 2023

The study aims to investigate the role of digital stories in promoting the concepts of preventive health among primary stage students. The study tool used to conduct this study is a questionnaire that contains 30 items focusing on six areas, namely health food, risk management, personal health, environmental health, first aid, and physical health. The study sample consists of 218 male and female teachers. The study concluded that digital stories have an average role in promoting the concepts of preventive health in general among primary stage students from the viewpoint of class teachers. The study recommended the necessity of honing the skills of teachers of the primary stage regarding preventive health concepts. In addition, it is recommended that seminars and training courses should be conducted to teach teachers how to present such concepts to students using digital stories.
Exploring Students' Experiences and Problems in Online Teaching and Learning During Covid-19 and Improvement of Current LMS through Human-Computer Interaction (HCI) Approaches
Authors: Ali Sabir , Fatima Fozia , Hussain Javed , Qureshi Muhammad Imran , Fatima Safia , Zahoor Asiya
Published: July 2023

This study tried to explore students’ experiences and problems with online teaching and learning during COVID-19 and the improvement of current LMS through Human-Computer Interaction (HCI) approaches. A mixed-method approach was used in this project. A triangulation design was used in this study. This study was held at the university level and from Baltistan University; researchers took 12 students through a purposive sampling method. After thematic analysis, a survey was conducted. There are 2000 students at Baltistan University. 200 university students were randomly selected as the sample of this study. Semi-structured interviews and self-developed questionnaires were used as research tools. Thematic analysis and descriptive statistics were used to analyse the data. This study concluded that self-learning, family and teacher issues, financial, internet and light issues, IT assistance, and training needs at the students, teachers, and parental level were collectively described as a human-computer interface in the online teaching-learning process during COVID-19. All the students believed that when their family and teachers’ issues; financial, internet, and light issues, information technological assistance, and parents, students, and teachers’ training are improved then improvement of current LMS through Human-Computer Interaction approaches has occurred in Baltistan university.
Representación del indígena en el cine venezolano: Contrastando estereotipos: entre ficciones y realidades
Authors: Camero Emperatriz  Arreaza 
Published: July 2023

El objetivo de este trabajo es presentar la imagen de las comunidades indígenas que aparecen en algunas películas venezolanas, realizadas entre 1968-2008, con el fin de conocer la representación de estos grupos étnicos, dentro de la definición de “identidad nacional”, especialmente a partir de sus luchas por el derecho a la supervivencia cultural y étnica, a la autodeterminación indígena y a la tenencia de la tierra. Es importante recordar que, en 1968, durante el primer gobierno de Rafael Caldera (1969-1974), se inició en el país una “nueva política indigenista” dentro del modelo económico desarrollista implantado por este gobierno, llamada la Conquista del Sur, que a su vez permitió una aproximación etnográfica y socio-antropológica a las comunidades indígenas, por parte de diversos cineastas formados en Venezuela y el exterior. Por ello, es importante conocer los estereotipos más comunes en la cinematografía nacional, realizada por cineastas no indígenas y cómo estos estereotipos fueron contrastados posteriormente por los documentales realizados por cineastas indígenas.Este artículo presenta un inventario preliminar de esta filmografía, así como una muestra representativa de películas de ficción y documentales, con temática indígena, con el fin de conocer la representación de estas poblaciones en el imaginario audiovisual venezolano.
Au tribunal de Ṭalīt. Deux partages successoraux entre Coptes du Fayoum (ve/xie siècle)
Authors: Tillier Mathieu , Vanthieghem Naïm , Kamal Ahmad
Published: July 2023

