bluuebunny/crossref_metadata_2025 huggingface dataset:
Oxford and Cambridge in the Romantic Period
Authors: Ross Catherine E.
Published: May 2024

This chapter discusses the common criticisms of and debates about the Georgian universities, focusing on the narrowness of the curriculum, exclusivity, and cost. It cites the defences mounted by university leaders and the pro-and-con judgments of the Royal Commissions on these matters. It clarifies the degree to which students had freedom of choice about what they would study and how hard they might work. The chapter calls attention to the very small size of the universities: fewer than 1,300 students in total were enrolled in the two universities in 1800. It also investigates the ancient practice of labelling students according to their social rank. Using cost equivalence calculators, it compares the price of attending these universities in 1800 and 2020. It notes the reforms that were coming into place during the period and corrects the notion that the Romantic poets uniformly disliked and or dismissed their university education
The Curriculum of the English ‘Confessional’ University
Authors: Ross Catherine E.
Published: May 2024

This chapter surveys in detail the curriculum at Oxford and Cambridge, starting with their ancient statutes, which mandated classical language study along with mathematics and religion. It explains the Georgian educators’ reasons for pursuing this curriculum, primarily their belief that classics and mathematics have intrinsic value and are ‘instruments of mental discipline’. The chapter notes that grammar-school boys arrived at the universities well-prepared in three areas and ready to advance. Oxford’s emphasis upon classics and religion and Cambridge’s emphasis of mathematics over but not to the exclusion of the other two disciplines are noted and discussed. Provided in this chapter are lists of standard texts and genres studied. A comparison of the work completed by two ‘reading men’ and by less motivated students illustrates how rigorous or relaxed study at the universities could be.
Pedagogies of Oxford and Cambridge in the Georgian Period
Authors: Ross Catherine E.
Published: May 2024

This chapter details and discusses university pedagogies, using the teaching notes of one of Wordsworth’s college tutors, as well as examples of the translation, composition, and public speaking exercises used at both Oxford and Cambridge. It explains the universities’ educators’ rejection of compulsion, their belief in the efficacy of ‘self-education’, and their practice of allowing college ‘gentlemen’ to make their own decisions about how long and hard they would work. Specific exercises in public speaking and argument, such as the Acts and Opponencies tradition at Cambridge, are described, as is the distinguishing pedagogy of Oxford and Cambridge, their college and university exams.
The Educators of Oxford and Cambridge in the Georgian Period
Authors: Ross Catherine E.
Published: May 2024

This chapter explains who carried the teaching load at the universities and explains the differences in the expectations and practices of college tutors and university professors. It details how tutors were selected from among college fellows and how closely they worked with students to prepare them for college and university exams. Using diaries and letters of both tutors and students, the chapter offers examples of the hands-on teaching, personal guidance, and supervision delivered by tutors. It reports that tutorial instruction varied according to each student’s talent and needs. The oft-criticized practice of hiring private tutors is noted. The selection and workload of university professors (often dictated by ancient statutes) are explained. Profiles of tutors and professors from both universities are also provided. The information provided here about Romantic-era tutors and professors argues against the generally negative opinion modern university scholars have of these men
Leadership at Oxford and Cambridge
Authors: Ross Catherine E.
Published: May 2024

Chapter 11 demonstrates how the universities brought students into spheres of national influence. Chancellors were usually great men from the court, the universities elected their own Members of Parliament, and college heads were often appointed or approved by the crown. It notes that attending one of the universities, even without attaining a degree, imparted a level of public status unavailable to those without this education. The administrative roles of Vice Chancellors and the wide-ranging public duties of college heads are explained. The careers of three college heads, including the poet’s brother, Christopher Wordsworth of Trinity, are used as examples of the sort of leadership college men witnessed. The selection, responsibilities, and behaviour of college fellows are detailed and evaluated. The chapter closes with discussion of the academic career, influence, and demise of Coleridge’s tutor, William Frend, a fellow of Jesus College.
Conclusions
Authors: Ross Catherine E.
Published: May 2024

The chapter reaffirms the arguments made throughout the book that the Anglo-Classical Academy deserves more credit for the Romantic Period’s bumper crop of important and original writers than it has been given in the past. It summarizes the specific benefits of this education; concludes it provided incomparable training and practice in composition for writers, especially poets; and asserts that knowledge of this education can benefit both modern scholarship and teaching practice. Finally, this chapter asserts that this Academy taught the Romantics about the “inherent and indestructible qualities of the human mind” and encouraged them to believe that they might “teach others what [they had] learned”.
Politicking and Peacebuilding in Northern Ireland
Authors: DeYoung Elizabeth
Published: May 2024

Chapter Two sets out the peacebuilding and legislative framework within which the Girdwood development process took place. It provides context on the Good Friday Agreement, the power-sharing government it instituted and the subsequent prescriptions for transforming conflict. In particular, Section 75 of the Northern Ireland Act was designed to enshrine ‘equality of opportunity’ into policymaking. The chapter then explores the ways in which these well-intentioned promises have been subverted by politicians; as in other societies, backroom dealings and trade-offs are part and parcel of governance in practice. The rise of the Protestant/Unionist DUP and Catholic/Nationalist Sinn Fein as the predominant political parties in post-Agreement Northern Ireland further reflects a move towards more intransigent identity politics.
‘Shenanigans and Skullduggery’
Authors: DeYoung Elizabeth
Published: May 2024

