bluuebunny/crossref_metadata_2025_split huggingface dataset:
Finding life beyond the classroom walls: a Change Laboratory supporting expansive de-encapsulation of school
Authors: Engeström Yrjö , Rantavuori Pauliina , Ruutu Piia , Tapola-Haapala Maria 
Published: September 2023

In an encapsulated classroom, the school text – the knowledge conveyed by teachers and textbooks and reproduced in tests and exams – tends to become the object of the activity instead of being an instrument for understanding the world. In order to understand and promote sustainable de-encapsulation, we need to identify, document, analyze, and foster a wide variety of actions and practices. Our article contributes to this need by presenting a practical, methodological, and conceptual framework for de-encapsulation in schools. In this study, 8th graders from one comprehensive school in Finland worked on projects chosen by themselves, with the support of researchers during the school year. The projects were carried out in Change Laboratory intervention, a method of participatory analysis and design based on the theory of expansive learning. We built an analytical framework to examine how students took actions to break out of the encapsulated classroom and school while working on the projects significant for them. The expansive de-encapsulation actions were analyzed using three dimensions: 1) the individual or collective nature of the de-encapsulation efforts; 2) the direction of the movement, and 3) the composition of the movement. The findings show significant variation of de-encapsulation actions in the four projects. None of the four project groups was unable or unwilling to engage in de-encapsulation. This indicates that there is a broad spectrum of possible student-led projects that can, in a variety of ways, involve and nourish actions of expansive de-encapsulation. Allowing students to create and lead their own projects has strong potential for the opening up of the school and creating partnerships with progressive actors outside the school.
Acute Myeloid Leukemia Causes T Cell Exhaustion and Depletion in a Humanized Graft-versus-Leukemia Model
Authors: Jia Bei , Zhao Chenchen , Minagawa Kentaro , Shike Hiroko , Claxton David F , Ehmann W Christopher , Rybka Witold B , Mineishi Shin , Wang Ming , Schell Todd D , Prabhu K Sandeep , Paulson Robert F , Zhang Yi , Shultz Leonard D , Zheng Hong 
Published: September 2023

Abstract
Allogeneic hematopoietic stem cell transplantation (alloSCT) is, in many clinical settings, the only curative treatment for acute myeloid leukemia (AML). The clinical benefit of alloSCT greatly relies on the graft-versus-leukemia (GVL) effect. However, AML relapse remains the top cause of posttransplant death; this highlights the urgent need to enhance GVL. Studies of human GVL have been hindered by the lack of optimal clinically relevant models. In this article, we report, the successful establishment of a novel (to our knowledge) humanized GVL model system by transplanting clinically paired donor PBMCs and patient AML into MHC class I/II knockout NSG mice. We observed significantly reduced leukemia growth in humanized mice compared with mice that received AML alone, demonstrating a functional GVL effect. Using this model system, we studied human GVL responses against human AML cells in vivo and discovered that AML induced T cell depletion, likely because of increased T cell apoptosis. In addition, AML caused T cell exhaustion manifested by upregulation of inhibitory receptors, increased expression of exhaustion-related transcription factors, and decreased T cell function. Importantly, combined blockade of human T cell–inhibitory pathways effectively reduced leukemia burden and reinvigorated CD8 T cell function in this model system. These data, generated in a highly clinically relevant humanized GVL model, not only demonstrate AML-induced inhibition of alloreactive T cells but also identify promising therapeutic strategies targeting T cell depletion and exhaustion for overcoming GVL failure and treating AML relapse after alloSCT.
Significance of the Ancillary Posterior Knee Soft-Tissue Edema Sign in Traumatic Knee Injuries
Authors: Shah Ali , Iyengar Karthikeyan. P. , Beale David , Sonsale Paresh , Botchu Rajesh 
Published: September 2023

Introduction/Background:
Traumatic soft-tissue injuries of the knee involve a spectrum of pathologies of the soft-tissue envelope, menisci or rupture of supporting tendinous or ligamentous structures. Magnetic resonance imaging (MRI) is an excellent, noninvasive modality to assess these injuries to guide patient management and improve patient outcomes.

