bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study of Histological Changes of Placenta in Pregnancy-Induced Hypertension in Poorvanchal Region of Uttar Pradesh, India
Authors: Singh Vishram , Ranjan Kumud , Tewarson S. L. , Singh Rashi , Yadav Yogesh 
Published: April 2021

Introduction:
The placenta is a fetomaternal organ. It is a connection of the fetus with the uterine wall of mother. Through the placenta, exchange of gases and nutrient supply takes place. Through the placenta, fetal blood tissue comes in direct contact with the maternal blood without any rejection. It is a special transient organ of pregnancy. In our study, we carried out the microscopic examination of the placenta in pregnancy-induced hypertension, i.e., syncytial knot, cytotrophoblastic cellular proliferation, fibrinoid necrosis, endothelial proliferation, and calcified villous spot.

Material and Methods:
One hundred and fifty-two placentas of full-term pregnancy were collected from the labor room/operation theater of the Gynecology and Obstetrics Department of the Government Medical College and Superfacility Hospital Azamgarh. Out of one hundred and fifty-two placentas, 76 cases were controls from mothers with no known history of preexisting hypertension and 76 were collected from mothers with pregnancy-induced hypertension. Placentas were kept in 10% formalin for 24 h for fixation. After 24 h, tissues of placentas were passed through a series of the procedures from dehydration and clearing to wax impregnation before being sectioned from automated microtome. Time took for processing was 24 h. Five microns thick tissues sections were cut. Prepared slides were mounted in DPX and covered with the cover slip. Through binocular light, microscope slides were examined at ×10, ×40, and ×100 magnifications.

Results:
Histology in our study revealed that syncytial knots were present in placentas of all 100% of hypertensive and only 32.89% of normotensive mothers. Cytotrophoblastic proliferation was seen in 98.68% and 19.73% placentas of hypertensive and normotensive mothers, respectively. Fibrinoid necrosis of placenta was found in 88.15% of hypertensive and only 28.94% of normotensive mothers. The 100% placentas of the hypertensive mothers had endothelial proliferation as compared to controls. Calcified villous spots were seen in 84.21% and 31.57% of placentas of hypertensive and normotensive mothers, respectively.

Discussion and Conclusion:
Pregnancy-induced hypertension adversely affects the health of the fetus through its harmful effects on the placentas. Syncytial knots, cytotrophoblastic cellular proliferation, fibrinoid necrosis, endothelial proliferation, and the calcified villous spots were present more in the placentas of hypertensive mothers in our study in comparison to the study of other authors. In our research, we found that endothelial proliferations were present in all placentas. If proper treatment is given to the mother in the early stage of pregnancy, it may prevent the death of a fetus. Hence, this study helps the clinician for early diagnosis and treatment of pregnancy-induced hypertension.
Vascular Anatomy of Distal End of Femur and Its Clinical Implications
Authors: Bhat Deepa , Doddaiah Sunilkumar , Murugesh Pushpalatha , Pushpa N. B. 
Published: April 2021

Introduction:
The distal end of the femur is a highly vascular tissue with unique features in its blood supply. The outcome of surgical interventions is determined by the interference of corresponding blood supply. The study examines the pattern of blood supply in terms of density, size, and direction of vascular foramina (VF) to the distal end.

Material and Methods:
The lower end of normal adult dry femora (n = 300) was divided into segments. The number, size, and direction of VF in each segment were documented. Wilcoxon signed-rank test identified the statistical difference in the number of VF between various segments and Friedman test compared the difference between segments of two sides.

Results:
The maximum average number of VF was observed in medial condylar surface while minimum in central part of intercondylar region. Condylar medial recorded the highest number of VF of all sizes. The number of VF of >2 mm size was found to be significantly different between right and left in right condylar lateral and right intercondylar posterior regions. Right condylar lateral had considerably large number of VF of >2 mm size with statistical significance (P = 0.000). A Friedman test indicated that segements of two sides rated differently.

