bluuebunny/crossref_metadata_2025 huggingface dataset:
Finding Robotic Wide Free Space Path in Dynamic Environment by Improving MAX–MIN Ant System Algorithm
Authors: Ali Hadi Hasan  , Hasanen S. Abdullah  , Mohamad Ab. Saleh
Published: July 2023

— This paper proposes a new obstacle avoidance method for finding an optimal path passing through wide free space based on the optimized MAX-MIN Ant System (MMAS) algorithm in dynamic environments. The proposed improvement of the MMAS algorithm occurs in two stages. The first stage analyses the environment with two modifications by proposing a new relation of pheromone trail updating to construct the consequence modified (deposited) pheromone trail update in each iteration based on adding a new parameter (clean) to calculate the possible wide empty locations. Another alteration at this level involves checking and identifying the four horizontal and vertical states. Suppose the two nodes on either side of the four diagonal nodes are barriers in the next neighbor locations. In that case, the Tight Tunnel state is then attained, and it is managed by sealing this location to prevent passing through it before the robot movement stage. Another alteration is made to the robot-moving stage by recommending a new relation of tour building probabilities to determine the best option for moving the robot from the start node through a dynamic environment that incorporates dynamic obstacles moving through free space by locating and exhibiting the ideal path via broad free space. The main outcome of the experiment simulation of the new method involves that the robot avoids going through narrow tunnels and chooses the best course through open areas to reach its destination without running into any impediments in various dynamic environments conditions. In addition, the comparison of average time occupied to find the paths by the new method reduces to 54.32% as compared with that required with the method of hybrid the basic D* algorithm with the Lbest PSO algorithm, and to 11.95% in comparison to the time occupied recorded when applying the method of the improved MAX–MIN ACO algorithm.
Imágenes y estereotipos del indígena en la producción fílmica de Ciro Guerra: Pájaros de verano
Authors: Reverol Carmen Laura Paz , Bajo María Dolores Fuentes
Published: July 2023

El presente artículo tiene como meta el estudio de la imagen que nos ofrece el cine colombiano del indigenismo; nos fijaremos para ello en uno de los directores más premiados, Ciro Guerra, y en su largometraje Pájaros de verano, estrenado en 2018. En esta película el director se centra en el pueblo wayuu, en la época dorada de la marimba. En este sentido, nos proponemos fijar nuestra atención en el análisis de las imágenes y estereotipos que sobre lo indígena se construyen y que son hábilmente mostrados por Ciro Guerra, en su tránsito de la invisibilidad a la reivindicación. Esto sin dejar de lado problemáticas como el narcotráfico que desestructuran la vida de los pueblos indígenas.
La imagen del gaucho argentino en los primeros films de dibujos animados estadounidenses
Authors:  Fanchin Ana Teresa
Published: July 2023

En esta contribución se analizan films producidos por Disney, que encabezan la nómina de historietas desplegadas en el celuloide. Esta particular fuente de dibujos animados, expuestos en la pantalla y que alcanzaría amplia difusión, ha de ilustrarnos sobre la representación del gaucho de las pampas argentinas por parte de la visión estadounidense, en instancias que aspiraba alcanzar su hegemonía mundial. Al mismo tiempo, en razón a que estas proyecciones iban destinadas principalmente a la población infantil, se considera la concepción de la infancia en la época y la generación de espacios recreativos, no sólo como ámbitos de socialización, sino como facilitadores de la transmisión de principios y valores culturales.
Viajes, comercio y cultura corsa en el noreste venezolano (S. XIX): aproximación histórica a los estereotipos de viaje a través del documental De navíos, ron y chocolate
Authors: Aizpurúa Edda O.  Samudio , V. Barrios-Barrios Johnny
Published: July 2023

El presente trabajo busca abordar, estudiar y exponer de forma analítica la importancia del viaje y los viajeros durante el periodo decimonónico, así como algunos estereotipos registrados en torno a la presencia extranjera en Venezuela. Este ejercicio se hace a partir del reconocido documental De navíos, ron y chocolate (Roncayolo, 2011), donde es posible observar el contexto de este periodo y los aspectos económicos y socioculturales sobre la presencia corsa en el oriente venezolano, lo que permite una aproximación histórica a la temática de viajes a través de la documentación, testimonios orales, dramatización, perspectivas imaginarias y evocación de imágenes históricas, elementos que acercan al observador a narrativas, representaciones, aspectos sociosimbólicos y percepciones de la cultura venezolana. El interés por este documental radica en que permite reivindicar ante las nuevas generaciones cómo en el proceso de emigración se pierde mucho de la tierra natal, pero se gana en la de acogida. Desde siempre, Venezuela ha sido una tierra de posibilidades donde conviven armónicamente las herencias que son la base de su crisol cultural.
Les émirats irano‑turks entre jihad et fitna. Approche comparative de la légitimation de la guerre chez les Samanides et les Ghaznévides (ixe‑xie siècle)
Authors: Rhoné-Quer Camille
Published: July 2023

