bluuebunny/crossref_metadata_2025 huggingface dataset:
Can Electrophysiologic Facial nerve Monitoring Prevent Facial nerve Palsy during Parotidectomy?
Authors: Bonthu Pavan Kumar , Bakshi Jaimanti , Panda Naresh K. , Verma Roshan
Published: September 2023

Background:

One of the most feared complications in parotid surgery is facial nerve palsy which is known to affect the patient’s quality of life severely. Many instrument systems are already available commercially for electrophysiologic facial nerve monitoring.

Objectives:

The present study aims toward exploring the role of electrophysiologic facial nerve monitoring in the identification, dissection, and protection of facial nerve during parotid surgery.

Materials and Methods:

Forty confirmed cases of parotid tumors were recruited into the control and experimental groups. Intraoperative facial nerve monitoring was performed in the experimental group whereas no facial nerve monitoring was performed in the control group. The feasibility of locating the facial nerve, surgical time for locating facial nerve, and postoperative facial nerve function was compared in the control and experimental groups.

Results:

We have found that the electrophysiological monitoring of the facial nerve can reduce the occurrence of facial nerve palsy and can reduce the surgical time by early localization of the facial nerve.

Conclusion:

Facial nerve monitoring can help the surgeon in preventing facial nerve damage. It is strongly recommended that intraoperative facial nerve monitoring should be adopted during primary as well as revision parotid surgery.
An extremely rare case of Rogers syndrome or thiamine responsive megaloblastic anemia
Authors: Kaur Gurpreet , Ahuja Ankur , Sen Arijit , Singhal Paresh , Verghese Renjith
Published: September 2023

Rogers syndrome is an extremely rare autosomal recessive syndrome of which only 100 cases are known worldwide. It is characterized by thiamine-responsive megaloblastic anaemia, diabetes mellitus and sensorineural deafness. It results from the deficiency of a thiamine transporter protein. We herein report a 16-year-old Indian male referred to our centre with complaints of refractory anaemia, deafness, diabetes pulmonary arterial hypertension and tricuspid regurgitation. Based on the clinical features and haematologic picture and dramatic response of anaemia to thiamine therapy the possibility of a TRMA was considered. Sequencing analysis for TRMA revealed a homozygous c.242dup (p.Tyr81Ter) mutation of the SLC19A2 gene.
A rare case of bilateral ocular surface squamous neoplasia in an immunocompetent patient
Authors: Nayak Swatishree , Misra Neeta , Ravi Ashik , Misra Somen
Published: September 2023

Ocular surface squamous neoplasia (OSSN) is a broad entity that includes dysplastic lesions involving the squamous epithelium of conjunctiva and cornea. It is commonly seen in males between 50 and 75 years of age and has higher incidence in places close to the equator. Although a disease seen in 75% of cases unilaterally in older males, the younger cohort can have a bilateral presentation, where there is a strong suspicion of immunosuppression. Herein, we report a rare case of bilateral OSSN in an immunocompetent patient.
To analyze age for prescription of presbyopic glasses and factors influencing frequency of their change
Authors: Venugopal Kavitha Chikkanayakanahalli , Acharya Pavana , Narendra N. , Sandeep K. , Sreelekshmi S. R. , Javagal Akshatha P.
Published: September 2023

Purpose:

The purpose of this study was to analyze age for prescription of presbyopic glasses and factors influencing the frequency of their change.

Materials and Methods:

This was a hospital-based cross-sectional study conducted on patients presenting to the outpatient department of ophthalmology of a tertiary care center from January 2022 to June 2022. Informed written consent was taken. History regarding near work was obtained and detailed examination was done.

Results:

Males 293 (58.6%) had more preponderance than females 207 (41.4%). Occupations such as tailors, teachers, drivers, engineers, and welders required early (<40–49 years) need of presbyopic correction and frequent (2–3 times in the span of 10 years) change of glasses. Individuals with short height, lower upper segment: lower segment (US: LS) ratio, and hypermetropia were in need of early presbyopic correction and frequent change of glasses.

Conclusion:

Factors contributing to early need of presbyopic correction in age ranging from <40 to 49 years were occupations needing near work, short height, lower US: LS ratio, and hypermetropia. Factors contributing to increased frequency of change of glasses were occupations needing near work, normal to taller height, lower US: LS ratio, hypermetropia, and the usage of visual display units.
Understanding Childhood Constipation Through the Prism of the Caretaker
Authors: DCunha Aureen Ruby , Rai Sandeep B. , Rao Swathi Sunil , D'Souza Neevan
Published: September 2023

Aims:

Childhood constipation is presenting with increasing frequency at pediatric surgical clinics. The caregiver's role in prevention and management is pivotal. This study aimed at determining mothers' knowledge, attitudes, and practices with regard to childhood constipation and the association of these with demographic variables.

Materials and Methods:

This was a survey-based descriptive study conducted at a tertiary care hospital in South India. Randomly selected mothers of children aged 1–10 years consulting for any problem other than constipation were included in the study. Data collection was done by means of a pretested and prevalidated questionnaire.

Results:

There were 169 mothers with a median age of 30 years. Over half were homemakers and of a rural background. Urban mothers scored better than their rural counterparts in the attitude section (P = 0.034). Mothers with greater knowledge had better attitude (P = 0.001) and practice (P = 0.020) scores. Those with higher attitude scores also fared better in the practice section (P = 0.04).