Objective:
To highlight and explore the clinico-radiological significance of posterior knee soft-tissue edema (PKSTO) ancillary sign in traumatic knee injuries.

Materials and Methods:
MRI of 150 consecutive young adults undergoing within 1 week of an acute knee injury were reviewed. The area of interest behind the knee was specifically assessed for the presence of PKSTO sign. MRI of patients with PKSTO was analyzed further for associated ligament and meniscal injuries.

Results:
There were 18 patients with PKSTO sign with a mean age of 21.7 years (range 9–39 years). There was a male preponderance. The most common associated injury found was of the anterior cruciate ligament with four patients having multiple injuries. The average volumetric area of PKSTO was 68.5 cm3 (1.5 cm3–486 cm3) with a proportional increase depending on the severity/number of ligamentous or meniscal pathologies.

Conclusion:
Detection of the PKSTO ancillary sign on sagittal MRI sequences is associated with clinically relevant knee soft-tissue injuries including multi-ligament and meniscal tears.
Dental Caries Prevalence, Severity, and Pattern Among Male Adolescents in Kano, Nigeria
Authors: Okolo Chizoba Chineme , Oredugba Folakemi A. , Denloye Obafunke O. , Adeyemo Yewande I. 
Published: September 2023

Background:
Dental caries is the most common oral disease of mankind; however, there are limited data on the oral status of adolescents in northern Nigeria. Recently, the World Health Organization set the global caries goal as significant caries (SiC) index score of <3. This study was designed to appraise the magnitude of the disease among adolescents in northern Nigeria.

Objectives:
The objective of the study was to determine the prevalence, pattern, and severity of caries among 10–12-year-old adolescents in Kano, Nigeria.

Materials and Methods:
Six hundred and ninety-four school-aged children were selected through a multi-stage sampling of 10–12-year-old children in Kano and examined for dental caries using the WHO protocols. Data analysis was carried out using the Statistical Package for the Social Sciences (SPSS version 20 Inc. Chicago IL, USA).

Results:
The prevalence of caries was 22.9% with mean DMFT and SiC scores of 0.5 (±1.2) and 3.7 respectively. DMFT >0 ranged from 1 to 8. Tooth 85 (the right mandibular second primary molar) and tooth 36 (left mandibular permanent first molar) had the highest caries count for primary and permanent teeth respectively. More lesions occurred on the left mandible in primary and permanent teeth. The second primary molars and the first permanent molars were most affected by the disease.

Conclusion:
The prevalence of dental caries was low among male adolescents in Kano as evidenced by the low mean DMFT/dmft scores; however, the condition exceeded the recommended WHO thresholds. Caries occurred more frequently on teeth 85 and 36.
Determinants of Obstetricians’ Pattern of Care for Sickle Cell Disease in Pregnancy
Authors: Nwagha Theresa Ukamaka , Okoye Helen Chioma , Ugwu Angela Ogechukwu , Ugwu Emmanuel Onyebuchi , Duru Augustine Nwakuche , Ezebialu Ifeanyichukwu Uzoma , Menuba Ifeanyi E. , Ugwu Alloy Okechukwu , Eze Stephen Chijioke 
Published: September 2023

Background:
Pregnancy in sickle cell disease (SCD) is high risk. With improved comprehensive obstetric care, pregnant females with SCD can achieve successful pregnancy outcomes, especially in resource-poor settings.

Objectives:
To determine the predictors of Obstetricians’ pattern of care for SCD in pregnancy in Nigeria.

Materials and Methods:
Self-administered, pre-tested, pre-validated questionnaires containing 18 questions on demographic details of obstetricians, and their pattern of practice towards antenatal care for pregnant SCD patients were distributed to attendees of the 2018 conference of the Society of Obstetrics and Gynaecology of Nigeria (SOGON). Regression analysis was done to determine the possible predictors, and a significant level was <0.05.