À partir du début du iiie/ixe siècle, les émirats des marges orientales du Dār al‑Islām, au Khorassan et en Transoxiane, sont aux mains des dirigeants iraniens (Tahirides, Samanides, Saffarides) puis Turks (Ghaznévides, fin ive‑ve/xe-xie siècle). Ceux‑ci fondent leur légitimité politique sur la défense du territoire contre les ennemis venant des steppes ou sur l’expansion du Dār al‑Islām face aux infidèles de l’Inde. Toutefois, plusieurs épisodes militaires montrent que leurs ambitions territoriales, multidirectionnelles, menacent d’autres dynastes musulmans sunnites, qu’il s’agisse d’émirs iraniens ou du calife abbasside lui-même. Dans ce contexte, divers arguments sont invoqués pour justifier – ou parfois condamner – une guerre a priori illégale. Nous analyserons ces arguments, mais soulignerons aussi les divergences des sources en la matière.
La légitimation de la rébellion dans le sultanat mamelouk (xiiie‑xvie siècles). Discours juridique et pratique sociopolitique
Authors: Onimus Clément
Published: July 2023

Alors que la notion de conflit interne dans l’islam médiéval est associée à des connotations sacrées de fin des temps et d’explosion de la communauté des croyants, le cadre conceptuel qui l’entoure semble évoluer à l’époque mamelouke, tant est manifeste la fréquence de la fitna dans les chroniques. En même temps que le droit sur les guerres internes évolue dans le sultanat du Caire, les sources historiographiques montrent à quel point l’anathème n’est plus guère utilisé pour condamner les rebelles. Les fitna‑s deviennent alors systémiques, engagées dans le fonctionnement du régime comme un élément clef de son équilibre. Des fatwā‑s sont parfois promulguées pour condamner un rebelle mais généralement pour des crimes d’ordre civil plutôt que politique, et surtout, la plupart des révoltes ne donnent pas lieu à de tels actes juridiques. Ce sont les normes sociopolitiques et non les normes juridiques qui décidaient de l’éclatement ou non de rébellions : les émirs ou mamelouks invoquaient tantôt la capacité militaire du souverain, tantôt le consensus des émirs, tantôt les abus d’autorité, tantôt l’équité de la répartition des ressources et des honneurs pour justifier de tels soulèvements. Ce sont ainsi les normes de la pratique sociopolitique qui se sont imposées pour faire évoluer les normes juridiques et la nature du discours sur la fitna. Celle-ci ne perdit toutefois pas ses connotations sacrées mais la sacralité se déplaça de l’histoire des origines de l’islam vers l’histoire du début du régime dit « circassien » pour condamner fermement la guerre interne et faire du rebelle triomphant non point le transgresseur mais le restaurateur de l’ordre et de la justice.
La presse et ses passeurs méconnus, intermédiaires indispensables à la circulation de la littérature américaine en France dans les années 1940
Authors: Cadin Anne
Published: July 2023

La presse a été un intermédiaire indispensable à la circulation de la littérature des États-Unis dans les années 1940 en France ; pourtant, son rôle dans ce processus d’importation a été très peu étudié. Or, l’étude d’un corpus d’une quarantaine de titres (Combat, La Bataille, Action, Carrefour, Esprit...) confirme l’hypothèse de la construction d’un « goût français » en termes de littérature américaine, mais aussi le fait que l’éloge de l’apport américain est rapidement critiqué dans les périodiques, d’ailleurs de toutes étiquettes, ce qui a pu donner lieu à de virulentes polémiques. En outre, c’est dans la presse que des passeurs demeurés méconnus apportent leur pierre à l’édifice de la construction du discours critique autour d’une possible influence des textes d’Outre‑Atlantique sur les écrivains français : il s’agit d’universitaires (Las Vergnas, Sigaux, Larnac), d’aficionados exigeants (Beaumont, Blanzat, Fauchery, Hoog, Lalou, Morel) mais aussi de détracteurs de cette importation (Henriot, Kanapa). L’arrivée massive de la littérature américaine en France ne génère pas seulement une éphémère fébrilité médiatique : au contraire, c’est dans la presse qu’est scruté ce « moment » littéraire américain et que sont abordées des problématiques essentielles, telles que la réalité de la nouveauté de l’apport américain ou l’avènement d’une massification littéraire par le biais de l’influence américaine.
Langston Hughes chez Pierre Seghers : récit d’un engagement poétique
Authors: Ettlin Annick
Published: July 2023

Bien qu’elle ait sensiblement marqué les poètes de la négritude dans les années 1920, la Renaissance de Harlem a fait l’objet en France d’une réception éditoriale et académique pour le moins confidentielle. Or, entre quelques poèmes traduits autour de 1925 et l’intérêt que manifestent les chercheurs depuis les années 2000, deux principaux canaux de diffusion ont permis d’introduire dans le domaine français la poésie de Langston Hughes en particulier, dans les années 1950 et 1960 : la revue Présence Africaine et, de façon plus inattendue, les Éditions Pierre Seghers. Cet article entreprend d’évaluer le travail de promotion de Seghers entre 1947 et 1966. Il examine les circonstances et les choix ayant mené à la publication de la première autobiographie de Hughes, d’un recueil de poèmes traduits par François Dodat en 1955, d’un volume de la collection « Poètes d’aujourd’hui » paru en 1964 et de deux anthologies préparées par Hughes en 1962 et 1966. Il s’appuie en outre sur l’étude des lettres échangées par Hughes et Seghers entre 1955 et 1966, conservées à la bibliothèque Beinecke de l’Université de Yale. À partir de l’examen de ces différentes pièces, dont il compare les stratégies, l’article met à l’épreuve l’hypothèse suivante : Langston Hughes, par le biais de l’intervention de Pierre Seghers, a été reçu en France non comme l’un des acteurs de la Renaissance de Harlem, ni même comme l’auteur de poèmes à tonalité politique, mais pour son engagement en faveur de la diffusion de la poésie, c’est-à-dire comme médiateur culturel. Pour Seghers, la biographie et l’œuvre de Hughes contribuent à fonder le modèle d’un geste poétique idéal : à la fois actif et apte à solliciter l’action.
Parallel Universes? Alison Bechdel’s Dykes to Watch Out For (1983-2008) and Diane DiMassa’s Hothead Paisan: Homicidal Lesbian Terrorist (1991-1996)
Authors: Tison Hélène
Published: July 2023