Discussion and Conclusion:
The density of VF through which vessels traverse at lower end were not only numerous but also constant and uniformly scattered. Detailed understanding of the arterial anatomy of lower end helps to identify and localize vascular pedicles, thus ensuring vitality of graft as well as donor site.
Chromosomal Microarray in Isolated Congenital and Developmental Cataract
Authors: De Guimarães Thales A. C. , Capasso Jenina E. , Bello Nicholas R. , Wangtiraumnuay Nutsuchar , Lingao Michelle D. , Wuthisiri Wadakarn , Lai Yu-Hung , Johnson Erica S , Zanolli Mario , Khetan Vikas , Bajaj Renu , Wang Zi-Xuan , Peiper Stephen C. , Levin Alex V 
Published: April 2021

Introduction:
The etiologies of congenital and developmental cataracts are diverse. Most are not syndromic and have no identifiable cause, thus creating a diagnostic dilemma. We investigated the utility of chromosomal microarray in identifying the etiology of isolated childhood cataracts.

Methods:
Patients with congenital or developmental cataracts without other associated abnormalities received a single-nucleotide polymorphism (SNP) microarray. copy number variations (CNV) and regions of homozygosity (ROH) were compared with previous literature reports and analyzed for candidate genes to assess pathogenicity.

Results:
We enrolled 37 patients. The mean age of the patient population was 10.98 years old. Nineteen patients (51.4%) had bilateral cataract. Positive family history was found in 11 patients (29.7%). Eighteen patients (48.7%) had a variant on microarray: 10 (27%) with CNV, 5 (13.5%) with ROH, and 3 patients (8.1%) with both CNV and homozygosity. In five patients (13.5%), we found a potentially causative cataract gene within an ROH.

Discussion:
There is a high rate of notable findings among the CNV and ROH detected. Three patients were homozygous in a region known to have a cataract gene suggesting a possible autosomal recessive disease. In those with CNV, segregation would help to affirm the pathogenicity of these regions and may lead to the identification of new genes.

Conclusion:
SNP microarray had a surprisingly high rate of notable findings in patients with isolated cataract and may reveal the opportunities for genetic counseling, lead to discovering new cataract genes and identify additional affected genes that could lead to other clinical abnormalities.
Perioperative care of obstructive sleep apnea patients
Authors: Bamgbade Olumuyiwa A. , Oluwole Oluwafemi , Khalaf Wael M. , Namata Christine , Metekia Lidya M. 
Published: April 2021

Background:
Obstructive sleep apnea (OSA) is prevalent in the surgical patient population and is associated with high risk of perioperative complications. There are limited guidelines and wide practice variations regarding the perioperative care of obese and OSA patients. This is a study of European anesthesiologists' clinical practice of perioperative care of OSA patients.

Methods:
This survey evaluated United Kingdom anesthesiologists' clinical practice of the perioperative care of OSA patients. Outcomes and variables were compared between 4100 anesthesiologists of different clinical experience and hospital settings.

Results:
Approximately 45% of respondents manage OSA patients rarely, 42% occasionally, and 13% regularly. Most respondents order OSA screening tests if patients have tonsillar hypertrophy, head/neck tumor, BMI >35, increased neck circumference, craniofacial anomaly, and right-sided electrocardiography (ECG) anomaly. Majority request preoperative polysomnography, ECG, overnight pulse oximetry, and arterial blood gas analysis. Majority recommend preoperative weight loss, optimisation, smoking cessation, reduction of substance use, and regular mask-CPAP use. Majority consider endoscopy, and ophthalmology as appropriate day case procedures, but not laparoscopy. Majority postpone elective airway, laparoscopic, laparotomy, and head/neck surgery; if patients are not optimized preoperatively. For major surgery, combined general + neuraxial anesthesia was ranked as 3rd option. For major limb surgery, neuraxial anesthesia without sedation was ranked as 1st option, nerve block without sedation was ranked 2nd, and general anesthesia + nerve block was ranked 3rd or 4th. At anesthesia emergence, majority ensure that patients have normal consciousness, respiration and neuromuscular function. Majority ensure postoperative oximetry, telemetry, and oxygen supplementation.

