bluuebunny/crossref_metadata_2025 huggingface dataset:
PRODUKSI TANAMAN KARET (Hevea brasiliensis) PADA WAKTU PENGUMPULAN LATEKS YANG BERBEDA
Authors: Andriyanto Mochlisin , Andi Wijaya  , Junaidi  , Arief Rachmawan
Published: June 2023

Latex is a colloidal suspended of rubber particle in rubber tree (Hevea brasiliensis). Technically, the capacity of rubber productivity can be determined by latex collectionperiod after being tapped. The objective of research was to obtain the differences of latex collection period. The study was conducted in September-November 2017 at the Sungei Putih Research Center in Experimental Estate with PB 260 (7 years tapped) on BO-2 (S/2 d3.ET2.5% Ga1.0 6/y(m)).The experimental designused a Randomized Block Design (RBD) with four treatments of latex collection periodi.e 20, 40, 60, 80 minutes after being tapped with three replicates respectively. The parameters observed was gram/tree/tapping (g/p/s), kg/ha/years, latex flow rate (ml/minutes) and total solid content (%).The results showed that latex collection period was significantly different to g/p/s, kg/ha/years and latex flow rate. Total solid content (TSC) was not significantlydifferent in all treatments. The latex collection period of 20 minutes after being tapped had higher productivity than 40, 60, 80 minutes.
Boekbesprekings: HB Klopper: The Law of Third Party Compensation
Authors: Joubert Yvette
Published: June 2023

None
Boekbesprekings: E de Stadler, IL Hattingh, P Esselaar and J Boast (eds): Over-thinking the Protection of Personal Information Act
Authors: Ismail Nazreen
Published: June 2023

None
Pengesahan Instrumen Pengurusan Risiko Aktiviti Kokurikulum di Institut Pendidikan Guru Malaysia: Model Pengukuran Rasch
Authors: Badin Pairins , Hamid Hashima
Published: June 2023

Instrumen pengurusan risiko aktiviti kokurikulum (PRAKO) telah dibangunkan untuk mengukur pengurusan aktiviti kokurikulum yang dilaksanakan oleh tenaga pengajar di Institut Pendidikan Guru Malaysia (IPGM). Kajian ini adalah untuk mengesahkan instrumen PRAKO dengan model pengukuran Rasch (Winsteps). Instrumen PRAKO mengandungi 58 item yang menggunakan skala Likert lima mata dengan tiga pecahan konstruk. Tiga pecahan konstruk itu ialah manusia, peralatan dan persekitaran yang terhasil daripada penggunaan prinsip asas pengurusan risiko, iaitu pengenalpastian, penilaian, pemilihan operasi dan pelaksanaan. Sampel kajian yang diperoleh melalui pensampelan rawak mudah terdiri daripada 107 tenaga pengajar yang berpengalaman melebihi 20 tahun dalam bidang kokurikulum dari 27 kampus. Analisis kesahan menunjukkan PTMEA-Corr bagi kesemua 58 item berada pada nilai positif >0.00(+), semua item dikekalkan kerana menepati kehendak nilai outfit MNSQ, outfit ZSTD dan PTMEA-Corr. bagi kesesuaian item. Konstruk manusia mempunyai peratus RV explained by measures (53.2%) dengan nilai unexplained variance dalam kontras pertama (8.8%), konstruk peralatan (55.4%, 9.4%), dan konstruk persekitaran (42.2%, 8.7%) adalah baik, memiliki keekadimensian yang kuat dan kesahan konstruk yang tinggi bagi analisis komponen utama. Kesahan dan kebolehpercayaan PRAKO diakui oleh nilai alfa Cronbach (KR-20) sangat tinggi iaitu 0.96. Kebolehpercayaan item (0.94) dan responden (0.89). Nilai pengasingan item (4.07) dan responden(2.89). Jelaslah bahawa, PRAKO dapat mengukur pengurusan risiko aktiviti kokurikulum dalam kalangan tenaga pengajar kokurikulum di IPGM.
Distribution of Serum 25-Hydroxyvitamin D Levels in Hypertensive Heart Disease Patients with Atrial Fibrillation in a Secondary Medical Facility in Edo State, Nigeria
Authors: Atoe Kenneth , Ekiye Ayinboumwan
Published: June 2023

Vitamin D deficiency has been implicated in the pathogenesis of hypertension and other cardiovascular diseases which are common risk factors for atrial fibrillation (AF). It also exhibits anti-inflammatory and antioxidant properties. This study aimed to estimate the level of vitamin D in hypertensive heart disease patients who had atrial fibrillation.
FORMULATION AND IN-VITRO CHARACTERIZATION OF MUCOADHESIVE PATCHES OF ROOT EXTRACT OF ADENIUM OBESUM
Authors: Pal Poonam , Pratap Shourya , Singh Shalini
Published: June 2023

Patches are punched from a sheet that serves as the intermediate product. Oral mucosal medication delivery alternatives to tablets have been studied, including polymers like cellulose etc. can be used to create mucosal patches. The present research was based on the development and in-vitro characterization of mucoadhesive patches of root extract of Adenium obesum utilizing different polymers. Adenium obesum (fresh roots) was obtained from the Unnao region. Eudragit L-100, Propylene glycol, Tween 80, Methanol, Ethanol and HPMCK 4M & HPMCK 15M were purchased from the local market. The initial stages of processing involve grinding the roots into a coarse powder. The Soxhlet equipment was used to extract the powder and then weigh it. After preformulation study, the Adenium obesum mucoadhesive patches were created using the solvent casting technique. Patches were evaluated for physical appearances, thickness, pH, % drug content, in-vitro drug release, SEM and stability. In results, an excellent % drug release was demonstrated by the buccal patch. In order to estimate stability profile of mucoadhesive patches, it was evaluated for physical appearance. In conclusion, patches i.e., F2, F3 and F6 exhibited a significant estimation parameters like drug content, % drug release etc. The buccal drug of herbal (A. obesum) mucoadhesive patch has shown improved stability. It will ease to provide the long-lasting action by suppressing the symptoms of insomnia, agitations etc. Therefore, it may be produced commercially after its successful clinical trials.
Public Speaking Anxiety in Oral Communication Among Grade 11 Students of PHINMA-COC
Authors: Lungay Ian Rey E.
Published: June 2023