Le tribunal de Ṭalīt, dans le Fayoum méridional, n’était jusqu’ici connu qu’à partir d’un unique document remontant au début de la période fatimide. La présente contribution offre l’édition et la traduction de deux nouveaux documents, comportant en tout cinq textes qui permettent de mettre en évidence le fonctionnement de ce petit tribunal provincial présidé par un substitut, ainsi que son articulation aux échelons supérieurs et inférieurs du système judiciaire islamique. Le procès-verbal d’une audience (maḥḍar), une pétition de plaideur (qiṣṣa) et le rescrit (tawqīʿ) auquel celle‑ci donna lieu, projettent une lumière nouvelle sur les usages de l’écrit dans les tribunaux, surtout étudiés jusqu’ici à partir des sources littéraires. Enfin, à travers ces documents, transparaissent les stratégies successorales d’une famille de notables coptes du village de Ṭuṭūn/Tebtynis, les Banū Ǧirǧa, qui recoururent au tribunal islamique pour sanctionner des accords à l’amiable conformes à leurs coutumes.
Investigating English clippings experimentally:
Authors: Hilpert Martin , Saavedra David Correia , Rains Jennifer
Published: July 2023

This paper investigates English clippings such as prof (< professor), delish (< delicious), or condo (< condominium). Clipping is highly variable, but a growing body of evidence suggests that clipping variability follows predictable tendencies (Lappe 2007; Berg 2011; Arndt-Lappe 2018; Hilpert et al. 2021). As yet, however, experimental work on clipping variability is scarce. This paper addresses this gap by focusing on speakers’ choices between consonant-final clippings (e.g. renov < renovation) and vowel-final clippings (reno < renovation). We devise two experiments in order to analyze the factors that impact speaker behavior. The first is a forced choice task in which participants see a source word (e.g. emollescence) and two possible clippings that differ in their final segment (emo vs. emol). We find that speakers’ choices are sensitive to word length, stress position, status of a compound or a lexicalized multi-word unit, and the vowel type in the final syllable. The second study is a production task in which participants see a source word and propose a clipping. The responses show a preference for final consonants in monosyllabic clippings and clippings that derive from compounds or lexicalized multi-word units. We contextualize our results against the background of empirical work on clipping that has been carried out on the basis of large databases (Lappe 2007; Berg 2011; Hilpert et al. 2021).
Satisfaction des employés de contact dans les institutions de Microfinance : développement et validation d’une échelle de mesure
Authors: Kanyurhi Eddy Balemba , Akonkwa Deogratias Bugandwa Mungu , Cubaka Patrick Murhula , Mbonekube Willem Bitakuya
Published: July 2023

Les études qui développent une échelle pour mesurer la satisfaction des employés dans les institutions de Microfinance (IMFs) sont rares. La présente étude comble ce vide. Les données sont collectées auprès de deux échantillons (226 et 419 employés) issus de 50 et 53 IMFs en République Démocratique du Congo. Les données sont traitées grâce aux analyses factorielles (exploratoire et confirmatoire) et aux équations structurelles. Les résultats indiquent que la satisfaction des employés est un construit multidimensionnel composé de dix facteurs. Les résultats confirment que l’échelle développée est valide, fiable et spécifique au contexte et au secteur d’activité sous analyse.
The Need for Accreditation in Medical Education to be based on Regional and National Health Priorities
Authors: Karunathilake I. M. , Grant J. , Rashid M. A. , Samarasekara D. , Prihatiningsih S. T. , De Abrew A. , Atapattu C. , Amarasiri M. M. P. L. , Abeysooriya M.
Published: July 2023

No abstract available
Institutional advantages and challenges of Chinese outbound direct investment in South Asia
Authors: Yan S. , Karunaratne J. A. ,  Wang L. , Huang X. , Fernando N. T.
Published: July 2023