Conclusion:
This study highlights variations in anesthesiologists' perioperative care of OSA patients; even in developed countries with advanced medical training and standards. The study outcomes will improve perioperative care of OSA patients.
Comparative evaluation of intubation performances using two different barrier devices used in the COVID-19 era
Authors: Kannaujia Ashish , Haldar Rudrashish , Shamim Rafat , Mishra Prabhakar , Agarwal Anil 
Published: April 2021

Background and Aims:
Protection of anaesthesiologists from contaminated aerosols of COVID 19 patients during endotracheal intubation has spurred the development of barrier devices like aerosol boxes and clear transparent plastic sheets and usage of videolaryngoscopes in COVID 19 patients. However, the efficiency, feasibility and difficulties faced by anaesthesiologist while performing endotracheal intubations under barrier devices require scientific validation. This manikin-based pilot study aims to assess the laryngoscopic performances of experienced anaesthesiologists under two different barrier enclosures.

Methods and Materials:
53 anaesthesiologists (14 Consultants and 39 Senior Residents) who were undergoing an airway training module as a part of preparedness for handling the COVID 19 pandemic were recruited. Using an aerosol box over a manikin, the participants attempted intubation using a Glidescope Videolaryngoscope and Macintosh laryngoscopes (GA and MA Groups). Subsequently, intubation was attempted under a transparent plastic sheet using both laryngoscopes (GP and MP groups). Time required for intubation, first pass success rates, subjective ease of intubation and the feedback obtained from the participants were recorded and analysed.

Results:
Time required for accomplishing successful intubation was 38.55 ± 12.16 seconds, 26.58 ± 5.73 seconds, 46.89 ± 15.23 seconds and 37.26 ± 8.71 seconds for GA, MA, GP and MP groups respectively. Time for intubation and difficulty (VAS) was least for Macintosh group with aerosol box (MA) and maximum time was taken in Glidescope group with transparent polythene drape (GP). First attempt success rate for Glidescope groups (GP and GA) were 100% and in MA and MP group was 98% and 96% respectively. Restriction in hand movement and stylet removal were the major difficulties reported

Conclusion:
Longer intubation times were observed while using Glidescope Videolaryngoscopes with either of the two barrier devices in place compared to Macintosh laryngoscopes.
The factors affecting nurses' assessments toward pain management in Saudi Arabia
Authors: Samarkandi Osama A. 
Published: April 2021

Background and Aims:
Pain assessment requires an extensive practice in diagnosis coupled with proficiency in recognizing health factors that lead to its occurrence. Nurses' education and training could be the main factor influencing pain perception and diagnosis. This study aims at comparing nurses' academic qualifications and relevant training courses that may impact their assessment skills toward patients in pain.

Methods:
A descriptive cross-sectional design using a Knowledge and Attitudes Survey Regarding Pain questionnaire was administered to a total of 247 nurses. In this survey, the nurses were asked to answer specific questions related to correctly diagnosing and assessing patients' pain, as well as answer questions about their previous training in pain assessment.

Results:
A total of 247 nurses answered the questionnaire, with an overall response rate of 82%. Questionnaires revealed that more than half (50.6%) of the nurses involved in this study have not received any pain education related to pain management in the 5 years following their initial nursing licensure or supervision under a nurse supervisor.

Conclusions:
The results of the paper show that nurses' experiential level has the highest impact on their knowledge of pain relief management and medications necessary for treating it. Also, nurses' pain education following their initial licensure and during their professional practice has the second highest impact on their pain relief management knowledge, whereas their primary nursing education had the lowest.
The comparison of the efficacy of ultrasound-guided paravertebral block versus erector spinae plane block for postoperative analgesia in modified radical mastectomy
Authors: Agarwal Shilpi , Bharati Sachidanand Jee , Bhatnagar Sushma , Mishra Seema , Garg Rakesh , Gupta Nishkarsh , Kumar Vinod , Khan Maroof Ahmad 
Published: April 2021

Introduction:
The ultrasound (US)-guided erector spinae plane (ESP) block is a new regional anesthetic technique that offers significant advantages over paravertebral block as it is easy and safe to perform. We aim to compare the efficacy of US-guided paravertebral block with ESP block for postoperative analgesia in modified radical mastectomy (MRM).

Methods:
Eighty female patients of age group 18–70 years, belonging to physical status American Society of Anesthesiologists (ASA) I and II, undergoing MRM were included in the study. In Group P, patients received paravertebral block and in Group E, patients received ESP block before induction of general anesthesia. Both the groups received 0.5% 20 mL ropivacaine. The time to first rescue analgesia and total doses of rescue analgesics were recorded in the postoperative period. Numeric Rating Scale (NRS) scores at 0 min, 30 min, 1 h, 2 h, 6 h, 12 h, and 24 h were noted, and patient satisfaction was evaluated at 24 h. Unpaired t-test or the Mann–Whitney U test was used to compare quantitative variables while Chi-square test or Fisher's exact test was used to compare qualitative variables.