Chapter Eight elaborates on this context with community-level ethnographic insights into the final phase of planning. Parties involved included community development groups, statutory agencies like the City Council, paramilitary groups and a private social enterprise operator, all of whom exerted varying levels of influence on the redevelopment. This chapter details the many meetings that occurred in the run-up to the opening of the Girdwood Community Hub. Disagreement, miscommunication and missed opportunities shaped the final phase of planning, despite the best efforts of some community groups involved in the process.
From Tropical Pathology to Tropical Plantation: The Hevea brasiliensis , 1839 to 1945
Authors: Wylie Lesley
Published: May 2024

This chapter will trace the way in which the Amazonian history of the rubber tree, Hevea brasiliensis, is entwined with discourses of tropical disorder and pathology. Drawing on accounts by contemporary travel writers and industry commentators, it will open with a consideration of disease during the Amazonian Rubber Boom, particularly in relation to theories of “tropical degeneration”. The second section will examine the way in which disease continued to dominate discussions around the Hevea into the 1930s and 40s, when Henry Ford’s famous experiment with Amazonian plantation rubber ended in failure because of South American Leaf Blight. The chapter’s central argument is that it was not the Hevea itself, but rather the extractive economy, that was the most significant source of pathology in the region.
Walking Mountains
Authors: Kocela Christopher
Published: May 2024

This essay examines the representation of mountaineering as a form of ecological Zen practice in Peter Matthiessen’s The Snow Leopard. Winner of the National Book Award for nonfiction in 1979, Matthiessen’s journal account of the two-hundred-and-fifty-mile expedition he made across the Dolpo region of Tibet with field biologist George Schaller in 1972 has proven enormously influential in popularizing mountain climbing and hiking as forms of spiritual seeking.
This essay argues that Matthiessen’s memoir draws heavily on the de-anthropocentric representation of mountains “walking” and “flowing” in Zen master Dōgen’s “Mountains and Waters Sutra” (1243), which Matthiessen first read while editing his Dolpo journals for publication between 1976 and 1978.
Through its disorienting attribution of movement and breath to the Himalayan mountains, The Snow Leopard becomes a form of ecological life writing in which the “climbing” and “walking” of mountains reflect not only human agency and striving, but also a radically decentered form of environmental awareness. It is this awareness that motivates Matthiessen’s repeated calls, throughout the text, for environmental conservation; representation of such awareness also helps to explain the ongoing popularity and relevance of The Snow Leopard for contemporary readers concerned about the commercialization of mountain spaces.
Contesting the Script
Authors: Jaising Shakti
Published: May 2024

Contemporary Indian English fiction is not merely a vehicle for animating the neoliberal script. The final chapter attends to novels that contest this all-pervasive script, beginning with Arundhati Roy’s Ministry of Utmost Happiness (2017), which fragments streamlined plots of personal and national maturation through its baggy form and “undisciplined” storytelling about the formation of a collective of dispossessed characters. From Roy’s fragmented, yet encyclopaedic narration of neoliberal India’s political and cultural life, the chapter moves to Aravind Adiga’s inversion of the upward mobility narrative in Selection Day (2016). In this novel Adiga traces the failure rather than triumph of impoverished young cricketers who are compelled to become investments for rich financiers. The chapter ends with the Netflix televisual adaptation of Selection Day, which ironically returns to the structure and imagination of the neoliberal script that the novel rejects. This web series points to new ways in which the Indian English novel circulates internationally–as well as to the challenges of disentangling fiction from neoliberalism’s justificatory narratives.
‘Emotionally We Arrive All the Time’: Stevens and Affect Theory
Authors: Figlerowicz Marta
Published: May 2024

This chapter considers how the emotional elements of Stevens’ poetry and the various affective postures he adopts can complement and inform emerging themes in the study of affect theory. The chapter argues that Stevens shows us, how affect theory shows us, what we can learn from our affective experiences. With a moving focus on Stevens’s late poetry from ‘The Rock’ onwards, the chapter demonstrates the ways in which we relate to our own affective experiences, and how our affective experiences and our feelings inform how we are able to construct our images of the world and reality.
The The
Authors: Gould Thomas
Published: May 2024

This chapter argues that Stevens’s poetry relates to other people in the manner of a neighbour. It argues that Stevens’ post-theological positionality places him in a particularly modern tradition of re-thinking what it means to live alongside others as a neighbour in a secular ecology. It draws from a number of thinkers of neighbourliness: Freud, Zizek, Eric Santner, and Kierkegaard. The chapter also argue that Stevens’s poems enact formal neighbourhoods, deriving sense and aesthetic pleasure from the side-by-side relations that characterise their elements.
Toward Cosmological Simulations of the Magnetized Intracluster Medium with Resolved Coulomb Collision Scale
Authors: Steinwandel Ulrich P. , Dolag Klaus , Böss Ludwig M. , Marin-Gilabert Tirso
Published: May 2024

