bluuebunny/crossref_metadata_2025 huggingface dataset:
MURO DAS PALPITAÇÕES: UM MANIFESTO DE MÃES NA UNIVERSIDADE
Authors: Carvalho Regiany , Carvalho Daniela Franco
Published: August 2023

Muro das palpitações é um manifesto sobre as barreiras que surgem cotidianamente na vida das mulheres no ambiente acadêmico, em decorrência da maternidade. Buscamos, com base metodológica na pesquisa narrativa, compreender suas trajetórias na universidade. A narrativa de cada uma ilustra as vivências nesse meio sendo mães, como também suas maiores dificuldades durante o percurso para que se mantivessem no curso que escolheram. O potencial dos depoimentos dessas mulheres permitiu reflexões teóricas com Leontiev e Angela Davis que culminaram na composição de uma carta manifesto, com narrativas minhas e de cada uma das Maria’s.
Planejamento no Sistema Único de Saúde: análise da agenda das práticas corporais e atividades físicas no âmbito federal no período de 2004 a 2023
Authors: Vieira Leonardo Araújo , Carvalho Fabio Fortunato Brasil de
Published: August 2023

As práticas corporais e atividades físicas (PCAF) têm sido incorporadas nos serviços do Sistema Único de Saúde (SUS), tendo o Programa Academia da Saúde como principal expoente. Porém, ainda não foi investigado o planejamento, que expressa as responsabilidades dos gestores quanto à saúde da população, para efetivação dessas práticas como políticas públicas de saúde. Assim, o presente manuscrito teve o objetivo de analisar a formulação e o desenvolvimento da agenda de promoção das PCAF a partir dos instrumentos de planejamento do âmbito federal do SUS – Plano Nacional de Saúde, Programação Anual de Saúde e Relatório Anual de Gestão, de 2004 a 2023. Por meio de estudo de caráter analítico-descritivo pautado em pesquisa documental foi realizada a busca de termos como: (in)atividade física; fisicamente ativo; exercício físico; práticas corporais; dentre outros. A formulação e o desenvolvimento da agenda de promoção das PCAF estiveram principalmente relacionados ao enfrentamento das doenças crônicas não transmissíveis e houve importante disparidade entre o que foi planejado e o executado, em desfavor da expansão do Academia da Saúde. Com o resgate histórico da agenda das PCAF no SUS apresentado são permitidos debates e iniciativas com vistas a efetivá-las enquanto política pública de saúde.
Automatically Finding the Right Probabilities in Bayesian Networks
Authors: Salmani Bahare , Katoen Joost-Pieter
Published: August 2023

This paper presents alternative techniques for inference on classical Bayesian networks in which all probabilities are fixed, and for synthesis problems when conditional probability tables (CPTs) in such networks contain symbolic parameters rather than concrete probabilities. The key idea is to exploit probabilistic model checking as well as its recent extension to parameter synthesis techniques for parametric Markov chains. To enable this, the Bayesian networks are transformed into Markov chains and their objectives are mapped onto probabilistic temporal logic formulas.
For exact inference, we compare probabilistic model checking to weighted model counting on various Bayesian network benchmarks. We contrast symbolic model checking using multi-terminal binary (aka: algebraic) decision diagrams to symbolic inference using proba- bilistic sentential decision diagrams, symbolic data structures that are tailored to Bayesian networks.
For the parametric setting, we describe how our techniques can be used for various synthesis problems such as computing sensitivity functions (and values), simple and difference parameter tuning and ratio parameter tuning. Our parameter synthesis techniques are applicable to arbitrarily many, possibly dependent, parameters that may occur in multiple CPTs. This lifts restrictions, e.g., on the number of parametrized CPTs, or on parameter dependencies between several CPTs, that exist in the literature. Experiments on several benchmarks show that our parameter synthesis techniques can treat parameter synthesis for Bayesian networks (with hundreds of unknown parameters) that are out of reach for existing techniques.
Shear resistance relaxation of granular materials under vibration and restricted deforming conditions
Authors: Xie Tao , Guo Peijun , Stolle Dieter
Published: August 2023