Over the past three decades, the proliferation of Chinese outbound direct investment (ODI) has been related to both financial and non-financial support conveyed by the state and related authorities of concerned countries. At the same time, the Covid Pandemic and the Russia-Ukraine war unveiled the tendency for geopolitical and global economic restructuring that has caused risks for Chinese ODI and its sustainable development. This qualitative study relied extensively on secondary data and employed strict textual analysis of the relevant literature. It focuses on the challenges that Chinese ODI causes when investigating in India, Sri Lanka, and Pakistan and argues that Chinese ODI engaged in an infrastructure-related sector strongly associated with institutional support from a home country may face high risks during economic and political uncertainty in countries such as Sri Lanka and Pakistan. Therefore, it suggested that Chinese investment should show greater diversification rather than one that shows a mere focus on its involvement in the infrastructure sector activities. Chinese ODI has played a role that has focused on the relationship between China and the governments of the host countries; however, diversifying investment into other industrial sectors that can link with the global value chain can make greater economic engagement with the host country. In the case of India, Chinese investments can be negatively affected by political risk as the level of India-China diplomatic relations fluctuates from time to time, especially during shifts in the global political structure. Chinese ODI cannot depend on the Chinese government to solve investment risks but seek solutions through the business and industrial community to face the local regulators and enhance its involvement in regional economic development and scale influence. Overall, with higher global economic uncertainty, Chinese ODI in South Asia that are heavily supported by Chinese government can face high institutional risks.
UMM-EL-BREIGÂT (TEBTYNIS): CAMPAGNA DI SCAVO 2021
Authors: Gallazzi Claudio
Published: July 2023

En 2021, la mission franco-italienne constituée par l’Ifao et l’Université de Milan a continué ses fouilles à Tebtynis dans les mêmes secteurs où elle avait travaillé les années précédentes: le vaste dépotoir à l’est du temple de Soknebtynis et la partie de l’habitat longeant la grande allée dénommée dromos de Tefresudj(ty ?). Dans le dépotoir, environ 150 textes ptolémaïques, écrits sur papyrus et tessons en démotique ou en grec, ont été recueillis et une maison d’exopylitai remontante aux IIIe s. av. J.-C. a été repérée. Dans l’habitat, trois salles affectées aux réunions d’associations religieuses ou professionnelles (IIe s. av. J.-C. – Ier s. apr. J.-C.) et six tombes de crocodiles (Ier s. apr. J.-C.) ont été retrouvées sur le côté sud de la rue. À l’extrémité est de l’allée, le temple du dieu dénommé Tefresudj(ty ?), bâti à la fin du IIe s. av. J.-C., a été atteint et en partie mis au jour. Au-dessous, les fondations du temple l’ayant précédé, érigé au début du IIIe s. av. J-C., ont été découvertes.
Gallstone ileus: Unusual complication of cholelithiasis
Authors: Kao Kuo-Feng , Yu Ji-Kuen , Yu Suan-Hung , Wei Chih-Wei , Huang Tai-Lin
Published: July 2023

Gallstone ileus is an unusual complication of gallstone disease. However, gallstone ileus is a serious cause of mechanical bowel obstruction. Gallstone ileus affects older adult patients with underlying medical diseases. It occurs when a gallstone passes through a fistula between the gallbladder and small bowel before becoming obstructed at the ileocecal valve. The symptom includes episodic obstruction caused by the stone rolling through the bowel lumen. Gallstone impaction produces abdominal pain and vomiting, which subside as the gallstone becomes disimpacted, only to recur again as the stone lodges in the more distal bowel lumen. The mean symptom duration before the emergency department visit is approximately 5 days, similar to our patient. Computed tomography is widely used to confirm the diagnosis.
Dilated Cardiomyopathy in Hyperthyroidism can be Reversed with Treatment
Authors: Alasmari Lama , Khairoalsindi Osama , Algethami Abdulaziz , Jizeeri Ahmed
Published: July 2023

The authors present a case of a 54-year-old male patient with a history of shortness of breath and orthopnea. The echocardiogram showed an ejection fraction (EF) of 35%–40%. Diagnosis of hyperthyroidism was missed initially although the patient had bilateral exophthalmos and thyroid function tests suggesting it. Medical treatment of the hyperthyroid state reversed the cardiomyopathy within 6 months of treatment. Repeated echocardiograms after hyperthyroidism treatment showed a normalized EF.
Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting in Complex Coronary Artery Disease
Authors: Hesse Kerrick , Egred Mohaned , Zaman Azfar , Alkhalil Mohammad , Farag Mohamed
Published: July 2023

Background:

Clinical equipoise between a percutaneous coronary intervention (PCI) and coronary artery bypass grafting surgery (CABG) in the treatment of complex coronary artery disease (CAD), including unprotected left main coronary artery (LMCA) and/or three-vessel disease (3VD), remains debatable.