We present the first results of one extremely high-resolution, nonradiative magnetohydrodynamical cosmological zoom-in simulation of a massive cluster with a virial mass of M
vir = 2.0 × 1015 solar masses. We adopt a mass resolution of 4 × 105
M
⊙ with a maximum spatial resolution of around 250 pc in the central regions of the cluster. We follow the detailed amplification process in a resolved small-scale turbulent dynamo in the intracluster medium (ICM) with strong exponential growth until redshift 4, after which the field grows weakly in the adiabatic compression limit until redshift 2. The energy in the field is slightly reduced as the system approaches redshift zero in agreement with adiabatic decompression. The field structure is highly turbulent in the center and shows field reversals on a length scale of a few tens of kiloparsecs and an anticorrelation between the radial and angular field components in the central region that is ordered by small-scale turbulent dynamo action. The large-scale field on megaparsec scales is almost isotropic, indicating that the structure formation process in massive galaxy cluster formation suppresses any memory of both the initial field configuration and the amplified morphology via the turbulent dynamo. We demonstrate that extremely high-resolution simulations of the magnetized ICM are within reach that can simultaneously resolve the small-scale magnetic field structure, which is of major importance for the injection of and transport of cosmic rays in the ICM. This work is a major cornerstone for follow-up studies with an on-the-fly treatment of cosmic rays to model in detail electron-synchrotron and gamma-ray emissions.
Resolving Red Giant Winds with the Hubble Space Telescope*
Authors: Wood Brian E. , Harper Graham M. , Müller Hans-Reinhard
Published: May 2024

We describe recent spectroscopic observations of red giant stars made by the Space Telescope Imaging Spectrograph (STIS) instrument on board the Hubble Space Telescope, which has provided spatially resolved observations of the warm chromospheric winds that predominate for early K to mid-M giants. The H i Lyα lines of a set of 11 red giants observed with the STIS/E140M echelle grating are first analyzed to ascertain wind H i column densities and total wind mass-loss rates. The M giants have estimated mass-loss rates of

M

̇

=
(
14
–
86
)
×

10

−
11

M
⊙ yr−1, while the K giants with detected wind absorption have weaker winds with

M

̇

=
(
1.5
–
2.8
)
×

10

−
11

M
⊙ yr−1. We use long-slit spectra of H i Lyα for two particular red giants, α Tau (K5 III) and γ Cru (M3.5 III), to study the spatial extent of the Lyα emission. From these data we estimate limits for the extent of detectable emission, which are r = 193 R
* for γ Cru and r = 44 R
* for α Tau. The cross-dispersion emission profiles in the STIS echelle spectra of the larger sample of red giants also show evidence for spatial resolution, not only for H i Lyα but for other lines with visible wind absorption, such as Fe ii, Mg ii, Mg i, O i, and C ii. We characterize the nature of these spatial signatures. The spatial extent is far more apparent for the M giants than for the K giants, consistent with the stronger winds found for the M giants from the Lyα analysis.
A Novel
COL2A1
Gene Pathogenic Variant in a Turkish Family With Ocular Stickler Syndrome
Authors: Bozkurt Banu , Güler Ramazan , Özdemir Ebru Marzioğlu , Esin Deniz , Gönül Şaban
Published: May 2024

A 6-month-old female infant with megalophthalmos was referred with the suspicion of congenital glaucoma. Refractive measurements obtained with handheld autorefractometry were −7.00 −2.00 × 90° in the right eye and −6.00 −2.00 × 100° in the left eye and ultrasonic axial lengths were 22.50 mm in both eyes. Intraocular pressures and vertical and horizontal corneal diameters of the proband were 11 mm Hg, 11 mm, and 11.50 mm in both eyes, respectively. She was diagnosed as having early-onset high myopia. Her father also had degenerative high myopia (−12.00 diopters) in the right eye, bilateral congenital lens opacities, and retinal detachment in the left eye. Her mother was emmetropic with normal eye examination results. Clinical exome sequencing analysis revealed a novel ENST00000380518.3 c.3528_3530 delins GACCATTAGCA (Chr12:48369813: GCA > TGCTAATGGTC) variant in the collagen type II alpha 1 chain (
COL2A1
) on chromosome 12q13 (OMIM 108300), consistent with the Stickler syndrome type 1. Subsequent segregation analysis revealed paternal inheritance. Although many pathogenic null variants have been described within the
COL2A1
gene, there is currently no documented literature pertaining to this specific variant, making this the inaugural report of its manifestation in scientific discourse.