Cartoonists Alison Bechdel and Diane DiMassa, writing in a socially and culturally heteronormative context, give life to a fantasy: worlds that, instead of excluding dykes from public space, are entirely organized around lesbian characters. Both reflect the debates within lesbian feminist groups, the tensions between lesbian and straight feminists, and the strategies that can be deployed in the face of discrimination. They create utopian (Bechdel) and dystopian (DiMassa) universes that parallel and question contemporary US realities. DiMassa presents a caricatured, degraded version of US society, focusing on its relation to minorities, as seen through the eyes of a “homicidal lesbian terrorist” intent on reclaiming their right to exist in the world. Bechdel’s syndicated bi-monthly strip is a twenty-five-year running commentary on US politics viewed from a lesbian perspective, that also discusses such feminist and/or LGBTQ+ issues as gender relations, the sodomy laws, trans rights, marriage equality, etc., and that shows her characters evolving on a number of these issues, as many Americans have since the 1980s. For all their provocation and humor, these comics from the margins have remained eerily topical.
Perceptions of Radiography Students Regarding the Qualities of an Effective Clinical Educator in Zambia
Authors: Bwanga O. , Iyamvwa P. , Chanda E. , Bwalya M.
Published: July 2023

Background: Clinical education is the most influential and important component for the preparation of future radiographers. During clinical education, experiences of radiography students are formalised, managed, and assessed to ensure competence in radiography. Clinical educators are vital to this development and help students apply theory to practice. In Zambia, the qualities of effective clinical educators of radiography students are not well-defined. This study explored the perceptions of radiography students regarding the qualities of an effective clinical educator in Zambia.Methodology: The study was conducted at the Lusaka Apex Medical University (LAMU) of Zambia, using a qualitative exploratory research design. Data was collected using semi-structured interviews with a purposive sample of eight radiography students. Data was audio-recorded, transcribed, and analysed using framework analysis.Results: Three qualities of an effective clinical educator were identified: clinical competence skills, clinical education skills, and personal attributes. Exhibiting knowledge and experience in radiography and teaching, and displaying good communication skills were the most common qualities of an effective clinical educator that enhanced the learning experiences of radiography students. On the other hand, favourism was the main negative quality reported of clinical educators which hindered the radiography students’ learning process.Conclusion: The identified qualities of clinical educators will help radiographers who supervise students to self-assess, develop, and maintain the qualities necessary for effective clinical education. The study findings will also help schools of radiography to support their clinical educators and can be used for clinical education quality assurance.
A Novel Teaching-learning Method of Nerve Injury Using Banana and Toothpick: A Low Fidelity Static Model Approach
Authors: Nalini Y. C. , Gowda A. , Nayak V. K. R.
Published: July 2023

No abstract available
Effect of Education in AETCOM Competencies in Shaping the Professional Attitudes of Medical Students
Authors: Amarantha D. R. , Noor T. , Swanand S. P.
Published: July 2023

Introduction: The Attitude, Ethics and Communication (AETCOM) module has been introduced in the recent Competency Based Medical Education (CBME) curriculum in the year 2019 as a means of directly and explicitly imparting soft skills to students. As this program has been implemented phase-wise in our institution, we conducted a preliminary survey to identify professional attitudes of students in the 2019-20 batch who have had some exposure to AETCOM education as compared to the earlier 2017-18 batch who had no exposure to the modules.Methods: This was an observational cross-sectional study involving two groups of undergraduate medical students who were exposed and not exposed to AETCOM modules respectively. A self-administered semi-structured questionnaire comprising 20 closed-ended and 4 open-ended items related to the study topic was designed for data collection. Responses were entered and tabulated in MS Excel and analyzed using SPSS version 21 by descriptive and inferential statistics.Results: A total of 103 medical students participated. The Mean Attitude Score (MAS) was significantly higher in the batch exposed to the AETCOM sessions. Among those exposed, 91.65% agreed that their behaviour towards patients had changed after attending the sessions. In addition, they gave suggestions on how the delivery of the modules could be improved in the second professional year.Conclusion: Formal training in AETCOM competencies has a positive effect in shaping the professional attitudes of medical students. Role plays and clinical exposure are perceived as effective ways of imparting ethics education. This positive effect can be enhanced with improved teaching-learning methods for successive batches of undergraduate medical trainees at our institution.
Medical Museums should Inspire rather than Macabrely Horrify
Authors: Ting J. Y.
Published: July 2023

No abstract available
Non-communicable Diseases Competencies in Undergraduate Curricula at Medical University in Bhutan
Authors: Tenzin K. , Yangzom T. , Zam S. , Yangden K. , Zangmo S. , Choeda T. , Denka C.
Published: July 2023

