bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Promising Effects of Erdosteine and Vitamin B in the Liver Ischemia/Reperfusion Model in Anesthetized Rats
Authors: Eygi Elif , Gul Rauf , Aslan Murat , Tas Zeynel Abidin , Dokuyucu Recep 
Published: May 2024

Background and Objectives: Erdosteine (Erd) is an antioxidant and anti-inflammatory drug. Vitamin B has been reported to exert anti-inflammatory and antioxidant effects. In this study, we investigated the effect of erdosteine and vitamin B complex on a liver ischemia/reperfusion (I/R) model. Materials and Methods: Thirty-two Wistar Albino male rats weighing 350–400 g were used. The animals were randomly selected and divided into four groups. The groups are as follows: first group (Sham), second group (I/R), third group (I/R + vit B), and fourth group (I/R + vit B + Erd). Rats were subjected to 45 min of hepatic ischemia, followed by a 45 min reperfusion period in the I/R and Vitamin B + Erd groups. An amount of 150 mg/kg/day of erdosteine was given orally for 2 days, and 0.05 mL/kg of i.p. vitamin B complex was given 30 min before the reperfusion. Serum biochemical parameters were measured. Serum Total Antioxidant Status (TAS) and Total Oxidant Status (TOS) were measured, and the Oxidative Stress Index (OSI) was calculated. Hepatic tissue samples were taken for the evaluation of histopathological features. Results: In terms of all histopathological parameters, there were significant differences in the I/R + vit B group and I/R + vit B + Erd group compared with the I/R group (p < 0.01). In terms of aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), TNF-alpha, and IL-6 levels, there were significant differences between the I/R group and treatment groups (p < 0.01). The lowest TOS and OSI levels were obtained in the treatment groups, and these groups had statistically significantly higher TAS levels compared with the sham and I/R groups (p < 0.01). Conclusions: As a preliminary experimental study, our study suggests that these agents may have potential diagnostic and therapeutic implications for both ischemic conditions and liver-related diseases. These results suggest that the combination of vit B + Erd may be used to protect against the devastating effects of I/R injury. Our study needs to be confirmed by clinical studies with large participation.
The effect of the pitch of the boards in the transverse layer on the deformability and stress distribution in a threelayer CLT panel rigidly clamped on both sides
Authors: Troshin M. Yu. , Turkov A. V. , Zaev A. V. 
Published: May 2024

CLT panels are made by gluing several layers of boards crosswise, which provides them with high load-bearing capacity and bending resistance. In addition to the number of layers in the panel, the deformability and bearing capacity are influenced by the geometric parameters of the plate, the way the layers are attached to each other, the way the structure is supported, etc. Due to the fact that the material has recently been used in construction, many issues remain poorly understood, and therefore there is an opportunity and need to optimize some aspects both in the CLT panels themselves and in the way they interact with other building structures.In this article, the influence of the pitch of boards in the transverse layer on the deformability and stress distribution in a three-layer CLT panel rigidly pinched on both sides was studied. Numerical studies of the finite element method (FEM) were carried out using the computing complex SCAD+. The computational model of the plate in this study is a composite orthotropic plate with rigid connections between the layers. The result of the study is numerical data reflecting the dependence of the distribution of normal stresses OX and OY and the transverse deformation of the plate on the pitch of the lamellae (boards) in the bottom layer. Projections of the computational model with normal stress isofields on the stretched and compressed plate layer are also obtained. This makes it possible to identify general patterns of stress distribution and deformation changes with variations in geometric parameters for this type of support for their use in the design of building structures using CLT panels as well as in the optimization of the structure in order to increase the cost efficiency of resources.
Desarrollo de habilidades sociales y el método de aprendizaje cooperativo en adolescentes
Authors: Ramos-García Manuel Augusto , Bardales-Encinas Giovana Del Pilar 
Published: May 2024