Public speaking is always an essential skill a person must do especially in school. Grade 11 students struggle to speak most of the time in front of their classmates and teachers. This study determined the level of Public Speaking Anxiety in Oral Communication among Grade 11 students in Cagayan de Oro College during the SY 2022-2023. This study specifically sought to determine the following:1) the respondents’ characteristics, 2) the respondents level of Public Speaking Anxiety in Oral Communication, and 3) the significant difference in the respondents’ Public Speaking Anxiety in Oral Communication when grouped according to their characteristics. This study made use of a descriptive research design. The questionnaire used was adopted from Subatira (2022), originally from McKroskey (1970). The respondents were the nine hundred thirty-one (931) Grade 11 Students of PHINMA-Cagayan de Oro College, School Year 2022-2023 who took Oral Communication in the Context subject. The statistical tool used were frequency, percentage, mean and standard deviation for Problems 1 and 2, and ANOVA for Problem 3. The study found that there were a majority of the respondents who have a positive attitude towards Public Speaking, but most of the respondents have a high level of Public Speaking Anxiety in terms of Motivation, Self-esteem, Audience and Situation in Oral Communication. Further, there is no significant difference in the respondents’ Public Speaking Anxiety in Oral Communication and respondents’ characteristics according to Sex, Family Monthly Income, and Organizational Affiliation. On the other hand, there is a significant difference in the respondents’ Public Speaking Anxiety in Oral Communication and respondents’ characteristics according to Academic Strand and Attitude towards Public Speaking. It concluded that respondents have a high level of Public Speaking Anxiety. Thus, the Grade 11 students need to be motivated, to have high self-esteem so that they will not be distracted by a large audience, and need to have a positive environment in order for them not to experience anxiety or fear in public speaking.
A Critical Legal Analysis of Child Labor in Bangladesh with Special Recommendation of ILO, UNICEF and UNESCO
Authors: Hossain Farzana
Published: June 2023

A significant proportion of child laborers are compelled to work in exploitative environments, and experience both deteriorating health and financial loss. The present study sought to determine the factors affecting child labor and the characteristics of their working environment. A questionnaire survey was conducted with 80 child laborers aged 5 to 17 years. Alongside descriptive statistics, a newly devised technique known as the Influencing Causes Index (ICI) was administered and tested. The demographic findings reveal that most child laborers are young children (12–14 years) and 32.5% of child laborers have never attended school. The thorough assessment of determinants reflects that not only poverty but schooling expenses and a lack of access to opportunities in primary schools are also the top-ranked push factors to trigger children towards labor. Around 72.5% of children work for over 8 hours a day. A significant proportion of participants received no leave, training, or access to hygiene facilities. The existing pattern of employment and working conditions resulted in musculoskeletal pain and dermatological infections among child laborers. This research suggests that income measures for households and an education program for both children and parents would expedite the abolition of child labor.
A Comparison of the Mahila Samman Savings Certificate with Other Small Savings Schemes for the Empowerment of Women in India
Authors: V. A. Namreen Asif , Aithal P. S. , Panakaje Niyaz
Published: June 2023

Background/purpose: Despite this, women are having high exposure and they are working in all fields like defense, engineering, medicine, etc. In order to make all women in the nation attain a standard Women Empowerment is needed. Women Empowerment focuses on empowering each and every woman in the country to make them independent in all aspects of society, to be aware of their rights, and to make them equipped with physical security.
Objective: This paper focuses, Mahila Samman Savings Certificate, A New Modest Savings Scheme for Women in India, programs available to women and girls in India, as well as women who are gaining benefits from various government programs that have been implemented with government aid, are the main topics of this article.
Design/Methodology/Approach: Numerous programs for women are funded by the central government and are sponsored by the Indian government. A research study has been undertaken to learn about these plans and make a comparison of these programs. The Ministry of Finance, the Ministry of Women and Child Development, Google, Google Scholar, new papers, journals, theses, and other websites were some of the sources used to compile the secondary data for this research study.
Findings: This article focuses on the different schemes and factors that have made women's empowerment possible. The Mahila Samman Small Savings Yojana Program and other women-specific small savings initiatives are the primary subjects of this study. The Mahila Samman Savings Certificate Program is a modest savings program supported purely by the government for women and girls. Therefore, it has no credit risk and, pays the highest rate of interest when compared to other programs. Small Savings Scheme, for example, pays the highest rate of interest when compared to fixed-rate deposits (FDs) offered by public banks in various states, while Sukhnya Samridi Yojana has a shorter tenure of just two years.
Originality/Value: This paper focuses on the different schemes and purposes that have made women's empowerment possible. The Mahila Samman Small Savings Yojana Program and other women-specific small savings initiatives are the primary subjects of this study.
Paper Type: Research Paper
Factors Affecting Entrepreneurial Success: Evidence from the Micro-hydro Sector in Nepal
Authors: Yadav Maheshwar Prasad , Aithal P. S.
Published: June 2023

