bluuebunny/crossref_metadata_2025 huggingface dataset:
Perspective Chapter: Liposome Mediated Delivery of Immunotherapeutics for Cancer
Authors: Iscaro Alessandra , H.N. Howard Faith , Yang Zidi , Jenkins Fern , Muthana Munitta
Published: November 2022

Tumors have complex properties that depend on interactions between epithelial cancer cells and the surrounding stromal compartment within the tumor microenvironment. In particular, immune infiltration plays a role in controlling tumor development and is now considered one of the hallmarks of cancer. The last few years has seen an explosion in immunotherapy as a targeted strategy to fight cancer without damaging healthy cells. In this way, long-lasting results are elicited by activation of an antitumor immune response, utilizing the body’s own surveillance mechanisms to reprogram the tumour microenvironment. The next challenge is to ensure targeted delivery of these therapies for increased efficacy and reduction in immune-related adverse events. Liposomes are an attractive drug delivery system providing versatility in their formulation including material type, charge, size and importantly surface chemical modifications that confer their tumour specificity. These tunable properties make them an attractive platform for the treatment of cancer. In this chapter, we will discuss clinically approved immunotherapies and those undergoing clinical trials together with, recent liposomal approaches for enhanced specificity and efficacy.
Diversity of Epiphytic Mosses (Bryophyta) in Forests of Polylepis (Rosaceae) in the Urubamba Mountain Range, Cusco, Peru
Authors: Saji Saire Marisol , E. Holgado Rojas María , Diaz P.V. Sylvester Mitsy , Paul Sylvester Steven
Published: November 2022

The diversity of mosses was evaluated in four Polylepis (Rosaceae) forests in the Cordillera del Urubamba, Cusco region – Peru. Epiphytic mosses were collected from the lower base of the trunk, canopy area, and terminal branches in paper bags, selecting specimens with sporophytes. Twenty-seven species distributed in seven orders, 13 families, and 17 genera were determined. Three species are new records for Peru, that is, Neckera ehrenbergii, Zygodon quitensis, and Didymodon challaense. Fourteen species are reported for the first time in the Cusco region. These chorological novelties demonstrate the importance of Polylepis forests as stores of cryptogamic diversity.
Role of Activated Carbon in Water Treatment
Authors: Jaya Rajan Muthaian , Indira Anish Clastin
Published: November 2022

Heavy metals, such as lead, mercury, zinc, aluminum, arsenic, nickel, chromium, and cobalt, are the common pollutants present within the environment from various natural and Industrial sources. Synthetic dyes are commonly used for dyeing and printing in a variety of industries. The traditional methods for the removal of heavy metals and dyes from wastewater are chemical precipitation, ion exchange, adsorption, membrane processes, and evaporation which require high capital investment and running costs. Activated carbon prepared from agricultural wastes and its by-products are good alternative sources for adsorption because they are low-cost, renewable sources with high carbon, volatile contents, low ash, and reasonable hardness. The preparation means of activated carbon are physical and chemical methods. The important advantages of chemical activation over physical activation are the process that can be accomplished even at lower temperatures and the yield obtained in chemical activation tends to be greater since burn-off char can be avoided. In this chapter, the removal of heavy metals and dyes, using activated carbon, which was prepared by using agricultural waste, biomass was presented. This helps the researchers to accumulate knowledge.
Upper and Lower Gastrointestinal System Endoscopy Indications
Authors: Kartal Bahadir , Abdussamet Bozkurt Mehmet
Published: November 2022

As endoscopic procedures have become widespread, they have largely replaced radiological methods in the diagnosis of gastrointestinal system diseases; because the accurate diagnosis rates of endoscopic procedures are very high compared to conventional radiological procedures. In addition, tissue and cell sample for histopathological studies It is also advantageous because it can be taken and some diseases can be treated endoscopically. Rigid endoscopes have been replaced by flexible endoscopes, making them widely used in both diagnosis and treatment. The increase in the use of endoscopy brings with it complications. Therefore, the indications for endoscopy should be clearly stated. Indications for endoscopic examination of the digestive system can be divided into three as diagnosis, follow-up and treatment.
Germanium Telluride: A Chalcogenide Phase Change Material with Many Possibilities
Authors: Nandy Turja , Anwar Farhana , A. Coutu Jr. Ronald
Published: November 2022

Germanium telluride (GeTe) is a chalcogenide phase change material which is nonvolatile and changes its phase from amorphous state to a highly conductive crystalline state at approximately 180–230°C temperature, dropping the material’s resistivity by six orders of magnitude. These temperature-induced states lead to different physical and chemical properties, making it a suitable candidate for optical storage, reconfigurable circuit, high-speed switching, terahertz (THz), and satellite applications. Besides, GeTe-based devices offer complementary metal oxide-semiconductor (CMOS) compatibility and simplified, low-cost fabrication processes. In this chapter, three applications of GeTe will be discussed. They are as follows: (1) how GeTe can be utilized as DC and RF switching material with their high OFF/ON resistivity ratio, (2) how GeTe can contribute to current THz technology as split-ring resonators and modulators, and (3) effect of threshold voltage on GeTe for reconfigurable circuits.
Clinical Decision Support Systems for Diabetes Care: Evidence and Development between 2017 and Present
Authors: Zhang Xiaoni , Jiang Haoqiang , Ozanich Gary
Published: November 2022