El propósito de la presente investigación fue determinar la relación entre habilidades sociales y aprendizaje cooperativo en adolescentes pertenecientes al quinto año de educación secundaria de una Institución Educativa en Trujillo-Perú. Mediante muestreo no probabilístico, se seleccionó una muestra de 172 estudiantes de 16 a 18 años. Se aplicaron dos instrumentos de recolección de datos: Escala de evaluación de Habilidades Sociales de Arnold Goldstein y col. (1980), y el Cuestionario de medición del Aprendizaje Cooperativo (CAC) con 0.908 y 0.930 de confiabilidad respectivamente. Los resultados mostraron que existe una relación altamente significativa (p<0.01) entre las habilidades sociales y el aprendizaje cooperativo, con un coeficiente de correlación Rho = 0.835. Por ende, se concluyó que las habilidades sociales desempeñan un papel crucial en la mejora del aprendizaje cooperativo en los adolescentes.
Kulturotwórcza rola mediów polonijnych
Authors: Bonusiak Andrzej , Bonusiak Grzegorz 
Published: May 2024

W powyższym opracowaniu na wybranych przykładach pokazano rolę mediów polonijnych w działaniach na rzecz kultury polskiej za granicami Polski. Na podstawie przeprowadzonej analizy czterech wybranych tytułów (prasa, radio, internet) pokazano ich działania, omówiono założenia przyświecające redaktorom i uwypuklono rezultaty działalności. Wykazano, że pomimo różnych warunków wynikających z odmienności czasu i przestrzeni, w których media funkcjonowały, ich podstawowy cel działalności pozostawał taki sam. Było i jest nim przeciwstawianie się depolonizacji środowisk polonijnych i polskich na świecie, walka z akulturacją.
Transformacja systemowa a postkomunistyczne społeczeństwo
Authors: Grata Paweł , Jaroszyk Joanna 
Published: May 2024

Artykuł analizuje stosunek polskiego społeczeństwa do procesów prywatyzacji i reprywatyzacji w gospodarce, nieodłącznie związanych z przejściem z gospodarki kolektywistyczno-planowej do systemu kapitalistycznej gospodarki mieszanej. Autorzy tekstu odpowiadają na pytanie, w jaki sposób procesy upowszechniania własności prywatnej (prywatyzacji we wszystkich jej formach) oraz zwrotu własności znacjonalizowanej przez komunistów po wojnie (reprywatyzacja) były przyjmowane przez wchodzące w sposób nieświadomy w transformację, a następnie coraz lepiej poznające zasady funkcjonowania gospodarki rynkowej polskie społeczeństwo. Z artykułu wynika, iż prywatyzacja i reprywatyzacja odbierane były przez obywateli w omawianym okresie ambiwalentnie. Prywatyzacja, jako proces obiektywnie widoczny i mogący stać się przedmiotem ocen wynikających z jej przebiegu, w pierwszych miesiącach transformacji była przyjmowana pozytywnie. Z czasem oceny te stały się w przeważającej części negatywne, co wynikało z wielu niekorzystnych zjawisk z prywatyzacją się kojarzących. Dopiero gdy podstawowe procesy prywatyzacyjne zostały zakończone, a społeczeństwo przestało być bombardowane doniesieniami o nieprawidłowościach i aferach z nimi związanych, ich ocena stała się ponownie bardziej pozytywna. W sposób zbliżony, mimo braku systemowego rozwiązania kwestii reprywatyzacji, kształtowały się poglądy opinii publicznej na problem zwrotu znacjonalizowanej własności dawnych właścicielom bądź ich spadkobiercom. Dość stabilne poparcie dla takiego rozwiązania widoczne w ostatniej dekadzie XX w. przerodziło się później w przewagę przeciwników reprywatyzacji. Mimo zatem powszechnie dostrzeganego powodzenia transformacji w Polsce opinia publiczna raczej sceptycznie oceniała niezbędne z punktu widzenia tego sukcesu zmiany własnościowe, traktując je raczej jako zło konieczne, a nie integralną część składową procesu przemian.
سيميائية اللغة الدرامية
Authors: م.د.سافرة ناجي جاسم  
Published: May 2024