The phenomenon of vibration-induced shear resistance relaxation (ViSRR) refers to the loss of shear resistance in granular materials subjected to vibration, without an observable increase of excess pore pressure, under restricted deforming conditions. Essentially, ViSRR occurs when the total deformation of granular materials is unable to keep up with the plastic deformation induced by the vibration, given the restricted deforming conditions. In this study, ViSRR is investigated through a series of specially designed experiments together with theoretical simulation based on the extended shear transformation zone (STZ) model developed for granular materials. The results demonstrate that ViSRR takes place in granular materials under monotonic shearing when the vibration is superimposed, and the magnitude of shear resistance relaxation depends on the intensity of the vibration. The occurrence of ViSRR is subject to two fundamental prerequisites: superimposed vibration as the driving force for plastic deformation, and restricted total deformation that impedes a granular material's deformability to follow the development of plastic deformation. The simulation results obtained from the extended STZ model are in agreement with laboratory test results, indicating that the model is effective in describing the process of shear resistance relaxation and the accompanying volumetric strain during vibration.
Metodologias ativas de ensino utilizando a gamificação como ferramenta para facilitar o aprendizado de Bioquímica no ensino superior
Authors: Viana Maria das Neves Silva , Delaguila Francy Anne Lima , Alves Matheus Viana , Viana Bernardo Silva
Published: August 2023

A literatura relata a dificuldade de alunos em relação ao aprendizado de Bioquímica devido à densidade e à complexidade do conteúdo, tornando a disciplina uma das mais temidas. Provavelmente isso se deve não somente à grande quantidade de estruturas químicas, mas também à forma como o conteúdo vem sendo apresentado. Introduzir a gamificação no ensino colabora com uma metodologia motivadora, estimula a participação do aluno e desenvolve aptidões e competências. O objetivo da criação desse jogo foi tornar o aprendizado mais dinâmico e atrativo. A metodologia aplicada consiste em um jogo de tabuleiro com perguntas do conteúdo da disciplina, no qual a turma é dividida em times que se enfrentam promovendo interações entre os jogadores e entre os times que se preparam para desenvolver a melhor performance. O jogo foi nomeado AVC (Atividade Avaliativa Contínua) e vem sendo aplicado desde 2019 para as turmas do curso de Medicina. A proposta da gamificação é apresentada no primeiro dia de aula e a execução no último módulo da disciplina. Os resultados mostram que apesar do nível de dificuldade ser o mesmo das avaliações padrão, o desempenho dos estudantes é muito melhor. Do ponto de vista do trabalho em grupo, a gamificação estimula a ação colaborativa, respeito, empatia e a descoberta de habilidades dos colegas de turma. Concluímos que o jogo tornou a compreensão mais fácil e o ensino da disciplina mais atrativo.
Circulating microRNA in Myasthenia gravis (MG)
Authors: Punga Anna , Punga Tanel
Published: August 2023

One of the main difficulties in predicting the clinical course of Myasthenia Gravis (MG) is the heterogeneity of the disease, where disease progression differs greatly depending on the patient's subgroup. MG subgroups are classified according to the age of onset [early onset MG (EOMG; onset ≤ 50 years) versus late-onset MG (LOMG; onset >50 years]; the presence of a thymoma (thymoma associated MG), antibody subtype [acetylcholine receptor antibody seropositive (AChR+), muscle-specific tyrosine kinase antibody seropositive (MuSK+)], or presence of antibodies against low-density lipoprotein receptor-related protein 4 (Lrp4) or agrin as well as clinical subtypes (ocular versus generalized MG). The diagnostic tests for MG, such as antibody titers, neurophysiological tests, and objective clinical fatigue scores, do not necessarily reflect disease progression. Hence, there is a great need for reliable, objective biomarkers in MG to follow the disease course and the individualized response to therapy toward personalized medicine. In this regard, circulating microRNAs (miRNAs) have emerged as promising potential biomarkers due to their accessibility in body fluids and unique profiles in different diseases, including autoimmune disorders. Several studies on circulating miRNAs in MG subtypes have revealed specific miRNA profiles in patient sera. In generalized AChR+ EOMG, miR-150-5p and miR-21-5p are the most elevated miRNAs, with lower levels observed upon treatment with immunosuppression and thymectomy. In AChR+ generalized LOMG, miR-150-5p, miR-21-5p, and miR-30e-5p levels are elevated and decreased by the clinical response after immunosuppression. In ocular MG, higher levels of miR-30e-5p discriminate patients who will later generalize from those remaining ocular. In contrast, in MuSK+ MG, the levels of the let-7 miRNA family members are elevated. Studies of circulating miRNA profiles in Lrp4 or agrin antibody seropositive MG are still lacking. This review summarizes the present knowledge of circulating miRNAs in different subgroups of MG.
MiR-146a in myasthenia gravis thymus: from uncontrolled innate immunity to B cell-mediated autoimmunity
Authors: Cavalcante Paola , Tarasco Maria Cristina , Iacomino Nicola , Antozzi Carlo , Mantegazza Renato
Published: August 2023

