bluuebunny/crossref_metadata_2025 huggingface dataset:
A Participação Plural no Contexto da Governança do Turismo de Curitiba/PR
Authors: Feger Jose Elmar , Kaizer Everton Felipe , Minasi Sarah Marroni , Fratucci Aguinaldo Cesar
Published: February 2024

A governança em turismo entendida como um processo, e não como um modelo de gestão, deve buscar a participação plural, ou seja, aquela em que incluem a participação mediata e a imediata dos stakeholders envolvidos. O objetivo deste estudo é compreender a participação (mediata e imediata) de moradores no desenvolvimento do turismo em Curitiba influenciada pelas políticas de descentralização e participação social no Brasil, ocorridas após a Constituição de 1988. Para atingir tal objetivo, o estudo de caso com abordagem qualitativa e descritivo foi conduzido por uma pesquisa bibliográfica e documental nos canais de comunicação com a população do município de Curitiba: Central 156, página do Facebook da Prefeitura Municipal, Fale Conosco do Instituto Municipal de Turismo de Curitiba, Programa Fala Curitiba e Conselho Municipal de Turismo de Curitiba. Os resultados obtidos evidenciam a disponibilidade dos canais de comunicação para o processo de governança em turismo em Curitiba. Todavia, verifica-se que nem todos os atores impactados pelo turismo participam das deliberações ocorridas no COMTUR. Observa-se que o cidadão curitibano se importa com o turismo da cidade e critica situações, bem como, sugere melhorias nos atrativos e pontos de informação turística. E neste sentido, as participações por meio dos diversos canais podem qualificar as políticas e programas de desenvolvimento do turismo no município.
Assessment of Stress and Resilience in the General Population during COVID-19: A Cross-sectional Study
Authors: Prasad Amritha , Gopinath S , Sivabalan E
Published: February 2024

Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic, which began in Wuhan, China, in December 2019, has quickly spread worldwide, causing numerous challenges for people, such as lockdowns, isolation, and subsequent mental stress. Developing mental resilience is crucial for handling stress effectively. Understanding the impact of the COVID-19 pandemic on stress and the resilience of the Indian population enables insight and facilitates thoughtful reformation in aiding the community. Aim: To assess the stress and resilience among the general population during the COVID-19 pandemic and to find the association between demographic variables and stress and resilience. Additionally, the study aimed to evaluate the correlation between stress and resilience among these subjects. Materials and Methods: A cross-sectional study was conducted Department of Psychiatry, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India, from February 2021 to April 2021. A total of 740 willing respondents affected by the COVID19 pandemic participated in the study. A snowball sampling method was used in which participants were approached via a Google form circulated through their known contacts. The study encompassed those who had experienced either direct or indirect effects of the COVID-19 pandemic. The user-friendly Google form collected essential demographic information such as gender, marital status, and employment type. The stress and resilience levels were measured using the Perceived Stress Scale (PSS) and Resilience Scale. The statistical analysis of sample characteristics with frequency distributions and categorical variables was done with the application of Chi-square tests. Correlation analysis was done using the Spearman's test. A p-value of <0.05 was considered statistically significant. Results: The research demonstrated remarkably low resilience levels and heightened stress levels among female participants as well as single individuals. Conversely, a significant number of married men exhibited greater resilience (p=0.013) and reduced stress levels (p<0.001) compared to the rest of the population. Individuals in formal employment experienced less stress compared to those in informal employment (p=0.008). Notably, there was a moderate negative correlation between perceived stress and resilience which was significant (r=-0.562, p<0.001). Conclusion: The COVID-19 pandemic has greatly affected mental health and coping mechanisms; factors such as gender, social connections, and financial stability play significant roles. The study found that women, single individuals, and those working in informal sectors faced increased stress during these challenging times. Hence, psychological interventions targeting the pandemic crisis need to be planned considering the highlighted biological, socio-economic, and occupational factors.
Academic Achievement of First-year Medical Students using Self-directed Learning with Formative Assessment vs Conventional Teaching Method: A Longitudinal Study
Authors: Roy Tapati , Basu Rituparna , Chaudhary Ranjeeta , Khatoon Taslima , Paul Sreetama , Ghosh Debanjana
Published: February 2024