اﻓـرزت اﻟد ارﺴـﺎت اﻟﻨﻘدﻴـﺔ اﻟﻌدﻴـد ﻤـن اﻟﻤﺼـطﻠﺤﺎت واﻟﻤﻔـﺎﻫﻴم اﻟﻤﻌرﻓﻴـﺔ اﻟﺘـﻲ ﺘﻨﺎوﻟـت
ﺠﺴــد اﻟــﻨص اﻻﺒــداﻋﻲ ٬ وﻟﻌــﻝ ﻤــن اﻟﻤﻔــﺎﻫﻴم اﻟﺘــﻲ اﻓرزﺘﻬــﺎ ﻫــذﻩ اﻟد ارﺴــﺎت ﻫــو ﻤﺼــطﻠﺢ
(اﻟﺴﻴﻤﺎء) اﻟذي ﺨﻠق ﺠدﻻً ﻤﻌرﻓﻴﺎً ﻓﻲ ﻤدﻴﺎت اﻟﻘ ارءة واﻟﻨﻘد ﻟﺠﺴـد اﻟـﻨص وﺘﻔﻛﻴـك ﺸـﻔ ارﺘﻪ ٬ اذ
ﻏﻴـر اﻟﻛﺜﻴـر ﻤـن اﻟﻤﻔـﺎﻫﻴم ﺘﺠﺎﻫـﻪ اﻟـذي ﻛـﺎن ﺨﺎﻀـﻌﺎً ﻓـﻲ اﻟﻘـ ارءة ﻟﻤـدﻴﺎت اﻟﻤؤﻟـف ذاﺘـﻪ ٬ ﻓـﻲ
ﺤﻴن ﺘرى اﻟﺴﻴﻤﺎء اﻟﻨص ﻗﺎﺌﻤﺎً ﺒذاﺘﻪ ٬ ﻤﻤﺘﻠﻛﺎً ﻟﻤﻘوﻤـﺎت اﺒداﻋـﻪ اﻟﺘـﻲ ﻴرﺴـﻤﻬﺎ اﻟﻤﺘﻠﻘـﻲ ﺒﺘﻔﻛﻴـك
ﺸــﻔ ارﺘﻪ دواﻟــﻪ وﺒــؤرﻩ ﺒﻤــدﻟوﻻﺘﻬﺎ اﻟﻤﺘﺒﺎﻴﻨــﺔ ﻤــن ﺨــﺎرج اﻟــﻨص ﻋﺒــر اﻟﺒﻨــﺎء اﻟﻌﻼﺌﻘــﻲ ﻟﻌﻨﺎﺼــر

اﻟﻨص.
ﺻﻌﻭﺑﺎﺕ ﺗﺩﺭﻳﺱ ﺍﻟﻣﻧﺎﻫﺞ ﺍﻟﺗﺭﺑﻭﻳﺔ ﻣﻥ ﻭﺟﻬﺔ ﻧﻅﺭ ﻁﻠﺑﺔ ﻗﺳﻡ ﺍﻟﺗﺭﺑﻳﺔ ﺍﻹﺳﻼﻣﻳﺔ ﻭﺍﻟﺣﻠﻭﻝ ﺍﻟﻣﻘﺗﺭﺣﺔ ﻟﻬﺎ
Authors: ﻡ.ﺩ.ﻭﻓﺎء ﻛﺎﻅﻡ ﺳﻠﻳﻡ ﻋﺑﻳﺩ  , ﻡ.ﻡ.ﺇﻳﻧﺎﺱ ﻋﺑﺩ ﺣﺳﻥ  
Published: May 2024

ﻟﻘد ﻟﻤﺴت اﻟﺒﺎﺤﺜﺘﺎن ﻤن ﺨﻼﻝ ﻋﻤﻠﻬن اﻟﻤﻴداﻨﻲ ﻓﻲ اﻟﺘدرﻴس ٬

إن

ﻫﻨـﺎك ﻤﺸـﻛﻠﺔ ﻛﺜﻴـ اًر ﻤـﺎ ﻴﻌـﺎﻨﻲ ﻤﻨﻬـﺎ طﻠﺒـﺔ ﻗﺴـم اﻟﺘرﺒﻴـﺔ اﻹﺴـﻼﻤﻴﺔ ﻓـﻲ ﻤﻨـﺎﻫﺞ اﻟﻤـواد اﻟﺘرﺒوﻴـﺔ