Purpose: To investigate factors affecting business success in Nepal’s micro-hydro sector.
Design/methodology/approach: The causal-comparative research design was adopted. It is based on primary data. The necessary data were collected using a structured questionnaire from 40 micro-hydro construction companies having 99 respondents. The data have been analyzed by estimating econometric models and correlation analysis through SPSS.
Results/findings: The paper concludes the company’s success is positively impacted by financial resources for expansion, network ties, trust, and years of schooling with a higher impact. On the other side, determinants like initial investment, shared vision, and experience have a lower impact on the company’s accomplishment.
Originality/value: No such study uses recent data related to Nepal’s micro-hydro sector is accessible. The paper, therefore, is valuable for private companies, development actors, and policymakers to create an enabling environment for the company’s accomplishment. This work may potentially be useful to academia for future studies.
Future Avenue: The expansion of this study may be achieved by investigating ways to motivate current employees and policy preparation friendly to acquire finance for the company’s expansion instead of its establishment.
Paper type: Empirical research
Filosofía y novelas
Authors: Lazo Briones Pablo
Published: June 2023

¿Qué sentidos abren las novelas como narraciones filosóficas? Esta pregunta con la que iniciamos el liminar de nuestro dosier Filosofía y novelas supone un abordaje de interpretación, a la vez combativo y constructor, de los artículos que lo componen. Combativo porque se enfrenta a una lectura dogmática de lo que debían ser la filosofía y la literatura como géneros enfrentados y excluyentes, o si acaso como discursos en donde la relación es de dependencia y subordinación: la filosofía como ejercicio fuerte, racional y sistemático de la razón que subordina el mero ejercicio imaginativo, débil y asistemático de la literatura. A su vez, un abordaje constructor porque, al demostrar en casos específicos de novelas que esta separación artificiosa de géneros discursivos puede derrumbarse, genera ligas de sentido que podemos llamar la narración filosófica de las novelas.
Reason After its Eclipse. On Late Critical Theory, Martin Jay
Authors: Sánchez Felix Karla
Published: June 2023

A pesar de que Max Horkheimer en Eclipse de la razón había analizado los límites de la razón subjetiva, atendien- do a las posibilidades de retornar a la razón objetiva y a su función después del eclipse, a Jay le parecían aún insuficientes estas respuestas. Por ello, regresó al estudio de las conceptualizaciones filosóficas de los fundadores de la teoría crítica y de quienes se quedaron a cargo del Instituto de Investigación Social en Frankfurt. En este sentido, este texto podría verse en continuidad y a distancia respecto a su primer li- bro: Dialectical Imagination. A History of the Frankfurt School and the Institute of Social Research, 1923-1950 (1973); producto de su trabajo de doctorado, enfocado en la formación del Instituto de Investigación Social; en sus principales integrantes: Herbert Marcuse, Max Horkheimer, Theodor Adorno, Leo Löwenthal, Walter Benjamin,Franz Neumann, Otto Kirchheimer, Henryk Grossmann, Erich Fromm, Karl August Wittfogel; en la integra- ción del psicoanálisis; en su exilio a América; en los estudios empíricos sobre el autoritarismo, la estética y la industria cultural.
El paisaje natural y los jardines en la vida de las ciudades
Authors: Mansur Garda Juan Carlos
Published: June 2023

El presente artículo es una reflexión sobre los paisajes naturales y los jardines como paisajes construidos, a fin de hacer comprensible su importancia en las ciudades, así como la necesidad de reincorporarlos a la vida citadina y al diseño urbano. Para ello, me he centrado en las consideraciones filosóficas de Simmel y Watsuji sobre el tema, con el propósito de mostrar que el encuentro poéti- co entre la naturaleza y su contemplador no sólo permite reconoce el carácter particular o Stimmung del paisaje natural con el cual nos vinculamos, sino que, al habitar poéticamente con la naturaleza, se manifiesta nuestro Kimochi, éste revela nuestro vínculo existencial e histórico con el clima y los eventos naturales, nos invita a desarrollar un lazo cultural existencial con los demás y con nosotros mismos. De ahí la necesidad de incorporar la naturaleza en las ciudades y apren- der a habitar poéticamente con ella.
Walter Benjamin y la experiencia de la ciudad:
Authors: Sabugal Villamar Anaid
Published: June 2023

Walter Benjamin fue quizás el primer pensador en proponer un análisis de la ciu- dad desde un acercamiento filosófico laberíntico, único en su tipo; buscó exten- der su crítica hacia el empobrecimiento de la experiencia humana, que en su ver- tiente citadina aceleró, a su juicio, esta pauperización. De entre todas las vías de acceso que tenemos para comprender las ideas de Benjamin sobre la experiencia de la ciudad industrial capitalista, creemos que sus examinaciones sobre figuras como la del bohemio y el flâneur nos proporcionan suficientes herramientas para sopesar dicha experiencia y significarla. Sin embargo, consideramos relevante no sólo recuperar esta reflexión, sino añadir dos propuestas más a sus fisonomías, las cuales juzgamos fundamentales para situarnos en el estudio de la experiencia de la ciudad contemporánea.
Rodrigo Escobar-Holguín. Territorio y voluntad comunitaria
Authors: Suárez-Astaiza Andrés
Published: June 2023