Conclusions:

Knowledge, attitude and practice concerning childhood constipation are connected to each other. South Indian mothers are sufficiently aware of the nuances surrounding childhood constipation, but focused large-scale outreach programs and health education are necessary to bridge the gaps.
Assessment of Antenatal and Postnatal Prognostic Indicators in the Outcome of Neonatal Congenital Diaphragmatic Hernia
Authors: Deivasigamani Aniruthan , Naredi Bikash Kumar , Jindal Bibekanand , Sambandan Kumaravel , Govindarajan Krishnakumar , Plakkal Nishad , Gowda Mamatha
Published: September 2023

Context:

Despite advances in neonatal intensive care, surgical methods, and anesthesia, congenital diaphragmatic hernia (CDH) is still associated with significant mortality. Predicting which babies will have poorer outcomes is essential to identify the high-risk babies and to give targeted care and accurate prognosis to the parents, especially in a resource crunch set-up.

Aims:

The aim of this study is to evaluate the antenatal and postnatal prognostic factors in neonatal CDH that can be used to predict the outcome.

Settings and Design:

This was a prospective observational study in a tertiary care center.

Subjects and Methods:

Neonates presented with CDH within 28 days of life were included in the study. Bilateral disease, recurrent diseases, and babies operated outside were excluded from the study. The data were collected prospectively, and babies were followed until discharge or death.

Statistical Analysis Used:

Data were expressed in mean with standard deviation or median with range based on normality. All the data were analyzed using the SPSS software version 25.

Results:

Thirty babies with neonatal CDH were studied. There were three right-sided cases. The male-to-female ratio was 2.3:1, and 93% of babies were antenatally diagnosed. Seventeen out of the 30 babies underwent surgery. Nine (52.9%) underwent laparotomy, and 8 (47%) underwent thoracoscopic repair. Overall mortality was 53.3%, and operative mortality was 17.6%. Demographic characteristics were comparable between expired versus survived babies. The significant predictors of outcome identified were – Persistent pulmonary hypertension (PPHN), mesh repair, high-frequency oscillatory ventilation (HFOV), use of inotropes, 5-min APGAR, ventilator index (VI), and HCO3 levels.

Conclusions:

We conclude that the prognostic indicators associated with poor prognosis are low 5-min APGAR, high VI, low HCO3 levels in venous blood gas analysis, mesh repair, HFOV, inotropes usage, and PPHN. None of the antenatal factors studied showed any statistical significance. Further prospective studies with a larger sample size are recommended to confirm the findings.
Gastrointestinal Duplications
Authors: Gupta Rahul , Kumar Ajay , Agrawal Liladhar , Bhandari Anu , Gupta Arun Kumar , Goyal Ram Babu
Published: September 2023

Context:

Gastrointestinal (GI) duplications are rare congenital malformations with diverse presentations. They usually present in the pediatric age, especially in the first 2 years of life.

Aims:

To present our experience with GI duplication (cysts) at a pediatric surgery tertiary care teaching institute.

Settings and Design:

It is a retrospective observational study undertaken in the department of pediatric surgery at our center between 2012 and 2022 for GI duplications.

Materials and Methods:

All children were analyzed for their age, sex, presentation, radiological evaluation, operative management, and outcomes.

Results:

Thirty-two patients were diagnosed with GI duplication. Slight male predominance was present in the series (M: F ≈ 4:3). Fifteen (46.88%) patients presented in the neonatal age group; 26 (81.25%) patients were under 2 years. In the majority of cases (n = 23, 71.88%), the presentation was acute onset. Double duplication cysts on opposite sides of the diaphragm were present in one case. The most common location was ileum (n = 17), followed by gallbladder (n = 6), appendix (n = 3), gastric (n = 1), jejunum (n = 1), esophagus (n = 1), ileocecal junction (n = 1), duodenum (n = 1), sigmoid (n = 1), and anal canal (n = 1). Multiple associations (malformations/surgical pathologies) were present. Intussusception (n = 6) was the most common, followed by intestinal atresia (n = 5), anorectal malformation (n = 3), abdominal wall defect (n = 3), hemorrhagic cyst (n = 1), Meckel's diverticulum (n = 1), and sacrococcygeal teratoma (n = 1). Four cases were associated with intestinal volvulus, three cases with intestinal adhesions, and two with intestinal perforation. Favorable outcomes were present in 75% of cases.

Conclusion:

GI duplications have varied presentations depending on site, size, type, local mass effect, mucosal pattern, and associated complications. The importance of clinical suspicion and radiology cannot be underrated. Early diagnosis is required to prevent postoperative complications. Management is individualized as per the type of duplication anomaly and its relation with the involved GI tract.
Incarcerated Littre's Hernia in a Neonate Presenting as Enteroscrotal Fistula
Authors: Gupta Rahul , Mathur Praveen
Published: September 2023

A 27-day-old male neonate, presented with feculent discharge from the scrotum. Operative findings revealed incarcerated right inguinal hernia with perforated Meckel's diverticulum as its content, leading to enteroscrotal fistula. Resection of the Meckel's diverticulum and end-to-end ileoileal anastomosis was performed along with repair of inguinal hernia from within the abdominal cavity. The outcome was favorable. Enteroscrotal fistula due to incarceration of inguinal hernia is a rare presentation. We are adding to the literature, an extremely rare case of incarcerated Littre's hernia in the right inguinal region presenting as enteroscrotal fistula in a neonate.
Pediatric Colonic Anastomosis
Authors: Ghosh Arindam , Biswas Somak Krishna , Ghosh Tapanjyoti , Basu Kalyani Saha , Biswas Sumitra Kumar
Published: September 2023