Introduction: The Self-Directed Learning (SDL) approach is an important component of the Competency-Based Medical Education (CBME) curriculum. However, learning independently can be challenging, even for the brightest and most motivated students. Moreover, self-evaluation is quite difficult. If SDL is used in combination with formative assessment and constructive feedback for individual topics, it would facilitate self-modulation by learners and guide them towards higher academic achievement. Aim: To compare the academic performance of first-year medical students in Anatomy Practical class using SDL with formative assessment and feedback versus conventional teaching methods. Materials and Methods: A comparative evaluation was conducted using a longitudinal study design in the Department of Anatomy, Medical College Kolkata, West Bengal, India, from November 2022 to June 2023. During Anatomy Practical classes, 250 first-year medical students, (Batch 2022-2023), were divided into two equal groups using simple random sampling through a lottery method. One group (study group) was taught by implementing SDL followed by formative assessment with immediate feedback, and the other group was taught by the traditional method (control group). Following the completion of each of the first three consecutive regions (superior extremities, inferior extremities, and thorax) during Anatomy Practical classes, summative assessments were conducted. The collected data were calculated in an Excel sheet and computed using JAMOVI software (free version). Independent t-test statistics for the three summative assessments were evaluated, and the p-value of each assessment was determined. A p-value <0.05 was considered to be statistically significant. Additionally, students’ feedback was documented and analysed. Results: It was observed that there was an improvement in academic scores in both groups. However, higher academic performance was progressively attained in the group which was provided SDL sessions and formative assessment with immediate feedback. A total of 55 (80%) students passed the third summative assessment in comparison to 40 (59.7%) students of the control group who passed the same exam. Differences between the means of the control and study group were found to be statistically significant (p-value≤0.001 and 0.023 in two summative assessments). Conclusion: The present study revealed that SDL with formative assessment followed by immediate feedback during Anatomy Practical classes had a remarkable positive impact on students’ academic performance compared to those students taught using conventional teaching methods and might be implemented in the future for better learning and improved academic achievement of students.
Open Surgical Retrieval of a Foreign Body in the Neck: A Case Report
Authors: Athavale Virendra Sudhakar , Jayakar Sudhir Ramchandra , Moghekar Smitha
Published: February 2024

Foreign body retention in the neck may be either traumatic or iatrogenic. Penetrating neck injuries with retained bodies are critical, as the neck serves as a passage for structures essential to life. Therefore, prompt detection and retrieval of the foreign body are paramount in preventing mortality. Here, authors present a case in which a successful surgical retrieval was performed without any postprocedural complications, despite the patient presenting relatively late after the injury. In this case report, a 23-year-old male labourer presented with a right-sided neck swelling two months after a workplace injury involving a shattered metal plate. Imaging confirmed a 15×5 mm hyperdense metallic object penetrating the sternocleidomastoid muscle. Successful open exploration extracted a 1.5 cm metallic shard at the C6 vertebral level, with no major vessel or airway damage. Postoperatively, the patient exhibited no movement restrictions, highlighting the atypical presentation of a retained metallic foreign body and the importance of timely intervention and comprehensive imaging for successful management.
Prevalence of Azygos Lobe of the Lung in Southern Indian Cadaveric Population: A Retrospective Observational Study
Authors: Kamble Gautham , Roshan S , Shivarama CH , Somesh MS
Published: February 2024

Introduction: The azygos lobe is a developmental anomaly found in the upper lobe of the right lung. It has a prevalence of 0.4% in clinical scenarios and 1% during routine anatomical dissections. Clinically, the azygos lobe mimics various conditions. It is a rare incidental finding during chest radiography or Computed Tomography (CT). Aim: To determine the prevalence of the azygos lobe during anatomical dissection. Materials and Methods: A retrospective observational study was conducted over a 13-year period from June 2010 to August 2023 in various medical colleges in Mangaluru, Karnataka, India. A total of 102 adult cadavers were studied. The dissected right and left lungs of each cadaver were examined for the presence or absence of an azygos lobe and recorded. The morphology of the azygos lobe was studied, including its size, the presence of the azygos fissure, the depth of the azygos fissure, and the course of the azygos vein. The presence of mesoazygos was also checked, and its attachments were noted. Descriptive statistics were used in terms of frequency and percentage. Results: Out of the 102 cadavers, only one right lung had an azygos lobe. None of the cadavers had bilateral azygos lobes. The maximum height of the lobe was 5.8 cm, and the width was 4.5 cm. An azygos fissure was found, through which the mesoazygos was present. The mesoazygos was located from the lung to the thoracic wall. Conclusion: Despite being an incidental finding, the azygos lobe is clinically important. Physicians should be aware of this anomaly, and thoracic surgeons should exercise caution during surgeries involving the thoracic region, such as Video-Assisted Thoracic Sympathectomy (VATS).
Examining the Power of Accumulation: A Case Study of the Lavera Project by Ambala Farmers Producer Company Limited in Haryana, India
Authors: Rajpurohit Tribhuwan Singh , Kumar Anil , Rajpurohit Girish , Kumar Rohtash , Choudhary Ravindra
Published: February 2024

The concept behind Farmer Producer Organizations is that farmers, who are the producers of Agricultural products, can form groups and register themselves under the Indian Companies Act. 1956. The aim is to enhance farmer's income, capacity building, and competitiveness and increase their advantage in emerging market opportunities. A case study was conducted in the Ambala District of Haryana to examine the role of farmer-producer organizations in enhancing farmers socio economic status. Studying the management and governance system of F.P.C. and assessing the impact of F.P.C. on members was the objective of the case study. Personal interviews and group discussion methods were used for data collection and secondary data from directors for gathering information on the F.P.C. Project Lavera Ambala Farmer Producer Organization, which was established on Sep 02, 2015, for collecting, processing, and marketing milk and milk products. It covered nine Ambala villages and collected raw milk from members and non-member farmers at higher prices than other value chain actors. The study's result indicates that farmers who supply milk to F.P.C. get 9-13 rupees per lit higher price than others. It also provides bonuses to member farmers who are company shareholders, and their income from dairy farming is enhanced by 25-30 percent. Lavera has enhanced net returns for farmers, increased revenue through value addition, and fostered entrepreneurship in rural communities. Members of F.P.C. are highly satisfied with the services provided by F.P.C. and its performance in local areas.
Analysing Television Captioning: Production, Readings and Effects
Authors: Eliah Victor
Published: February 2024