The clinical decision support systems (CDSs) for diabetes have improved significantly over the years. Multiple factors serve as driving forces for the uptake of CDSs. Newer technologies, initiatives, government mandates, and a competitive environment collectively facilitate advancement in diabetes care. This book chapter summarizes global CDSs development in recent years. Our review of the past few years’ publications on CDSs for diabetes shows that the United States is leading the world in technology development and clinical evidence generation. Developing countries worldwide are catching up in CDSs development and standards of patient care. Though most CDSs and published studies are on diabetes diagnosis, treatment, and management, a small portion of the research is devoted to prediabetes and type I diabetes. Increased efforts worldwide have been devoted to artificial intelligence and machine learning in diabetes care.
A Meta-Analysis on The Comparison of The Sensitivity of Three Test Methods Used in the Diagnosis of COVID-19
Authors: Kahraman Kilbas Elmas Pinar , Kilbas Imdat , Ciftci Ihsan Hakki
Published: November 2022

Background: Accurate detection of the global epidemic-causing coronavirus disease 2019 (COVID-19) is for disease surveillance. Additionally, RT-qPCR has been accepted as a reference test and is widely used for this purpose. However, RT-qPCR applications are not possible in all health centers. Therefore, the tests commonly used in the diagnosis of infectious disease should be evaluated from all angles to assess their potential role in the prognosis and management of COVID-19 patients. Objectives: The present study aimed to compare the diagnostic sensitivity of point of care (POC), enzyme-linked immunosorbent assay (ELISA), and computed tomography (CT) used in the diagnosis of COVID-19. Methods: This systematic review and meta-analysis was conducted via searching in databases such as NCBI, Google Scholar, and Medline in accordance with the preferred reporting items for systematic reviews and meta-analysis (PRISMA). Results: The pooled sensitivity of POC, ELISA, and CT was estimated at 68.62%, 88.05%, and 75.43%, respectively. In addition, the mean correct positivity rate of POC, ELISA, and CT was calculated to be 68.61%, 88.04%, and 79.25%, respectively. The sensitivity and true positivity rate of ELISA was observed to be the highest. Conclusions: According to the results, ELISA is a more accurate approach to the diagnosis of COVID-19 compared to POC and CT owing to its high sensitivity and true positivity rate, low false negative rate, short processing time, and simple study procedure. Although helpful in diagnosis, confirmation of ELISA results by polymerase chain reaction remains the ‘gold standard’.
ANALISIS RASIO SOLVABILITAS UNTUK MENILAI KINERJA KEUANGAN PADA PERUMDA AIR MINUM TIRTA BANTIMURUNG KABUPATEN MAROS
Authors: N. J. Lenas Meldilianus , Aminah Aminah
Published: November 2022

Penelitian ini bertujuan untuk mengetahui bagaimana kinerja keuangan pada Perusahaan Umum Daerah (PERUMDA) Air Minum Tirta Bantimurung Kabupaten Maros. Objek penelitian ini yaitu Perusahaan Umum Daerah (PERUMDA) Air Minum Tirta Bantimurung Kabupaten Maros. Data yang digunakan pada penelitian ini yaitu data primer dan data sekunder yang metode penelitian menggunakan tahap penelitian pustaka dan penelitian lapangan. Metode analisis menggunakan analisis rasio keuangan. Adapun sampel dalam penelitian ini adalah neraca dan laporan laba rugi Perusahaan Umum Daerah (PERUMDA) Air Minum Tirta Bantimurung Kabupaten Maros selama 3 tahun periode 2018 sampai 2020.

Hasil penelitian menunjukkan bahwa kinerja keuangan perusahaan yang diukur dengan RasioSolvabilitas baik, karenaPerusahaan Daerah Air Minum Tirta Bantimurung Kabupaten Maros dapat memenuhi kewajibannya baik jangka pendek maupun jangka panjang.

Kata kunci: Rasio Solvabilitas, Kinerja, Keuangan
Embedded in History: Camagu’s amaXhosa identity in Zakes Mda’s The Heart of Redness
Authors: Bell David
Published: November 2022

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Choderlos de Laclos’s Les liaisons dangereuses and Jane Austen’s Lady Susan: The Art of Manipulation
Authors: Josefsson Åsa
Published: November 2022

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The Dialectics of Class and Postcolonialism in Cities of the Red Night
Authors: William Frederick II
Published: November 2022

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Introduction to Emmanuel Levinas: ‘After you, sir!’
Authors: Filipovic Zlatan
Published: November 2022

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„Träume kommen ja aus dem Bauch“ Literatur und Traumtheorie im 18. Jahrhundert in Friedrich Schillers Die Räuber
Authors: Blawid Martin
Published: November 2022

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All'ombra del paratesto. Tre lettere napoletane del viaggiatore Björnståhl in traduzione italiana
Authors: Cariboni Killander Carla
Published: November 2022

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“A language that is ever green”: the poetry and ecology of John Clare
Authors: Paul Ronald
Published: November 2022