Bajo el título Territorio y voluntad comunitaria, la editorial Aula de Hu- manidades, de Bogotá, publicó en 2021 el trabajo de investigación doc- toral de Rodrigo Escobar-Holguín: “El ordenamiento territorial como acto volitivo comunitario. Un enfoque fenomenológico”, sustentado en junio de 2019, como requisito para optar al título de doctor en Filosofía por la Universidad del Valle en Cali, Colombia. La tesis fue dirigida por el profesor Julio César Vargas Bejarano y el jurado evaluador estuvo compuesto por los profesores Ana Patricia No- guera, Javier San Martín y Esteban Marín Ávila.
The Adoption of Solar Photovoltaic Systems in Rural Areas of Brazil
Authors: Malaquias Rodrigo Fernandes , Silva Altieres Frances , Borges Junior Dermeval Martins , Barra Neto André , Albertin Alberto Luiz
Published: June 2023

In this study, we categorize the perceptions regarding the benefits and the barriers of solar photovoltaic (PV) systems in rural areas. We collected the data through a questionnaire, answered by 116 Brazilian farmers. These respondents have farms located in the state of Minas Gerais, which is the Brazilian state with the large installed potency for PV energy. On one hand, the main results indicate that few farmers of the sample already use solar energy at their rural properties; respondents consider environmental issues and cost saving as the main benefits related to solar energy. On the other hand, the majority of the respondents informed that they intend to use PV systems in the future.
A Study on Social Media Influences on Generation Z Buying Behaviour
Authors: Dr. M. Bhuwaneshwari  , Hemasuruthi S
Published: June 2023

Generation Z has emerged as one of the most mystifying consumers as they are tech-savvy, digitally connected and educated users of technologies in the marketplace. Their cognitive power and social media networking have made them the market mavens who possess a wide range of information and consumer knowledge about many dimensions of the markets. To be the leader in the marketplace where so many options are available due to the free trade economy, marketers have to escalate their know how about their customers if they want to capture the attention of this segment of the market. The chief objective of the study is to find the social media influence on generation Z buying behavior, specifically from the angle of social influence and technology. A sample of 150 respondents was approached for a survey using a structured questionnaire. The results of this initial study indicate that Generation Z shoppers are coming up with unprecedented shopping habits and preferences. This research will adopt a quantitative approach and results showed that some of the most classical influential factors such as product features, price consciousness and family recommendations and social media influencers have a significant effect on the buying behavior of this generation Z. However, the results indicate the influence of computer literacy, peer and social influence and social media identity on the purchasing decision of Generation Z. The results of this study can be utilized to assist in predicting potential consumer adoption behavior and in designing favorable shopping environments that are compatible with these specific consumer traits
Unleashing the Potential of Digital Education in Post Covid Era
Authors: Dr. Nidhi Kakkar
Published: June 2023

The Covid-19 pandemic increases many challenges and leads to disruption across the Higher Education sector; university campuses closed, and face-to-face teaching and assessment shifted to andigital or online format. Students have the chance to make judgments in Pandemic that are based on facts, constructively solve challenges, and—most importantly—adapt to circumstances when new abilities are required. Flexibility in our educational institutions must be created if we want to guarantee that these abilities will be fundamental for all pupils. In India, the online education system has also led to a great deal of confusion, making it difficult for students to maintain their normal academic schedules. The majority of universities have taken the initiative to promote communication using Skype calls, the Zoom application, Google Classroom, and other digital and online modalities in order to resolve these issues. It prepares teachers and students to use online learning environments and other forms of technology to facilitate the sharing of knowledge. Digital India vision of the government is emerging as a vital tool for solving the present crisis due to Covid-19. It is a fact that technology-based education is more transparent with all respect. Keeping all these in mind present paper is an attempt to highlight the features of digital education in present scenario
Study on HR Management with Special Reference to Employees in Draup
Authors: Dr. M. Bhuvaneswari  , M. Anbu
Published: June 2023

The study on HR management with special reference to employees aims to explore the various dimensions of HR practices and their impact on employee outcomes within organizations. The objective is to provide insights and recommendations for HR professionals and organizational leaders to enhance HR management strategies and improve employee satisfaction, engagement, and performance. This study utilizes a mixed-method research approach, incorporating both quantitative and qualitative data collection methods. A thorough review of existing literature on HR management serves as the foundation for the study, establishing a theoretical framework and identifying research gaps. The primary data is collected through surveys, interviews, and observations, allowing for a comprehensive understanding of the HR practices implemented and their impact on employees
Students Placement Sign Anticipation System Using Artificial Intelligence
Authors: Nilesh Khedekar  , Dr Priti Shende
Published: June 2023

This paper presents an overview of artificial intelligence algorithms that use neural networks to predict a student's placement and give technical data. All educational institutions have a very crucial duty: the ability to predict a student's success. This will not be chosen only based on a student's academic standing. It is crucial to consider a student's behaviour, including their aptitude, attitude, communication style, technical competence, problem-solving skills, and demonstration-related information, to predict how they will do in the actual demonstration. Since this is the issue with predicting where undergraduate students will be placed, this study may be used to calculate the probability that an undergraduate student will be employed using different AI algorithms
Smart Attendance System using QR Code
Authors: Alure Vishal  , Chavan Jagdish  , Mudhe Akanksha  , Hembade Sonali  , Prof. D. Kulkarni
Published: June 2023

In this era of technology smartphones play a significant role in our day-to-day life. Nowadays smartphones solve most of the problems very quickly and easily. It has made life of every person simple and easier with different social app, commercial app, problem solving apps, app for education and marketing etc. Followed by the technology the paper purposed a system is a couple of two applications, one for generating the QR code by entering the student details and for second application for taking the attendance and generating the attendance in XLS format. The student will need to upload the QR code of the particular student in order to confirm their attendance. The paper discusses how the system verifies student identity to eliminate the false registrations. The system deals with the management and evaluation of attendance of all students. The student QR code will be provided to student through email. The student attendance reports will be generated in XLS sheet for further use.
Swarm Drone System with YOLOv8 Algorithm for Efficient Locust Management in Agricultural Environments
Authors: Abraham Kuriakose  , Raiz Badarudheen  , Lalitaditya Charapanjeri
Published: June 2023