The study is grounded in the encoding and decoding model by Stuart Hall, to map a connection between the creators of captions and the audiences who receive them. The study employs a mixed methods approach that takes on a descriptive design to gather data through questionnaire, interviews, and the observation. The study concluded that there are habitual caption problems in television programmes that emanate from various problems in the human resources and the available technologies. As such, the study recommended strengthening and establishment of programmes editorial units, establishment of quality assurance processes as essential in spearheading the quality of programmes production.
Chilli Leaf Curl Disease: An Emerging Threat to Chilli Cultivation in Maharashtra, India
Authors: Vedpathak K. A. , Mule A. B. , Deshmukh O. S. , Shinde P. P. , Madane S. V. , Jagtap K. D. , Palchoudhury S. , Deokar S. D.
Published: February 2024

Chilli leaf curl disease (ChiLCD) locally known as ‘Churda Murda’ is a most destructive disease of chilli (Capsicum annuum) in India. The ChiLCD is caused by whitefly (Bemisia tabaci)-transmitted Begomovirus, belonging to the family Geminiviridae. A study was conducted to investigate the current status of ChiLCD in Maharashtra. Survey was carried out in chilli growing districts of Maharashtra to study the disease incidence (DI) and percent diseases index (PDI) of ChiLCD. Artificial Intelligence (AI)-based application (App) ‘Plantix–your crop doctor’ was used to assess the diagnosis of ChiLCD. During the survey different symptoms of ChiLCD, leaf curling, leaf yellowing, crinkling, puckering, vein banding and stunting were observed in diseased chilli plants. In this study, ‘Plantix–your crop doctor’ App accurately diagnosed the ChiLCD and its pathogen Chilli leaf curl virus (ChiLCV). High ChiLCD incidence of 85-100% with PDI of 53.8-62.7% was observed at Kemwadi village in Osmanabad district and 80-90% with PDI of 42.3-45.7% at Ranmasle village in Solapur district of Maharashtra. The high incidence of ChiLCD in Maharashtra has been taken into consideration and this can be correlated with various factors such as weather conditions, insecticide resistance in whitefly populations, and the appearance of virulent strains of ChiLCV. Early detection of ChiLCV using the AI-based ‘Plantix–your crop doctor’ App and effective management of insect vector whitefly could prevent ChiLCV spread and minimize the crop yield losses.
Effect of Sulphur Application on Yield, Nutrient Uptake and Quality of Chickpea (Cicer arietinum L.)
Authors: Hadole S. S. , Sarap P. A. , Sarode Mayur , Reddy Y. A. , Aage A. B. , Nandukar S. D. , Dangore S.T.
Published: February 2024

A field experiment was conducted at Pulse Research Station in Dr. Panjabrao Deshmukh Krishi Vidyapeeth, Akola, Maharashtra from the period of Rabi 2020-21 to 2022-23 to study the effect of sulphur application on yield, Nutrient Uptake and quality of Chickpea (Cicer arietinum L.). The experiment was laid out in Randomized block design (RBD) with 9 treatments and 3 replications. The study revealed that the application of sulphur application is significantly influenced the yield, Nutrient uptake and quality. The highest Grain yield in Kilograms per hectare (2418 kg ha-1) and straw yield (3016 kg ha-1) were recorded with the application of S @30 kg ha-1 through Bentonite sulphur along with Recommended dose of fertilizers and it was found significantly superior over all the treatments. Similarly maximum N, P, K, S and micronutrient uptake and improved quality were observed with application of @ 30 kg ha-1 through Bentonite sulphur along with Recommended dose of fertilizers followed by the treatment of application of S @ 30 kg ha-1 through Gypsum + RDF.
Increasing Water Use Efficiency of Irrigated Rice through Water Saving Techniques in Yobe Basin, North East, Nigeria
Authors: Jajere Ibrahim Ahmed , Alhassan Ibraheem , Dantata Ishaku James , Maidala Aminu
Published: February 2024

Increasing world population and dwindling water resources is exerting pressure to develop strategies for producing more food using less water.

Aims: To investigate the effect of different irrigation schedules on grain yield and water use efficiency (WUE) of FARO 44 rice variety.

Study Design: The research was laid out in a split plot arrangement. Twelve treatments replicated three time comprising of 3 irrigation intervals as main plot and 4 irrigation depth as sub plot.

Place and Duration of Study: Gashua, Yobe State on the floodplains of river Yobe, Nigeria between March 2023 and July 2023.

Methodology: Comprised of 3, 5 and 7 days irrigation intervals as main plot, with irrigation depth (amount) at 100% of crop water requirement (ETc), 85% of ETc, 70% of ETc and the farmers flooding practice as the sub plot treatments. Some growth, yield and components of the rice were determined. Reference evapotranspiration (ETo) and Crop evapotranspiration (ETc) were computed using Cropwat model. Crop and irrigation water use efficiencies were also calculated.

Results: The 3 days irrigation interval produced the maximum growth parameters of rice along with both application of 100% of crop water requirement and the traditional flooding type of irrigation. The interaction of 3 days irrigation interval and 100%ETc and 85% of ETc significantly produced the highest grain yield (6484.85 kg ha-1.) 3 and 5 days irrigation interval with 100% and 85% of ETc irrigation depths significantly produced the highest water use efficiencies. A well fitted linear relationship (R2 = 0.834) existed between the irrigation scenarios and the rice grain yield.