Background: This review study aimed to assess non-communicable diseases (NCDs) competencies in three existing curricula at Khesar Gyalpo University of Medical Sciences (KGUMSB), Bhutan.Methods: A review study of the existing curricula for competencies in NCDs was carried out using the World Health Organization (WHO) NCDs competency framework in the three curricula at KGUMSB.Results: NCD competencies for both medical doctors and community health workers were almost similar but the level of mastery in competencies differed between the two curricula. For nursing, most of the NCD competencies were missing.Discussion: There was a lack in clarity on strategies to develop the listed competencies by learners in all three curricula.Conclusions: There was a lack in clarity on strategies to build psychomotor and affective domains for numerous NCD competencies in the existing curricula. Some critical strategies such as work place-based assessment, simulation-based learning and entrustable professional activities could be incorporated in the revised curricula at KGUMSB.
HISTORIC-ARCHAEOLOGICAL RESEARCH OF THE CATHOLIC UNIVERSITY OF THE SACRED HEART OF MILANO ON THE INDUS DELTA (2019-2021)
Authors: Piacentini Fiorani Valeria
Published: July 2023

storic-Archaeological Research of the Catholic University of the Sacred Heart of Milano on the Indus Delta (2019-2021). History and Archaeology, Science and Technology. During the last three years of field-work (2019-2021), in the central-western portion of the mound we came across a vast area stretching along the east-west main road-axis of past epochs, replanned and rebuilt as a market-zone, where luxury goods were produced by skilled craftsmen converged there from different parts of the Indian Ocean (see ibid preceding note 2018/2019 and Piacentini & Fusaro PSAS 2022). We were facing a new phase of the site’s life and model of peopling. This article aims at focusing on the historical stage of this last period (written data complemented and integrated with archaeological evidence), the role played by our site as crossroads within the international trades of its time on land, on river and on sea. How science and technology have complemented a theoretical panorama through archaeometric analyses and drone’s plans of the bastioned mound, its environment and excavated trenches (see here below the notes by Prof. Mario Piacentini, and A. Tilia & S. Tilia). Stratigraphic levels associated with pottery and other little objects found in situ provide a first image of the new urban plan, its political and institutional reorganization and economic system. Textual sources confirm and integrate. Archaeometric analyses have allowed chronologies (complementing historical texts), pottery’s provenience (produced in situ, imitation or imported), interesting notes on glass and metallurgy, plus some hypotheses on the significance of the rich variety of moulds found in situ (spare parts used and thrown away?) or around small smelting kilns. All in all, a vivid plastic image of the last phase of the site’s peopling and its abandonment.
Fibromatosis colli, an unusual neck mass: A case report
Authors: Chen Pin-Hua , Hsu Chih-Chuan , Fan Hueng-Chuen
Published: July 2023

Fibromatosis colli (FC) is a condition of benign fibrous tissue proliferation on one side of the sternocleidomastoid (SCM) muscle leading to focal or diffuse enlargement of the neck and is often clinically associated with torticollis. Here, we report a case of a 2-month-old infant who was healthy except for a bulky neck mass on the left side of the SCM muscle. The patient was diagnosed with FC using sonography, which is a favored imaging tool because it can differentiate FC from other causes of neck masses. Physiotherapy can significantly improve the majority of FC cases.
Effect of probiotics therapy on intestinal leakage: A meta-analysis of randomized controlled trials
Authors: Li Chen-Pi , Kuo Wu-Hsien , Chang Ko-Shih , Yu Jui-Ting , Tsai Ru-Yin
Published: July 2023

Background:

Currently, there is no clear conclusion regarding whether the ingestion of probiotics by humans can effectively maintain the intestinal physical barrier. The abundant bacterial population within intestinal tissues may encounter potential health issues, such as inflammation and infections. Therefore, the preservation of the integrity of the intestinal physical barrier plays a crucial role in reducing the body’s inflammatory response. However, further research is still needed to determine whether oral probiotics in humans can effectively maintain the functionality of this physical barrier.

Objectives:

This study aimed to investigate whether probiotic interventions alleviate intestinal leakage and strengthen intestinal barrier function.

Methods:

This systematic literature review and meta-analysis was conducted using three databases (PubMed, Science Direct, and ProQuest) to search for studies published from January 2010 to October 2020. Only randomized controlled trials of probiotic intervention for people with high intestinal permeability situations were included.

Results:

This meta-analysis included five randomized controlled trials, comprising 283 participants in total. Intestinal permeability was not significantly improved by probiotics intervention neither in short-time nor in long-term administrate.