In recent years, the recurring invasions of locusts have emerged as a significant threat to global agriculture, jeopardizing both crop yields and vast uncultivated lands. To address this pressing issue, this research paper introduces an innovative approach that leverages artificial intelligence (AI) for real-time locust management. Extensive investigations into locust behavior, life cycles, and existing management techniques have informed the development of a novel swarm drone system capable of detecting and eliminating locusts in farms using object detection and targeted pesticide spraying. The core technology employed in the system is the YOLOv8 algorithm, a convolutional neural network model renowned for its robustness in object recognition. The coordinated actions of the swarm drones are facilitated by the ArduPilot system, enabling efficient collaboration and synchronized locust eradication efforts. By harnessing AI for locust detection and eradication, the proposed system demonstrates the potential to significantly enhance efficiency and accuracy, thereby mitigating crop damage and elevating agricultural yields. This research paper sheds light on a promising solution that amalgamates AI, drones, and object detection to tackle the critical issue of locust management, fostering sustainable agricultural practices in the face of mounting challenges
Epidemiology, Management, and Outcome of Atypical Hemolytic Uremic Syndrome in an Omani Cohort
Authors: Al Riyami Dawood , Mohammed Saja , Al Salmi Issa , Metry AbdelMasiah , Al Kalbani Naifain , Almurshadi Fathyia , Al Rasbi Samira , Al Ismaili Faisal , Hola Alan , Hannawi Suad
Published: June 2023

Objectives: Atypical hemolytic uremic syndrome (aHUS) is a rare, life-threatening disease of chronic uncontrolled complement pathway activation that leads to thrombotic-microangiopathy, along with severe organ damage, including end-stage kidney disease. This study aimed to evaluate the epidemiology, management, and outcome of aHUS in an Omani population. Methods: This retrospective descriptive cohort study assessed all cases of aHUS diagnosed and followed up at two tertiary care centers in Oman from January 2008 to December 2019, based on clinical features, complement pathway assays, histopathological, and genetic testing. Results: The study accrued 19 patients who fulfilled the inclusion criteria, of whom 11 (57.9%) were male. The participants’ median age was 25.0 years (range = 0.1–69.0). Most (15; 78.9%) patients presented in the acute phase of the disease. The triad of hemolytic anemia, acute kidney injury, and thrombocytopenia was present in all patients. A trigger factor (e.g., infection) was identified in 68.4% of cases. Of the 14 (73.7%) patients who underwent kidney biopsy, 10 (71.4%) were found to have aHUS in native kidneys and three in grafted kidneys. Of the 11 (57.9%) patients who underwent genetic analysis, five (45.5%) were found to have a known pathogenic variant in their aHUS susceptibility genes. Plasma exchange followed by eculizumab was the treatment method in 11 (57.9%) cases. Complete renal recovery was achieved in seven (36.8%) patients, while four (21.1%) passed away during the study period. Conclusions: The wide spectrum and multiple expressions of aHUS make it a challenge to diagnose and consequently may delay the commencement of the targeted treatment. Eculizumab is considered the first-line therapy and should be commenced as early as possible.
Clinico-laboratory Profile and Outcomes of Megaloblastic Anemia presenting as Severe Pyrexial Illness mimicking Tropical Infection
Authors: Behera Vineet , Kumar Rajiv , Agrawal Chaturbhuj , Kapoor Rajan , Kaur Navjyot , Nair Velu
Published: June 2023

Background: Anemia-causing fever has been described in patients with megaloblastic anemia. Although the exact mechanism of this is unknown, high-grade fever is relatively less reported. Materials and methods: This prospective observational study included all new cases of megaloblastic anemia presenting with febrile illness (>101°F) during a 3-year period. Patients with existing anemia, comorbidities, and other causes of macrocytosis were excluded. A detailed evaluation for megaloblastic anemia and workup for excluding tropical infections was done. The patients were treated with parenteral vitamin B12, folic acid, and other hematinics. Results: Around 24 cases of megaloblastic anemia presenting with high-grade fever were included, with 14 (58.3%) males, mean duration of fever 7.7 days (4–18 days), and 09 (37.5%) having temperature >103°F. The mean hemoglobin (Hb) was 8.15 g/dL (3.7–11.1 g/dL), the mean corpuscular volume (MCV) was 111 ± 7.8 fL, 18 (75%) had unconjugated hyperbilirubinemia, the mean lactate dehydrogenase (LDH) was 814 ± 24 IU/L, and 21 (87.5%) had low B12 or folate levels. Most showed good therapeutic response to B12 or folic acid with defervescence in 1–5 days (mean 2.6 days) and improvement in lab parameters in 1 week. The study population was divided into those with temperature ≥103°F, and temperature <103°F it was seen that there was a significant association (p < 0.05) with leucocyte count of ≤3000/cumm, and MCV ≥110 fL, in patients with temperature ≥103°F. Conclusion: Megaloblastic anemia should be considered in the differentials of a patient presenting with a febrile illness with no clinical localization and a negative initial fever workup. Early identification and prompt therapy of this easily treatable disorder are very essential.
Clinical Profile and Outcome of Snake Bite Patients from Tertiary Healthcare Center: In Sub-Himalayan Region: A Medical College-based Study
Authors: Negi Ram Chander , Machhan Prem , Raj Monika , Barwal Vijay Kumar , Chander Subhash , Thakur Suman , Mokta Jatinder
Published: June 2023