Conclusion: It can be concluded that irrigation frequency and amount can be reduced to arrive at highly acceptable yield in the study area. High rice yield can be maintained with 3 days irrigation interval and 85% of the crop water requirement and also improve its water use efficiency.
Robot-assisted Aquaculture and Sustainable Seafood Production for Enhanced Food Security
Authors: Lal Shyam , Ahirwar Shashi Bala , Kanojia Seema , Rai Sumit , Vidhya C. S.  , Gupta Swapnil , Nautiyal Chanda Thapliyal , Nautiyal Pankaj
Published: February 2024

This paper explores the integration of robotics in aquaculture practices to achieve sustainable seafood production, thereby enhancing global food security. With the increasing demand for seafood and the challenges posed by overfishing and environmental changes, innovative solutions are required to ensure a consistent supply of high-quality seafood. Robotic technologies offer promising avenues for optimizing various aspects of aquaculture, including monitoring, feeding, disease detection, and habitat management. Through a comprehensive review of recent advancements and case studies, this paper highlights the potential benefits, challenges, and future directions of robot-assisted aquaculture systems. By leveraging automation, data analytics, and artificial intelligence, the aquaculture industry can achieve greater efficiency, reduced environmental impact, and enhanced seafood availability, ultimately contributing to improved food security on a global scale.
Evaluation of Sweet Potato (Ipomoea batatas) for Early Blast Disease (Alternaria solani)
Authors: Falade Moses Jimoh , Agbowuro Gbenga Oluwayomi
Published: February 2024

Aims: Early blight disease (Alternaria solani) is one of the main biotic factors limiting sweet potato production in the tropics. A multi-locational research was carried out to screen and identified sweet potato accessions that are resistant to the disease.

Methodology: 21 sweet potato accessions were collected from different agro-ecological zones of Nigeria and screen against Alternaria solani by artificial inoculation of the pathogen in three diverse agro-ecological conditions. The accessions were named against their place of condition. The research were laid out in a Randomized Complete Block Design (RCBD) with three replications. Data were collected on days to 50% flowering, fresh root weight per plant, number of root per plant, number of main branches per plant, and above ground fresh biomass yield per plant at 15 weeks after planting (WAP). Disease scoring was done using rating scale 0f 0-9 and analyzed with IRRI STAR software.

Results: The result revealed that there are variations in the 21 accessions studied. Offa performed best across the three environments followed by Umudike while Ado-Ekiti had the least performance in term of root yield. The screening shows that none of the 21 accessions is highly resistant. Four of the accessions were resistant, six accessions were moderately resistant, four accessions were susceptible, and three accessions were moderately susceptible while 4 accessions were highly susceptible to the pathogen.

Conclusion: The findings concluded that the resistant accessions that gave high number roots could be used as a gene pool for Alternaria solani resistance breeding for cultivar improvement. The use of the identified resistant accessions with high root yield by farmers is encouraged pending the time commercial Alternaria solani resistant cultivars will be readily available and accessible.
Influence of Naphthalene Acetic Acid, Gibberellic Acid and Calcium Chloride on Quality Parameters of Kagzi Lime (Citrus aurantifolia Swingle)
Authors: Patel Suneel Kumar , Tripathi V. K.
Published: February 2024

An experiment was carried out to investigate the influence of Naphthalene acetic acid, Gibberellic acid and Calcium chloride on quality parameters of Kagzi lime (Citrus aurantifolia Swingle) in the Garden, Dept. of Fruit Science, C. S. Azad University of Agriculture and Technology, Kanpur (U.P.) during two cropping seasons i.e., 2021-2022, 2022-2023. The experiment was laid out in Randomized Block Design with three replications and Ten treatments viz, T1-NAA (20 ppm), T2-NAA (40 ppm), T3-NAA (60 ppm), T4-GA3 (10 ppm), T5-GA3 (20 ppm), T6-GA3 (30 ppm),T7-CaCl2 (0.10%),T8-CaCl2 (0.15%),T9-CaCl2 (0.2%) and T10-Control (water spray only). During both years of investigation, it was recorded that GA3 at 20 ppm exhibited significantly higher amount of total soluble solids (9.300Brix) andtitratable acidity (8.70%) as compared to all other treatments. Similarly, NAA treatments also contributed to an increase in the TSS and titratable acidity content with the rise in their concentrations. In terms of TSS: acid ratio, there were no significant differences were recorded within the treatments, indicating its stability. Ascorbic acid content was significantly higher in GA3 treated fruits and with the GA3 at 20 ppm maximum amount of ascorbic acid was recorded (56.47 mg/100ml juice) while the control fruits had the lowest ascorbic acid content. The juice content in fruits were increased in NAA and GA3 treatments, while in CaCl2 treatments it remained relatively stable. Higher amount of juice content (56.49%) was also recorded in fruits treated with GA3 at 20 ppm. In the context of sugar content, GA3 at 20 ppm also exhibited the highest reducing (0.86%), non-reducing (0.70%) and total sugar (1.56%) content in the plains of north India.
Impact Possibility of Organic, Inorganic and Integrated Production Systems for Crop Productivity and Soil Fertility
Authors: Desai L. J. , Patel K. M. , Patel P. K. , Patel Vidhi K. , Gami J. K.
Published: February 2024