Conclusion:

The meta-analysis study suggested that probiotics might not be an effective intervention for people with intestinal leakage. Probiotics might be considered as supplement food in maintaining normal intestinal permeability.
A rare cause of hepatic abscess: Fish bone penetration leading to abscess formation
Authors: Chung Jen-Hung , Liou Jiun-Fu , Wei Chih-Wei , Hsueh Kuan-Chun
Published: July 2023

Liver abscesses due to foreign body penetration from the gastrointestinal tract are relatively rare events. The inability to recognize this condition may lead to poor response to standard treatment of liver abscesses. This group of liver abscesses has a distinct location and growth of microorganisms from liver abscesses of other etiologies. Laboratory studies often present nonspecific findings. Computed tomography exam is the best tool to recognize and diagnose this condition. Treatment often would require foreign object removal to prevent the recurrence of abscess formation.
Isolated intracranial cerebral artery dissection associated with a competitive soccer match: A pediatric case report
Authors: Yang Chung-Hsiang , Chen Yen-Lin , Wang Ann-Ching
Published: July 2023

Stroke during sport activities is very rare in children. We report the case of an 11-year-old boy in whom, during a competitive soccer match, distal intracranial cerebral artery dissection caused acute left-side middle cerebral artery infarction. The risk of stroke in relation to sports in children is underestimated; however, because of the immaturity of the cervical spine in children, the intracranial cerebral vessels may press against the bony compartment of the upper cervical spine, which can lead to vascular damage during participation in sports. Therefore, emergency room clinicians must consider the possibility of stroke in children, who exhibit sudden onset of weakness, facial droop, and slurred speech during sports activities; early recognition may yield better outcomes.
Can music and medicine be effective on anxiety, depression and chemotherapy-related nausea and vomiting? (PEGASUS study)
Authors: Tanriverdi Ozgur , Karaoglu Turan , Aydemir Fatma Nil
Published: July 2023

Background:

Music and medicine can be used in patients with cancer as a palliative complementary therapy. It is aimed to show the effect of music therapy performed on anxiety, depression, and chemotherapy-related nausea/vomiting.

Methods:

A total of 62 patients with colon cancer who previously experienced grade 1 or 2 chemotherapy-related nausea and vomiting were divided into two groups as intervention and control group based on the addition of music and medicine to infusion chemotherapies and 1:1 randomized. The groups were compared in terms of the effect of music and medicine on anxiety, depression, heart rate, blood pressure, and chemotherapy-related nausea-vomiting. Statistical analysis was done using SPSS Statistics for Windows, Version 19.0. A value of P < 0.05 was found statistically significant.

Results:

The patients were evaluated in terms of study variables at the beginning and after the completion of a chemotherapy session. As a result, there was a significant decrease in systolic blood pressure (P = 0.042), diastolic blood pressure (P = 0.44), heart rate (P = 0.046), state and trait sections of the state-trait anxiety inventory scores (P = 0.047 and P = 0.046, respectively), as well as a significant decrease in anxiety degree (P = 0.036) and a significant improvement in chemotherapy-related nausea (P = 0.021) and vomiting (P = 0.038) experience in the intervention group. However, no significant effect of music and medicine on depression was detected (P = 0.218).

Conclusion:

Although it has not been shown to have an effect on depression, it was concluded that music and medicine with classical music integrated into the chemotherapy session can reduce the degree of nausea/vomiting and anxiety levels.
Knowledge and preventive practices regarding malnutrition among mothers of under-fives in Kaduna North Local Government Area
Authors: Nwankwo Bilkisu , Kakamor Mary Daie , Usman Nafisat Ohunene , Omole Victoria Nanben , Oyefabi Adegboyega Moses
Published: July 2023

Background:

Malnutrition (undernutrition) and its attendant complications remain the plight of many countries globally. However, sub-Saharan Africa is disproportionately affected with the burden of this largely preventable condition. Basic knowledge of nutrition and good feeding practices among caregivers are essential to reduce childhood malnutrition. The aim of this study was to determine the knowledge and preventive practices related to malnutrition among mothers of children aged <5 years in Kaduna North Local Government Area.

Methods:

This was a cross-sectional descriptive study that was carried out to determine the knowledge and preventive practices related to malnutrition among mothers of children aged <5 years. A multistage sampling technique was used to select 262 mothers of children aged <5 years, from whom data were collected using interviewer-administered questionnaires. Data were analyzed using SPSS version 25.

Results:

The mean age of the respondents was 27.5 ± 3.5 years. The majority of the respondents, 164 (62.6%), had secondary school education. Only 11.5% of the respondents had good knowledge on malnutrition. Almost one-third (30.9%) of the respondents had good preventive practices regarding malnutrition. There was a statistically significant relationship between respondents' knowledge of malnutrition and their educational status (P < 0.0001), occupation (P < 0.0001), and the number of children they have (P < 0.0001). There was a statistically significant relationship between respondents' preventive practice regarding malnutrition and their educational status (P < 0.0001) and occupation (P < 0.0001).

Conclusion:

In view of the findings of poor knowledge and practice among the respondents, improving female education will lead to better nutritional outcomes among their children.
Thoracotomy in children
Authors: Ogunleye Ezekiel Olayiwola , Olusoji Olugbenga Oluseyi , Adekola Oyebola Olubodun
Published: July 2023

Background:

Thoracotomy in children is relatively rare compared to adults. It can be very challenging due to the peculiar anatomy and physiology in this age group. The objective of the study was to study the indications, outcomes, and complications following thoracotomy.

Methods:

This was a retrospective analysis of the medical charts of neonates, infants, and children who had undergone thoracotomy under general anesthesia from January 2011 to December 2020 at our institution. Furthermore, we searched for the childhood thoracic diseases necessitating thoracotomy; the indications and complications following thoracotomy, as well as, the quality of life following thoracotomy. The children had either posterolateral or lateral thoracotomy, which spared the latissimus dorsi and/or serratus anterior. Data collected included demographics, surgical intervention, duration of intensive care unit admission, postoperative complications, and clinical outcome.