Result:
Almost all the respondents (98.4%) considered pregnancy in SCD as high risk, and 96.2% proposed for preconception care in a tertiary hospital. The majority, (62%) agreed that antenatal visits in the first and second trimesters should be more frequent. The majority (96.2%) reported they would routinely order urine tests among other investigations. Majority of respondents,74.9% and 98.4% knew that foetal medicine specialists and haematologists should be part of preconception care team, respectively. Respondents’ practice centre and designation, significantly contributed to their “willingness to consult a haematologist” (P = 0.004),” and willingness to consult a foetal specialist” (P = 0.047), while practice centre and practice population significantly contributed to their response to “ideal centre for management of SCD pregnancy”: (P = 0.049), (P = 0.024) respectively.

Conclusion:
Obstetricians’ level of training, practice centre, and practice population of pregnant women with SCD are significant contributors to their pattern of care towards antenatal care for pregnancy in SCD.
The Burden of Geriatric Trauma at the University College Hospital, Ibadan Nigeria
Authors: Ogunrewo Tolulope , Alonge Oluwagbenga T. 
Published: September 2023

Background:
Geriatric populations presently account for 9% of the world population and this is expected to increase. Injuries to the elderly accounted for 5.8 million accident and emergency visits in the US as well as 4% of patients treated for traumatic injuries in Abuja, Nigeria. Traumatic injury is therefore a major cause of morbidity in the elderly as such the need for the study in our environment.

Aims and Objectives:
The aim of this study was to review the incidence and types of traumatic injury among the elderly population that presented at the University College Hospital Ibadan and to determine the causes of traumatic injury involving the geriatric age group in our environment.

Materials and Methods:
A retrospective hospital-based study involving the records of geriatric patients that presented with traumatic injuries between January 2014 and June 2021 at the geriatric center and the accident and emergency department of the hospital. The record was retrieved from the Total Quality Management Unit of the hospital.

Results:
Approximately 7.61% of the traumatic injury that presented at the accident and emergency department within the study period involved geriatric patients with a male-to-female ratio of 1:1.08, whereas 0.3% of the patients for inpatient care at the geriatric center had a traumatic injury. Fall was the most common cause of traumatic injury observed and fracture was the most common traumatic injury observed.

Conclusion:
Less than 10% of the patients with the traumatic injury that presented at the University College Hospital Ibadan are in the geriatric age group. Most of the traumatic injury involving geriatric patients in our environment is due to low energy falls and fracture is the most common injury observed with the femur being the most affected bone. Therefore, interventions directed at reducing the incidence of falls in our environment will hopefully help in reducing the incidence of traumatic injuries in older person.
Power Plug of a Mobile Phone Charger in the Orbit
Authors: Habib Saudat Garba , Ibrahim Usman Yuguda , Mohammed Isyaku , Umar Saudatu Madaki 
Published: September 2023

Background:
This is the case of a girl who sustained orbital injury while playing with a mobile phone charger.

Case Report:
The patient presented to the tertiary hospital 5 h after she sustained a penetrating injury with the power plug of a mobile phone charger to the right upper lid. There was associated headache, tearing, bleeding, discharge, and inability to open the right eye.

On Examination:
She was ill-looking and anxious, not febrile or pale. Systemic examination did not reveal any abnormality. Unaided visual acuity in the right eye (OD) could not be tested, left eye (OS)—6/9. The right eyelid was completely closed with a penetrating power plug of the phone charger in the supero-lateral aspect of the upper eyelid. A diagnosis of penetrating power plug of a charger in the right upper lid and orbit was made. Computed tomography scan showed the power plug of the charger in the right orbit with a little blood collection in the right maxillary sinus. She underwent examination under anaesthesia, foreign body removal, and repair of the lid penetration. The findings were right upper lid penetration with ptosis, corneal epithelial erosion, phone charger power plug in the medial orbital wall, and cataract. The foreign body was removed, and lid and conjunctival lacerations repaired. Eight weeks post-operatively, ptosis had resolved, leaving the anterior polar cataract (<3 mm) and a best corrected visual acuity of (OD) 6/6 and (OS) 6/5. About 6 months afterwards, the cataract matured with a visual acuity of 6/60 for which she had right phacoemulsification with posterior chamber intra-ocular lens implant insertion.

