Conservative Approach Research Articles

Mydriasis and Ophthalmoplegia in a 10-Year-Old Girl: A Diagnostic Predicament

This case reports a 10-year-old girl who presented with sudden-onset diplopia and bilateral mydriasis following a recent upper respiratory infection. Ocular examination showed poor light response and mild abduction deficits. Initial low-resolution MRI was normal, but a high-resolution MRI revealed bilateral enhancement of the abducens and oculomotor nerves. Viral-induced cranial nerve palsies were suspected. The use of systemic steroids was considered but concerns about side effects in children led to a conservative approach. Patient achieved full recovery four months later. This case highlights the importance of high-resolution imaging in diagnosing cranial nerve palsies in children and raises questions about the role of corticosteroids in managing viral-induced neuropathies. Further research is needed to determine optimal treatment strategies for such cases.

Re‐Purposing Business Schools: Potential, Progress, and Precarity

AbstractWith recent management studies of organizational purpose concentrating on the reactions of corporate elites to external change stimuli, little attention has been given to the emergent phenomenon of internally‐driven business school re‐purposing. Breaking with a tradition of incremental change in the field, re‐purposing denotes a transformational process that arises from business school leaders' attempts to focus their organizations on the pursuit of their purpose to enhance the public good, from management scholarship and the way that business schools operate. This paper frames business school re‐purposing as the endogenous enactment of a purpose logic, and it draws from early cases in the UK and France to present an analysis of the leadership activity involved. The potential for further business school re‐purposing is assessed critically with reference to general challenges of infusing purpose into organizations, and the specific threats posed by a field that is dominated by a countervailing logic of purpose, a conservative approach to management, and increasing financial pressures.

Endemic Plant Species of India: Challenges and Conservation Strategies

India is home to a rich diversity of endemic plant species, many of which face severe threats due to habitat destruction, climate change, and unsustainable human activities. This paper explores the current status of endemic plant species in India, highlights the challenges they face, and proposes conservation strategies. India boasts a significant number of endemic species, with many of them listed as threatened, underscoring the urgency for effective conservation. Habitat loss, primarily driven by urbanization, agriculture, and deforestation, is a major contributor to this decline. Climate change further exacerbates these threats, altering species distributions and accelerating the loss of suitable habitats. The paper discusses various conservation approaches, including in situ and ex situ methods, along with the importance of local community involvement in conservation efforts. Technological innovations such as GIS and satellite monitoring have proven to be instrumental in mapping biodiversity hotspots and enhancing conservation efforts. Policy frameworks like the Biological Diversity Act of 2002 have laid a foundation for species protection, but stronger enforcement and broader initiatives are needed. Finally, the paper outlines future directions for conservation, emphasizing the need for integrated approaches that combine technology, research, policy, and community participation. The survival of India's endemic plant species is crucial for maintaining ecological balance and safeguarding biodiversity for future generations.

Acute Aortic Dissection Complicating Emergency Coronary Intervention for Hyperacute Stent Thrombosis

Introduction: Iatrogenic acute aortic dissection resulting from coronary interventions can have fatal consequences. Although it is an uncommon complication during percutaneous coronary interventions (PCI), it can arise from various factors. Our case report aims to address this rare presentation further, seeking to enhance preprocedural planning which can result in better outcomes. Case Report: We describe an intriguing case of an elderly female patient with multiple cardiovascular risk factors who came to our emergency department presenting with chest pain. Her Electrocardiogram revealed an inferior ST-elevation myocardial infarction (STEMI) for which she underwent successful primary PCI of the right coronary artery (RCA). Four days later, she had an infero-posterior STEMI, which necessitated immediate coronary angiography. Angiography revealed thrombosis of the stent placed earlier in the RCA. On attempting recanalization of the vessel, an acute aortic dissection was identified and was successfully managed by ostial stenting. Follow-up imaging showed no residual dissection, and the patient was found to be comfortable and stable post-procedure. Conclusion: We recommend optimizing blood pressure and performing rapid ostial stenting in these cases, irrespective of the dissection’s origin. This will facilitate effective sealing of the entry site and prevent further progression of the dissection. Our report highlights the favorable results achieved with immediate ostial stenting while discussing the conservative approach to managing such cases.