Methods:

A retrospective analysis of an unselected cohort undergoing contemporary PCI versus CABG at a large center in 2015. Patients who received nonemergent treatment of unprotected LMCA and/or 3VD were included. The primary study endpoint was all-cause mortality at 5 years. Secondary endpoints included a composite of all-cause mortality, spontaneous myocardial infarction (MI), or ischemia-driven repeat revascularization at 30 days and 1 year.

Results:

Four hundred and thirty patients met the inclusion criteria, 225 had PCI, and 205 had CABG. PCI patients were older with frequent LMCA involvement and higher EuroSCORE yet they had a fourfold shorter in-hospital stay compared to CABG patients. At 5 years, there was no significant difference in the primary endpoint between CABG and PCI (adjusted Hazard ratios 0.68, 95% confidence interval: 0.38–1.22, P = 0.19). Likewise, there was no significant difference in the incidence of the secondary composite endpoint or its components at 30 days or 1 year. A propensity score-matched analysis in 220 patients revealed similar outcomes.

Conclusions:

In real-world long-term contemporary data, survival after PCI was comparable to CABG at 5 years in patients with unprotected LMCA and/or 3VD. At 1 year, the incidence of spontaneous MI and ischemia-driven repeat revascularization did not differ between the two cohorts. The mode of revascularization in these complex patients should be guided by the heart team.
Surgical or Percutaneous Repair of Sinus of Valsalva Rupture
Authors: Paymard Mohammad , Higgins Mark Daniel , Sinhal Ajay , Musameh Muntaser D.
Published: July 2023

The rupture of the sinus of the Valsalva aneurysm is a rare but very serious condition. Rapid and accurate diagnosis and prompt treatment are critical for these cases. We present two cases of sinus of Valsalva ruptures. One case was managed with open surgical repair and the second case was treated percutaneously. We have discussed these two therapeutic approaches available to treat sinus of Valsalva rupture.
Mapping of traditional healthcare providers and their healing approaches in a tribal community of district Sirohi, Rajasthan
Authors: Dwivedi Rakhi , Goyal Prachi , Yadav Suraj S. , Dwivedi Pradeep , Singh Pratibha , Singh Kuldeep
Published: July 2023

ABSTRACT

Introduction:

Traditional applications of medicinal plants in healthcare practices provide indication to new therapeutic concepts; hence, their relevance is highly recognized. The objective of the study was to map the traditional healers from the aspirational district and scientific documentation of their healing practices to treat various diseases.

Method:

This was community-based study in tribal subpopulation zone of district Sirohi. The data was collected through field survey and interviews of tribal healers by using semi-structured questionnaire.

Result:

We identified 1015 tribal healers (68% male and 32% female), and all belong to Bhil, Meena, and Garasia communities of district Sirohi. The mean age was 60.45 ± 16.56 years, 82.6% healers were uneducated, and 12.6% had primary education, while 1.2% were graduates. Tribal healers act as primary point of care for tribal community and practiced various treatment modalities including herbal healing (32.7%), diviners (28.9%), child birth attendant (24.7%), and bone setters (13.7%). We recorded 88 herbal healing practices from tribal communities of district Sirohi and scientifically documented. The common diseases treated by tribal healers included wound healing, skin infection, fever, arthritis, pain, diarrhea, cough, and cold. The Fabaceae family was credited with highest number (17%) of plants used by herbal healers. It was also noted that some of the plants used for medicinal purpose are endangered and overexhausted.