A field experiment was conducted from 2015-16 to 2021-22 at the Centre for Research on IFS, S.D. Agricultural University, Sardarkrushinagar to study the Impact possibility of organic, inorganic and integrated production systems for crop productivity and soil fertility. Crop sequence Groundnut- wheat-greengram recorded significantly highest groundnut equivalent yield (4886 kg/ha) with application of RDF + 10 t/ha FYM once in year, The percent increase in average of three cropping sequences was about 39.1 % in soil organic carbon, 4.1 % in soil available nitrogen, 1.6 % in available phosphorus, 7.2 % in available soil potash, 26.1% in Fe, 22% in Mn, 15.1% in Zn and 64.7% in Cu, while 9.9 % increase in soil water holding capacity and 2.1 % decrease in bulk density, highest microbial counts (bacteria, Actinomycetes and Fungi) under 100 % organic treatment over  treatment of State recommendations + 10 FYM/ha once in a year.
Detection and Molecular Characterization of Shiga-toxin-producing Escherichia coli from Fecal Samples of Cattle Farms Al-Buḥayrah Governorate Egypt
Authors: Elsayed Mohamed Sabry Abd Elraheam , Abutabeikh Samaa Mahmoud Mohamed
Published: February 2024

Escherichia coli that produce the Shiga toxin (STEC) has become one of the most significant foodborne pathogens linked to serious illnesses. Our study was aimed to detect the existence, antimicrobial profiles, and virulence repertoire of different STEC serotypes from fecal samples of dairy cattle.

We collected 19 fecal samples (12 diarrheic and 7 non-diarrheic) from dairy cattle. E. coli isolation and identification were performed. Shiga toxins genes were detected and the antimicrobial resistance was investigated.

E. coli was detected at the rate of 13/19 (68.4%) from the fecal samples. The frequency of Stx2a represented 12/13 (92.3%), Stx2 represented 3/13 (23.14%), and Stx1d, Stx2f, Stx2g, and eae represented 2/13 (15.4%). While the virulence genes Stx1, Stx1c, Stx2c, Stx2d, Stx2e, and ehxA represented 0/13 (0%). The most effective antimicrobials were tulathithromycin 30 (53.84%) followed by ceftiofur 30 and marbofloxacin (46.16%), amikacin (15.38%), and the least resistance was recorded for nalidixic acid and oxytetracycline (7.70%). The resistant antibiotics with percentages reached to 100% were Amoxicillin/ Clavulanic acid, Ceftriaxone, Ciprofloxacin, Doxycycline, Erythromycin, Gentamicin, Ninezolid, Nitrofurantoin, Penicillin G, Streptomycin, and Trimethoprim/Sulfamethoxazole, followed by chloramphenicol, nalidixic acid, oxytetracycline, and Tylosine (92.30%), Amikacin and Ampicillin (84.62%), Ceftiofur (23.07%), Marbofloxacin (15.38%) and Tulathithromycin 30 (7.70%).

The findings demonstrated that E. coli that are resistant to numerous groups of antimicrobials spread through feces and may pose a risk to human and animal health.
Post-Operative Range of Motion Exercises Performed Most Days at 50% Maximum ROM with Recupe Digital Health Improved ROM Recovery and Reduced Complications
Authors: Hui Timothy , Greene Hunter , Sasaura Paul , Subramanian Subu , Sharew Bereket Ayalneh , Woldebirhan Yordanos , Gorham Jamin
Published: February 2024

Range of Motion (ROM) exercises are common after knee surgeries, but little has been researched about the actual amount of movement performed in active exercises at home.  This was previously difficult to measure, as the patient was not in the office.  But now, with wearables used during home exercises, Plethy Recupe, a digital health platform, was able to shed some light on whether full ROM is required for post-operative ROM exercises after Total Knee Arthroplasty (TKA).

This study involved 170 TKA patients performed by the same orthopedic group.  Demographics, such as age, gender, and BMI, office visits, and physical therapy care were all similar.  For patients using Recupe, exercises were performed and average of 4.84 days per week.  Recupe used a mobile app to direct exercises, and a wearable to measure the ROM.  The ROM performed by these patients during home exercises ranged from 46.9 (sd 19.3) degrees in the first two weeks post-op, to 50.6 (sd 23.0) degrees at 1 month post-op.  Meanwhile, the maximum ROM, as measured by the orthopedist, rose from 114 (sd 10.76) degrees before surgery, to 120 (sd 9.08) degrees at 1 month post-op.

These are vastly different numbers, greater than 2 SD, and the home exercises show a great deal more variation.  What is clear though is the fact that the patient did not bend their knees anywhere near the maximum range.  Still, these patients experienced significantly better knee flexion recovery compared to patients at the same center who did not use Recupe, averaging 120 degrees versus 114 degrees.  Also, patients using Recupe experienced significantly fewer Manipulation Under Anesthesia (MUA) complications, 2% versus 5%.  As the other variables were similar for patients using Recupe and those who did not, the likely cause for these differences was frequency of home exercise performance.  However, there is not a measurement of the home exercise frequency for those patients not using digital health.