Short-medium term complications of bariatric surgery: a pilot study.

Bariatric surgery (BS) stands as a highly effective intervention for severe obesity; however, limited understanding exists regarding its short to medium-term complications. This study aimed to analyze short-medium term complications in patients undergoing BS in an Ecuadorian hospital. A retrospective cohort study included 1132 patients who underwent BS between October 2021 and April 2022, specifically evaluating those with complications needing hospital readmission. Demographic, clinical, surgical, and therapeutic data were collected. The degree of complications was evaluated using the Clavien-Dindo classification. Out of the 1132 patients, 1.6% experienced early complications requiring hospital readmission within the first six months post-BS. Complications occurred in 7% of patients with revisional surgery, 2% with gastric bypass, and 1.2% with gastric sleeve. The most common complications were stenosis (28%), leaks/fistulas (17%), gallbladder and/or bile duct pathologies (17%), and fever (17%). Management strategies involved conservative treatment (28%), combined endoscopic and surgical approaches (28%), and surgical reintervention alone (33%). According to the Clavien-Dindo classification, 28% presented mild-moderate and 72% serious complications. BS showed a low incidence of early complications that required readmission. However, a substantial proportion (almost 70%) of patients with early complications experienced severe ones, resulting in prolonged hospital stays. These findings emphasize the need for ongoing monitoring and specialized care in the postoperative period, contributing valuable insights to the safety profile of BS in an Ecuadorian context.

Trends and Outcomes in Pituitary Apoplexy Management: A Spanish Observational Multicenter Study.

Currently, the management for pituitary apoplexy (PA) has been promoted toward a more conservative approach, particularly for patients with low-grade PA scores. Our aim was to investigate trends in PA management and compare clinical presentation, therapeutic approaches, and outcomes before and after 2017, additionally to evaluate long-term outcomes in conservatively treated patients. Spanish multicenter, retrospective study. Statistical analyses compared clinical presentation and outcomes between periods, adjusting for confounders. A total of 215 patients with PA and nonfunctioning pituitary adenoma were included, with the median age of 62.2 years and 68.4% were male patients. Of which 94 (43.7%) were diagnosed before 2017 and 121 (56.3%) in 2017 or later. Conservative treatment increased from 17% before to 30.6% in the recent period (odd ratio 0.47, 95% CI 0.24-0.90, P 0.02) This trend remained significant after adjusting for hospital, age, and Knosp grade (odd ratio 0.46, 95% CI 0.22-0.89, P = .03). However, surgery remained the most frequently used therapeutic option in both periods. There were no statistically significant differences in outcomes at 3 months between periods. Surgery compared with conservative management was associated with higher permanent arginine vasopressin deficiency in both periods (0 vs 17.9%, P = .07 before 2017; 0 vs 16.7%, P = .01 after). Up to 89.7% of patients treated conservatively, presented more than 25% spontaneous tumor shrinkage, and 74.4% had more than 50% tumor reduction. Although conservative management increased in the last years, surgery remains the predominant option. Patients managed conservatively experience a lower risk of permanent arginine vasopressin deficiency, and a high proportion exhibit clinically significant tumor shrinkage over time.

UKCropDiversity‐HPC: A collaborative high‐performance computing resource approach for sustainable agriculture and biodiversity conservation

UKCropDiversity‐HPC: A collaborative high‐performance computing resource approach for sustainable agriculture and biodiversity conservation

Enhancing accurate prediction of soil permeability coefficients using data-driven approaches for soil and water conservation

Enhancing accurate prediction of soil permeability coefficients using data-driven approaches for soil and water conservation

Socio-Economic and Environmental Interactions in the Maasai Mau Forest Kenya: A Comprehensive Household Survey Analysis