Results:

Out of the 39 patients, a majority were female 20 (51.3%), the most common indication for thoracotomy was congenital anomalies in 25 (64.1%) patients (lung malformations, 35.9% and patent ductus arteriosus, 28.2%), followed by foreign body aspiration (20.21%). Postoperative complications were seen in 15 (38.5%), out of whom 3 (20%) had atelectasis, chylothorax in 1 (6.7%), and wound dehiscence in 2 (13.3%). The 30-day mortality was 12.8%. The quality of life as assessed by Karnofsky performance status within 6–12 months after discharge in 32 children was 100 and in two patients (90).

Conclusion:

The most common indication and complication following thoracotomy at our institution was congenital anomalies in 25 (64.1%) patients (lung malformations, 35.9% and patent ductus arteriosus, 28.2%), and atelectasis, respectively. The 30-day mortality after thoracotomy was 12.8%.
Imaging spectrum, associations and outcomes in acute invasive fungal rhino-ocular-cerebral sinusitis in patients with COVID-19 pneumonia
Authors: Patel Viral B. , Patel Aashvi , Mishra Girish , Shah Nilay , Shinde Mayur K. , Musa Raish K.
Published: July 2023

ABSTRACT

Background:

Coronavirus Disease 2019 (COVID-19) has been speculated to enhance mucormycosis infection due to its immune-altering pathophysiology. Early identification of high-morbidity conditions is crucial for optimal treatment and improved outcomes.

Methods:

A retrospective study was conducted on 63 patients with clinical and microbiological evidence of rhino-ocular-cerebral mucormycosis, who had a history of COVID-19 infection. The clinical, demographic, and imaging data were retrieved and analyzed. Descriptive statistics (mean [SD] and frequency [%]) were used to describe important characteristics across audit cycles.

Results:

Out of 63 patients, 54 (85.71%) patients had associated comorbidities, with diabetes mellitus being common comorbidity and all patients had received injectable and/or oral corticosteroids. Imaging showed nasal and paranasal sinus, perisinus, maxillary alveolar arch, and hard palate involvement in 62 (98.41%), 33 (52.38%), 5 (7.94%) and 5 (7.94%) patients, respectively. Orbital involvement was seen in 24 (38.10%) patients. Skull base involvement was seen in 11 (17.46%) patients, and intracranial extension of disease was present in 11 (17.46%) patients. A total of 16 patients were on mechanical ventilation, of whom 3 succumbed. The mean (standard deviation [SD]) intensive care unit (ICU) stay was 13.2 days (6.8) for 5 patients who succumbed and 6.4 days (4.6) for 30 patients who survived (P value = 0.008).

Conclusion:

Cross-sectional imaging not only provides the extent of disease spread but also plays a vital role in providing a surgical roadmap to treating surgeons and in predicting prognosis in patients with invasive fungal infections.
Current distribution of medical colleges in India and its potential predictors: A public domain data audit
Authors: Mondal Himel , Soni Sachin , Juyal Ankita , Behera Joshil K. , Mondal Shaikat
Published: July 2023

ABSTRACT

Background:

A teaching hospital or medical college may help provide better health care delivery to the people of the vicinity. Hence, building new medical colleges and upgrading existing hospitals to teaching hospitals are being implemented in India.

Objective:

This study aimed to observe the current distribution of medical colleges in Indian states and find correlation with area, population, and net state domestic product (NSDP).

Methods:

We collected data from public domain websites provided by government agencies. The State-wise number of government and private medical colleges and their annual intake were obtained from the National Medical Commission website. The state-wise number of medical colleges, geographical area, and population were calculated as the percentage of total Indian colleges, area, and population, respectively. Spearman’s correlation was calculated to find any correlation of colleges and annual intake versus parameters such as area, population, and NSDP.

Results:

India has a total of 612 [321 (52.45%) government-run and 291 (47.55%) private] medical colleges. Tamil Nadu (70), Uttar Pradesh (67), Karnataka (63), Maharashtra (62), and Telangana (34) are the top five states with 296 (48.37%) medical colleges. States and union territories such as Karnataka, Kerala, Maharashtra, Puducherry, Tamil Nadu, and Telangana have higher medical colleges, and states such as Assam, Bihar, Odisha, Madhya Pradesh, Rajasthan, and Uttar Pradesh have lower medical colleges when compared with their population percentages. There was significant positive correlation of number of medical colleges with area (rs = 0.769, P < 0.0001), population (rs = 0.91, P < 0.0001), and NSDP (rs = 0.91, P < 0.0001).

Conclusion:

The current distribution of medical colleges in India is clustered over some states. Although geographical area and population are major predictors of medical colleges in Indian states, a more population-based balanced distribution of medical colleges would help distribute quality health care to the majority of the population.
Pancreatogenic diabetes presenting with diabetic ketoacidosis: A rare manifestation of chronic pancreatitis
Authors: Shriwastav Ujjawal K. , Agarwal Mayank , Raina Rohit , Kant Ravi
Published: July 2023