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¿Pienso, luego no estoy loco? Reflexiones teóricas sobre la locura y la obra narrativa de Ramón Hernández (Madrid, 1935)
Authors: García Nespereira Sofía
Published: November 2022

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Living in the Meta Immersive Smart 21st Century and Beyond: A Digital Transformation in Open and Distance Learning (ODL)
Authors: Kurubacak Gülsün , Sharma Ramesh C. , Uğur Serap
Published: November 2022

Open and distance learning system is now well-established serving millions of students globally. The technological developments in the 4th industrial revolution era have impacted open and distance learning system. Artificial intelligence, blockchain, 3D printing, computer vision, internet of things, internet of behaviour etc. have introduced smart services in teaching, learning, curriculum design, learning design, user experience, instructional delivery and evaluation and assessment systems. In this paper we discuss how such technologies have brought the digital transformation to open and distance learning. We also examine the meta immersive smart future of open education.
Realizing food security through the development of urban farming to support the family economy during the Covid-19 pandemic
Authors: PUTRİ WENANG LUSİANİNGRUM Farah , NUR BHAKTİ PERTİWİ Widya
Published: November 2022

Food is a basic need for humans. Since March 2020, Covid-19 has been detected in Indonesia, which is feared to have an impact on food availability. Banten is a province that is included in Priority Category 3 in handling food insecurity. Cilegon is one of the cities in the Banten Province that is experiencing shrinkage of agricultural land. The purpose of this research is to formulate an urban farming development strategy in Cilegon. The method used in this research is the survey method. This type of research is descriptive, namely research that interprets the factors with the SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis method to produce strategies that can support the development of urban farming. The number of samples is 22 residents who carry out urban farming in Ramanuju Baru, Cilegon. The results showed that the internal factor that became the strength was the residents having high motivation and initiative in carrying out urban farming, while the internal factor that became the weakness was the limited knowledge of the residents in developing urban farming from an economic perspective. The results of research from external factors that become opportunities are Cilegon Government Policies in realizing food security, while the threats are pests and diseases in urban farming plants that need to be controlled naturally. Based on the analysis of internal and external factors using the SWOT matrix, the strategy to develop urban farming in Cilegon is to collaborate with the government and urban farming experts to provide consistent assistance to make urban farming activities in Cilegon economically valuable. To realize food security in Cilegon, collaboration is needed in aiding the community to manage urban farming professionally, so that it can provide economic value for the community.
Sustainability as a communication policy created by the economic system
Authors: SERTTAŞ Aybike , SARIKAYA Tugay , ÜNĞAN Esmanur
Published: November 2022

Today's world, in which we need the effort to make it livable both in terms of material resources and spiritual satisfaction, has many other borders and layers, despite physical ones. One of these layers is understanding sustainability. In this study, the relationship between sustainability and communication has been examined. Sustainability and communication are broad topics. For this reason, the study has the characteristics of a literature review and a general evaluation. In this study, questions were asked about how these two main topics can be related since it is possible to examine sustainability in the context of communication, education, various fields of media, and even cinema. The question of how sustainability can be evaluated in parallel with brand and communication strategies is the base of the critical view on the subject. The sustainability studies of institutions and organizations, which are the cause of the main complaints about sustainability, have been the points that obscure the issue and lead to various inquiries. As a result, it is emphasized that sustainability has supra-disciplinary importance. According to the results of the study, sustainability is an issue that can be guided by communication processes and strategies and requires both individual efforts of consumers as well as public professionalism and cooperation.
The role of real exchange rate in the trade balance between Turkey and Libya: Evidence from nonlinear and wavelet-based approaches
Authors: ALSANUSİ Mohamed , ALTINTAŞ Halil , ALNOUR Mohammed
Published: November 2022

The time-invariable models would suffer to give a clearer description to the relationship between exchange rate and trade flows. Therefore, the growing strand of literature has failed to reach a consensus. This study aims to contribute to this discussion by employing not only nonlinear model to capture the asymmetric effect, but also to detect the time frequencies and explore the lead-lag relations between real exchange rate and trade balance between Libya and its major trade partner ‘Turkey’ by applying both NARDL and wavelet coherence approaches, using monthly data spanning January 2013 to December 2020, selected based on data availability. The findings disclose that trade balance responds to the real exchange rate asymmetrically. The asymmetric effect is skewed more in the negative direction, as the impact of negative change is significant and greater than the positive change in long run. While the oil price shocks positively impact trade balance, economic policy uncertainty negatively affects trade balance. The wavelet coherence analysis indicates that real exchange rate and economic policy uncertainty are lagging in trade balance, while oil price leads trade balance. Among various other policy suggestions, we recommend that stable exchange rate through the intervention in the foreign exchange market will promote the trade balance at the end.
For what the bell tolls: A contribution to understanding dependence of the pandemic and global trade
Authors: Malović Marko , Petrović Vesna
Published: November 2022