Background:

Enhanced recovery after surgery (ERAS) protocols after colorectal surgery focused on reduced bowel preparation, standardized feeding schedule, earlier return of bowel function, and earlier resumption of normal activities. ERAS in pediatric surgical practice is not well established. The present study aims to present the results of two colonic anastomosis techniques of interrupted single-layered closure: Halsted (Horizontal Mattress) and Matheson (serosubmucosal or appositional extramucosal) along with two different methods of colostomy wound closure and their influence on the adoption of ERAS protocol of early feeding and early discharge.

Materials and Methods:

This single institute-based randomized control study was conducted in a tertiary care facility in Kolkata for 2.4 years. Patients were chosen randomly for serosubmucosal (Group I) and full-thickness (Group II) anastomosis.

Results:

Among total of 91 patients (Group I–43 and Group II–48), Return of bowel sounds and passage of bowel averaged 1.51 ± 0.51 and 1.91 ± 0.55 days in Group I and 1.91 ± 0.57 and 3.9 ± 0.66 days in Group II, respectively. Postoperative hospital stay averaged 5.88 ± 1.12 days in Group I and 8.9 ± 1.17 days in Group II. Overall 15 (16.48%) patients had complications among which SSI (Suprficial surgical site infection) and minor leaks (Group I–3 and 1 and Group II–5 and 3, respectively) which were treated conservatively (Clavien–Dindo Grade-I) and three major leaks under Group II requiring surgical intervention (Clavien–Dindo Grade-III).

Conclusion:

This study concludes that the technique of colostomy closure in the form serosubmucosal closure helps in the implementation of ERAS protocol by producing early bowel movement, early initiation of food, and less postoperative complications.
Retrospective Analysis of the Outcome of Stoma Closure in Children without Preoperative Mechanical Bowel Preparation
Authors: Saxena Rahul , Bhatt Somya , Pathak Manish , Goel Akhil D , Rathod Kirtikumar J , Sinha Arvind , Nayak Shubhlaxmi R. , Jadhav Avinash S.
Published: September 2023

Introduction:

Stoma closure is one of the most frequently performed surgical procedures by pediatric surgeons worldwide. In this study, we studied the outcome of children undergoing stoma closures without mechanical bowel preparation (MBP) in our department.

Materials and Methods:

This is a retrospective observational study of children <18 years undergoing stoma closure from 2017 to 2021. The primary endpoints were surgical site infection (SSI), incisional hernia, anastomotic leak, and mortalities. The categorical data are expressed in percentages and the continuous data are in medians and interquartile ranges. The postoperative complications were classified according to the Clavien–Dindo system.

Results:

A total of 89 patients underwent stoma closure without bowel preparation during the study. The anastomosis leak and incisional hernia were seen in one patient each. The SSIs occurred in 23 patients (25.9%), which were superficial in 21 and deep in 2 patients. The Clavien–Dindo Grade III complications occurred in 2 (2.2%) patients. The median duration to start feeds and pass first stools was significantly longer in patients with ileostomy closure (P = 0.04 and 0.001, respectively).

Conclusion:

The outcome of stoma closures without MBP was favorable in our study and hence it can be suggested that the use of MBP in colostomy closures can be safely avoided in children.
Case Report of Primary Synovial Sarcoma of the Thyroid Gland
Authors: Lekshmi R. , Gupta Sweety , Pabi Shreeya , Mandal Shreyosi , Singh Ashok , Agarwal S. P. , Gupta Manoj
Published: September 2023

Primary synovial sarcoma of the thyroid gland is extremely rare, aggressive, and has a dismal prognosis. We report the case of a 15-year-old male who presented with a progressively increasing neck mass, which was excised and the histopathological and immunohistochemical study suggested biphasic synovial sarcoma of the thyroid gland which was confirmed by synovial sarcoma translocation. There are 14 cases of primary synovial sarcoma of the thyroid reported in the literature so far. This study aimed to document the occurrence of synovial sarcoma histology at an unusual anatomical location with a review of the literature on this rare entity.
Tracheoesophageal Fistula with Bilateral Facial Cleft
Authors: Peters Nitin James , Behera Shaswati , Bade Ramyasree , Dogra Shivani , Solanki Shailesh , Samujh Ram
Published: September 2023

Commissural or lateral facial cleft (macrosomia), classified at Tessier number 7 craniofacial clefts, is a rare congenital anomaly usually associated with deformities of other structures developed from the first and second branchial arches. It affects the esthetics and functional aspect of the oral cavity. Bilateral transverse cleft occurring alone is uncommon and it's with tracheoesophageal fistula (TEF) has not been reported to the best of our knowledge. We report a case of esophageal atresia (EA) and TEF with macrosomia. EA was repaired, and the patient was discharged on full feeds. He is awaiting cleft repair.
Vulvar Lichen Sclerosus Et Atrophicus
Authors: Luqman Thasneem S , Kalavant Akshay , Sunil Kumar KS , Swathy AR
Published: September 2023