ABSTRACT

Diabetes mellitus (DM) is a clinical syndrome that is manifested by hyperglycemia. Out of the numerous causes of diabetes, an uncommon cause is chronic pancreatic disease due to destruction of islet cells. Diabetic ketoacidosis is a rare entity in such cases as alpha cells are destroyed along with beta cells, which causes lack of glucagon that is responsible for ketogenesis. We hereby report a case of a 55-year-old woman with history of gall stone disease and who presented to the emergency department with multiple episodes of non-bilious, non-blood mixed vomiting along with increased frequency of micturition on background of malaise and anorexia along with significant weight loss. Her capillary blood glucose was 501 mg/dl, arterial blood gas showed high anion gap metabolic acidosis, and urine ketone were largely positive. Thus, she was diagnosed with diabetic ketoacidosis. She was admitted to the high dependency unit and her condition was treated along the lines of diabetic ketoacidosis. Further evaluation showed high HbA1c values without previous history of diabetes and computed tomography of the abdomen revealed presence of chronic pancreatitis. Though being a rare entity, this case outlines that DM3c can present with diabetic ketoacidosis (DKA); thus, early diagnosis and management are crucial to prevent mortality.
Comparative assessment of attitudes among medical and dental professionals in Saudi Arabia toward e-professionalism using the SMEPROF-S scale
Authors: Alzahrani Arwa K. , Banaser Alaa H. , Alsulami Rola R. , Alluqmani Yazeed A. , Althubyani Gada S. , Al Luhaybi Fatimah H. , Alqurashi Sarah M. , Al-Alwani Abeer Y. , Aboalshamat Khalid T.
Published: July 2023

ABSTRACT

Background:

Social media (SM) usage is on the rise among health professionals at all levels to align with the emerging digital and SM era. e-Professionalism is described as attitudes and actions that resemble traditional professionalism paradigms but are expressed through digital media. Although there are a number of studies conducted in the past several years measuring e-professionalism of medical and dental professionals, there is no validated scale to assess the level of e-professionalism among medical and dental professionals in Saudi Arabia. Therefore, this study aimed to assess attitudes toward e-professionalism among medical and dental professionals in Saudi Arabia using the SMePROF-S scale.

Methods:

This cross-sectional study recruited 338 medical and dental students and practitioners from 20 cities in Saudi Arabia to complete an online SMePROF-S self-reported questionnaire measuring attitudes about e-professionalism.

Results:

Among participants, 31.66% believed that it is acceptable to communicate with patients through SM, but only 16.86% agreed with communicating via personal SM account messaging. Many participants (35.80%–50%) fear that SM use can cause problems with getting hired, people making inaccurate assumptions and perceptions, and job losses. There were 31.36% who believed that sharing patient information without consent is acceptable. The majority (63.02%–63.31%) do not believe that medical/dental professionals should be barred from using SM, and 40.53% believe that schools/organizations have no right to interfere with their online activities. Only 22.19% believed that SM use removed professional protections from the public. A few statements were statistically different by specialty and gender.

Conclusion:

There is a variability of attitudes about e-professionalism among medical and dental professionals in Saudi Arabia, with some alarming issues requiring national guidelines to ensure patient rights, privacy, and confidentiality.
Association between smoking and colorectal cancer in Eastern Mediterranean Regional Office (EMRO): A systematic review and meta-analysis
Authors: Keivanlou Mohammad-Hossein , Amini-Salehi Ehsan , Hassanipour Soheil , Mahapatro Abinash , Raghuma Nakka , Joukar Farahnaz , Letafatkar Negin , Habibi Arman , Norouzi Naeim , Aleali Maryam Sadat , Javid Mona , Mirdamadi Arian , Mansour-Ghanaei Fariborz
Published: July 2023

Background:

Smoking poses a significant risk for colorectal cancer (CRC), considered the third leading reason for cancer-related deaths worldwide. However, there has been limited research on the relationship between smoking and CRC in the Eastern Mediterranean Regional Office (EMRO). Therefore, a meta-analysis was conducted to combine available data and gain a comprehensive understanding of the relationship between smoking and CRC in EMRO.

Methods:

Two independent researchers searched PubMed, Scopus, and Web of Science until December 2022. The included studies were checked for risk of bias administering the Newcastle-Ottawa scale. Heterogeneity was evaluated using I2 statistics and the Cochrane test. Publication bias was determined through funnel plot analysis and Egger’s regression test. Additionally, a meta-regression analysis explored the impact of a country’s Human Development Index (HDI) on the relationship between smoking and CRC.

Results:

The final analysis included 26 studies, revealing a significant association between smoking and CRC (OR = 1.40; 95% CI: 1.11 - 1.78; P = 0.004). Moreover, smoking had a more pronounced adverse effect on CRC in countries with higher HDIs compared to those with lower HDIs (OR = 1.30; 95% CI: 0.99 - 1.71; P = 0.054).