The outburst of COVID-19 pandemics has heavily contracted and structurally altered both the size and the flows of international trade throughout 2020 and 2021. Even though contagion effect on global trade is clearly a negative one for a number of reasons elaborated in the paper, we venture to argue that this is in fact an evolutionary, expected and unavoidable consequence of the globalisation process itself. Among the key trends affecting the present and future of the international trade, roughly half of them are fully independent and the other half at best semi-dependent from the pandemics itself. In other words, it appears that the bell tolls for the wrong suspect, in as much as the two phenomena might be coextensive, not to mention the ideological and operational confusion behind recently widespread deliberations to deploy trade policies in order to simultaneously achieve several non-trade objectives of dubious compatibility. Notwithstanding the grim prospects on the horizon, some Mediterranean economies, if proven capable, may yet turn out to be the unintended winners of the silver lining.
Gated communities in Europe: Fashionability or a social challenge?
Authors: Đorđević Snežana
Published: November 2022

This paper deals with the poorly researched concept of fenced settlements (housing policy), which was developed in the USA in the middle of the 20th century, but has recently been particularly affirmed in NEO-liberal society, all over the world. Walled settlements also exist in social-democratic Europe, and the article studies the consequences of applying this concept, i.e. the influence of fenced settlements on the democratic spirit of the city and the democratic and development potential of the city, on the example of cities in Europe (France, Britain and Ireland) with lessons learned. Gated settlements have a number of negative effects on the community. For the needs of fenced communities, authorities often privatize roads, public spaces, and access to remaining public areas, to the detriment of the majority of residents, for whom entire complexes in the city remain inaccessible. This creates numerous social and spatial injustices, which actively undermines the democratic capacity of the city. These processes are in conflict with the democratic concept of the open city and the model of mixed housing, cultivated during the welfare state. The article relies on the analyses of existing research and studies of fenced settlements in the world through indicative examples and case studies (content analysis, synthesis, generalization, comparison). Statistical methods, analysis of regulatory changes, interviews and surveys of tenants, development managers, politicians and officials were often used in these studies. The comparative method in this paper compares the similarities and differences of fenced settlements in various countries, which is the basis for conclusions and recommendations for optimal housing policy and urban development (synthesis). The article introduces this challenging topic into the debate space of political and social sciences (field of urban studies), presents the existing consequences, and through comparison allows us to synthetically arrive at recommendations for choosing the optimal housing policy (learning from experience).
The war in Ukraine and changes in the global economic system
Authors: Dimitrijević Bojan , Dželetović Milenko
Published: November 2022

The US years-long irresponsible policy with the excessive printing of dollars, reinforced by the COVID-19 crisis and the war in Ukraine, has led to a large public debt and increasing inflation in the US, which significantly threatens the position of the dollar as the world's reserve currency. The latest challenge to the dollar came from Russia, China and the BRICS countries. The paper analyzes the consequences of the war in Ukraine, the sanctions-based war between Russia and the West, the position of the dollar as the world's reserve currency and the weaknesses of the international financial-monetary system leading to financial instability, frequent crises and growing inequality. A special emphasis has been placed on possible reforms of global finances and alternative proposals for a new reserve currency and more efficient work of global economic institutions (IMF) with the aim of achieving greater equality and faster economic growth.
Information systems in small and medium-sized enterprises of the textile and clothing industry
Authors: Dimitrijević Dragan , Adamović Živoslav
Published: November 2022

Market uncertainty and financial instability in the era of global competition force companies to work faster and increase productivity and business efficiency with continuous cost reduction and qualitative efficiency, which serves as a basis for strengthening the competitiveness and sustainable development of all, including SMEs -small and medium-sized enterprises of the textile and clothing industry. Various innovative contents and adequate technological solutions, as well as reengineering of business/production processes, with massive and adequate implementation of technical-technological innovations based on information and communication technologies -ICT and flexible automation, i.e. on the direct and efficient implementation sector defined information systems, also represent possible elements of functional competitiveness and sustainable development. Otherwise, changes in the environment and ways of doing business of companies require a better understanding and integration of data, as well as their more efficient exploitation in the functioning and development of the company, which imposes the need for permanent generation, adaptation and development of quality and efficient information systems. As a result of such requirements, the responses of industrial production through the implementation of technical-technological innovations are inevitable, whereby quality and efficient ICT infrastructure, coherence of innovative technologies and flexible production, as well as compatibility and complementarity of production and business information systems, are necessary elements and indicators of efficiency and quality. The implementation, efficient exploitation, as well as the development of various business and production information systems, obviously has its benefits, presented through more efficient, better quality and faster operations, but also disadvantages, because it is obviously conditioned by the stochastic laws of the global market, the variable human factor or the lack of high-quality, highly educated professionals staff, requirements for high initial investments, but also the specifics of the textile/clothing industry and SMEs, as well as the incompatibility of the implemented production and business systems.
Chain type hand stitch imitation machines for men suit manufacturing
Authors: Nemeša Ineta
Published: November 2022