Vulvar lichen sclerosus et atrophicus is an inflammatory disease which can affect the pediatric age group, although rarely. Its prevalence is underestimated. It may have genital or extragenital manifestations. If left untreated, it may progress to complications which hamper the quality of life. The treatment of choice is topical clobetasol propionate. Here, we present a case of prepubertal vulvar LS, which was refractory to topical clobetasol but responded to topical tacrolimus application.
A Cost-effectiveness Model Comparing Urinary Biomarkers with Diuretic Renogram in Diagnosing Ureteropelvic Junction Obstruction in Children
Authors: Sangeetha Geminiganesan , Babu Ramesh
Published: September 2023

Background and Aims:

In this cost-effectiveness model, we compared the cost-effectiveness of commonly used urinary biomarkers with conventional diuretic renogram (DR) in diagnosing ureteropelvic junction obstruction (UPJO). We hypothesized that urinary biomarkers are as effective as DR.

Methods:

We used incremental cost-effectiveness ratio (ICER) as a tool for our cost-effectiveness analysis model. The cost of biomarker assay and renogram were sourced from the same center while the accuracy data of DR and urinary biomarkers from the relevant pubications.

Results:

As the accuracy of individual biomarker increased, the ICER also got better. As a panel of biomarker was introduced, the ICER went to the negative range suggesting cost saving as well. ICER of most urine biomarkers is currently less expensive and less effective. When a biomarker panel was applied ICER became more expensive and effective. With higher samples, test running cost is likely to go down in future and thus biomarkers are likely become less expensive and more effective.

Conclusions:

Individual urine biomarkers are currently less expensive and less effective compared to DR in predicting UPJO. In future, biomarker panel is likely to be more cost-effective and reduce the need for invasive renogram thus reducing the radiation exposure.
A Randomized Control Trial to Evaluate the Effect of Local Instillation of Mitomycin-C at the Porta after Kasai Portoenterostomy in Patients of Biliary Atresia
Authors: Solanki Shailesh , Kanojia Ravi Prakash , Gupta Pramod Kumar , Singhai Palak , Lal Sadhna Bhasin , Mahajan Jai Kumar
Published: September 2023

Background:

Kasai portoenterostomy (KPE) is the initial treatment for biliary atresia (BA). Even after initial jaundice clearance, a significant number of children presented with the reappearance of symptoms due to ongoing fibrosis involving porta and intrahepatic ducts. Mitomycin-C (MMC) is an antifibrotic agent, and the study hypothesized that local application of MMC at porta can decrease fibrosis, which can improve jaundice clearance and lead to better native liver survival (NLS).

Materials and Methods:

This prospective randomized control trial included children with BA, who were allocated to groups A or B. The patients in both groups underwent standard KPE; in addition, a 5 French infant feeding tube (IFT) was placed near the porta through the Roux limb in Group B children. During the postoperative period, MMC was locally instilled over the porta in Group B children through IFT. Postoperative jaundice clearance and NLS were assessed and compared.

Results:

A total of 27 children were enrolled in the study, 16 in Group A and 11 in Group B. Both groups were comparable preoperatively. Although the NLS was not statistically significant in Group B, the survival was quite higher, that was 91%, 81%, and 73% at 6 months, 1 year, and 2 years, respectively, compared to 63%, 50%, and 38% in Group A.

Conclusion:

Children in Group B clinically showed an early jaundice clearance and a better trend of serial bilirubin levels as well as longer NLS than Group A, but it was not statistically significant. The procedure was technically easy, and no complication was encountered related to surgical technique or MMC instillation.
Neonatal Sigmoid Colon Perforation in Low Anorectal Malformation
Authors: Singh Ram Jeewan , Suman Bijay Kumar , Sinha Amit Kumar , Kumar Bindey
Published: September 2023

Anorectal malformations (ARMs) are common congenital anomalies in neonates. Colonic perforation is very rare in ARMs. Delay in diagnosis of neonate with ARM results in colonic perforations and life-threatening morbidity. Colonic perforation due to ARM may not be completely avoided; however, early diagnosis and management are essential in assuring better outcomes.
Evaluation of Clinical Outcomes in Children with Intrahepatic Cholestasis Postpartial External Biliary Diversion
Authors: Nasr El-Din Hadeer Mohamed , Yassin Noha Adel , EL Koofy Nehal M , Obeida Alaa , Kaddah Sherif Nabhan , Eltagy Gamal Hassan , Mohamed Wesam
Published: September 2023

Background:

Severe pruritus caused by progressive familial intrahepatic cholestasis (PFIC) and Alagille syndrome (AGS) is refractory to medical treatment. Surgical interruption of the enterohepatic circulation is considered the mainstay of alleviating distressing symptoms and delaying cirrhosis.

Aim and Objectives:

This study aims to evaluate the short-term effect of partial external biliary diversion (PEBD) on pruritus, liver disease progression, patient's growth, and quality of life.

Material and Methods:

This prospective cohort study enrolled children with PFIC and AGS from July 2019 to July 2021, whose guardians consented to the PEBD procedure. A standard surgical approach was performed by a single surgeon. Outcomes were measured subjectively and objectively pre- and post-procedure using the pruritus 5-D itching score, Paediatric Quality of Life Inventory scale (PedsQL), growth parameters, bile acids level, and liver function tests. Patients’ follow-up period ranged from 6 to 12 months.