Conclusion:

Ethnopharmacological data is the foundation for further validation and value addition of herbal healthcare practices. The mapping of indigenous knowledge holders and scientific documentation of their knowledge might be a crucial step for providing clue regarding new therapeutic molecules.
A case of tubercular empyema with pyopneumothorax
Authors: Annareddy Srinivasulareddy , Aurangabadkar Gaurang , Choudhary Sumer S. , Jadhav Ulhas , Khan Shafee , Ghewade Babaji
Published: July 2023

ABSTRACT

Pyopneumothorax is a common complication associated with tuberculosis, especially in patients with lung parenchymal cavitatory lesions. In this publication, we highlight the case of a 43-year-old female patient who presented with chief complaints of dry cough, left-sided chest pain, and dyspnea on exertion. An X-ray of the chest posteroanterior (PA) view, revealed a left-sided moderate pleural effusion with pneumothorax. Immediate intercostal chest drain (ICD) insertion was done and a pleural fluid cytology sample was sent which was suggestive of tubercular empyema and the patient was promptly initiated on anti-tubercular treatment to which she responded well and showed clinical and radiological improvements.
Morphological changes in white blood cells in systemic inflammatory response syndrome (SIRS) with and without sepsis: An observational study
Authors: Sharma Siddharth , Pratima Kumari , Ambedkar Shivlok Narayan , Kumar Rajesh , Kundan Meghraj
Published: July 2023

ABSTRACT

Background:

This is an observational study which aims to research morphological changes of white blood cells in patients with Systemic Inflammatory Response Syndrome (SIRS) with and without sepsis and evaluate morphological changes in white blood cells as predictors of sepsis.

Methods:

Patients aged 18 years or more with SIRS with sepsis and SIRS without sepsis were included and those with haematological disorders or pregnant patients were excluded. A total of 52 patients with SIRS with sepsis and 32 patients of SIRS without sepsis were included. Peripheral blood smear was prepared from the venous blood sample drawn. The presence of toxic granules, cytoplasmic vacuoles, and Dohle bodies in both cases of SIRS with sepsis without sepsis were assessed and it was compared with culture-positive sepsis and shock.

Results:

The difference in the presence of toxic granules (55.8% vs. 12.5%; p <0.001), cytoplasmic vacuoles (30.8% vs. 6.3%; p -0.012), and Dohle bodies (17.3% vs. 0%; p = 0.012) was significantly higher in the SIRS with sepsis group, compared to the SIRS without sepsis group. In the subgroup analysis of patients in the sepsis group, it was observed that patients with positive blood culture (9%) had a significantly higher proportion of toxic granules (100% vs. 51.1%; p=0.059), cytoplasmic vacuoles (40% vs. 29.8%; p=0.637) and Dohle bodies (40% vs. 14.9%; p=0.202). However, these differences were not statistically significant.

Conclusion:

Toxic granules and cytoplasmic vacuoles in the neutrophils of patients with SIRS with sepsis were found more frequently, compared to patients of SIRS without sepsis. Dohle bodies were found only in patients with sepsis and not in those with SIRS without sepsis.
Allergic rhinitis guidelines knowledge, attitudes, and practices among primary health care physicians: A national multicentre cross-sectional study
Authors: Almousa Hisham , Alsaad Saad M. , Ismail Dawood , Mahjoub Saleh , Bin Obaid Sultan , Alsaleh Saad
Published: July 2023

ABSTRACT

Background:

Allergic rhinitis (AR) is considered one of the most common reasons for patients visiting primary health care clinics. Physicians’ adherence to management guidelines for AR results in better patient outcomes. Therefore, the present study aimed to assess the knowledge, attitudes, and practices of primary health care practitioners (PHCPs) towards allergic rhinitis guidelines in Saudi Arabia.

Methods:

This observational cross-sectional study conducted from August 2021 to November 2021 included 282 primary care physicians across all regions of Saudi Arabia. We used a two-part, validated, self-administered Perception Attitude and Practice of Primary Care Practitioners questionnaire. The first part was demographics, and the second part comprised three domains (perception, attitude, and practice) including 48 items. Statistical Package for the Social Sciences (SPSS), version 21 was used to analyze the data.