Machines of chainstitches 104 create imitation of hand stitches 209 from one material side. Every hand stitch is formed from two threads, therefore the seams are more accented and very short length pick stitches are larger than created seams from real hand stitches 209. The length of the hand stitches is determined by the distance between a sewing needle and a hook needle of the machine. To create different length hand stitches a gauge set of the machine has to be changed. Because of different appearance of the stitches on top and bottom fabric surfaces the machines are used for top stitching of seams which are seen on a ready garment from one side only. In men suit manufacturing there are: top stitching of a jacket's lining, top stitching on pockets, fronts, etc. of jackets, vests, trousers. There are also available chainstitch 104 machines which create different variations of the hand stitches: double row hand stitches, parallel hand stitches, angular hand stitches. Comparing with the machines of real hand stitches 209, the machines of chainstitches 104 are much lower priced and have much higher productivity .
Investigate the fabric performance of Tencel-cotton blended denim in terms of the percentage change of Tencel
Authors: Islam Imranul , Khan Nazmul , Islam Atiqul , Rahaman Masudur , Islam Merajul
Published: November 2022

In terms of sustainability & wearing comfort, denim manufacturers are entering a new era of product variety. Tencel's regenerative nature and unique mechanical qualities usher in a new era for the denim industry. In this work, denim fabrics were manufactured using Tencel Cotton blended yarn using very fi ne yarn (20 Tex or 30 Ne), and fabric performance was examined following factors like tensile strength and other relevant metrics. For better evaluation, All the structures were 2/1 RHT (right-hand twill) that contained 115 EPI & 70 PPI and also indigo blue dyed. According to the result of the investigation, 100% Tencel Fabric (both the warp and the weft yarn were 100% Tencel) demonstrated the highest quality of fabric performance in terms of tensile strength, tearing strength, stiff ness, air permeability, and water vapor permeability than any other cotton or cotton Tencel blended fabric. However, a downward trend of abrasion resistance was observed in Tencel or cotton Tencel blended fabric concerning the percentage change of Tencel. Additionally, the performance of the fabric was significantly improved by the percentage addition of Tencel fiber in the warp and weft directions. In addition, a denim fabric made entirely of cotton performed the least well when compared to fabrics made entirely of Tencel or a blend of Tencel and cotton.
Identificação da flora utilizada por Bombus Morio (Swederus, 1787) e Bombus Pauloensis (friese, 1913) (Hymenoptera: Apidae) por meio da análise palinológica de cargas de pólen corbicular
Authors: Silva Jocélia Gonçalves , Beche Manoela , Bauermann Soraia Girardi , Radaeski Jefferson Nunes , Silva Cláudia Inês da , Guedes Jerson Carus
Published: November 2022

Interações planta-polinizadores são relações que envolvem na maioria das vezes ganhos para ambos os organismos. Os polinizadores coletam recursos alimentares (principalmente pólen e néctar), e suas atividades favorecem a reprodução das plantas. Neste estudo, por meio de observação indireta, foi avaliado o uso das plantas para a coleta de recursos florais por Bombus (Thoracobombus) morio Swederus (1787) e Bombus (Thoracobombus) pauloensis Franklin (1913), por meio da análise palinológica de cargas de pólen corbicular de indivíduos amostrados enquanto forrageavam em flores. O estudo possibilitou a identificação das espécies vegetais visitadas e também polinizadas por B. morio e B. pauloensis durante o forrageio. As coletas das abelhas nas flores foram feitas durante a primavera e verão de 2017 a 2018. Com a análise polínica, foi possível identificar a origem botânica dos recursos florais e verificado que na maioria das vezes os grãos de pólen predominantes não condiziam com a espécie de planta na qual o Bombus foi amostrado. A espécie B. morio foi amostrada em flores de 10 espécies de plantas e por meio da análise palinológica, identificado 52 tipos polínicos, enquanto que na espécie B. pauloensis, amostrada em flores de seis espécies de plantas, foram identificados 38 tipos polínicos. O recurso floral mais visitado por B. morio foi Jacaranda brasiliana e por B. pauloensis, Senna macranthera, no entanto, o tipo polínico encontrado em maior quantidade nas amostras de pólen para ambas as espécies foi de Solanum sp., permitindo inferir que essa planta é a mais atrativa. No total foram identificadas 11 espécies de plantas visitadas e 55 tipos polínicos associados à essas duas espécies de Bombus no Rio Grande do Sul, representados principalmente por plantas nativas (98%).
Vecchia Approximations and Optimization for Multivariate Matérn Models
Authors: Fahmy Youssef , Guinness Joseph
Published: November 2022

We describe our implementation of the multivariate Matérn model for multivariate spatial datasets, using Vecchia’s approximation and a Fisher scoring optimization algorithm. We consider various pararameterizations for the multivariate Matérn that have been proposed in the literature for ensuring model validity, as well as an unconstrained model. A strength of our study is that the code is tested on many real-world multivariate spatial datasets. We use it to study the effect of ordering and conditioning in Vecchia’s approximation and the restrictions imposed by the various parameterizations. We also consider a model in which co-located nuggets are correlated across components and find that forcing this cross-component nugget correlation to be zero can have a serious impact on the other model parameters, so we suggest allowing cross-component correlation in co-located nugget terms.
Vesiculobullous diseases, connective tissue and rheumatological disorders
Authors: Shanshal Mohammed
Published: November 2022