Conclusions:

Our findings underscore the importance of implementing smoking cessation programs and policies in EMRO countries, as they demonstrate a positive relationship between smoking and the risk of CRC. Furthermore, the results suggest that a country’s level of human development may influence the association between smoking and CRC. Further research is needed to investigate this potential connection and develop targeted public health interventions.
Geochronology and geochemistry of zircon from Early to Middle Devonian granitic and felsic volcanic rocks from the Cashes Ledge igneous suite, central Gulf of Maine, USA
Authors: Kuiper Yvette D. , Barr Sandra M. , Crowley James L. , Souders A. Kate
Published: July 2023

New zircon U–Pb, trace element, and Lu–Hf laser ablation inductively coupled mass spectrometry (LA-ICP-MS) data are presented for five Early to Middle Devonian granitic and felsic volcanic rocks from the Cashes Ledge igneous suite, central Gulf of Maine, USA. These samples were previously analyzed by U–Pb LA-ICP-MS and whole-rock geochemical methods and the new data generally corroborate the earlier results. Coarse-grained alkali-feldspar granite from northwest of the Fundy magnetic anomaly, the interpreted fault boundary in the offshore between Gondwanan microcontinents Ganderia to the northwest and Avalonia to the southeast, yielded a crystallization age of 414 ± 2 Ma. Southeast of the inferred fault, crystallization ages are 385 ± 3 Ma and 386 ± 3 Ma for two crystal tuff samples near the fault, 403 ± 3 Ma for an alkali-feldspar granite ~50 km southeast of the fault, and 399 ± 5 Ma for syenogranite ~25 km southeast of the fault, which also yielded inherited grains at ~1.3 Ga and between 613 ± 15 Ma and 558 ± 9 Ma. Lu–Hf LA-ICP-MS data for zircon retaining igneous crystallization ages have εHf(t) between 2.9 and 13.1 and model ages based on felsic sources between 0.52 and 1.04 Ga, reflecting a mix of late Mesoproterozoic (Avalonian?) basement and primitive melt, possibly in an extensional setting. Zircon Nb/Hf ratios generally greater than 0.001 indicate a predominately within-plate/anorogenic/rift setting, consistent with their whole-rock chemistry. U/Yb-Nb/Yb and U/Yb-Hf tectonic setting discrimination diagrams show ocean island to continental arc signatures, with a stronger continental arc signature for the syenogranite. Most zircon grains have Eu/Eu* values less than 0.1, indicating a crustal thickness of ~30 km or less at the time of their crystallization.
Mucous Membrane Pemphigoid in a Nonagenarian: A Case Report
Authors: de Lignac Océane Babin , Carvalho Priscille , Carrette Marion , Cellier Lucie , Courville Philippe , Tedbirt Billal
Published: July 2023

Mucous membrane pemphigoid is a rare autoimmune blistering disease characterized by post-bullous erosion of mucous membranes. Herein, we present a case of a nonagenarian man who was referred to our department of dermatology presenting with painful erosion of the buccal mucosa. Physical examination revealed palate erosion associated with erosion of the buccal mucosa. A diagnosis of mucous membrane pemphigoid was confirmed, and the patient was successfully treated with topical corticosteroids.
Religion, ca. 1770–1914
Authors: deVries Jacqueline R.
Published: July 2023

This essay focuses on the study of religion in nineteenth century British Society. It examines how religion has undergone a considerable shift in recent decades, moving from a field
focused on institutions and prominent churchmen to one that explores lived religious experience among diverse segments of society. The essay argues that using social and cultural
methodologies to analyze a broad range of source materials, ‘church history’ has given way to the ‘history of religion in society and culture.’ It examines how as a result, the field
is growing more inclusive of the religious perspectives and experiences of women, the working classes, religious minorities, and colonized peoples, and is raising new questions about
the diffusive nature of religion’s influence and seeks to provide an in-depth discussion and analysis of religion in Britain throughout the 19th century.
Political cultures
Authors: Shoop-Worrall Christopher
Published: July 2023

This essay provides an overview of the political landscape of Britain during the long nineteenth century, with a particular emphasis on the two types of mass cultures that emerged
during the period. While elections were a significant part of the British political system, this essay focuses more on the ways that politics intersected with wider popular culture,
and the lives of increasing numbers of the British public, in two broad ways. First, the long nineteenth century saw the emergence of various radical popular cultures, including
Chartism, the unstamped presses of the nineteenth century, and the emergence of socialist groups, including the modern Labour party. Second, the same period saw politics increasingly
intersect with everyday life as part of the wider urban and massified consumer popular culture that emerged particularly throughout the Victorian period. This included the birth of
political social clubs, movements such as the Primrose League, and a mass popular press which articulated politics in ways that directly connected the political sphere with the mass
entertainment culture enjoyed by its large readerships. These simultaneous and often-conflicting political cultures underline the wider vibrancy and complexity of British politics
during this period, and its realities beyond the isolated periods of general elections.
Education and learning
Authors: Ellis Heather
Published: July 2023

This essay provides an overview of key shifts in the history of education and learning in Britain over the course of the long nineteenth century, from 1770 until 1914. It examines the
transformation of educational opportunities for children and adolescents, which saw the patchy and voluntary-controlled provision of the earlier part of the century, replaced with a
state-directed and funded nationwide system of formal elementary education after the Education Act of 1870. It also considers the ways in which secondary education for the children of
middle- and-upper-class families developed over the same period. Finally, it explores important changes in adult and higher education, in particular the flourishing of locally based
initiatives such as mechanics’ institutes in the first half of the nineteenth century, followed by a considerable expansion of university provision into London and the major provincial
towns from the 1820s onwards.
Consumer culture in imperial context
Authors: Ferguson Christopher
Published: July 2023

This essay offers an introduction to the history of consumer culture in nineteenth-century Britain. It identifies the various approaches scholars have used when defining ‘consumption’
and its implications for different aspects of nineteenth-century society. This is followed by an overview of patterns of consumption during the century, addressing both elements of
change and continuity in British consumer culture. The final section examines the relationship between consumption and different categories of identity, including those of class,
gender, and nation.