[
J Pediatr Ophthalmol Strabismus.
2024;61(3):e23–e27.]
Integrating gene selection and deep learning for enhanced Autisms' disease prediction: a comparative study using microarray data
Authors: Abdelwahab Mahmoud M. , Al-Karawi Khamis A. , Semary H. E.
Published: May 2024

In this article, Autism Spectrum Disorder (ASD) is discussed, with an emphasis placed on the multidimensional nature of the disorder, which is anchored in genetic and neurological components. Identifying genes related to ASD is essential to comprehend the mechanisms that underlie the illness, yet the condition's complexity has impeded precise information in this field. In ASD research, the analysis of gene expression data helps choose and categorize significant genes. The study used microarray data to provide a novel approach that integrated gene selection techniques with deep learning models to improve the accuracy of ASD prediction. It offered a detailed comparative examination of gene selection approaches and deep learning architectures, including singular value decompositions (SVD), principal component analyses (PCA), and convolutional neural networks (CNNs). This paper combines gene selection methods (PCA and SVD) with deep learning models (CNN) to improve ASD prediction. Compared to more traditional approaches, the study revealed that its integrated methodology was more effective in improving the accuracy of ASD prediction results through experimentation. There was a difference in the accuracy between the PCA-CNN model, which achieved 94.33% with a loss of 0.4312, and the SVD-CNN model, which achieved 92.21% with a loss less than or equal to 0.3354. These discoveries help in the development of more accurate diagnostic and prognostic tools for ASD, which is a complicated neurodevelopmental disorder. Additionally, they provide insights into the molecular pathways that underlie ASD.
On some new frames along a space curve and integral curves with Darboux q-vector fields in $ \mathbb{E}^3 $
Authors: UYAR DÜLDÜL Bahar
Published: May 2024

In this paper, to start we defined osculating q-frame, normal q-frame, and rectifying q-frame along a space curve in Euclidean 3-space $ \mathbb{E}^3 $ by using the Darboux vector field of the q-frame. We obtained the derivative equations of these new frames. Later, we defined some new integral curves of a space curve and called them $ \overline{\mathsf{d}}_o $-direction curve, $ \overline{\mathsf{d}}_n $-direction curve and $ \overline{\mathsf{d}}_r $-direction curve. Finally, we gave some theorems and results related with these curves.
Analyzing Identity Storytelling for On-site Learning in Museums
Authors: Lei Zhichao
Published: May 2024

This research investigates the specific designs of on-site identity storytelling in city museums, made of three case studies with an Identity Education (IdEd) framework proposed in an early conference paper by the author. Conclusions of the case studies are reached on how the city museums take advantage of different contextual factors to engage the visitors of five motivational types, whether there is any gap between the target identity expected by the city and the identity narratives presented by the city museum, and if any, how huge the gap is. The subsequent discussion, comparing the three cases, makes this research a comparative study and provides suggestions for each city museum. In general, this research sets an example of how the IdEd framework could be applied to the evaluation of on-site learning materials and opportunities in museums, thereby helping better the instructional design on the part of curators and offering guidelines for observing the museum visitors’ learning experiences in future field studies with similar educational concerns.
Stanley Milgram’s Obedience Studies: A Critical Review of the Most Influential Explanatory Accounts
Authors: Russell Nestar , Künstler Raphaël
Published: May 2024

In 1960 Stanley Milgram wondered if ordinary people would, as many Germans did during the Holocaust, obey higher orders to harm innocent people. Soon after, he ran the New Baseline experiment: at the behest of a scientific authority, 65 percent of subjects inflicted what appeared to be potentially lethal shocks on another person with a mild heart condition. Although, to date, there is no widely accepted explanation that can account for this finding, three theories continue to attract a disproportionate amount of attention: the Incredulity Hypothesis, Agentic State, and Engaged Followership. The aim of this paper is to present an overview of how Milgram invented his basic procedure and then use the insights gained from his journey of discovery as a foundation from which to critically review these three explanatory accounts. Succeeding this critical review, a lesser well-known theory will be presented; one that is supported by Milgram’s original results.
True Believers: The Incredulity Hypothesis and the Enduring Legacy of the Obedience Experiments
Authors: Doris John M. , Niemi Laura , Machery Edouard
Published: May 2024

Numerous commentaries on the Milgram experiments entertain versions of the Incredulity Hypothesis, which maintains that Milgram’s participants did not as a rule believe they were administering actual shocks. If the Incredulity Hypothesis were generally applicable, it would appear that obedient participants typically did not believe they were doing anything wrong, with the implication that MiIgram was not able to demonstrate alarming levels of destructive obedience—as countless commentators have taken him to have done. In this paper, we demonstrate that the Incredulity Hypothesis is not generally applicable: it cannot easily explain participant behavior in the Milgram experiments and their many replications, nor does it comport well with participants’ self-reports of their experience.
Pourquoi les perpétrateurs de génocides obéissent-ils ?
Authors: Ludwig Pascal
Published: May 2024

Les expériences de Milgram ont eu une influence considérable sur l’étude historique du comportement génocidaire, qui trouve son origine dans le livre révolutionnaire de Christopher Browning, Ordinary men. L’objectif de mon article est d’examiner et d’évaluer de manière critique la thèse suivante, qui est souvent considérée comme allant de soi : « Thèse de la pertinence : les résultats de la psychologie sociale, en particulier les résultats de Milgram sur le comportement d’obéissance, sont causalement pertinents pour expliquer les comportements des auteurs d’actes criminels. » La thèse de la pertinence présuppose que certaines études paradigmatiques en psychologie sociale ont une validité à la fois interne et externe. Dans le contexte de la crise de réplication qui a affecté de nombreux résultats récents en psychologie sociale, il semble crucial de discuter ce présupposé. Je soutiendrai que les données empiriques sont mitigées. S’il demeure probable que la thèse de la pertinence soit vraie, son importance a probablement été exagérée.
Power From the Ground Up: Respecifying Performative Power as First Overt Resistance in Milgram’s Lab
Authors: Hollander Matthew M.
Published: May 2024