Maasai Mau Forest contains a diversity of flora and fauna, which are a source of livelihood for the local communities and provide various valuable ecosystem services. However, it is under threat from illegal subsistence farming in the Mau catchment and its surrounding areas due to anthropogenic activities leading to deforestation. The main objective of the study was to look at socioeconomic and environmental contexts of the households to inform sustainable land management (SLM) and conservation efforts. A descriptive cross-sectional research design was employed with a study area located in the Maasai Mau Forest region, Narok County, Kenya, which comprises of communities living within and around the Maasai Mau Forest. The study participants included Maasai communities, with a study population being mainly household-headed in the Maasai Mau Forest, which mainly depended on agriculture and animal farming for their livelihoods. A multi-stage sampling approach was also used in selecting the sampling units, such as villages, which were then further stratified into different areas or locations depending on the boundaries. The final sample size comprised of 385 households. Data were collected using semi-structured household questionnaires. Data was analyzed by the software SPSS using frequencies and percentages for nominal data and means for numeric data. About 59.5% of the respondents were women, a higher proportion compared to male-headed households of 76.1%. The major source of education of respondents was primary education (49.9%) followed by secondary education (29.6%) while only 14% had no formal education. Sources of income included crop farming (37.4%); livestock production (28.2%) followed by casual employment (15.8%). About 77.9% of the households had monthly incomes of below KES 15,000. Land ownership was freehold with 97.7% of the land in the freehold status and an average of a freehold land size at 1.4 acres. Most households kept various livestock including cattle (71.7%), poultry (12.5%) followed by other livestock kept. Crop production declined from the past years; with maize (96.4%) and beans (90.9%) being the main crops grown followed by potatoes (30.6%) and wheat (29.8%). Food security was a main concern with 54% of households indicating a downward trend in crop production over time. The survey objectives were met, showing that there are challenges with socio-economic issues, resource base, agricultural productivity and food security impacting the Maasai Mau Forest. However, there are opportunities for investing in sustainable agriculture and enhancing community involvement in conservation. The study recommended an integrated conservation approach that addressed the economic related issues, improved sustainable farming practices and enhanced community involvement, by: Improving land use planning and its management; Improving agricultural productivity and increasing market access; and Increasing food and water security to support improved sustainability of the Maasai Mau Forest Ecosystem.

Management of Delayed Vascular Occlusion in Free Flap Breast Reconstruction: A Systematic Review of Literature and Case Report.

Free flap surgery is a reliable and safe procedure for breast reconstruction. The survival of free flaps depends on their vascular pedicle initially, but neovascularization can sustain their blood supply after a while. Management of late pedicle occlusion in free flap breast reconstruction and potential implications of late pedicle occlusion on the transferred tissue are controversial. We systematically reviewed current literature focusing on articles that reported on late pedicle occlusion in free flaps for breast reconstruction. We aimed to analyze incidences of late pedicle occlusion, the existing evidence for the most appropriate management strategy for late pedicle occlusion, and its implications on overall outcomes. In support of the review, we present a clinical case of a salvage of a deep inferior epigastric artery perforator flap following late arterial thrombosis 12 days postoperatively. The literature is limited to a few case reports on pedicle occlusion in free flap breast reconstruction and a few heterogeneous retrospective reviews reporting on late pedicle occlusion in general. Despite the heterogeneity of articles and approaches to salvage flaps with late pedicle occlusion, we found no convincing evidence that surgery is the best choice to salvage flaps in breast reconstruction that appear to have late pedicle occlusion. Our case demonstrates that a conservative approach may be justified more than initially deemed necessary. Late pedicle occlusion is a rare but serious event in free flap breast reconstruction. Surgery does not seem to be the most appropriate approach in every case. Decisions should be based on clinical dynamics and imaging findings such as indocyanine-green angiography. A carefully carried out conservative approach may lead to flap salvage.

Gender in Social Media: A Comparative Study of Abd. Somad and Adi Hidayat’s Interpretation on Gender Equality

This research aims to explore and compare the views of two popular preachers in Indonesia, Ustaz Abdul Somad and Ustaz Adi Hidayat, regarding the concept of gender equality, conveyed via social media. In the digital era, social media has become an important platform for religious figures to convey their views and educate the public. The main focus of this research is to identify differences in the interpretations of each ustaz regarding gender issues, especially those involving women’s rights in the Islamic context. Data was collected through content analysis of videos and uploads spread on platforms such as YouTube and Instagram, which were studied using a descriptive-qualitative approach. The findings show that although both have the same foundation in Islamic teachings, there are variations in how they interpret the role of women and gender equality. Ustaz Abdul Somad tends to use a conservative approach that emphasizes traditional gender roles according to sharia norms. In contrast, Ustaz Adi Hidayat offers a more contextual approach, highlighting the importance of women’s empowerment within the limits set by Islam. These two interpretations reflect the diversity of thought in understanding gender equality among Indonesian ulama. It is hoped that this research can enrich the literature regarding the interpretation of gender in Islam and provide a better understanding of the influence of social media on public perceptions regarding gender issues in Indonesia.