Conclusion:
Prompt presentation and management lead to good visual outcomes in this patient.
Paediatric Acute Appendicitis
Authors: Kalu Ukoha Agwu , Jones Taiwo , Fadahunsi Olufunke O. , Ibiyeye Taiye T. , Odi Temitope O. , Abdur-Rahman Lukman Olajide 
Published: September 2023

Introduction:
The diagnosis of acute appendicitis (AA) is usually clear cut but sometimes there is atypical presentation of this condition in children. There is a need to determine and compare the diagnostic accuracy of these three pre-operative diagnostic modalities: Paediatric Appendicitis Score (PAS), abdominal ultrasonographic scan (USS) findings, and serum C-reactive proteins (CRPs). The objective of this study was to determine the diagnostic accuracy of the three diagnostic modalities and to compare each diagnostic test result with the histopathological results of the appendix specimens.

Materials and Methods:
This was a prospective cross-sectional study that involved children aged 4–15 years with suspected AA who presented at the emergency paediatric unit of a tertiary health care hospital in North Central, Nigeria. The PAS, quantitative serum CRP, and abdominal USS were performed for all eligible patients.

Results:
A total of 43 patients were included in this study. Forty appendicectomy specimens (93%) were histologically confirmed to be AA and three appendicectomy specimens (7%) were normal appendix. The diagnostic accuracy values of PAS, abdominal USS, and CRP were 95.3%, 93.0%, and 90.7%, respectively.

Conclusion:
This study demonstrated that PAS, abdominal USS, and serum CRP provided useful diagnostic accuracy for AA in children.
Bacterial and Antibiotic Sensitivity Pattern in Secondary Peritonitis
Authors: Ojo Adedoyin Babatunde , Omoareghan Irabor David 
Published: September 2023

Background:
Peritonitis is inflammation of the peritoneum usually as a result of a localized or generalized infection. Secondary peritonitis which is the most common type follows an infective process in a visceral organ. The role of peritoneal cultures and use of antibiotics effective against culture results remain controversial.

Objectives:
This study was conducted to determine the bacterial and antibiotic sensitivity pattern in patients with secondary peritonitis. It also compared the use of empirical antibiotics and culture-sensitive antibiotics with outcomes of patients with secondary peritonitis.

Materials and Methods:
A prospective randomized clinical study was conducted. Five millilitres of peritoneal fluid was sampled intra-operatively, and microscopy, culture, and sensitivity testing was performed in patients with secondary peritonitis. The patients, randomized into two groups, had antibiotics administered for 7 days. The first group had empirical antibiotics throughout (Ceftriaxone + Metronidazole), whereas the second group had empirical antibiotics (Ceftriaxone + Metronidazole) for the first 2 days and antibiotics according to the sensitivity report for the remaining 5 days. The post-hoc analysis was also done on a third group, who, even though were randomized to either groups, had no growth on culture of peritoneal fluid.

Results:
The commonest pathogens identified from the peritoneal culture of the participants were Escherichia coli, Klebsiella pneumonia, Anaerococcus group, and Bacteroides fragilis. Complications including mortality were significantly higher in those who received empirical antibiotics than those who received culture-sensitive antibiotics.

Conclusion:
The outcome of antibiotics administration in patients with secondary peritonitis with a positive culture was better in those who received culture-sensitive antibiotics than those who received empirical antibiotics.
Difficult Laparoscopic Cholecystectomy Predictors and its Significance
Authors: Karim Shivam Tanweer , Chakravarti Sumit , Jain Atul , Patel Gaurav , Dey Subhajeet 
Published: September 2023

Background:
Laparoscopic cholecystectomy (LC) has become the procedure of choice for the management of symptomatic gallstone disease. In LC, the surgeons encountered difficulties with acutely inflamed or gangrenous gallbladder (GB), dense adhesions at Calot’s triangle, fibrotic and contracted GB, and cholecystoenteric fistula. Depending on the difficulty faced during the surgery, the outcome of LC may vary from abandoning the procedure or partial cholecystectomy to conversion into open cholecystectomy. Complications related to biliary tract or adjoining structures or vessels may also occur. Our aim was to assess the different preoperative factors in patients of cholelithiasis and ascertain the validity of the scoring system devised by Randhawa and Pujahari in preoperatively predicting the difficult LC in our hospital scenario.