Results:

Seven patients had PEBD procedure; five with PFIC and two with AGS. A significant improvement was detected in the 5-D itching score (p-value < 0.001), PedsQL (p-value < 0.001), and bile acids level (p-value 0.013). The preexisting growth failure was ameliorated. The downward trend in the bilirubin level was not significant. No influential difference in the other liver function tests occurred. No intra-operative complications encountered. Only one case had a post-operative stoma prolapse which was managed surgically.

Conclusion:

PEBD procedure could be considered as an effective and safe treatment options for intractable pruritus in patients with PFIC or AGS, providing preserved synthetic liver functions.
Voiding Pressures in Boys
Authors: Vaze Poonam Guha , Saha Subhasis , Sinha Rajiv
Published: September 2023

Introduction:

Invasive urodynamics (UDS) is a standard investigation in children. Studies measuring voiding pressures in children use varied nomenclatures and quote a wide range of voiding pressures. Thus, voiding pressures in children are not considered reliable and they do not find any place in the pediatric diagnostic armamentarium. On the contrary, adult studies have well-defined nomograms and standard values which make voiding studies indispensable in the diagnosis of voiding dysfunctions in adults. The difference primarily lies in the uniformity of parameters assessed in adults and the contrasting heterogeneity in the pediatric literature.

Objective:

The objective of this study was to study the voiding parameters observed during UDS in boys.

Study Design:

We retrospectively reviewed the pressure flow data obtained during conventional invasive UDS in 106 neurologically normal boys (6 months–16 years) who had different indications for urodynamics. The values of Pdetmax and PdetQmax were analyzed and compared with the existing data of pressure flow studies in children.

Results:

Pdetmax decreased with age whereas PdetQmax was independent of age. The difference between the values of Pdetmax and PdetQmax was more in the younger kids. The wide range of voiding detrusor pressure (Pdet) in the existing pediatric literature is similar to the values of Pdetmax observed in our study, whereas the value of PdetQmax is much lower.

Discussion:

The values of Pdetmax observed in this study are similar to the values of “maximum Pdet during voiding” documented in previous studies and are determined by detrusor contractility and functional/dynamic contraction of outflow during voiding. PdetQmax has been documented in very few pediatric studies and is significantly less than Pdetmax. Further prospective studies are needed to corroborate UDS findings with radiologic/cystoscopic findings to create nomograms of voiding parameters in children.

Conclusion:

Existing literature on pediatric voiding studies mentions voiding pressures during variable phases of void (usually Pdetmax) and the values have been very heterogeneous, making voiding pressure-flow studies unreliable in children. PdetQmax values are much lower than values quoted as “standard” pressures and are age independent. The use of PdetQmax instead of PdetMax may make voiding pressures in children more reproducible and informative.
Right Phrenic Nerve Palsy following Long-Gap Esophageal Atresia and Tracheoesophageal Fistula Repair
Authors: Pokharkar Ashitosh D. , Aditya M. , Kandpal Deepak , Balan Saroja , Gupta Vidya , Chowdhary Sujit K.
Published: September 2023

Esophageal atresia (EA) and tracheoesophageal fistula (TEF) are surgically correctable congenital anomalies with reported surgical common complications such as anastomotic leaks, recurrent TEF, and esophageal strictures; however, phrenic nerve injury (PNI) is a very rare but possible complication which we have highlighted in our case report. Here, we report a baby girl operated for long-gap EA and TEF having respiratory distress and failed attempts to wean off oxygen support. Serial chest X-rays showed elevated right hemidiaphragm, whereas ultrasound thorax confirmed our diagnosis of right PNI causing diaphragmatic palsy. Conservative management with the hope of spontaneous recovery failed, so diaphragmatic plication was done at 5 weeks from index surgery. Postplication, the baby was weaned off oxygen and pressure support the very 1st day and had improved respiratory physiology.
Maintaining and Enhancing Advanced Driver Assistance Systems with
Connectivity
Authors: Parle Amber , Schwinke Steve , Sikaria Mayank , Sawant Amol
Published: September 2023

The power of advanced driver assistance systems (ADAS) continues to increase
alongside vehicle code and software complexity. To ensure ADAS functionality and
maximize safety, cost efficiency, and customer satisfaction, original equipment
manufacturers (OEMs) must adopt a solution that allows them to mine data,
extract meaningful information, send remote software updates and bug fixes, and
manage software complexity. All of this is possible with an embedded
telematics-based software and data management solution. Event-based logging
enables OEMs to actively measure ADAS effectiveness and performance. It allows
them to analyze driver behaviors, such as whether response times increase after
a certain time of day, and adjust the ADAS settings to increase functionality,
such as providing an earlier warning or automated response. A vertically
integrated solution also enables the identification and correction of software
and calibration defects for the entire vehicle life cycle through over-the-air
(OTA) software update packages. This eliminates the need for costly and
time-consuming dealer visits and allows troubleshooting, updates, repairs, and
recalibration to be performed remotely. There are industry-wide benefits of deep
connectivity as well, such as the sharing of critical and safety-related data to
make functional enhancements and use in the creation of a real-world safety
rating system instead of one based on lab data and general speculation.
Connected services are essential for not only the future of ADAS but also for
the creation of a safer driving environment for all.