So, from this data, it appears that bending post-surgical knees to full range is not required for recovery.  Instead, it appears that the key is exercise plan adherence, where the Recupe group performed exercises around 5 times per week.
Teachers’ Perceptions of ICT Use in Promoting Teaching Learning Processes and Its Outcomes at Senior Secondary Level in Mbeya Region, Tanzania: A Review
Authors: Minga Chrispin , Ghosh Saraswati
Published: February 2024

Information and Communication Technology (ICT) has led to a debate between teacher-centred and student-centred approaches to teaching and learning in academia. While some teachers view ICT positively and think it makes teaching and learning exercises easier, others view it negatively and think it replaces the traditional teacher-centred approach, making teaching and learning exercises more challenging as respect for the teachers are eroding because students are using current technology to solve issues rather than depending only on teachers. The present study aims to understand teachers’ perceptions of ICT use in promoting teaching-learning processes and its outcomes at the senior secondary level in the Mbeya region, Tanzania as a conveniently designed study area for the researcher. The study is based on related reviewed materials/information which was gathered from different secondary sources between July and December 2023.

Information was analysed and presented in a descriptive form for easy perception and understanding. It showed that the majority of teachers at’ senior secondary level used ICT to enhance their teaching effectiveness. At the same time, their perception focused on learning an aspect which was easy to grasp, deep understanding and long-lasting. It enhances the interaction between students and teachers and offers more imaginative answers to many learning queries in the teaching and learning process. The study recommends that educators should use a holistic strategy when thinking about how to integrate information and communication technology (ICT) to improve the teaching and learning process and embrace a culture of flexibility and lifelong learning to improve student comprehension and engagement.
Prevalence of Methicillin-Resistant Staphylococcus aureus in Nasal Cavity of Medical Students at Shendi University, Sudan
Authors: Abdelgader Leila Mohamed A. , Habiballuh Ali Mohammed S. , Altoum Azam Zaher A. , Mahjaf Ghanem Mohammed , Hakim Nusaiba Abdelrahman M. , Altaher Tibyan Abd Almajed , Gorish Babbiker Mohammed Taher
Published: February 2024

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is becoming ever more prevalent in Sudan, and the proportion of MRSA to methicillin-sensitive Staphylococcus aureus (MSSA) seems to be increasing. New strains of MRSA are ever-developing resistance to antibiotic treatment, increasing morbidity and mortality rate.

Objectives: To detect the prevalence of methicillin-resistant Staphylococcus aureus in the nasal cavity of medical students at Shendi University and to detect variations of MRSA Colonization between student smokers and non-smoker students.

Methodology: 60 swabs were collected from medical students of Shendi University, culture, and direct gram stain were done, then the plates were examined for any significant bacterial growth. The isolated bacteria were then identified by colonial morphology, indirect gram stain, and biochemical tests.

Results: All data were analyzed using Statistical Package for Social Sciences (SPSS). Of these, 66.7 % (40/60) were males. 33.3% (20/60) were females. The isolated organism was Staphylococcus aureus 24 (40%), with no growth 36 (60%). The study showed that the overall resistance of Staphylococcus aureus to Methicillin was 21 (35%) and 3 (5%) Sensitive to Methicillin. Methicillin-resistant Staphylococcus aureus cases were found in nine (100%) of the students who smoked and twelve (80%) of the students who did not smoke. Of the pupils who did not smoke, three (20%) had Staphylococcus aureus. Methicillin Sensitive.

Conclusion: The carriage rate of S. aureus is consistent with similar studies. MRSA carriage in this university study appears high as compared to the general population. Although this study did not confirm a variety of risk factors for the carriage of MRSA previously identified by others, university healthcare personnel should be aware of the changing epidemiology of MRSA and the preventive measures needed to avoid outbreaks.
Pathologic prognostic factors for gastrointestinal cancer
Authors: Ismail T. , Hallissey M. T. , Fielding J. W. L.
Published: October 2004

Numerous clinicopathologic factors have been reported to have prognostic significance for gastrointestinal cancer. Many problems, however, confront the surgeon assessing the extent of disease and the clinical and molecular pathologist distinguishing differences in tumor differentiation, behavior, and defining important prognostic markers of cancer. This review assesses current pathologic prognostic variables of gastric and colorectal cancer that have been reported to influence survival.
pTNM and residual tumor classifications: Problems of assessment and prognostic significance
Authors: Hermanek Paul
Published: October 2004

The anatomic extent of tumor (TNM, pTNM) and, in case of treatment, the residual tumor status following treatment (residual tumor, or R classification) are the strongest predictors for outcome of patients with gastrointestinal cancer. The results of the pTNM and the R classifications depend on the methods used. In particular, the pN classification correlates with the number of nodes examined. The findings of micrometastases or isolated tumor cells in bone marrow should be indicated, and such cases must be analyzed separately from other metastatic cases. The same applies to patients with positive cytology in ascites fluid or peritoneal washings without gross involvement of the peritoneum. For the R classification the additional descriptors (conv), for conventional methods used, and (soph), for sophisticated, are recommended to indicate the methods used for classification. In general, long‐term survival can be expected only after R0 resection (resection without residual tumor). The observed 5‐year survival after R0 resection is 15% to 40% for esophageal carcinoma. 40% to 75% for gastric carcinoma, and 55% to 60% for colorectal carcinoma; the respective figures for R1 and R2 resections are only about 5% each. In R1 and R2 cases prognosis is determined primarily by the absence or presence of distant metastases, and pT and pN are of minor significance. After R0 resection there is a wide spectrum of prognoses. Careful pTNM classification allows a good estimation of the prognosis and can be considered the gold standard for any analysis of treatment results.
External beam plus intraoperative irradiation for gastrointestinal cancers
Authors: Gunderson Leonard L. , Nagorney David M. , Martenson James A. , Donohue John H. , Garton Gracila R. , Nelson Heidi , Fieck Jennifer
Published: October 2004