Conservative Management of Horizontal Root Fracture: ACase Report.

In cases where permanent teeth have closed apices and completely erupted roots, the probability of root fractures is increased due to the stable support given by the adjacent bone and periodontal tissues. Fractures have the potential to affect several dental structures, including the pulp, dentin, cementum, bone, and periodontal tissues. In cases of horizontal root fractures (HRF), the apical section typically maintains vitality; however, the present case presented an unusual apex necrosis. Given the patient's age and tooth stability, traditional apical surgery was deemed inappropriate. Instead, a conservative treatment approach was chosen to preserve the tooth. This case report details the management and a 2-year follow-up of a maxillary central incisor exhibiting a HRF and apical necrosis, successfully addressed through the application of Mineral Trioxide Aggregate (MTA) in the both apical and coronal segments. Using MTA prevented apical surgery in cases of apex necrosis accompanied by HRF.

Accelerated Basal Melt Rates of Ice Shelves in North Greenland From 2013 to 2022 Estimated With the High‐Resolution ArcticDEM

AbstractBasal melting of ice shelves has become one of the main causes of mass loss from the Greenland ice sheet. However, most studies have focused on individual ice shelves, making it difficult to gain a more comprehensive understanding of basal melting across Greenland ice shelves. To address this issue, we utilized timestamped ArcticDEM strip data coregistered with ICESat‐2 data to estimate the basal melt rates of the ice shelves in North Greenland at a resolution of 150 m from 2013 to 2022, employing a mass conservation approach within the Lagrangian framework. Additionally, to investigate the influence of temperature on basal melt rates, a basic analysis correlating the basal melt rates with temperatures was conducted. Overall, the mass loss caused by basal melting of the six ice shelves has amounted to 27.86 ± 35.63 Gt yr−1, accounting for approximately 90% of the non‐calving mass loss, equivalent to a sea level rise of 0.08 ± 0.10 mm yr−1, far exceeding surface mass loss and glacier calving. The two larger ice shelves, Petermann and 79° North (79N), have contributed to 85% of the basal melt mass loss. Regarding the spatiotemporal distribution, the basal melt rates have gradually decreased from near the grounding line to the ice shelf front. Apart from the Ryder ice shelves, the basal melting of the other ice shelves is in a state of accelerated ablation. Moreover, compared to the skin temperature of the ice shelf, the sea water potential temperature has a greater impact on the basal melt rate.

Stable Isotope Ratio and Elemental Analysis (CNS) in Mangrove Leaves in the Creek Ecosystem: An Indicator of Coastal Marine Pollution

AbstractThe stable isotopes ratio and elemental composition in the mangrove leaves are excellent indicators for coastal marine pollution. The present study investigated the composition of Carbon, Nitrogen, and Sulfur, δ13C and δ15N values in mangrove leaves to identify the source of pollution and energy to the mangroves in the creek ecosystem of Mumbai Harbour Bay. The oxygen and hydrogen stable isotope ratios (δ18O and δ2H) of leaf water were estimated to understand the relative contribution of freshwater and seawater to the mangrove's water source. The Carbon, Nitrogen and Sulfur contents were found to vary from 37.79 to 42.55% (Average: 40.06 ± 1.54%), 2.13–3.79% (Average: 2.94 ± 0.45%) and 0.37–0.81% (Average: 0.53 ± 0.14%) in the mangrove leaves, respectively. The δ13C and δ15N values were found to vary from − 30.43 to − 28.41‰ (Average: − 29.46 ± 0.74‰) and from − 2.67 to 5.54‰ (Average: 2.21 ± 3.20%), respectively. The δ18O and δ2H values were found to vary from − 2.7 to 0.83‰ and − 6.86 to 5.43‰ with an average of − 0.94 ± 0.83 and − 2.03 ± 3.52‰ respectively. According to the observed δ18O and δ2H values, mangroves in the northern part had a relatively higher contribution of freshwater input compared to southern part of the study area. The lower values of δ15N towards the northern end of the creek indicate a relatively higher contribution of nitrogen from industrial discharges. Similar values of δ13C in mangrove in the region suggest a common source of carbon. Mangroves found near discharge locations have different elemental composition and δ15N values compared to those mangroves that are not located near discharge location. These differences can be used as potential markers to identify the coastal marine pollution. The results of the present study may be used for developing rational approaches for protection and conservation of the mangrove ecosystem in the bay.