In this paper we will:

Look at emerging trends in ADAS vehicle systems

Show how connected vehicle data can measure real-world ADAS
performance, including false positives and false negatives

Show how connected vehicle data can be used to understand driver
behaviors including usage patterns and feedback responsiveness

Show how systems can be maintained and enhanced throughout the
product life cycle in a cost-effective manner
The implementation of rights management information provisions in WIPO internet treaties: a comparative law perspective
Authors: Zhan Qian
Published: September 2023

With the rapid development of information technology, intellectual property protection in the digital environment has gradually become a critical issue. WIPO Internet Treaties have included new provisions for digital intellectual property protection since 1996, which require all the members to provide adequate and effective legal remedies for rights management information (RMI). However, WIPO Internet Treaties only afford a basic framework, leaving much discretion for members to decide how to implement their treaty obligations. The domestic protection of RMI generally differs in five aspects: definition of RMI; the scope of prohibited acts; knowledge elements; exceptions of liabilities; and legal remedies. By examining the RMI provisions in WIPO Internet Treaties and their implementation in jurisdictions, this article focuses on the perceived flaws, puzzles, and problems that the RMI provisions may cause, and speculates on the effectiveness of the RMI provisions in accomplishing predetermined goals.
Pedagogía y didáctica crítica. Una visión desde la praxis de los docentes de química
Authors: Chirinos González Jeanmary Josefina
Published: September 2023

Este estudio fue realizado en la Universidad Politécnica Territorial de Falcón “Alonso Gamero” de Venezuela, constituye una investigación en la perspectiva cualitativa, tuvo como propósito, interpretar el significado que los docentes del programa nacional de formación en química y procesos químicos, le otorgan a la pedagogía y a la didáctica critica (PDC) desde sus vivencias. el método usado es interpretativo-hermenéutico crítico, la recolección de la información se realizó con entrevista semiestructurada a seis (6) docentes. Las categorías que emergieron se agruparon y se aplicó la técnica de la triangulación. Los hallazgos develan que los docentes presentan poca claridad conceptual, filosófica y metodológica de la PDC desde el paradigma Sociocrítico (PSC), coexistiendo en su praxis concepciones lineales y reductoras del positivismo. Descubren dificultad para aplicar estrategias en la PDC y coinciden en que requieren formación docente en la instrumentalización del PSC.
Procesos gerenciales para la gestión del cambio en las instituciones educativa
Authors: Acosta Faneite Savier Fernando , Barrios Caba Manuel Antonio
Published: September 2023

El propósito del estudio fue describir los procesos gerenciales para la gestión del cambio en las instituciones educativas de Maracaibo, Venezuela. Metodológicamente el estudio utilizó el procedimiento descriptivo, el diseño de campo y no experimental; participaron en la investigación 98 docentes y 24 directivos, a quienes se les aplicó un cuestionario; los datos se procesaron según los procedimientos de la estadística descriptiva, también se elaboró un baremo para la interpretación del promedio. Los hallazgos señalan que los componentes que intervienen en los procesos gerenciales como la confianza, motivación y adaptación son poco eficientes en las instituciones educativas; además, que los fundamentos que intervienen en los procesos gerenciales el pedagógico, administrativo y social son poco eficientes. Se concluye que los procesos gerenciales no pueden verse como mecanismos de acción unidireccionales, expuestos desde una perspectiva individualista debido a que de esta manera no se desarrolla la gestión del cambio.
Proyecto de profundizacion en la educacion media en el Colegio Heladia Mejia: Avances y perspectivas
Authors: Sáenz Suárez Homero , Niño Cubillos Claudia Leonor , Fino Moreno Flor Maximima , Ojeda Zambrano Milton Jimmy , Otálora García Bárbara
Published: September 2023

Este artículo en la modalidad de experiencia educativa presenta algunas consideraciones sobre los avances, luego de ocho años de implementación del proyecto LIDERAZGO PARA GESTION DE PROYECTO DE VIDA SOSTENIBLE que orienta el núcleo de profundización de educación media en el colegio Heladia Mejía IED. El  acompañamiento pedagógico integral y oferta diversa en las asignaturas Emprendimiento, Investigación, Matemáticas Financieras y Fundamentos de Mecatrónica, teniendo como pilares las competencias del siglo XXI, habilidades socioemocionales y los ODS, con exitosa aplicación del ABP ha permitido a los estudiantes de grados 10 y 11 el desarrollo de proyectos articulados con las cuatro asignaturas, que  constituyen su trabajo de grado, que además de aportar avances en ciencia y tecnología, facilitan la articulación  con la educación superior y/o el mundo laboral. Esto ha contribuido a la formación de jóvenes con calidad humana, que construyendo su proyecto de vida trascenderán en la sociedad como ciudadanos competentes.
La responsabilidad social de las universidades y su compromiso con la agenda 2030
Authors: Castillo Ramos Leonardo Alberto
Published: September 2023

Este artículo se genera como resultado de la investigación documental llevada a cabo en el contexto de una futura tesis doctoral y considera elementos fundamentales que han permitido la aproximación a un escenario teórico que coadyuvará en la comprensión de la realidad a estudiar, relacionada con el compromiso de las universidades con la promoción de la Agenda 2030, desde la mirada de la responsabilidad social universitaria. Para abordar estos aspectos, en el presente ensayo, se interpretó la información obtenida para la debida reflexión en cuanto al compromiso que las instituciones de educación superior deben asumir en la promoción de los objetivos de desarrollo sostenible, fundamentando estas acciones en los principios de la responsabilidad social universitaria. Bajo este enfoque las universidades deben ofrecer respuesta ante los impactos en el entorno y asumir en corresponsabilidad con los grupos de interés, las acciones necesarias para ofrecer respuesta a las demandas de la sociedad.
El ser humano producto de la evolución y referente para la transformación histórico social
Authors: Vera Vélez Diego Patricio , Aguilar Floralba
Published: September 2023