Although useful palliation can often be achieved when external beam irradiation and chemotherapy are used to treat locally advanced gastrointestinal malignancies, local control and long‐term survival are infrequent in view of the limited tolerance of surrounding organs and tissues. In view of dose limitations of external beam irradiation, intraoperative irradiation (IORT) with electrons has been used as a supplement to external treatment in an attempt to improve the therapeutic ratio of local control versus complications. An IORT dose of 10 to 20 Gy has been combined with fractionated external beam doses of 45 to 55 Gy in 1.8 Gy fractions in studies performed in the United States, Japan, Europe, and Scandinavian countries. In this paper the indications for and the results of aggressive combined techniques that include IORT are discussed. Results obtained with external beam techniques alone or with chemotherapy and resection are presented by site to demonstrate the need for higher doses of irradiation. When results from IORT series are compared to standard treatment with regard to disease control and survival, local control appears better with locally advanced colorectal, gastric, and pancreatic cancer; and survival appears better with colorectal ± biliary cancers. With pancreatic cancer, improvements in local control do not translate into increased survival in view of the high incidence of subsequent liver and peritoneal failures. Implications for future strategies in all sites are discussed.
Multimodal treatment for squamous cell esophageal cancer
Authors: Fink U. , Stein H. J. , Wilke H. , Roder J. D. , Siewert J. R.
Published: October 2004

Preoperative chemotherapy (CTx) and combination radiochemotherapy (RTx/CTx) in patients with squamous cell esophageal carcinoma has recently received increasing attention. Although several prospective randomized trials could not show any benefit of neoadjuvant therapy in patients with potentially resectable tumors, preoperative CTx and combination RTx/CTx appear to increase the resection rate, the rate of complete tumor resection, and survival time in patients with locally advanced tumors. Most available studies show that a survival benefit from multimodal therapy can be expected primarily in patients who have a complete histopathologic response to preoperative treatment (i.e., no viable tumor in the resected specimen). Preoperative RTx/CTx increases the response rate and improves local tumor control compared to preoperative CTx alone, but it is associated with substantial perioperative mortality and morbidity. Distant tumor recurrences are insufficiently controlled with current combined modality protocols. These data indicate that neoadjuvant therapy must be considered investigational in patients with potentially resectable esophageal carcinoma but may soon become standard in patients with locally advanced tumors. Research must focus on modalities that allow pretherapeutic identification of those patients who will respond to neoadjuvant therapy. Furthermore, more effective and less toxic preoperative therapy regimens are required to increase the response rates and combat systemic recurrences. Finally, randomized prospective studies are essential to assess the role, extent, and timing of surgical resection for the combined modality approach to patients with squamous cell esophageal carcinoma.
Multimodality treatment of cancer arising from Barrett's epithelium
Authors: Roth Jack A.
Published: October 2004

Adenocarcinoma arising in Barrett's epithelium is seen with increasing frequency. Most patients are diagnosed with advanced cancer, and the overall survival is less than 15%. Therefore novel preventive and therapeutic strategies are needed. Molecular markers are being developed that may predict which patients with Barrett's will develop cancer. Combined modality therapy with chemotherapy and surgery has been studied extensively in clinical trials. Although the results of these studies suggest improved survival, definitive proof must awit completion of ongoing randomized trials. Surgical resection of adenocarcinoma provides restoration of swallowing and local tumor control with a low operative mortality.
Potentially resectable gastric carcinoma: Current approaches to staging and preoperative therapy
Authors: Ajani Jaffer A. , Mansfield Paul F. , Ota David M.
Published: October 2004

The incidence of gastric carcinoma has declined worldwide during the past several decades, and yet this cancer remains the most common malignancy in several countries around the world, particularly Japan, Chile, and Costa Rica. Gastric carcinoma, although not as common in the United States as it was in the past, is still the eighth most frequent cause of cancer death. For patients with localized gastric carcinoma, surgery remains the most effective therapy, resulting in a consistent but low rate of cure. Unresectable gastric carcinoma is an incurable disease with the exception of a small fraction of patients who are salvaged with chemoradiotherapy. In Western countries curative resection rates have been dismal because of the lack of early diagnosis. Additionally, postoperative adjuvant strategies in the United States and Europe have been ineffective. Even patients with curative resection frequently develop intraperitoneal and systemic carcinoma in addition to locoregional relapses. Many investigators have therefore embarked on the therapeutic strategies of preoperative chemotherapy and postoperative intraperitoneal chemotherapy. The preoperative chemotherapy strategy has particular appeal because of its potential to reduce the size of the primary tumor, thereby allowing a higher rate of curative resection; early systemic therapy of micrometastates might prove biologically more effective. To date, several studies using preoperative chemotherapy have demonstrated its feasibility. The effectiveness of repeated courses of postoperative intraperitoneal chemotherapy remains unsettled mainly owing to the inadequacy of peritoneal drug distribution and the associated toxic effects. Additional investigations are necessary to improve preoperative staging with the use of endoscopic ultrasonography and laparoscopy (peritoneal staging). More effective preoperative chemotherapy combinations that might lead to 5% to 10% complete pathologic response in the presence of modest toxicity must be established prior to launching large‐scale trials. The impact of these novel strategies on resection rates, failure sites, and patients' survival can be determined only by carefully designed, controlled clinical trials.
Patient selection and treatment of peritoneal carcinomatosis from colorectal and appendiceal cancer
Authors: Sugarbaker Paul H.
Published: October 2004