This section reviews the emergency presentations of autoimmune blistering diseases, connective tissue and rheumatological disorders as well as common pitfalls associated with their diagnosis and management
Dermatologic Emergencies CME Part V: Abuse-Related skin manifestations, dermatologic surgical emergency and other rare miscellaneous emergencies
Authors: Shanshal Mohammed
Published: November 2022

The last part of this continual medical education series reviews the cutaneous manifestations of physical and sexual abuse and their differential diagnosis, dermatologic surgical emergencies and miscellaneous dermatologic emergencies such as acute graft-versus-host disease, hypereosinophilic syndromes and vascular Ehlers-Danlos syndrome
Detection of subsurface defects in silicon carbide bulk materials with photothermal radiometry
Authors: Liu Yuan-Feng , Li Bin-Cheng , Zhao Bin-Xing , Liu Hong ,   School of Opto-electronic Science and Engineering, University of Electronic Science and Technology of China, Chengdu 610054, China,   Institute of Optics and Electronics, Chinese Academy of Sciences, Chengdu 610209, China
Published: November 2022

With excellent physical, mechanical and processing properties, silicon carbide (SiC) has gradually become a preferred lightweight optical material for primary mirrors of large space optical systems. The subsurface defects generated during the preparation and processing procedures of SiC will affect the optical quality of the primary mirrors and the imaging performance of the corresponding optical systems employing the SiC primary mirror as well. In this work, photothermal radiation (PTR), a powerful nondestructive testing technique for detecting sub-surface defects of solid materials, is employed to characterize the subsurface defects of bulk SiC material for primary mirrors.

Theoretically, three-dimensional one-layer and three-layer PTR theoretical models are developed to describe the defect-free and defect regions of an SiC bulk material. By analyzing the frequency dependence of PTR phase of the SiC bulk material with different defect depths, an empirical formula for estimating the defect depth via a characteristic frequency (appearing at the minimum of the PTR phase-frequency curve) defined thermal diffusion length is proposed, and simulation results show reasonably good agreement between the estimated and simulated defect depths in a depth range of 0.05–0.50 mm. Experimentally, an SiC bulk sample with a subsurface defect region is tested by the PTR via position scanning and modulation frequency scanning to obtain the position and frequency dependent PTR amplitude and phase. From the spatial distributions of PTR amplitude and phase measured at different frequencies and the phase difference frequency curves of measurement positions in the defect region, the depth and shape of the defect region are estimated and found to be in good agreement with the actual shape of the defect region, which is destructively measured via a depth profiler. The experimental and calculated results demonstrate that the PTR is capable of detecting non-destructively the subsurface defects of SiC bulk material. In addition, for subsurface defects with relatively flat interface, the defect depth can be determined accurately by the developed empirical formula.
Could posterior-anterior projection cervical spine radiographs improve image quality and dose reduction
Authors: Faulkner Rebecca , Lockwood Paul
Published: November 2022

Introduction: Anterior-posterior (AP) cervical spine X-rays are routine examinations to assess degenerative change, persistent pain and traumatic injuries. Multiple radiosensitive organs lie anteriorly within this anatomical region, increasing the stochastic risk of cancer. If a posterior-anterior (PA) projection was utilised, the radiation dose could potentially be reduced. The hypothesis of this study is to evaluate the change in radiation dose and image quality between AP and PA positions.
Materials and methods: An anthropomorphic phantom was positioned AP erect against a digital radiography (DR) detector with 30 thermoluminescent dosimeters (TLDs) inserted to record the thyroid, breast, ovaries, and testes absorbed radiation dose at an exposure of 66 kV and 8 mAs. The phantom was repositioned PA erect and repeated. Images were assessed against an image quality criteria Likert scale by qualified radiographers. The mean and standard deviations were calculated for dose and image quality and compared using a t-test and Wilcoxon Signed Ranks Test.
Results: The PA erect cervical spine reduced radiation dose to the right thyroid by 92% (44.7 µGy; p=0.00) and the left thyroid by 89% (43.7 µGy; p=0.00), with further reductions in scatter dose to the breasts (0.35-0.45 µGy; p=0.85), ovaries (0.41 µGy; p=0.57), and testes (0.04 µGy; p=0.98). Image quality scores for the end plates, pedicles, joint spaces, spinous and transverse processes, cortical and trabecular bone patterns, and soft tissues were near equivalent (p=0.32).
Conclusion: Data analysis suggests that PA cervical spine positioning for X-rays in the laboratory adheres to as low as reasonably practicable (ALARP) guidance on X-ray examinations to reduce radiation dose to male and female internal organs (thyroid, breast, ovaries) without a reduction in image quality compared to AP positioning. Further research in clinical practice is advised.
Outcome of Active versus Expectant Management in Preterm Premature Rupture of Membranes between 34 weeks to 36 weeks Six days: A Retrospective Study
Authors: Baby Shilpaann , Anjali M
Published: November 2022