The role of the Gbétitapéa Sacred Forest in Mammal conservation (Central-Western Côte d’Ivoire)

Sacred forests are traditional management systems aimed at biodiversity conservation, yet few studies focus on the mammalian fauna of these ecosystems. This study aims to assess mammal diversity in the Gbétitapéa sacred forest to promote this endogenous conservation approach. Specifically, it seeks to identify the mammal species present in this forest through local population surveys and on-foot surveys using linear transects and reconnaissance walks. Results show the presence of 13 mammal species across five orders (Rodents, Carnivores, Primates, Artiodactyls, and Bats), with Lowe's Monkey (Cercopithecus lowei) being the most abundant. All identified species are classified as Least Concern (LC) except for Lowe's Monkey, classified as Vulnerable (VU), and the Lesser Spot-nosed Monkey (Cercopithecus petaurista), classified as Near Threatened (NT) according to the IUCN Red List. Mammal diversity is closely linked to religious and cultural belief systems that shape conservation attitudes, practices, and policies. Integrating these cultural dimensions into conservation efforts could yield more sustainable and effective biodiversity conservation outcomes.

Biodiversity conservation in private forests: Preferences of Latvian forest owners in the context of involuntary conservation

Private forests play an important role in biodiversity conservation. Countries utilize various mechanisms for integrating private forests into biodiversity conservation strategies. While voluntary private forest conservation of biodiversity dominates in Nordic Europe countries, in Latvia the involuntary approach remains the main biodiversity conservation path. We aimed to explore the attitude of Latvian forest owners towards existing forest biodiversity conservation mechanisms, and preferences regarding potential motivating mechanisms. Our survey (analysis of 599 responses) was targeted on forest owners who had experienced biodiversity conservation related restrictions under involuntary conservation and who owned forest properties with significant biodiversity values. Our results suggested that owners of small forest properties under 5 ha, who are less financially dependent on forestry income and lack forestry education, as well as female forest owners, are more positive towards biodiversity conservation measures. Our results showed that most forest owners were not ready to accept substantial forestry restrictions. However, they would be ready to accept minor forestry restrictions such as no felling during bird breeding season and obligation of retention of a greater number of ecologically important trees and deadwood. Most forest owners considered the existing compensation system (annual payments) to be unfair. However, our results did not reveal larger acceptance for a voluntary conservation approach, as opposed to the existing system. Provision of information regarding biodiversity conservation in forest management remains a crucial task, however it primarily should be addressed through the forestry education system and forestry institution information channels.

Forward modelling of white spruce radial growth at trailing edge demonstrates high plasticity

Climate conditions throughout the 21st century across much of western Canada's boreal forest have been drier than normal leading to significant impacts on forest productivity and tree growth. Determining the limiting factors of radial growth in common boreal tree species under current and future conditions is crucial to reconcile how they will continue to respond to climate change. In this study, we used a network of 26 white spruce tree-ring chronologies south of its natural range as an artificially constructed trailing edge to assess climate-growth relationships and limiting factors by identifying seasonal climate relationships and using the Vaganov-Shashkin Lite (VS-Lite) model, respectively. Analysis revealed that white spruce in the study region is positively correlated to precipitation and negatively associated with temperature from the current and previous growing seasons. VS-Lite showed that moisture was the primary limiting factor in growth across the entire study area. The modelled radial growth from the VS-Lite model showed moderate success (14 of 26 site models were significant) and was more variable than measured tree-ring index values. The model systematically overestimated drought-related impacts on radial growth, especially during the middle portion of the growth season (June–August) indicating white spruce likely employs a conservative approach to carbohydrate storage as the region is much more susceptible to moisture deficits. The outcome of our research illustrates that white spruce may be resilient to hotter, drier conditions through environmental plasticity in the Boreal Plains.