Colorectal cancer is a disease process that disseminates through lymphatic channels, through hematogenous routes, and by invasion through the bowel wall. These mechanisms result in lymph node metastases, liver metastases, and peritoneal seeding. Although lymphatic and venous dissemination requires an invasive local process, peritoneal seeding may occur with both high grade and low grade malignancies. Cancer dissemination that causes liver and lymphatic metastases occurs prior to surgical resection of the primary colorectal cancer. Peritoneal seeding and seeding of the resection site (local recurrence) may also occur as a result of the surgical trauma that accompanies resection of the primary lesion. Leakage of malignant cells from transected lymphatic channels may be the mechanism of this intraoperative intraperitoneal cancer dissemination. To limit the progression of peritoneal seeding and to treat large volume, low grade intraabdominal tumor deposits, combinations of cytoreductive surgery and intraperitoneal chemotherapy have been successfully employed. Selection factors that correlate with long‐term benefit are (1) low grade of malignancy, (2) lack of lymph node or liver metastases, and (3) treatment of low volume disease. For patients with moderate or high grade colorectal cancer, only a low volume of disease can be treated successfully. For patients with low grade cancer, peritonectomy procedures are used to achieve minimal residual disease before initiating the intraperitoneal chemotherapy. In properly selected patients, peritoneal carcinomatosis from colorectal and appendiceal cancer is a treatable condition that may result in long‐term disease‐free survival.
Adjuvant therapy for patients with colorectal cancer
Authors: Steele Glenn
Published: October 2004

There are now excellent data that patients with stage III colon cancer or stage II and III rectal cancer live longer if they receive, respectively, systemic or regional and systemic therapy after surgery. In addition, disease‐free survival, particularly freedom from the symptom of regional recurrence, in the high risk rectal cancer patient population has been markedly improved by application of multimodality treatment approaches. Newer prospective protocol testing variations in administration of systemic therapy, addition of 5‐fluorouracil modulation techniques that proved effective in advanced disease settings, and the combination of therapy attempting to decrease single treatment toxicities while maintaining an antitumor effect have been built on the initial dramatic successes of the past 20 years. This paper concisely summarizes the data that should allow a marked decrease in mortality and morbidity if applied uniformly to patients who remain at high risk for recurrence after surgery for their colon or rectal adenocarcinomas.
Intraportal chemotherapy for colorectal hepatic metastases
Authors: Laffer Urban Th. , Metzger Urs
Published: October 2004

One‐third of colorectal cancer patients suffer from liver metastases on initial diagnosis. Overt liver metastases appear to be the first site of relapse for 40% to 50% of the patients with operable disease. The fact that tumor cells can be discovered in the mesenteric blood during surgery may indicate that circulating tumor cells give rise to metastases. Experimental investigations have shown that metastatic tumors reaching a diameter of 5 to 7 mm are predominantly perfused by the arterial route, which explains the unsuccessful attempts to treat established liver metastases through the portal vein. However, because metastases in the liver presumably arise via blood flow through the portal vein, adjuvant intraportal chemotherapy might permit ready access of the drug to small liver deposits in a way that systemic chemotherapy might not. The interest in portal adjuvant cytotoxic liver infusion in radically resected colorectal cancer patients is based on an early publication by Taylor, who in 1979 reported on a significant reduction of the incidence of liver metastases in a group of patients randomly assigned to perioperative adjuvant portal infusion with 5‐fluorouracil. Based on these results, several groups initiated prospective randomized trials comparing intraportal infusion of various regimens to surgery alone. Results of most of these trials have been published during the last few years. All but one demonstrate improved overall survival and disease‐free survival and a reduction of the incidence of liver recurrences in the adjuvant‐treated patient group. Ongoing meta‐analyses of the randomized trial data may confirm this tendency soon.
Therapeutic modalities and prognostic factors for primary and secondary liver tumors
Authors: Lehnert Thomas , Otto Gerd , Herfarth Christian
Published: October 2004

During the past decade considerable progress has been reported in the treatment of primary and secondary hepatic malignancies. Refined techniques in surgery, transplantation, radiotherapy, and chemotherapy apparently have made the delivery of treatment safer. At the same time improved understanding of tumor biology has been incorporated in treatment strategies. More recently specific and nonspecific, active and passive immunotherapies have excited wide interest, and information from the first randomized studies is now available. We review current treatment options for primary and secondary hepatic malignancies in an attempt to extract plausible treatment guidelines and to identify promising future directions.