Results:

Most of the 282 physicians were Saudis (79%). Allergic rhinitis and its impact on asthma (ARIA) guidelines were recognized by 71% of the physicians. Second-generation oral antihistamines were considered the safest drug by the majority (82%), followed by intranasal corticosteroids (75.2%). Most physicians diagnosed AR based on clinical history (95%), while (43%) utilized allergy testing. Intranasal corticosteroids were the most preferred treatment option (70%) followed by second-generation and first-generation oral antihistamines (66% and 55%, respectively).

Conclusion:

Our study demonstrates the importance of education and awareness for PHCPs managing AR. ARIA guidelines should be implemented as a standard of care for AR, as PHCPs are the first ones to encounter patients with AR, to improve outcomes and avoid undertreatment and complications.
Long-term health and economic benefits of switching to tenofovir alafenamide versus continuing on entecavir in chronic hepatitis B patients with low-level viremia in Saudi Arabia
Authors: Sanai Faisal M. , Aljawad Mohammed , Alghamdi Abdullah Saeed , Yehoshua Alon , Khathlan Abdullah , Alghamdi Mohammed , Kozma Sam , Smith Nathaniel , El-Moustaid Fadoua , Jeyakumar Sushanth , Kachru Nandita
Published: July 2023

Background:

Despite the success of current treatments, many chronic hepatitis B (CHB) patients still live with low-level viremia [LLV] resulting in liver disease progression. This study evaluated the long-term health and economic impact of switching to tenofovir alafenamide (TAF) from entecavir (ETV) in Saudi Arabia (SA) in chronic hepatitis B (CHB) LLV patients.

Methods:

A hybrid decision tree Markov state-transition model was developed to simulate a cohort of patients with CHB LLV treated with ETV and switched to TAF over a lifetime horizon in SA. While on treatment, patients either achieved complete virologic response (CVR) or maintained LLV. CVR patients experienced slower progression to advanced liver disease stages as compared to LLV patients. Demographic data, transition probabilities, treatment efficacy, health state costs, and utilities were sourced from published literature. Treatment costs were sourced from publicly available databases.

Results:

Base case analysis found that over a lifetime horizon, switching to TAF versus remaining on ETV increased the proportion of patients achieving CVR (76% versus 14%, respectively). Switching to TAF versus remaining on ETV resulted in a reduction in cases of compensated cirrhosis (-52%), decompensated cirrhosis (-5%), hepatocellular carcinoma (-22%), liver transplants (-12%), and a 37% reduction in liver-related deaths. Switching to TAF was cost-effective with an incremental cost-effectiveness ratio of $57,222, assuming a willingness-to-pay threshold of three times gross national income per capita [$65,790/QALY].

Conclusions:

This model found that switching to TAF versus remaining on ETV in SA CHB LLV patients substantially reduced long-term CHB-related morbidity and mortality and was a cost-effective treatment strategy.
Adhesive small-bowel obstruction: Conservative versus surgical management?
Authors: Li Shikuan , Li Yunlong
Published: July 2023

Bowel obstruction is a common emergency requiring acute medical care. Small-bowel obstruction (SBO) accounts for 80% of all mechanical bowel obstruction, and adhesive SBO is the most common cause of SBO. Computed tomography imaging in patients with abdominopelvic surgery history is useful to diagnose adhesive SBO (ASBO), to exclude other causes of SBO, and to identify patients who need emergency surgeries which usually are closed-loop obstruction, strangulated obstruction, or perforation. For uncomplicated ASBO, the timing when surgery has always existed controversy. Studies revealed that prolonged nonoperative management is associated with increased morbidity. On the other hand, operative management of ASBO may decrease the risk of recurrence. During the conservative management for patients who do not need emergency surgeries, gastrografin challenge may accelerate relief from obstruction and avoid unnecessary surgery, or promote surgical decision-making and avoid delayed surgery. In addition, early postoperative SBO (EPSBO) with adhesive or inflammatory causes and unresectable malignant bowel obstruction should be identified and avoided surgery, although these patients have past abdominopelvic surgery history.
Adapting infection prevention and control assessment tools for use in low- and middle-income countries
Authors: Hinson Chandler Sasser , Wanyoro Anthony , Oburu Amos , Solomkin Joseph
Published: July 2023