اﻟﻤﻘـررة ﻟﻠﻤ ارﺤـﻝ اﻟد ارﺴـﻴﺔ ﻛﺎﻓـﺔ ٬ إذ إن اﻟﻛﺜﻴـر ﻤـن ﻤﺒﺎدﺌﻬـﺎ وﻤﻀـﺎﻤﻴﻨﻬﺎ ﻤـن اﻷﻤـور اﻟﺘـﻲ

ﻴﺼـﻌب ﻋﻠـﻰ اﻟطﻠﺒـﺔ ﻓﻬﻤﻬـﺎ واﺴـﺘﻴﻌﺎﺒﻬﺎ ﺒﺼـورة ﺴـﻠﻴﻤﺔ ٬ ﻟـذا ﻓﻬـذﻩ اﻟﻤـواد ﺘﻌـد ﺼـﻌﺒﺔ ﻤﻘﺎرﻨـﺔ

ﺒﺒــﺎﻗﻲ اﻟﻤــواد اﻷﺨــرى ٬ ذات اﻟﺼــﻠﺔ ﺒﺎﺨﺘﺼﺎﺼــﻬم ٬ ﻓﻀــﻼً ﻋــن إﻨﻬــﺎ ﺘﻀــﻊ ﺤﻔــظ وﺘﻠﻘــﻴن

اﻟﻤﻌﻠوﻤــﺎت ﻓــﻲ اﻟدرﺠــﺔ اﻷوﻟــﻰ ﺒــدﻻً ﻤــن إﻫﺘﻤﺎﻤﻬــﺎ ﺒﺎﻨﻤــﺎط اﻟﺘﻔﻛﻴــر واﻻﺴــﺘﻴﻌﺎب ٬ وﺘﻌﺘﻘــد

اﻟﺒﺎﺤﺜﺘـﺎن إن اﻟﺴـﺒب اﻟـرﺌﻴس ﻗـد ﻴﻌـود اﻟـﻰ ﻋـرض اﻟﻤـﺎدة اﻟﻌﻠﻤﻴـﺔ دون اﻟﻤﺴـﺘوى اﻟﻤطﻠـوب ٬

ﻓﻬـﻲ ﺨﺎﻟﻴـﺔ ﻓـﻲ ﻤﺤﺘوﻴﺎﺘﻬـﺎ أو ﻤﻔرداﺘﻬـﺎ وط ارﺌﻘﻬـﺎ ووﺴـﺎﺌﻠﻬﺎ ﻤـن ﻋﻨﺼـر اﻟﺘﺸـوﻴق واﻹﺜـﺎرة ٬

وﻗﻠﺔ إرﺘﺒﺎطﻬﺎ ﺒﺤﺎﺠﺎت اﻟطﻠﺒﺔ وﻤﺸﻛﻼﺘﻬم .

ٕواﻴﻤـﺎء ﻤـﺎ ﺴـﺒق ﻓﻛـرت اﻟﺒﺎﺤﺜﺘـﺎن ﺒـﺄﺠ ارء اﻟد ارﺴـﺔ اﻟﺤﺎﻟﻴـﺔ ﻟﻌﻠﻬـﺎ ﺘﺴـﻬم ﻓـﻲ ﻤﻌﺎﻟﺠـﺔ
اﻟﻤﺸﻛﻠﺔ أو اﻟﺘﺨﻔﻴف ﻤن ﺤدﺘﻬﺎ .
Analisis Sistem Informasi Akuntansi Simpan Pinjam Sebelum Dan Setelah Menggunakan Metode Rapid Application Development (RAD) Pada KPRI Dhaya Harta Jombang
Authors: Giri Pramesty Wahyuning , Taufik Hidayat Agus 
Published: May 2024