Introduction: An important cause of neonatal morbidity and mortality is the prelabour Preterm Rupture of the Membranes (PPROM) which refers to, the rupture of the membranes before 37 weeks. There are two modes of managing PPROM, active management (immediate delivery) and expectant management (therapy directed toward extending the pregnancy to improve neonatal outcome). Aim: To compare neonatal outcomes following active and expectant (conservative) management in PPROM cases from 34 weeks to 36 weeks six days. Materials and methods: This retrospective study was conducted in the Department of Obstetrics and Gynaecology at Government Medical College (tertiary care teaching hospital), Thiruvananthapuram Kerala, India, from February 2021 to July 2021. The data collection period was from January 2013 to December 2014. PPROM cases between 34 weeks and 36 weeks and six days were retrospectively studied. A total of 62 patients among the Active Management (AM) group and 62 patients among the Expected Management (EM) group were selected. The neonatal outcomes (respiratory distress syndrome, hypoglycaemia, neonatal sepsis) and maternal outcomes (caesarean section, chorioamnionitis) were compared. The latency period in conservative management and in active management was also compared. The data was analysed using the Chi-square test. Results: In the AM group, 13 (21%) babies had respiratory distress syndrome, whereas, in the EM group it was 4 (6.5%) (p-value=0.019). In the AM group, 13 (21%) babies had hypoglycaemia, whereas, in the EM group, it was 5 (8.1%) (p-value=0.041). In the AM group, 3 (4.8%) women had signs and symptoms of chorioamnionitis, whereas, in the EM group, it was 7 (11.3%) (p-value=0.187). In the AM group, 16 (25.8%) of women had Caesarean section, whereas, in EM it was 9 (14.5%) (p-value=0.117). In AM group, 1 (1.6%) has neonatal sepsis and in EM it was 3 (4.8%) p-value=0.309. The latency period in conservative management was 119.5±31 hours and in active management, it was 51.5±13.2 hours. Conclusion: The present study indicated that expectant management of PROM between 34 weeks to 36 weeks and six days leads to a statistically significant reduction of neonatal respiratory distress syndrome and hypoglycaemia.
Awareness and Compliance to International Patient Safety Goals among Healthcare Personnel of a Tertiary Care Hospital in Northern India
Authors: Joshi Dinesh Chandra , Saini Ravinder Singh
Published: November 2022

Introduction: Advances and commitment to patient safety worldwide have grown since the late 1990s which have led to a remarkable transformation in the way patient safety is viewed. Having begun as a subject of minor academic interest, it is now embedded in most healthcare systems worldwide. The International Patient Safety Goals (IPSG) are important guidelines developed by Joint Commission International to promote safe and high-quality patient care. Patient safety is the responsibility of every healthcare personnel who is directly or indirectly involved in patient care. Aim: To determine the level of awareness amongst doctors, nurses, and technicians and their compliance to IPSG in a tertiary care hospital. Materials and Methods: This observational cross-sectional study was conducted from March to May 2021, in a tertiary care teaching hospital. Stratified sampling technique was used in determining the number of doctors, nurses, and technicians required for this study. A validated questionnaire was used to assess the awareness level of healthcare personnel to IPSG. ‘1’ mark was assigned to each correct answer and ‘0’ were awarded to wrong answers. Results: A total of 394 patient records/documents were audited for patient safety compliance. It was observed that 339 (86%) documents revealed compliance to all six IPSG. Out of the six goals of IPSG, the best compliance was observed for the 4th goal of IPSG (ensure safe surgery) for which the compliance was 100%. The lowest compliance was observed for 2nd, 5th and 6th goal (improve effective communication, reduce the risk of healthcare associated infection and reduce the patient harm resulting from fall) which was 81%, 80% and 78%, respectively. The awareness questionnaire was given to doctors (n=60), nurses (n=86) and technicians (n=76). The findings revealed that awareness was highest in nurses (84.8%) followed by doctors (81.7%) and technicians (80.2%). Conclusion: The study has found out that the awareness level of doctors, nurses, and technicians towards patient safety goals is good. Further quality improvement in this field can be achieved by conducting on the job-training, workshops, lectures, and seminars.
Role of Intraoral Scanners in the Detection of Dental Caries: A Review
Authors: Sebastian Nikitha , Singh Ankita , Gehlot Paras Mull , Mariswamy Annapoorna Ballagere
Published: November 2022

Dental caries is an irreversible, microbial disease of the tooth which is characterized by demineralisation and dissolution of the hard tissues. Conventional methods such as visual and tactile examination, radiography, laser or light induced fluorescence methods help in the diagnosis of dental caries, though they lack sensitivity. Being an irreversible process, it is important to detect the caries process in its incipient stages. Very recently, intraoral scanners have also found their way through to the detection and diagnosis of dental caries, particularly, the incipient lesions. Use of advanced technology for the detection of dental caries in its incipient stages has enabled a change in the paradigm to minimally invasive dentistry which focuses more on a preventive approach to caries management. This review paper attempts to summarize the available literature on the role of intraoral scanners in caries diagnosis by performing a online search on PubMed, Embase, SCOPUS and MEDLINE databases. Only full text studies authored in English and published in peer reviewed journals between 2010 and 2022 were included in the research. Keywords and terms from both review articles and original research papers were taken. A total of 36 papers were reviewed including full texts and abstracts.
Survey of bats on the south coast and ranges of the Shoalhaven region in New South Wales
Authors: Daly Garry , Hoye Glenn
Published: November 2022