Objective: Snake bite is an emergency in tropical and subtropical countries. It is a neglected disease and is most commonly seen in rural setups, where people are ignorant about the venomous snake bites. It results in increased mortality and morbidity because precious time is wasted, either in consulting traditional healers or waiting for the development of signs and symptoms of envenomation. Then only the patient is shifted to a health center. Here we studied the clinical profile, management, and outcome of snake bite patients. Materials and methods: This study was done by retrieving the records of patients with snake bites admitted to the Department of Medicine, Indira Gandhi Medical College & Hospital, Shimla, from 1st January 2017 through December 2019. The recorded data was entered in a precoded performa, and analysis was done with respect to various variables. Result: We evaluated the records of 190 patients. The incidence of the bite was higher among females, 62.1% (n = 118). The commonest age group involved was 21–50 years, 70.1% (n = 34). In 55.8% (n = 106), the site of the bite was the upper limb. The daytime bite was present in 54.7% (n = 106). The maximum incidence of snake bites was found during the rainy season, 81.5% (n = 155). 28.4% (n = 54) of patients presented within 6 hours of the bite. Coagulopathy [whole blood clotting test (WBCT) of >20 minutes] and neurotoxicity were seen in 77.9 and 7.9% of patients, respectively. Anti-snake venom (ASV) was given to 87.8% (n = 167) of patients. In 80% (n = 152) of the cases, hospital stay was up to 3 days. Mortality was seen in only two (1.05%) cases. Conclusion: There is a need to create awareness among the community, particularly in rural areas, about snake bite envenomation and early transportation of victims to the nearest health center. Training of health professionals is also needed to manage cases of snake bites efficiently and judiciously, thereby reducing morbidity and morbidity.
Coagulation Abnormalities in Severe Scrub Typhus and Their Association with Complications
Authors: Singla Deepti , Singh Balraj , Ahire Komal , Mahajan Sanjay K
Published: June 2023

Aim: To describe coagulation abnormalities and their association with complications in patients with severe scrub typhus. Materials and methods: A cohort study was conducted among all patients of severe scrub typhus [immunoglobulin M (IgM) positive] who reported to this facility from 1st August 2019 to 31st July 2020 and met our inclusion criteria. We estimated the incidence of severe thrombocytopenia (<50,000/µL) and overt disseminated intravascular coagulation (DIC) (DIC score of ≥5). We determined the association [risk (RR) ratios] of these abnormalities with complications of scrub typhus, namely—septic shock, multiple organ dysfunction syndrome (MODS), and septic shock with MODS. Results: In total, 71 patients were studied with a mean age of 50 ± 15.5 years, of which 45 (63.4%) were females. On presentation, fever 70 (98.5%), myalgias 22 (31.0%), loose stools 13(18.3%), cough, vomiting, headache 11 (15.5%), altered sensorium 10(14.1%), and pain abdomen 9 (12.7%) were main symptoms. On examination, hypotension 31 (43.7%), eschar 25 (35.2%), icterus 17 (23.9%), and rash 16 (22.5%) were noted. The d-dimer (>0.5 µg/mL) levels were increased in all (100%) patients. Thrombocytopenia (91.5%) was the commonest hematological abnormality and 31 (43.6%) of them had severe thrombocytopenia, 25 (35.2%) patients had low fibrinogen levels (<200 mg/dL) and prothrombin time (PT >16.7 seconds) was prolonged in 20 (28.1%). A total of 42 (59.1%) patients developed MODS, 33 (46.4%) developed septic shock, 24 (33.8 %) had MODS with septic shock, 17 (23.9%) developed overt DIC, and eight (11.2%) died. Severe thrombocytopenia (p = −0.028) and overt DIC (p = 0.045) were significantly associated with septic shock development. Conclusion: In the patients admitted with severe scrub typhus; thrombocytopenia was the commonest hematological abnormality. The development of septic shock was significantly associated with severe thrombocytopenia and overt DIC.
To Study the Effectiveness of Inhalation Technique Training in Patients with COPD and Asthma
Authors: Meena Manoj , Arora Piyush , Goud M Srikanth , Kumar Lokender
Published: June 2023

Introduction: Asthma and chronic obstructive pulmonary disease (COPD) are characterized by chronic airway inflammation. Lack of knowledge about the correct inhalation techniques leads to poor control of both diseases. This study aimed to study the effectiveness of inhalation technique training in patients with COPD and asthma. Materials and methods: A total of 132 patients fulfilling the inclusion criteria were trained with the correct technique of inhalation on day 0 and at the end of 1 and 6 months. Evaluation of technique training was done on these three occasions posttraining. The mean score of devices was obtained, and the mean inhalation technique score of various devices was compared. Results: Out of 132 patients, 65.1% (86/132) patients were using a dry powdered inhaler (DPIs), 26.5% (35/132) patients used metered dose inhalers (MDIs), and 8.4% (11/132) patients used MDI with spacer. The mean scores of patients using MDI at baseline were 5.68 ± 0.83, and after 1 month, 6.68 ± 0.58 (p < 0.000). The inhalation technique mean score of MDI improved after 6 months, 7.02 ± 0.56 as compared to baseline (p < 0.008) mean score of the patients using DPIs improved after 1 month, 5.53 ± 0.58 as compared to baseline 4.37 ± 5.53 (p < 0.000). There was no statistical improvement in the device mean score of DPIs after 6 months, 5.62 ± 0.55 when compared with 1 month, 5.53 ± 0.58 (p < 0.117). Patients who used pressurized metered-dose inhalers (pMDI) with spacers improved their inhalation score after 1 month by 6.90 ± 0.94 as compared to the baseline score of 6.90 ± 0.94 (p < 0.001). The mean score decreased marginally after 6 months, 7.818 ± 0.60, as compared to the score at the end of 1 month of 8.27 ± 0.64 (p < 0.053). Discussion: Patients showed improvement in the technique of inhalation after educational training, reinstructions, and a standard checklist
A Review on Vitamin D Deficiency and Related Disorders: What is the Right Serum Vitamin D Level?
Authors: Bantwal Ganapathi
Published: June 2023