Results:
The time for the first analgesic request was 232.5 min (140-1200) in ESP group as compared to paravertebral group in which the duration was 205 min (135-1190) (P value = 0.29). The total dose of rescue analgesics and NRS scores in postoperative period were comparable. However, the time to perform ESP block was significantly shorter than that of paravertebral block.

Conclusion:
ESP block can be used as a safe and easy to perform alternative analgesic technique over paravertebral block in breast cancer surgeries.
Cost-effectiveness analysis of colorectal cancer screening in a low incidence country
Authors: Naber Steffie K. , Almadi Majid A. , Guyatt Gordon , Xie Feng , Lansdorp-Vogelaar Iris 
Published: April 2021

Background:
Colorectal cancer (CRC) screening is cost-effective in many Western countries, and many have successfully implemented CRC screening programs. For countries with a lower CRC incidence, like Saudi Arabia, the value of CRC screening is less evident and requires careful weighing of harms, benefits, and costs.

Methods:
We used the MISCAN-Colon microsimulation model to simulate a male and female cohort with life expectancy and CRC risk as observed in Saudi Arabia. For both cohorts, we evaluated strategies without screening, with annual or biennial faecal immunochemical testing (FIT), and with 10-yearly or once-only colonoscopy. We also considered different start and end ages of screening. For both cohorts, we estimated lifetime costs and effects of each strategy. We then identified a set of potentially cost-effective strategies using incremental cost-effectiveness ratios (ICERs) defined as the additional cost per additional quality-adjusted life year (QALY).

Results:
Without CRC screening, an estimated 14 per 1,000 males would develop CRC during their lifetime and 9 would die from CRC. Several strategies proved potentially cost-effective including biennial FIT at ages 55-65 (ICER of $7,400), once-only colonoscopy at age 55 (ICER of $7,700), and 10-yearly colonoscopy at ages 50–65, 45–65, and 45–75 (ICERs of $34,000, 71,000, and 375,000, respectively). For females, risk of CRC was lower and CRC screening was therefore less cost-effective, but efficient strategies were largely similar.

Conclusions:
Despite low CRC incidence in Saudi Arabia, some FIT or colonoscopy screening strategies may meet reasonable thresholds of cost-effectiveness. The optimal strategy will depend on multiple factors including the willingness to pay per QALY, the colonoscopy capacity, and the accepted budget impact.
Development of a Solar Distiller for the Production of Potable Water for Human Consumption
Authors: Manta I.H. , Awu J.I. , Kasali M.Y. , Ubah J.I. 
Published: April 2021

The study is a continual quest towards the provision of affordable, health-friendly fresh potable water in rural areas; using available, affordable and durable materials for the construction of a solar distiller for freshwater production. The aim of this study was to develop a solar distiller for the production of potable water in waterborne diseases infested rural communities in northern Nigeria. Solar radiation with an intensity of 32 kcal/day was made to pass through a transparent polythene of 1039.6 cm2 that covers a 6800 cm3 of water collected through evaporator made with 78% refined clay constituent distilling 1.3 litres/day of pure water. An efficiency of 77% was determined after several test runs. Information from this study will serve as a guide to researchers on the production of portable water from the solar distiller. Also, it will guide the government and agencies on policy and decision making on water resources.
Keywords: Distilling water, solar radiation, collector and evaporator
Sacred Kingship and Political Power in Ancient Rwanda
Authors: Nkaka Raphael , Mulinda Charles Kabwete 
Published: April 2021