Regulation by enforcement: the impact of Securities and Exchange Commission enforcement actions on crypto valuation

Purpose This paper aims to examine the impact of enforcement actions by the US Securities and Exchange Commission (SEC) on the valuation of major crypto assets. Design/methodology/approach Given the recent increase in regulatory efforts to combat fraudulent activity within the market, the paper concentrates on the period from 2019 to 2023 and uses the event study approach. Findings The analysis reveals a negative and economically significant effect of SEC actions on crypto valuations, ranging from −0.7% to −1.4% over a three-day window surrounding the announcement of enforcement actions for the entire sample. Particularly, a pronounced negative reaction is observed from crypto investors to SEC enforcement actions in 2022 and those where individuals are charged. Originality/value The findings align with existing literature, even though the study uses more conservative methodological approaches and data selection criteria. Specifically, the author uses a market event study model, account for potential confounding events, and use initial news reports about investigations rather than official SEC communications as event dates.

Why Constitutional Courts Back Death Penalty? Insights from Indonesia and South Korea

This article explores the paradoxical affirmation of the death penalty by the Constitutional Courts in Indonesia and South Korea, despite constitutional guarantees for the right to life and the fundamental right of human dignity. Through historical and content analyses, it explores how these courts interpret these rights in relation to the death penalty and why they affirm it constitutional. Both countries recognise the nonderogable nature of these rights, yet their Constitutional Courts allow for legal restrictions. Constitutional Court’s decision to impose limitations on nonderogable rights demonstrates their preference for maintaining a cautious and conservative approach. The examination of Constitutional Courts’ decisions reveals that the debate over the death penalty’s constitutionality extends beyond legal considerations, involving political dynamics and historical factors. This article underscores the complex interplay between constitutional guarantees, judicial interpretation, and sociopolitical contexts in shaping the countries’ human rights protection trajectories, especially in the context of nonderogable rights. It also highlights the crucial role of Constitutional Courts in safeguarding the right to life, as their decisions can significantly impact human rights protection in these countries.

Reconsidering evidence for psychedelic-induced psychosis: an overview of reviews, a systematic review, and meta-analysis of human studies.

Persons with schizophrenia are excluded from psychedelic-assisted therapy due to concerns about the risk of triggering or worsening psychosis. However, there is limited meta-analytic data on the risk of psychedelic-induced psychosis in individuals with pre-existing psychotic disorders. We conducted a systematic review, meta-analysis, and overview of reviews to assess the incidence of psychedelic-induced psychosis and symptom exacerbation in schizophrenia. Our pre-registered protocol (CRD42023399591) covered: LSD, psilocybin, mescaline, DMT, and MDMA, using data from Embase, PubMed, PsyARTICLES, PsyINFO, and trial registries up to November 2023. A random-effects model was used to calculate psychosis incidence, with standardized assessments of study quality. From 131 publications, we analyzed 14 systematic reviews, 20 reviews, 35 randomized-controlled trials (RCTs), 10 case-control studies, 30 uncontrolled trials (UCTs), and 22 cohort studies, most of which were low quality. Meta-analysis of nine studies showed an incidence of psychedelic-induced psychosis at 0.002% in population studies, 0.2% in UCTs, and 0.6% in RCTs. In UCTs including individuals with schizophrenia, 3.8% developed long-lasting psychotic symptoms. Of those with psychedelic-induced psychosis, 13.1% later developed schizophrenia. Sensitivity analyses confirmed the results. In summary, the reviewed evidence suggests that schizophrenia might not be a definite exclusion criterion for clinical trials exploring safety and efficacy of psychedelics for treatment-resistant depression and negative symptoms. However, given the low quality and limited number of studies, more high-quality research is needed, and a conservative approach is recommended until further data is available.