The interdisciplinary Stanley Milgram renaissance of the past two decades has fundamentally shifted debate about the most controversial social psychological experiments of the 20th century. A new angle, with implications for the philosophy of social psychology, is widespread interest in the conditions of possibility of his work. Social ontology (or historical ontology), of various styles, can bring into focus contingent features of “obedience to authority” and other classic experiments in North American social psychology. In this Milgram issue of Philosophia Scientiæ, my contribution is to show how an empirical focus on social interaction (EMCA: ethnomethodology and conversation analysis) can help illuminate—“from the ground up”—power in Milgram’s lab and resistance to continuing the experiment. First, I present power as a multidimensional feature of human sociality, highlighting its performative aspect. Milgram’s lab setting forced and constrained Teachers to exercise agency in starkly contrasting ways, either as exercising power over the Learner (complying with the Experimenter) or against the Experimenter (resisting him). Second, I propose that, like morality, performative power may be understood in terms of foreground and background (Gestalt figure and ground), with both sides of the phenomenon being empirically grounded and demonstrably oriented to in interactants’ concrete practices. Third, I respecify performative power as the detailed practice of Teachers resisting continuation of the experiment. Using a large collection of transcripts of Milgram’s archived audio-recordings, I analyze instances of Teachers’ first (earliest, lowest shock level) overt resistance, an aspect of Teacher resistance hitherto unstudied systematically. This section shows precisely how the resistance of both Disobedient- and Obedient-outcome Teachers first appeared: as a phenomenon of talk-in-interaction displaying sequential organization and various recurrent forms. Studying both outcome groups (rather than just one) demonstrates that resistance was common not only among Disobedient but also Obedient Teachers. Overall, the article shows the value of EMCA as a style of social ontology well suited to investigating power’s relationship to social psychological knowledge claims, and to reconstructing the presuppositions of classic North American social psychology.
Digital Finance and Commercial Banks' Risk
Authors: Mansour Nadia
Published: May 2024

China's digital financial growth has advanced rapidly, and the banking sector, which serves as the core of the real economy, is concerned about its capacity to resist the impacts of digital finance. The paper analyzes the impact of digital financing on commercial banking risk-taking via balance panel data from 2013 to 2022 from 160 Chinese banks. The results prove that the impact of digital finance on commercial banks' risk-taking and finds that firstly, in terms of the overall effect, digital finance has a dampening effect on commercial banks' risk-taking; in terms of the structural effect, the risk-dampening effect of the breadth of coverage is the strongest and the breadth of coverage and the depth of use play a significant role in the dampening of commercial banks' risk-taking.
Enhancing Logistics Optimization
Authors: Wang Lei , Liu Guangjun , Hamam Habib
Published: May 2024

With the expansion of the logistics network, enterprise logistics distribution faces increasing challenges, including high transportation costs, low distribution efficiency, and unstable distribution networks. To address these issues, this study focuses on optimizing enterprise logistics distribution using a double-layer (DL) model. In this paper, we propose a DL model for optimizing enterprise logistics distribution. The DL model is designed to find the optimal solution using the particle swarm optimization (PSO) algorithm. By leveraging location data from the region, the DL model evaluates and compares alternative distribution centers to determine the most efficient distribution strategy. The results demonstrate that the DL site selection model developed in this study effectively addresses the tasks of logistics center location and distribution optimization among alternative distribution centers. Comparison tests reveal that the distribution path proposed by the DL model is more accessible and cost-effective compared to alternative approaches.
A Rapid Point-of-care Fluorescence Imaging Device Helps Prevent Graft Rejection Post Modified Radical Mastectomy
Authors: Mirza Shahzad , Gupta Aayush
Published: May 2024

Pathogenic bacteria in wounds impede successful skin grafting. However, their detection relies on culture methods, which delay confirmation by several days. Real-time fluorescence imaging detects bacteria, allowing for rapid assessment and documentation. We herein report a post modified radical mastectomy, surgical site infection with multidrug-resistant Pseudomonas spp. that underwent repeated antibiotic therapy and debridement and eventually grafting. In this case, a real-time fluorescence imaging device helped prevent graft rejection.
Extrarenal teratoid wilms tumor
Authors: Unny Ashitha K. , Subramanian Balagopal , Srinivasan Arathi , Rabia Seyed
Published: May 2024

Teratoid Wilms tumor (TWT) is a variant of Wilms tumor. 30 cases have been reported so far. The extrarenal TWT variant has only been 5 in number. We are reporting a case of retroperitoneal TWT in a 6-year-old female child with diagnostic and therapeutic challenges.
To Compare Short-term Surgical Outcome among Patients given Continuous Postoperative Antibiotic Prophylaxis and those given no Postoperative Antibiotics after Urethroplasty for Hypospadias
Authors: Manchanda Vivek , Sengar Mamta , Kumar Parveen
Published: May 2024

Introduction:

There is no well-accepted guideline or uniform practice for the usage of prophylactic antibiotics along with urethroplasty for hypospadias. As antibiotic resistance is growing, it is imperative to rationalize the usage of antibiotics when a patient is operated for hypospadias.