Surveys for echolocating bats were conducted primarily by harp trapping and echolocation detection in the Shoalhaven region on the south coast region of New South Wales from 1989 to 2021. A total of 399 sites were surveyed by harp trapping and 175 sites through echolocation call detection. Mist nets were used to catch bats at one site in 1989. The survey covered a range of vegetation communities at altitudes that ranged from near sea level to 770m asl. One hundred and seventy-four harp trap sites were within conservation reserves/state forests and the rest were on freehold land. Each site was trapped from 1 - 4 nights for a total of 666 harp trap nights. Sites surveyed electronically were sampled between 1- 2 nights for a total of 230 samples of either 30 minutes duration or an entire night. A total of 18 species were captured in harp traps during the survey. The Yellow-bellied Sheath-tailed Bat Saccolaimus flaviventris was observed once during spotlight surveys and detected electronically. The White-striped Free-tailed Bat Austronomus australis was heard echolocating at night and detected electronically. The Little Bent-wing Bat Miniopterus australis was only detected electronically. The highest capture rate was in Jerrawangala National Park where 38 animals consisting of five species were trapped in one trap on a single night. The highest species richness and density was found in tall open forests, especially those along the Illawarra escarpment. Analysis of abundances found that the Little Forest Bat Vespadelus vulturnus was the most common species accounting for 45% of animals trapped. Seven species currently listed under the Biodiversity Conservation Act (2016) were caught and another detected electronically. Those trapped were the Large-eared Pied Bat Chalinolobus dwyeri, Eastern Falsistrelle Falsistrellus tasmaniensis, Golden-tipped Bat Phoniscus papuensis, Eastern Bent-wing Bat Miniopterus orianae oceanensis, Eastern Coastal Free-tailed Bat Micronomus norfolkensis, Large-footed Myotis Myotis macropus and Greater Broad-nosed Bat Scoteanax rueppellii. In addition, the regionally rare Ride’s Free-tailed Bat Ozimops ridei was trapped. The survey provided the first live specimens of Eastern Forest Bat V. pumilus in the south coast region, a range extension of some 260km south of the previous accepted records in the Watagan Mountains. The capture of a Large-eared Pied Bat at Meroo NP represents a southern range extension for this species. Morphometric data are presented plus comments on species habitat preference.
Factors Influencing the Implementation of Safety Standards and Guidelines in Public Secondary Schools in Garissa Township Sub-County, Kenya
Authors: Muhumed Mohamed Hussein , Gori Justus Mochama , Rotich Stephen K.
Published: November 2022

Although the essential component of teaching and learning success is school safety, physical Infrastructure in most of the schools Garissa township Sub- County does not comply with the safety standard as recommended by the ministry of education. Even more importantly, most schools do not have enough financial resources on the implementation of the safety standards as the training of teachers is not adequately done to implement safety standards. Despite vast research on safety standards and school safety, their findings on relationship between implementation of safety standards and guidelines in public secondary school in Garissa township Sub-County are inconclusive findings, hence this study. The goal of this research was to assess factors influencing the implementation of safety standards and guidelines in public secondary school in Garissa township Sub- County. This research used a survey research approach, with the 10 principals and 320 teachers in Garissa Township sub-county as the target population from where as sample of 106 respondents was obtained. Data was gathered using questionnaire interviews from where data was analyzed using Pearson r’ and verbatim respectively. The results show that at 5% significance level, safety sub-committee (r = 0.280, p<0.01), physical infrastructure (r = 0.405, p<0.01), financial resources (r = 0.588, p<0.01), and training of teachers (r = 0.469, p<0.01) had statistically significant and positive relationship with implementation of school safety standards and guidelines in public secondary schools in Garissa Township Sub- County.
Critical Congenital Heart Disease Sadly Diagnosed at Autopsy in Calabar, South-South Nigeria
Authors: Ipeh Ugbem Theophilus , Edem Ushie David , Kingsley Akaba , Venn Juliet , Okoi Okpebri, Komommo , Martin Nnoli , Abeng Ebughe Godwin , Olukayode Oshatuyi
Published: November 2022

Congenital heart disease (CHD) is the most common type of birth defect causing more deaths in the first year of life than any other birth defect. Medical practice in a third-world country is faced with numerous challenges, created by poor health facilities and the unavailability of basic imaging studies at the community level where the majority of the poor resides. We present a case series of 4 neonates with a ratio of 1: 3 admitted into the neonatology unit of the University of Calabar Teaching Hospital, Calabar, Nigeria. Two of the patients were delivered at home by a traditional birth attendant via spontaneous vertex delivery and the rest two were booked cases in a private and obstetric unit of the University of Calabar Teaching Hospital. Their age ranged were 18 hours to 27 days of life and their common presentation were poor sucking, difficulty in breathing, central cyanosis and failure to thrive. A fetal echocardiogram was carried out for one of the cases and there was strong clinical suspicion of congenital heart disease but the precise type is unknown. The other three could not afford the necessary investigations required. They were all oxygen-dependent till death. Pathologic-anatomic findings showed a rare Critical congenital heart defect of the univentricular heart chamber of various types for the three cases and a case of TGA. The Immediate cause of death for all four cases was congestive cardiac failure.