To maintain a healthy skeleton, vitamin D is crucial for phosphate as well as calcium uptake. It is of great significance for maintaining the various adaptive and innate immune response components. To reduce the development of various immune-related disorders, such as diabetes, hypertension, cardiovascular diseases, rheumatoid arthritis, and coronavirus disease 2019 (COVID-19), numerous studies evaluating the optimal threshold levels for serum 25-hydroxyvitamin D [25(OH)D]. It is documented in various evidence to increase the serum 25(OH)D intake from the current mindset of 30–50 ng/mL to attain the best overall vitamin D benefits. These values are in line with the results of various research showing that increased vitamin D intake is linked to a decreased risk of cancer and cardiovascular diseases. Therefore, it becomes vital to understand the “right” vitamin D levels to avoid deficiency along with its related disorders. In contrast to 30 ng/mL, this review emphasizes the significance of increasing vitamin D levels to 50 ng/mL to obtain several physiological benefits. An individual needs at least 60000 IU for 12 weeks to maintain serum vitamin D levels above 30 ng/mL. The article will interest physicians who desire to profit fully from vitamin D’s influence on clinical practice.
A Study of Thyroid Profile and Lipid Profile in Patients with Chronic Kidney Disease with or without Hemodialysis in a Tertiary Care Hospital
Authors: Gupta Nikhil , Dahiya Sulakshna , Bansal Pankaj , Kumar Satish , Agarwal Ashok K
Published: June 2023

Background: Chronic kidney disease (CKD), due to increasing frequency and prevalence, has become one of the leading public health issues. The Kidney Disease Outcome Quality Initiative (KDOQI) defines CKD as kidney injury or a reduction in the glomerular filtration rate (GFR) to <60 mL/minute/1.73 m2 for at least 3 months. This study aims to compare the effects of decreased renal function on thyroid profile and lipid profile in CKD patients. Materials and methods: This is a prospective cross-sectional observational study conducted among the patients attending Outpatient Department/Inpatient Department (OPD/IPD) at the School of Medical Sciences & Research, Sharda Hospital, Greater Noida, Uttar Pradesh, India, in known cases of CKD, irrespective of the treatment/stage of CKD. All patients of >18 years of age with CKD were included in the study. Result: A total of 200 patients who met the inclusion criteria were included after obtaining detailed informed consent, of which 100 were cases and 100 were controls. The mean age of patients in the study was 47.74 years, with the mean age in patients with CKD 52 years, and the control was 43 years. The mean level of triglycerides (TGs) was significantly higher among the cases, and the high-density lipoprotein (HDL) was significantly lower among cases compared to controls (p < 0.05). Pearson’s correlation between thyroid-stimulating hormone (TSH) with creatinine showed a weak albeit significant positive association (r = 0.200; p < 0.05). Conclusion: Our study shows a higher incidence of alteration in thyroid profile and dyslipidemia among the patients with CKD compared to controls. There is a necessary need to screen routinely for hypothyroidism and dyslipidemia among patients with CKD. Importantly, thyroid hormone levels and their effects on the progression of CKD have not been studied exhaustively.
Motor Assessment With the STEGA iPad App to Measure Handwriting in Children
Authors: Philip Benjamin A. , Li Fuhai , Hawkins-Chernof Elizabeth , Chen Ling , Swamidass Victoria , Zwir Igor
Published: June 2023

Importance: Handwriting and the fine motor control (hand and fingers) underlying it are key indicators of numerous motor disorders, especially among children. However, current assessment methods are expensive, slow, and subjective, leading to a lack of knowledge about the relationship between handwriting and motor control.

Objective: To develop and validate the iPad precision drawing app Standardized Tracing Evaluation and Grapheme Assessment (STEGA) to enable rapid quantitative assessment of fine motor control and handwriting.

Design: Cross-sectional, single-arm observational study.

Setting: Academic research institution.

Participants: Fifty-seven typically developing right-handed children ages 9 to 12 yr with knowledge of cursive.

Outcomes and Measures: Predicted quality, measured as the correlation between handwriting letter legibility (Evaluation Tool of Children’s Handwriting–Cursive [ETCH–C]) and predicted legibility (calculated from STEGA’s 120 Hz, nine-variable data).

Results: STEGA successfully predicted handwriting (r2 = .437, p < .001) using a support vector regression method. Angular error was the most important aspect of STEGA performance. STEGA was much faster to administer than the ETCH–C (M = 6.7 min, SD = 1.3, versus M = 19.7 min, SD = 5.2).

Conclusions and Relevance: Assessment of motor control (and especially pen direction control) may provide a meaningful, objective way to assess handwriting. Future studies are needed to validate STEGA with a wider age range, but the initial results indicate that STEGA can provide the first rapid, quantitative, high-resolution, telehealth-capable assessment of the motor control that underpins handwriting.