Aims and Objectives:

The study is aimed at finding if there is any difference in outcome if prophylactic antibiotics are given after urethroplasty for hypospadias.

Study Design:

Prospective randomized controlled study.

Material and Methods: Forty patients between 6 months and 12 years of age were included in the pilot study. All patients received a single preoperative antibiotic and surgery as per the discretion of the operating surgeon. The participants were randomly assigned to Group A or B, Group A not receiving any prophylactic antibiotic after surgery, and Group B receiving prophylactic antibiotics till indwelling urethral catheter was in situ as per the present antibiotic policy of the institute. The patients were followed up clinically at catheter removal, 1 week after surgery and 1 month after surgery. Urine was analyzed at the start of surgery and after catheter removal. Data were tabulated and analyzed using nonparametric Fischer's exact test with help of Epi Info™ v5.5.8.

Results:

Twenty-four patients were included in Group A and 16 in Group B. The clinical profile is presented in the detailed manuscript. Although pus cells could be demonstrated on urine examination in 82.5% of the study participants, only 10% grew organisms on culture media. No difference could be demonstrated among the two groups statistically. On following up with the patients for 1 month, the groups were comparable with respect to surgical site infections, and surgical complications such as urethrocutaneous fistula/dehiscence and thin stream.

Discussion:

There was a wide variability among practicing pediatric urologists in prescribing antibiotic prophylaxis for patients undergoing urethroplasty for hypospadias. In the Urologic Surgery Antimicrobial Prophylaxis Policy by the American Urology Association, no recommendation has been made with respect to urethroplasty. Our results are in concurrence with the available English literature which has not shown any benefit of prophylactic antibiotics after hypospadias repair.

Conclusions:

Antibiotics may not have a definite role in the prevention of surgical complications and it may be imperative to avoid unnecessary antibiotics to reduce antibiotic resistance.
A Case Report of Video-assisted Thoracoscopic Pericardiectomy for Postpericardiotomy Recurrent Loculated Pericardial Effusion
Authors: Chang Hao-Wen , Tsai Chen-Liang
Published: May 2024

Surgical drainage, particularly pericardiotomy, which has a low recurrence rate, can safely and efficiently treat symptomatic pericardial effusion in patients with cancer. A thoracoscopic video-assisted pericardiectomy is an effective treatment option for rare instances of recurrent localized pericardial effusion. A 63-year-old male presented with a rare form of recurrent pericardial effusion that was initially circumferential, but recurred in a loculated form. On the right side, a loculated pericardial effusion caused right ventricular dysfunction and lower leg edema. The patient’s clinical symptoms, especially severe pedal edema, improved significantly after video-assisted thoracoscopic surgery with pericardiectomy through the right chest wall. Infrequent instances of recurrent loculated pericardial effusion after pericardiotomy may manifest with atypical symptoms. In addition to echocardiography, chest computed tomography can be used to examine in great detail local lesions caused by postoperative pericardial adhesions or scarring. Video-assisted thoracic surgery improves visualization and effectively treats loculated pericardial effusion during pericardiectomy.
Empathy Assessment among Medical Doctors Working at the University College Hospital Ibadan, Nigeria
Authors: Obimakinde Abimbola Margaret , Iyoke Uyiose Odebambe , Ibiyo Morohunmubo Jesusemenaga , Emmanuel Oluwatosin Ann , Odefemi Ogooluwatan Faithful , Abiodun Adejumoke Hephzibah
Published: May 2024

Background:

Empathy is the competence of a physician to understand the patient's situation, perspective and feelings and to act on that understanding in a helpful therapeutic way. Empathy is the backbone of patient-physician communication in clinical care, it can be innate, learnt or acquired in the course of the medical career. This study, evaluated empathy and its correlates among medical doctors working in the University College Hospital, Ibadan, Nigeria.

Methods:

This was a cross-sectional study of 188 interns, resident and specialist doctors working at the University Hospital College, Ibadan in March-May 2018. Consecutive consenting doctors were given a self-administered questionnaire that collected information on sociodemography, work and empathy using the 20-items Jefferson Scale of Physician Empathy. Data were analyzed using the SPSS version 23 and statistical significance was set at P < 0.05.

Results:

The majority of the respondents were male (60.1%), between 30 and 39 years (60.6%) old, married (60.6%) and Christians (91.5%). Many worked in the Internal Medicine Department (38.3%), were Senior-Resident doctors (41.0%) and of Yoruba (82.4%) ethnicity. Senior-Residents doctors ([120.2 ± 15.4]; P = 0.009) and Consultants ([117.8 ± 21.4]; P = 0.009) had highest empathy scores. Doctors who are raised in lower social status families, lacked ability in taking patient's perspective ([56.2 ± 12.2]; P = 0.046). Doctors in surgical-related specialities had lower empathy scores, those in medical-related specialities, especially Psychiatrists (127.1 ± 10.1) and Family Physicians (125.8 ± 7.9) had the highest scores (P = 0.034). Doctors who had never learnt about empathy had the lowest score in perspective-taking ([50.5 ± 30.4]; P = 0.041). Duration of practice and work-hours respectively correlated positively ([rs = 0.174]; P = 0.018) and negatively ([rs = −0.206]; P = 0.005) with empathy scores.