Sistem Informasi Akuntansi merupakan sebuah bentuk dari sistem informasi akuntansi yang berkonsentrasi pada proses pembuatan, penyajian dan memperbaiki informasi kepada pihak berwenang mengelola kegiatan bisnis untuk dijadikan bahan dasar pengambilan kebijakan. Rapid Application Development (RAD) adalah model proses pembangunan perangkat lunak yang tergolong dalam teknik incremental (bertingkat). RAD menekankan pada siklus pembangunan pendek, singkat, dan cepat. Penelitian ini bertujuan untuk membuat model (prototype) perancangan system informasi akuntansi simpan pinjam dengan menggunakan model Rapid Application Development (RAD) pada KPRI Dhaya Harta Jombang. Pada penelitian ini menganalisis prosedur-prosedur simpan pinjam yang berjalan pada koperasi KPRI Dhaya Harta Jombang sesuai dengan tahap-tahap pada metode Rapid Application Development (RAD). Analisis masalah yng terdapat dalam koperasi digambarkan dalam suatu flowchart sistem dalam setiap prosedur yang berjalan.
Task-order control in dual-tasks: Only
marginal interactions between conflict at lower levels and higher processes of task
organization
Authors: Koob Valentin , Dignath David , Janczyk Markus 
Published: May 2024

AbstractWhen simultaneously performing two tasks that share response properties,
interference can occur. Besides general performance decrements, performance in the
first task is worse when the second task requires a spatially incompatible response,
known as the backward crosstalk effect (BCE). The size of this BCE, similar to
congruency effects in conflict tasks, is subject to a sequential modulation, with a
smaller BCE after incompatible compared to compatible trials. In the present study,
we focus on a potential bidirectional interaction between crosstalk (and its
resolution) at a lower level of task performance and higher-order processes of task
organization. Two questions were of particular interest: First, do participants
switch task order more frequently after a conflict-prone incompatible trial than
after a compatible trial? Second, does changing task order influence the efficiency
of conflict resolution, as indexed by the size of the sequential modulation of the
BCE. Across four experiments, we only found marginal evidence for an influence of
lower-level conflict on higher-order processes of task organization, with only one
experiment revealing a tendency to repeat task order following conflict. Our results
thus suggest practical independence between conflict and task-order control. When
separating processes of task selection and task performance, the sequential
modulation was generally diminished, suggesting that conflict resolution in
dual-tasks can be disrupted by a deliberate decision about task order, or,
alternatively, by a longer inter-trial interval. Finally, the study found a strong
bias towards repeating the same task order across trials, suggesting that task-order
sets not only impact task performance but also guide task selection.
Measuring transformative virtual reality experiences in children’s drawings
Authors: van Limpt-Broers H. Anna T. , Postma Marie , Louwerse Max M. 
Published: May 2024

Abstract
Transformative experiences in an individual’s life have a lasting impact on identity, belief system, and values. At the core of these experiences is the complex emotion of awe that promotes learning, making it worthwhile to study from an educational point of view. Drawing studies may provide a useful measure of awe in children—one that is more intuitive and attractive than questionnaires alone. Previous studies conducted with adults indicated that the diminished self, associated with transformative experiences, manifests in an actual decrease in size for figures representing the self in drawings. In the current study, self-representation was investigated in drawings of 10- to 12-year-old primary school children within the context of an immersive virtual reality (VR) experience that elicits the overview effect, known to lead to an intense apperception of awe. We did not replicate the adult findings regarding self-size in this younger age group. However, details and complexity in children’s drawings appeared to be impacted by the awe-elicitation procedure in VR. These elements subsequently correlated to learning gains instead of the overview effect, indicating that this measure could be linked to cognitive ability. The findings of the current study contribute to a better understanding of how drawings reflect self-transcendental experiences; however, they also reveal that in younger age groups, they are not necessarily reflected in decreased self-size.
Does the reliability of computational models truly improve with hierarchical modeling? Some recommendations and considerations for the assessment of model parameter reliability
Authors: Katahira Kentaro , Oba Takeyuki , Toyama Asako 
Published: May 2024