Este artículo en modalidad ensayo analiza al ser humano como producto evolutivo, viajero que aborda la nave del tiempo, recorriendo épocas y contextos con una larga trayectorita hasta llegar a nuestros días. El objetivo de este trabajo, es mostrar una visión panorámica de los antecedentes, factores y procesos de la evolución y al ser humano como referente de conocimiento, pensamiento y acción. El trabajo fue realizado siguiendo el método heurístico que consiste en encontrar e indagar en documentos o fuentes históricas la información necesaria para los procesos investigativos; y el método hermenéutico que explica, traduce e interpreta las relaciones existentes entre un hecho y el contexto en el que acontece. La exposición se desarrolla en cuatro apartados: el primer apartado, plantea el desarrollo de la evolución y expone sus precedentes y factores desde la filosofía de Lamarck y Darwin; el segundo apartado, esboza el pensamiento metafísico de Klages y el pensamiento historicista de Dilthey en el desarrollo de la historia; el tercer apartado, expone las acciones del ser humano como producto del pensar y el conocer; y finalmente el último apartado, plantea la realidad actual del ser humano, y sus desafíos en el largo proceso histórico-evolutivo.
PREPARATION AND PHYSICOCHEMICAL EVALUATION OF MUSTADI SYRUP
Authors: G K Anju , Puranik Prathviraj , - Kavya
Published: September 2023

The selection of drugs plays an important role in treatment. Good quality drugs administered appropriately after
analyzing the condition of both disease and patient will act as nectar. The concept regarding standardization and
quality control of Ayurvedic drugs can be traced back to ancient times. Kashaya Kalpana is a pharmaceutically
viable and therapeutically effective formulation but has a shorter shelf life. Kashaya Kalpana can be easily modified into syrup form which is widely acceptable due to palatability, longer shelf life, and easy administration.
Mustadi Yoga, a Kashaya preparation from Yogaratnakara mentioned in Krimi Roga Chikitsa is made into syrup
form. The present work aims at reporting the physicochemical evaluation of Mustadi syrup and is standardized as
per the physicochemical parameters of API, which will help for further research.
Platelet Rich Plasma (PRP) Augmentation: A Novel Approach in Management of Radicular Cyst Present at Different Locations within Jaw: A Case Series
Authors:   CGHS Dental department, VMMC and Safdarjung Hospital, New Delhi, India, Kaur Herninder , Samal Santoshni , Vassou V Manica ,   Department of Pedodontics and Preventive Dentistry, SCB Dental College and Hospital, Odisha, India, Bhatia Gaurav ,   Endodontist, At Right Bite, New Delhi, India
Published: September 2023

Periapical cysts are inflammatory cysts that developed due to caries and trauma of the involved tooth. Usually, the tooth becomes nonvital with pain, swelling, and sinus formation. On radiographic examination these cyst shows radiolucency around the apex of the involved tooth. On aspiration straw colored inflammatory fluid with or without pus comes out suggestive of a radicular cyst. Surgical removal with curettage of the lesion, apicoectomy, and root canal treatment should be performed to treat the lesion. Excised cavity can be augmented with PRP (Platelet rich plasma) or PRF (Platelet rich fibrin) for better healing of the lesion. This case series reported 3 such cases and their treatment with follow-up.
The Prevalence of Peripheral Vascular Disease (PVD) and Its Correlation with Biochemical Parameters in Type 2 Diabetes Mellitus (T2DM) - A Tertiary Care Hospital Based Study in Eastern India
Authors:   Medical College Kolkata, India, Das Chandan Kumar , Baisya Ritasman , Biswas KD , Roy PK Sinha
Published: September 2023

INTRODUCTION PVD, one of the major macrovascular complications of T2DM, usually begins at an earlier age and remains subclinical for a long duration. So early detection of PVD will help to assess its true prevalence and hence prevention of overt manifestation. OBJECTIVES To assess the true prevalence of PVD in T2 DM from Eastern India and its correlation with clinical and biochemical parameters METHODS It was a cross sectional study with consecutive diabetes patients attending OPD from 2015 January to 2016 July. Each was subjected to meticulous history, measurement of ABPI by handheld Doppler and various laboratory parameters. Patients having known vascular disease due to other causes were excluded. RESULTS Out of 103 patients, PVD was present in around 25% cases with positive association with age, male gender, and high body weight. Hypertension, hyperglycemic state (PPBS, HbA1C), total cholesterol, triglyceride and LDL independently increases the risk of PVD. Though low levels of HDL are a well-recognized risk factor for PVD, this was not reflected in study. CONCLUSION The true prevalence of PVD is higher in DM and ABPI can detect subclinical PVD much before its progression and overt manifestations
MAPEO DE LA PRODUCCIÓN CIENTÍFICA SOBRE LA GOBERNANZA TURÍSTICA
Authors: Infante-Batista Melissa Karla , Díaz-Pompa Félix , Herrera-Pupo Gerson , Rivas-Nuila José Ricardo
Published: September 2023