Conclusions:

Medical doctors possessed varying levels of empathy relative to their sociodemographic characteristics, the speciality of choice and level of expertise. Exposure to teachings on empathy and work-related challenges underscores empathic skills.
The Frequency of Persistent Symptoms after Acute COVID-19 among Iraqi Patients
Authors: Amen Shwan O. , Rasool Banan Q. , Yousif Salah H. , Shakir Sara S. , Shekho Bnar S.
Published: May 2024

Background:

Post–coronavirus disease 2019 (COVID-19) symptoms tend to persist in many survivors of COVID-19.

Objectives:

To find out the prevalence of persistent symptoms that continue to appear after the eradication of the COVID-19 infection among Iraqi survivors. We hypothesized that wearing a mask during the COVID-19 pandemic may lead to a lesser viral load in an individual who gets infected, thereby leading to milder symptoms and manifestations.

Materials and Methods:

Overall, 70 consecutive Iraqi patients diagnosed with COVID-19 during the period from early August to late September 2020 were enrolled in the study, and on a mean of 31 days after recovery, they were assessed for persistent symptoms after the acute COVID-19 infection.

Results:

The mean age ± SD was 40.5 ± 16.1 years old. On a mean of 31 days post-COVID-19 recovery, 91.4% of all the patients had at least one persistent symptom. The most common persistent symptoms recorded were fatigue (42.9%), dyspnea (32.8%), and chest pain (25.7%). There was a statistically significant difference (P = 0.002) among patients with hypertension, among whom 45.5% had persistent palpitation. Among patients with ischemic heart disease, 25% had constant chest pain, and 37.5% complained of palpitation post-recovery. Patients who had used masks before infection (85.4%) were managed at home, and they did not require hospitalization. Overall, 45.7% of those dyspneic during the infection period were still complaining of exertional dyspnea post-recovery (P = 0.041).

Conclusion:

A large proportion of the Iraqi patients with COVID-19 infection had persistent symptoms after recovery. The use of a mask before infection showed mild symptoms during the acute phase, and hospitalization or oxygen therapy was not indicated for them.
Usage of corticosteroids as therapeutic agents in diseases
Authors: Al-Mosawi Reyadh H , Alebadi Noor Alhuda Mohammed
Published: May 2024

Corticosteroids are class of human-made or synthetic drugs used in almost every medical specialty. They lower inflammation in the body by reducing the production of certain chemicals. At higher doses, corticosteroids also reduce immune system activity. Corticosteroids are commonly prescribed for a variety of indications due to the wide range of effects on the human body. Although they exhibit many therapeutic uses, corticosteroids are, unfortunately, known for their many dose—and duration—dependent toxicities. The purpose of this review is to explore indications for corticosteroid use, mechanism of action, review the toxicity of corticosteroids, and adverse effects and their management.
Ensuring Quality Assurance of the Faculty Development Programs in Medical Education Using the Kirkpatrick Model of Evaluation
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: May 2024

Faculty development programs (FDPs) occupy an important role in the effective delivery of the medical curriculum to the medical students. Owing to the specific recommendation by the regulatory body, all the medical colleges are conducting a specific number of mandatory FDPs. However, like any other program, the mere organization of any FDP does not serve the purpose, unless the quality assurance of such programs is ensured and the outcomes of the same are evaluated as a follow-up activity. The quality assurance of the FDP can be assessed via either the internal or external quality assurance methods. In conclusion, the FDPs play a crucial role in improving the competence level of the faculty members. However, in order to ensure that we accomplish the set targets, it is extremely essential to maintain the quality of the organized FDPs and follow it up in the subsequent period.
Pulmonary Spirometry in Type 2 Diabetics in Baghdad Teaching Hospital
Authors: Abbood Muhanad Hadi , Hassan Jabbar Sirhan , Mehammed Aqeel Jassim
Published: May 2024

Background:

Diabetes mellitus is a serious progressive condition associated with multisystemic involvement with a number of chronic complications due to macrovascular and microvascular damage. Pulmonary involvement is not studied extensively and is not explained by factors that influence lung function.

Objective:

The aim of this article is to study the effects of type 2 diabetes on lung function and delineate the association between lung function impairment and duration of the disease.

Materials and Methods:

This cross-sectional study was conducted in Baghdad Teaching Hospital. Ninety-one (91) type 2 diabetics with 56 control subjects were included in this study between March 2020 and June 2021. Both groups are matched by age, sex, height, and weight and are met with exclusion criteria. Spirometry was done on an electronic spirometer (videography U.K. 1982) for both groups with the following parameters: forced vital capacity (FVC), force expiratory volume in 1 s (FEV1), FEV1/FVC, and peak expiratory flow rate (PEFR). Statistical methods compared the results.