AbstractComputational modeling of behavior is increasingly being adopted as a standard methodology in psychology, cognitive neuroscience, and computational psychiatry. This approach involves estimating parameters in a computational (or cognitive) model that represents the computational processes of the underlying behavior. In this approach, the reliability of the parameter estimates is an important issue. The use of hierarchical (Bayesian) approaches, which place a prior on each model parameter of the individual participants, is thought to improve the reliability of the parameters. However, the characteristics of reliability in parameter estimates, especially when individual-level priors are assumed, as in hierarchical models, have not yet been fully discussed. Furthermore, the suitability of different reliability measures for assessing parameter reliability is not thoroughly understood. In this study, we conduct a systematic examination of these issues through theoretical analysis and numerical simulations, focusing specifically on reinforcement learning models. We note that the heterogeneity in the estimation precision of individual parameters, particularly with priors, can skew reliability measures toward individuals with higher precision. We further note that there are two factors that reduce reliability, namely estimation error and intersession variation in the true parameters, and we discuss how to evaluate these factors separately. Based on the considerations of this study, we present several recommendations and cautions for assessing the reliability of the model parameters.
CLEANing Cygnus A Deep and Fast with R2D2
Authors: Dabbech Arwa , Aghabiglou Amir , Chu Chung San , Wiaux Yves 
Published: May 2024

Abstract
A novel deep-learning paradigm for synthesis imaging by radio interferometry in astronomy was recently proposed, dubbed “Residual-to-Residual DNN series for high-Dynamic range imaging” (R2D2). In this work, we start by shedding light on R2D2's algorithmic structure, interpreting it as a learned version of CLEAN with minor cycles substituted with a deep neural network (DNN) whose training is iteration-specific. We then proceed with R2D2's first demonstration on real data, for monochromatic intensity imaging of the radio galaxy Cygnus A from S-band observations with the Very Large Array. We show that the modeling power of R2D2's learning approach enables delivering high-precision imaging, superseding the resolution of CLEAN, and matching the precision of modern optimization and plug-and-play algorithms, respectively uSARA and AIRI. Requiring few major-cycle iterations only, R2D2 provides a much faster reconstruction than uSARA and AIRI, known to be highly iterative, and is at least as fast as CLEAN.
Pleomorphic Adenoma - A Case Report on an Abnormal Mass
Authors: Deenadayalan N. , Pandyan Deepak Abraham , Satheesh C. , Aparnaa M. , Harthi G. 
Published: May 2024

Abstract

Rationale:
Pleomorphic adenoma (PA) is the most prevalent salivary gland tumour, accounting for 60%–80% of all benign salivary gland tumours, and frequently affects the parotid gland. Their epithelial and connective tissue origins can explain the ‘pleomorphic’ nature of tumours. This tumour is most common in women between 30 and 50 years.

Patient Concerns:
A 45-year-old female came with the chief complaint of a slow-growing, painless swelling on the left side of her face that had been present for 25 years.

Diagnosis:
PA of the parotid gland was diagnosed using computed tomography and fine-needle aspiration cytology. PA is a slowly progressing, asymptomatic swelling that rarely exceeds 6 cm in its greatest dimension; in our case, it was 13 cm × 10 cm and weighed 5 kg.

Treatment:
The ideal management is the surgical removal of the tumour mass, which was done under general anaesthesia. Early diagnosis and treatment planning was critical. Complete removal of the tumour without remnants is crucial to prevent a recurrence. Total parotidectomy was done in this case.

Outcomes:
There was no evidence of recurrence after comprehensive local surgical resection of the tumour during the follow-up period.

Take-away Lessons:
This case report is significant as it sheds light on the successful treatment approach for a large pleomorphic adenoma. It can provide valuable insights into the management of similar cases, potentially leading to improved patient outcomes and guiding future treatment strategies.
Foreign Body Ingestion in Children: An Experience of 99 Cases in a Tertiary Care Center in Delhi
Authors: Kinjalk Meghna , Sehgal Mehak , Ratan Simmi K. , Jain Nitin , Gupta Chiranjiv Kumar , Neogi Sujoy , Kumar Prafull , Bhoria Dhruv , Arora Vanshika , Chellani Gautam 
Published: May 2024

ABSTRACT

Background:
Accidental ingestion of foreign bodies in children is critical, as the inability to effectively communicate can potentially lead to devastating consequences. We aimed to determine the epidemiology of foreign body ingestion and variability according to age, gender, type, and location of foreign body, and describe its management.