Background:

There are many existing infection prevention and control (IPC) tools developed and validated by large organizations such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention. These tools are generally created with little input from professionals working in low-income regions and are tested in high-income countries and/or high-level facilities in low- and middle-income countries (LMICs). Recent publications have highlighted both the disproportionate burden of surgical site infections (SSIs) in LMICs and the very limited data on surgical conditions and practices in these regions. There is a need and a desire for quality improvement in SSI/IPC/patient safety in low-level facilities in LMIC. Therefore, a logical starting point would be to adapt available tools for use in resource-limited facilities, with a strong focus on input and enthusiastic participation from local health-care workers and leadership. Our goal was to assess IPC capacity of facilities by analyzing health-care-associated infection (HAI) surveillance, hospital workforce and infrastructure, environmental cleaning, and surgical operative practices.

Methods:

We created an adapted survey using components from the WHO’s Guideline on Core Components for IPC and Essential Surgical Care Situational Analysis Tool that addressed IPC program support, HAI surveillance, surgical preparation practices, and infrastructural support. Purposive sampling was used to identify 23 health facilities across 7 counties in Kenya. We chose to use cesarean section as a bellwether procedure because it is a high-volume procedure in LMIC. Permission to conduct the survey was solicited from facility leadership prior to the beginning of the survey. Two surveyors visited each facility to complete the adapted assessment framework.

Results:

All facilities had an IPC program and 22 (95.6%) reported that their program was supported by facility leadership and a professional IPC team. However, only 10 (43.5%) facilities reported a specific IPC budget. Eight (34.8%) facilities had on-site and 8 (34.8%) had off-site microbiological laboratory. Twelve (52.2%) conducted HAI surveillance, and out of those that conducted HAI surveillance, 11 (91.7%) monitored specifically for SSIs. Most had adequate and reliable water (95.6%) and power (91.3%). Fifteen (65.2%) allowed bed-sharing and 6 (26.1%) placed beds in hallways or areas other than rooms. Over 75% of facilities did not follow the WHO-recommended preoperative practices on bathing, hair removal, and skin preparation.

Conclusions:

This survey was a time and resource-efficient way of collecting the data needed to understand the variables associated with surgery, SSI, and IPC in low-level facilities. Clear targets for surgical practice improvement were identified, and the workforce and infrastructure data will be used to design effective and sustainable solutions.
Coherence and one-relator products of locally indicable groups
Authors: Howie James , Short Hamish
Published: July 2023

We extend several results of Helfer, Wise, Louder and Wilton related to coherence in one-relator groups to the more general setting of one-relator products of locally indicable groups. The methods developed to do so also give rise to a new proof of a theorem of Brodskiĭ.
Philanthropy
Authors: Ginn Geoffrey A.C.
Published: July 2023

This essay examines the practice of charitable gifts, organised care, and other forms of benevolence that formed the basics of the social relationships that structured everyday life for
British people through the period 1750–1914. The essay explores the philanthropy of the period ranging from donations, relief measures, improving schemes large and small and explores
how they formed a crucial dimension of civil society through this time, especially given the turbulent social changes of industrialism, urbanisation, and population growth.
Communication, transport, and mobility
Authors: Betts Oliver
Published: July 2023

This chapter offers an overview of the intertwined worlds of communication, transport, and mobility in the long nineteenth century. This was a period on the move, when the mobility of
people, goods, and ideas was in flux. New technologies, such as the electric telegraph and the railway, rubbed alongside older ones, such as innovations in road building and time
keeping, to revolutionise ideas of space and time. Key to understanding these technologies is an appreciation of the varied human contexts in which they operated. Development was rapid
but often uneven, and changes in communication, transport, and mobility reflected or created just as many social, economic, and political tensions in the nation as they
obliterated.
Development of water quality prediction model for water treatment plant using artificial intelligence algorithms
Authors: Shin Hwisu , Byun Yonghoon , Kang Sangwook , Shim Hitae , Oak Sueyeun , Ryu Youngsuk , Kim Hansoo , Jung Nahmchung
Published: July 2023