Results:

Type 2 diabetic patients show a significant reduction in FVC, FEV1, and PEFR relative to their matched controls (P < 0.05). However, there was no significant change in the FEV1/FVC ratio between the groups, meaning a restrictive pattern in diabetic patients.

Conclusion:

This study showed that type 2 diabetics had impaired lung function as evidenced by reduced FVC, FEV1, and PEFR as part of chronic complications of diabetes and showed a progressive decline in parameter with increased duration of the disease.
Eustachian Tube Dysfunctions due to Mask Among Quarantined Healthcare Professionals During COVID-19 Pandemic
Authors: Singh Abhishek , Nandini Harsh , Phulsunga Rohit Kumar , Gupta Vikas , Naik Sulabha M , Goel Pawan Kumar
Published: May 2024

Background:

Hand hygiene and personal protective equipment (PPE) are the key factors to prevent COVID-19 disease among healthcare workers. The documented side effects of continuous use of mask or PPE are dermatitis, but its effects on eustachian tube seems to be neglected.

Objectives:

So, we conducted this study by keeping our main objective as to investigate the eustachian tube dysfunctions (ETDs) due to continuous use of mask among healthcare professionals (HCPs) in district Nuh, Haryana.

Materials and Methods:

This cross-sectional study was conducted among 217 eligible HCPs. The sample size was calculated as 97 considering unknown prevalence of ETDs among HCPs (50%), so all HCPs were included in the study. We developed a structured questionnaire in which responses were close-ended and it attempted to capture the responses of the study participants and an association between variables was considered significant if the P-value was <0.05.

Results:

Out of the 217 subjects, only 207 subjects provided their written consent after understanding the study objectives and 206 were included in the analysis as one subject has pre-existing ear disease. The daily hours of mask usage among 52.4% of participants was between 4 and 8 h; 2.6% of doctors experienced severe pain and pressure in the ear. The Eustachian Tube Dysfunction Patient Questionnaire-7 (ETDQ-7) score was significantly higher among females and mask usage of four or more hours (P < 0.05).

Conclusion:

The present study revealed that 42.3% of the participants had ETDs. The results will facilitate hospital-level administration to provide practical recommendations to medical workers such as head-supported mask instead of ear-supported masks and use of ear protectors.
Bacteriological Profile and Antibiotics used for Septic Patients in Karbala, Iraq
Authors: Hameed Rana Majeed , Alafloogee Jabbar F. M. , Ma'an Ghalib K.
Published: May 2024

Background:

Sepsis is an issue of globular health care, characterized by complete inflammation of the body in response to microbial infection, which results in organ malfunction. This becomes a chronic patient complication. Therefore, sepsis may be a diverse and combined disease with varying etiology, severity, and treatment plan.

Objectives:

The purpose of this study was to demonstrate the existence of exposure and the resistance of microorganisms to the range of antibiotics in subjects of the local community.

Results:

Among 11 species of bacteria isolated from a variety of specimens, Escherichia coli (22.1%) and Staphylococcus aureus (20.3%) were the most common organism found over the subjects had been collected. The most sensitive antibiotics for Gram-negative E. coli were colistin 97%, imipenem 89%, meropenem 88%, and amikacin 79%, while the highest resistant rate was benzylpenicillin 93%, and oxacillin 86%. Methicillin-resistant S. aureus (MRSA) prevalence was 90%, vancomycin-resistant S. aureus (VRSA) 31%.

Conclusion:

Because of the high incidence of VRSA and MRSA, clinicians should become more vigilant in using vancomycin and another important antibiotic. Moreover, maintain this useful drug to be used for a prolonged time with good efficacy.
Simplifying the Creation of the Ulnar Basilic Arteriovenous Fistula: The Royal Wave Position – A Case Series
Authors: Vishwanath Guruswamy , Patil Bhushan R. , Sankhe Manashree , Modi Ankur D.
Published: May 2024

ABSTRACT

While the radio-cephalic arterio-venous fistula (RCAVF) remains the procedure of choice for hemodialysis, the value of the ulnar-basilic arterio-venous fistula (UBAVF) is perhaps underappreciated. The challenge of placing the forearm in a suitable and comfortable position for both the surgeon and the patient during the creation of the UBAVF may be an important factor inhibiting its use. We present a new method of hand positioning in the creation of the UBAVF that we have termed the “Royal Wave” position, which facilitates both patient comfort and surgical access intraoperatively. Patients suffering from chronic kidney disease stage -V were operated upon for the creation of UBAVF following the standardized protocol in the Royal Wave position. Patency (by Color Doppler) was recorded before discharge. Patients were clinically followed up for a period of 3 months. A total of five patients (four males) with the age range of 43–66 years were studied. The position was found to be comfortable for patients and suitable for surgeons. All five patients had successful creation of fistulas that remained patent, which was documented by Doppler report prior to discharge. The patients were followed up till 3 months post fistula creation. Thrombosis was not seen in any patient, and the basilic veins arterialized and were used for dialysis in all five patients. This innovation in positioning, the “Royal Wave” position improves the comfort of both the operator and the patient during surgery, and merits consideration when creating a UBAVF.