La gobernanza turística constituye un factor fundamental para el desarrollo de los destinos turísticos. El objetivo del presente estudio es analizar la producción científica relacionada con la gobernanza turística. Con el empleo de Biblioshiny y los indicadores bibliométricos seleccionados se representa y mapea la información y las principales tendencias en esta área del conocimiento. Se registró durante el período 2017–2022, un total de 1471 documentos en la base de datos Scopus. El análisis indica que: (1) la producción científica respecto al tema tiene una tendencia creciente; (2) Existen más de 600 revistas que dan cobertura a la temática; (3) La Universidad de Johannesburg destaca como la más productiva; (4) China, España, Estados Unidos, Reino Unido e Italia son los países de mayor producción científica; (5) Según el análisis de palabras clave, los destinos turísticos sostenibles y la Covid-19 resultan los desafíos actuales para la gobernanza turística.
Interviewing Female Teachers as a Male Researcher: A Field Reflection from a Patriarchal Society Perspective
Authors: Subedi Khim Raj , Gaulee Uttam
Published: September 2023

This article examines the role of gender difference in a qualitative interview from the theoretical lenses of the sociocultural perspective of teachers' identity in a localized context of Ph.D. field research. The study blends the researcher's critical reflections during interviewing female teachers in exploring their teacher identity and existing literature on gender differences in a qualitative interview. In addition, a research diary is used as the data source to unpack the complexity of gender dynamics in a qualitative interview. To add to the discussion of gender difference in a qualitative interview, we argued that gender difference between the interviewer and the interviewee mediates and shapes the data collection in a qualitative interview. Thus, to understand the role of gender difference in a qualitative interview, it is necessary to do a comprehensive analysis of the complex dynamics of gender matching, the cultural background of the interviewee, and possible power relations between the researcher and participants. This study contributes to the dynamics in interviewing women by a man outside the Western cultural setting, particularly during a field research experience by a Ph.D. scholar.
Weaving the Threads Between: Collaborative Auto-Ethnographic Reflections on Experiences of Migrant Learning and Teaching in Australia
Authors: Throssell Paul , Lu Jinjin (Helen)
Published: September 2023

This article aims to use the two authors’ life experience, as English teachers, and university academics in the U.K., China and Australia, to improve an understanding how life trajectories can assist exploration of cultural difference and changes. Our experiences can be utilized as a means of understanding how responses to change and cultural differences can be influenced. Using a collaborative auto-ethnography research method offers readers opportunities to engage with the text through encountering the cultural nuances in these transitional journeys. The analysis is undertaken through the theoretical lens of transformational learning, cultural identity, and space. This paper will be of benefit both to academics in multicultural settings and to pre-service teachers in postgraduate programs. First, it will assist in sensitizing readers to become more culturally aware and competent through understanding how change across cultures can be beneficially accomplished and, second, by showing how constructive change can influence all evolving cultural identities within vibrant, multicultural and multilingual contexts such as we experience in Australia.
Analyzing how the sobek tool can assist students’ writing
Authors: De Pontes Romário Ferreira , Padilha Thereza Patrícia Pereira
Published: September 2023

Reading and text production are two important skills for everyone, but it is known that even students in higher education have difficulties how to write high-quality texts. Currently, there are several automatic text analysis tools, also well-known as text mining tools, available on the Internet (paid and free) which can be used to support text production, such as LanguageTool (Zhang et al., 2018), TextAlyser (TextAlyser, 2019), TagCrowd (TagCrowd, 2019), and Sobek (Macedo et al., 2016). These tools usually highlight attention points in a text, present a statistical analysis, suggest connection words, and emphasize locals with repetitive words, turning out a text with higher quality. Thus, this paper presents a case study using the Sobek automatic text analysis tool to investigate its potential to support students in the learning process (reading and production/writing). One group of 26 students enrolled in 9th grade from a middle school in the Paraiba state, Brazil, participated in writing activities using the Sobek tool. From the experiments, the results have shown an upgrade in text writing skills, especially showing a vocabulary more diversified and text structures, which are discussed in this paper.
Desarrollo de un sistema LIBS basado en un espectrómetro de bajo cos-to con potenciales aplicaciones al análisis de objetos arqueológicos de oro, plata y cobre
Authors: Chávez Robin Noé Camacho , Aldama-Reyna Claver Wilder
Published: September 2023

En este trabajo se reporta el desarrollo de un sistema de espectroscopia de plasmas inducidos por láser más conocido como LIBS (Laser Induced Breakdown Spectroscopy) en base a un mini espectrómetro de bajo costo y de propósito general que junto con un arreglo óptico sencillo de colección de la luz y un láser pulsado Q-Switched de Nd:YAG con longitud de onda de 1064 nm fue adaptado para la adquisición de espectros de emisión de plasmas inducidos por láser pulsado en placas de oro, plata y cobre de alta pureza. La ablación láser de estas placas metálicas se realizó en aire y a presión atmosférica, detectándose las líneas espectrales características del oro, plata y cobre para que sirvan como espectros patrón para la identificación de la composición elemental de objetos arqueológicos metálicos. El sistema LIBS fue probado con una muestra arqueológica metálica determinándose que estaba hecha de una aleación ternaria de cobre, plata y oro. Estos resultados sugieren que es factible el uso de un sistema óptico sencillo y de un mini espectrómetro para el análisis elemental de objetos arqueológicos metálicos de oro, plata y cobre o sus aleaciones.