Aim and Objective:
The aim was to study the various types of foreign body ingestions in children admitted to pediatric surgery and their management.

Materials and Methods:
A retrospective study was conducted from January 2020 to June 2022 on children under the age of 12 years with a confirmed diagnosis of foreign body ingestion. Patients were clinically and radiologically assessed, after which standard protocols were followed wherein patients were followed by either observation or emergent management. Emergent management included removal of the foreign body by either endoscopy or surgery. Comparisons among multiple age groups, gender, type of foreign body, location of foreign body, and their management were analyzed.

Results:
Out of 99 subjects in our study, there were 76 boys and 23 girls. The median age of presentation was 5 years. Most children were asymptomatic at presentation. The most frequently ingested foreign body was a coin in all age groups. The majority of the foreign bodies were suspected to be in the small bowel. The foreign bodies that had crossed the duodenojejunal flexure (n = 74, 74.7%) were managed conservatively with the observation of a variable period of a minimum of 24 h and a maximum of 48 h. 21 cases were managed by endoscopic removal, while three cases required surgical intervention.

Conclusions:
Overall, the most common gastrointestinal foreign body was a coin in all age groups. Button battery is the most worrisome foreign body; however, depending on its position, it can be managed conservatively. Upper GI foreign bodies can be safely removed endoscopically. Parental counseling is very important for the prevention of ingestion of foreign bodies.
Delphi Method Analysis and Consensus of Prevalent Distinctive Practices for Biliary Atresia Management after Kasai Portoenterostomy
Authors: Vutukuru Sravanthi , Solanki Shailesh , Kanojia Ravi Prakash 
Published: May 2024

ABSTRACT

Background:
Extrahepatic biliary atresia (BA) is seen in infants, with an incidence of 1 in 15,000 live births. The presentation is progressive jaundice, dark-colored urine, and clay-colored stools. Kasai portoenterostomy (KPE) is the commonly performed surgical procedure in these patients. Postoperatively, phenobarbitone, ursodeoxycholic acid (UDCA), steroids, and other drugs are given to improve bile drainage and prevent inflammation and fibrosis. However, a definitive protocol regarding the need for different drugs, dosage, and duration varies across individual surgeons and centers. No universally accepted protocol exists for postoperative management after KPE.

Aim:
The aim of this study was to know the prevailing postoperative management of BA by subject experts and use the Delphi process to know if the experts want to change their practice based on the results from the survey.

Material and Methods:
A questionnaire was made after discussing with two experts in the field of BA. The questionnaire was mailed to 25 subject experts. The first survey data were analyzed and shared with all responders. In the second survey, change in the management based on the results from the first survey was assessed.

Results:
The Delphi questionnaire was answered by 17 experts. Postoperatively, prophylactic antibiotics are prescribed for 6–12 weeks by around 40% and >12 weeks by 30% of respondents. Phenobarbitone is prescribed for <3 months by nearly 50%. UDCA is prescribed for <3 months, ≤6 months, and 6 months–1 year by 47.1%, 23.5%, and 23.5% responders, respectively. Nearly 50% prescribe steroids (mostly prednisolone), and among them, two-thirds prescribe it for 6–12 weeks. Approximately 60% give antiviral drugs to children who are cytomegalovirus immunoglobulin M positive. In our survey, 50% of experts perform 5–10 KPE per year, and 25% each perform 10–15 and >15 KPE per year. The second survey noted that a significant percentage of responders want to change their practice according to consensus.

Conclusion:
From our Delphi survey, an overview of the postoperative management of BA could be made. However, multicentric studies are required for uniform protocol on the postoperative management of BA.