Materials and Methods:
This hospital-based observational study was conducted in the Department of General Surgery for a period of 2 years. All diagnosed cases of cholelithiasis admitted for elective LC during the study period in our hospital were included in the study.

Results:
In total, 154 patients, aged≥50 years, history of hospitalization for acute cholecystitis (AC), body mass index of 25 kg/m2 and more, abdominal scar, palpable GB, GB wall thickness ≥4 mm, pericholecystic collection, impacted stone found to be significant factors to predict difficult LC preoperatively. Endoscopic retrograde cholangiopancreatography and pancreatitis were found as independent risk factor for difficult LC.

Conclusion:
We recommend that the scoring system should be regularly used as a protocol for predicting difficulty levels preoperatively in LC. It can help to decide the surgical approach, counsel the patients, and reduce the complication rate, rate of conversion, and overall medical cost. The scoring system proposed by Randhawa and Pujahari is effective but has some lacunae.
Experience with Abdominoplasty at National Orthopedic Hospital, Enugu, South-East, Nigeria
Authors: Mba Uwakwe Cosmas , Ogbonnaya Iheuko Sunday , Uduezue Anthonia O. , Okoye Chukwuemeka Patrick , Okoli Chinedu Michael , Eze Balantine Ugochukwu 
Published: September 2023

Background:
Abdominoplasty is a body contouring surgical procedure designed to improve the contour of the lower trunk. It is one the most commonly performed cosmetic procedures in developed countries. In developing nations such as ours, it constitutes a small percentage of aesthetic procedures performed. In our hospital, a number of cases have been done in the past 12 years. However, some studies from developed countries suggest that cosmetic surgeries in developing countries in associated with higher risk of complications. The aim of this study was to evaluate the outcome of abdominoplasties performed in a specialist hospital of a developing country.

Patients and Methods:
The study was a 12-year retrospective study. The folders of all the patients that had abdominoplasty were retrieved and reviewed. Data was subjected to statistical analysis using PSPP4Windows®17 computer software version 1.4.1, 2019. The results are presented in prose, tables, charts, and figures.

Results:
A total of 30 women aged between 26 and 59 years had abdominoplasty. All were multiparous. About 76% of the patients had previous abdominal surgeries and 74% of this were caesarean section. No mortality was recorded but some patients had minor complications. The most common was respiratory distress which resolved on supportive treatment. Outcome was satisfactory in 95.5% and good in 4.5% of patients.

Conclusion:
Abdominoplasty in our environment is safe in trained hands.
Role of Serum Interleukin-6 and C-reactive Protein in Early Prediction of Severe Acute Pancreatitis
Authors: Kumar Ram Bharosh , Karim Tanweer , Jain Atul , Arora Sarika , Katiyar Vivek Kumar , Patel Gaurav 
Published: September 2023

Background:
Early prediction of severity is an important goal in acute pancreatitis (AP), to identify 20% of patients who are likely to have a severe course. Such patients have an expected mortality of 15–20% and may benefit from early admission to high dependency or intensive care units, with parenteral or nasojejunal feeding and prophylactic antibiotics. In severe AP (SAP), multiorgan dysfunction accounts for most of early deaths.

Aims:
The aim of this article is to assess the role of serum interleukin (IL)-6 and serum C-reactive protein (CRP) in early prediction of severity of AP.

Materials and Methods:
This observational analytical study was conducted in the Department of General Surgery and Department of Biochemistry in our hospital in 62 patients as per inclusion and exclusion criteria.

Results:
IL-6 on day 1 and day 2 as well as CRP on day 2 was 100% sensitive but IL-6 on day 1 and day 2 had a maximum specificity of 88.37% among them when compared with a specificity of 81.4% of CRP on day 2. Though CRP on day 1 also had a specificity of 88.37%, its sensitivity was 89.47%.

Conclusion:
IL-6 and CRP together appear to be a promising marker for assessing the severity of AP within 48 h. We recommend to do IL-6 and CRP in patients with AP, which can help in predicting severity of the disease in patients.