Accurate prediction of water quality changes in the water treatment process is an important factor for optimal decision-making process such as the design, operation, and diagnosis of water treatment facilities. This study developed an Artificial Intelligence (AI) algorithm model predicting dissolved organic carbon (DOC) removal and disinfection byproducts formation, and comparatively analyzed existing empirical models and prediction results to examine the applicability of AI algorithm techniques to water quality prediction in the water treatment process. We enhanced empirical models for predicting DOC removal and disinfection byproduct formation in Korea water purification plant. Six AI algorithm techniques were applied and tested using real-world data. All AI algorithm models outperformed the original empirical models in predicting DOC removal and byproduct formation. In terms of the DOC prediction model, multi-layer perceptron (MLP) showed the optimal performance (R2 = 0.9795; root mean square error [RMSE] = 0.0365 mg/L). MLP also showed the optimal performance in disinfection byproduct formation prediction (R2 = 0.9781; RMSE = 0.0008 mg/L. As a result, the prediction performance of AI algorithm models improved with larger sample sizes. By securing data samples for approximately 1 year, these models were confirmed to outperform empirical models.
CERRAHİ PROFLAKSİDE ANTİBİYOTİK UYUM ORANININ MALİ ETKİSİNİN DİJİTAL İYİLEŞTİRMELERLE DÜZENLENMESİ
Authors: PURKULOĞLU Esengül , ÜN Arzu , GÜMÜŞ Perihan , KARADAYI Aynur , ÖZKAN Elife
Published: July 2023

Cerrahi antibiyotik profilaksisi cerrahi enfeksiyonları önlemek amacıyla uygulanmaktadır. Seçilen antibiyotik sadece olası patojenleri kapsamalıdır ve doğru zamanda verilmelidir. Ulusal ve uluslararası cerrahi antibiyotik profilaksisi için kılavuzlar kullanılmaktadır. Bu çalışmanın amacı, cerrahi antibiyotik profilaksisi kılavuzlarına uyumu değerlendirmek ve profilaksi kurallarına uygun çalışılmasını ve maliyetin düşürülmesini sağlamaktır.

Çalışmada örnek olay incelemesi yöntemi kullanılmıştır. Örneklem olarak Tire Devlet Hastanesi’nde 2020 yılı cerrahi profilaksi uyum oranları ile 2021 yılı (ilk 6 ay) cerrahi profilaksi uyum oranları karşılaştırılmıştır. Veriler, hastane bilgi yönetim sistemi üzerinden toplanmıştır. Cerrahi profilaksi uyum oranı göstergelerle takip edilmektedir. 2020 yılı için uyum oranının %80 ve üzerinde olması hedeflenmiştir. Fakat bu hedefe ulaşılamamıştır. 2021 yılında hedef değer daha ulaşılabilir olması, ulusal ve uluslararası cerrahi profilaksi uyum oranları araştırmaları sonucunda %70 ve üzeri olarak belirlenmiştir. Uyum oranını arttırmak için çeşitli çalışmalar yapılmıştır. Bu çalışmalar içerisinde dijital çalışmalar etkin olmuştur.

Sonuç olarak, 2020 yılında %62,28 olan cerrahi profilaksi uyum oranı 2021 yılında (ilk 6 ayda) %76,56’ya yükselmiştir. Ayrıca 2020 yılında yapılan maliyet analizi sonucunda cerrahi profilaksi amaçlı kullanılan antibiyotiklerin zarar oranı %122 iken, 2021 yılında cerrahi profilaksi uyum oranının arttırılması için yapılan dijital iyileştirmelerle %84’e düşmüştür. Yapılan dijital iyileştirmelerin etkin ve yeterli olduğu görülmüştür.