What This Article Adds: The ability to control pen direction may be the most important motor skill for successful handwriting. STEGA may provide the first criterion standard for the fine motor control skills that underpin handwriting, suitable for rehabilitation research and practice.
AVALIAÇÃO DA VULNERABILIDADE À POLUIÇÃO DA ÁGUA SUBTERRÂNEA URBANA, USANDO O MÉTODO SI, EM RONDONOPOLIS, MATO GROSSO, BRASIL
Authors: CUTRIM Alteredo Oliveira , SALOMÃO Fernando Ximenes de Tavares , LUZ Joana Angélica Guimarães da
Published: June 2023

Esta pesquisa foi realizada na cidade de Rondonópolis, estado de Mato Grosso, com o objetivo de avaliar a vulnerabilidade à contaminação do Aquífero Furnas, usando o método SI - Susceptibility Index. O SI gerou as vulnerabilidades desprezíveis, baixas, moderadas e altas. Essas vulnerabilidades são consistentes com as características hidrogeológicas do aquífero e os tipos de uso e ocupação da área. Este desempenho do SI está relacionado às suas características e os ajustes feitos à área de estudo. Estes resultados podem ser usados para elaborar plano de gestão do aquífero, para estabelecer área de proteção de poço e rede de poços de monitoramento de qualidade de água.
MÉTODO DE AVALIAÇÃO DE VULNERABILIDADE NATURAL, ANTRÓPICA E TOTAL DE AQUÍFERO - VAN
Authors: CUTRIM Alteredo Oliveira , LUZ Joana Angélica Guimarães da
Published: June 2023

O método VAN foi desenvolvido com o objetivo de avaliar as vulnerabilidades natural, antrópica e total de aquífero, usando parâmetros hidrogeológicos e de uso do subsolo. A estimativa individual dessas vulnerabilidades permite avaliar a acessibilidade natural, induzida e total de aquífero, permitindo uma avaliação mais realista de impacto de obras subterrâneas sobre a vulnerabilidade de aquíferos. Desse modo, o método VAN será uma ferramenta importante para produzir dados e informações para subsidiar a elaboração de planjo de gestão de aquífero, considerando o impacto de obras subterrâneas.
MODELAGEM DA SUSCEPTIBILIDADE DE ESCORREGAMENTOS UTILIZANDO O MÉTODO DE PESOS DE EVIDÊNCIA EM UMA REGIÃO MONTANHOSA DE CLIMA TROPICAL
Authors: ARAÚJO João Paulo de Carvalho , BARELLA César Falcão , FERNANDES Nelson Ferreira
Published: June 2023

Escorregamentos são fenômenos naturais que ocorrem em regiões montanhosas e podem causar grandes catástrofes socioeconômicas. A identificação das áreas susceptíveis a escorregamentos é uma etapa essencial da gestão de riscos e auxilia a implementação de projetos que visam mitigar, ou mesmo evitar os danos causados por estes eventos. Este trabalho avalia a susceptibilidade a escorregamentos translacionais pelo método estatístico bivariado de Pesos de Evidência, assim como o controle individual de oito fatores predisponentes em duas bacias piloto no maciço da Tijuca, na cidade do Rio de Janeiro (RJ). Cinco modelos de susceptibilidade foram produzidos pela combinação dos fatores predisponentes e tiveram sua capacidade preditiva testada pelo cálculo da área abaixo da curva (AAC). A maior parte dos escorregamentos mapeados ocorreram nas cabeceiras de drenagem das bacias piloto, nas encostas com ângulo entre 34° e 51°, sustentadas principalmente por intrusões graníticas e coberta por floresta preservada. O mapa final possui cinco classes de susceptibilidade e demonstrou ser eficaz na previsão dos escorregamentos. O método é robusto e evita subjetividades, ao mesmo tempo que é bastante versátil. Apesar de pouco utilizado no Brasil, o método é apropriado ao contexto de complexa geodiversidade e carência de dados geotécnicos a nível regional e local.
IDENTIFICAÇÃO DOS ÍNDICES DE SENSIBILIDADE FLUVIAL AO DERRAMAMENTO DE ÓLEO EM AMBIENTES DO BAIXO AMAZONAS (ESTUDO DE CASO: SANTARÉM-PARÁ)
Authors: CORRÊA Luiz Felipe Aquino , RODRIGUES Suzan Waleska Pequeno
Published: June 2023

Este trabalho propôs utilizar o processamento de imagens RapidEye conciliado com etapas de checagem de campo para gerar um mapa de Índice de Sensibilidade Fluvial ao derramamento de óleo para a orla do município de Santarém – Pará. A classificação não-supervisionada resultou na geração do mapa de classes identificadas, composto pelas classes água, área urbana, praia fluvial, área de várzea. O índice Kappa Geral foi de ~0,86%, o qual é considerado um excelente resultado quanto acurácia da classificação.  A partir da conciliação do mapa de classes e da checagem de campo foi gerado o mapa de índice de sensibilidade fluvial (ISF) ao derramamento de óleo para a área estudada, composto por 5 índices (ISF 1- estruturas artificiais, ISF 4- escarpa / barranco, ISF 6- Praia ou banco de areia / seixo abrigada, ISF 10A- banco de macrófitas e ISF 10B- vegetação alagada (Igapós, várzea, chavascal e campo). Os ISF’s 1 e 4 que são considerados menos sensíveis aos danos ocasionados pelo contato com derivados de petróleo representam 5,1% da área total da aplicação dos índices. Já os ISF’s 6, 10A e 10B representam 94,9% da área total da aplicação do índice, estes são índices mais sensíveis.