This article revisits the sacred kingship in ancient Rwanda. The existing literature presented it as either obvious or doubtful. Using local sources and exploring theories related to sacred kingship, we argue that the kingship in Rwanda was sacred. We also identify the role that this sacred kingship played in the processes of unification the territory of Rwanda, creation of material culture, origins and consolidation of the kingship and the kingdom. The most important role of the sacred kingship appears to have been mainly the legitimization of the King’s power. We use documentary research and the historical method to present and discuss the following narratives related to the Rwandan kingdom: the tale of origins or the myth of Kigwa, the royal ideology during the reign of Mibambwe III Sentabyo, Gihanga seen as the Incarnation of the Sacred Kingship, the sacrality of Power as source of legitimacy of King Ruganzu II Ndori, and the role of the sacred kingdom through the rituals of the royal court known as Ubwiru.
Key words: Rwandan sacred kingship, power rituals, Rwandan history
Topical Skills for Accounting Graduates within Changing Business Environment: Stakeholders’ Satisfaction Levels in Rwanda
Authors: Nsengiyumva Innocent , Bokka Rama Rao 
Published: April 2021

Institution managers have always been seeking competent accountants and accounting technicians to fill the gaps created by the requirements of changing business environment and criticize the existing skills of newly graduated and less experienced accounting job aspirants from Rwandan Institutions of Higher Learning. This paper analyses the satisfaction levels of various stakeholders in Rwanda towards the skills held by accounting-employees and employers’ expectations, as this could remedy to the competence gap between the job market demand and human resource availability in accounting field. The target population includes the managers of selected institutions in Rwanda, the accountants employed by these institutions and the heads of departments in higher learning institutions delivering accounting programs. The sample was chosen randomly from each stratum of population from the selected districts. The study discovers that the competences acquired are not appropriate to fulfil the necessary skills required in accounting job. Collaboration between accounting firms and academic institutions is needed to synergize accounting practical training with theoretical learning in the classroom. Accountants will also have to equip with other extra knowledge and soft skills (information technology, critical thinking and effective communication) to match the market needs.
Key Words: Business environment, competences, topical skills, accountants, accounting technicians, employers’ requirements,
Conflicting Expectations by Lecturers and Students Regarding the Production of Good Academic Writing: A Case Study at the University of Rwanda
Authors: Twagilimana Innocent , Naidoo Devika 
Published: April 2021

In the academic context, lecturers often describe students’ academic writing as very poor whereas the students themselves affirm not to understand the lecturers’ expectations with regard to ‘good writing skills’. This is a report on a study conducted in Rwanda to explore students and lecturers’ expectations of good academic writing. The investigation is underpinned by recent developments in academic writing theories. Based on a qualitative approach and a case study methodology, data were collected by analysing key teaching materials, visiting classes and interviewing academics and students. The findings revealed that lecturers’ conception of teaching and learning academic writing is underpinned by an autonomous view - based on discrete skills. It is recommended that the lecturers’ understanding of the academic literacies approach should be properly developed to meet the expected literacy competence goals.
Key words: ESL, Writing skills, Academic writing, Literacies, Conceptualisation
Arbuscular mycorrhizae inoculation of einkorn wheat affects fatty acid, nutrient and mineral concentrations
Authors: Ayaşan T. , Esen S. , Esen V. Kader , Eseceli H. , Cabi E. 
Published: April 2021

The purpose of this study was to determine the effect of arbuscular mycorrhizae (AM) inoculation, which was administered to increase the quality of einkorn wheat in its fatty acid composition, quality and mineral concentration. Wheat grown from AM inoculated seed (AM+) had increased the dry matter (DM), iron (Fe), monounsaturated fatty acids (MUFA), especially oleic acid, and alpha-linolenic acid, and cis-5,-8,-11,-14, and cis-17 eicosapentaenoic acid from polyunsaturated fatty acids (PUFA) (P <0.05), but decreased crude ash (CA), potassium (K), and total saturated fatty acids (UFA), especially myristic acid, palmitic acid, stearic acid and monounsaturated fatty acids, especially cis-palmitoleic acid, cis-10-heptadecenoic acid, cis-11 eicosenoic acid, erucic acid, and linoleic acid (P <0.05) compared with einkorn wheat grown from non-inoculated seed (AM-). Crude protein (CP) content ranged from 10.56% to 10.68%, and ether extract (EE) content varied between 2.03% and 2.41%, neither of which was significantly different between treatments. Significant increases were observed in UFA, and in the ratios of UFA to SFA and PUFA to SFA in AM+ compared with AM-.
Keywords: mycorrhizal inoculation, nutrient composition, Triticum monococcum