The thymus is the main site of autoimmunity development in myasthenia gravis (MG) associated with anti-acetylcholine receptor (AChR) autoantibodies, a prototypic autoimmune disease affecting neuromuscular junction. Most MG patients with early-onset disease presents follicular hyperplastic changes of the thymus, that are critically implicated in the initiation and perpetuation of the autoimmune response against the AChR. Uncontrolled activation of Toll-like receptor (TLR)-mediated innate immune responses, chronic inflammation and ectopic germinal center (GC) formation are key pathological features of hyperplastic thymus in MG, indicating that a close link between innate immunity and B cell-mediated autoimmunity underlies the intra-thymic pathogenesis of MG.

MiR-146a, an “immune-miR” acting as key modulator of both innate and adaptive immunity, is a potent inhibitor of TLR signaling pathways, able to prevent and avoid an overstimulation of the inflammatory response by targeting the NF-κB signaling transducers IRAK1 and TRAF6. At the same time, miR-146a modulates the expression of c-REL, ICOS and ICOSL, which are crucial regulators of B cell function and GC response. Dysregulation of miR-146a expression is a common molecular event in several autoimmune disorders. Our recent findings revealed defective expression of miR-146a, associated with over-expression of its TLR- and B cell-related target genes, in follicular hyperplastic MG thymuses, indicating that loss of regulatory functions of this miRNA may significantly contribute to the immunopathological steps leading to MG. Of note, corticosteroids were found to increase the miR-146a expression levels, thus suggesting the miRNA capacity to mediate the effects of these drugs in inducing immunosuppression and autoimmunity control. 

In this review, we discuss the role of miR-146a as a molecular bridge between innate and adaptive immunity, and summarize the current knowledge on the miRNA contribution to the pathogenesis of MG. Based on our and literature data, we highlight the miR-146a potential as biomarker for therapeutic monitoring, as well as target of future advanced RNA-based therapies to modulate the immune system and counteract the autoimmune response in MG.
Targeting the safety factor for neuromuscular transmission to treat myasthenia gravis
Authors: Odierna Gianmaria Lorenzo , Phillips William
Published: August 2023

In myasthenia gravis autoantibodies attack the postsynaptic membrane of the neuromuscular junction causing fatiguing weakness that can wax and wane. Weakness occurs when the safety factor for neuromuscular transmission becomes marginal, meaning that the (postsynaptic) endplate potential is no longer sufficient to reliably trigger action potentials in the muscle fiber. Cholinesterase inhibitor drugs provide temporary relief by increasing the endplate potential amplitude, but additional symptomatic treatment options are needed. Here we discuss our recent experience in early preclinical testing of candidate compounds. Using an ex vivo mouse nerve-muscle contraction assay, followed up by endplate potential recordings, we examined the effects of cannabinoids. Our findings highlighted the potentially confounding effects of dimethylsulfoxide (DMSO) when used as a solubilizing agent. DMSO produced a dose-dependent restoration of force to curarized muscle and enhanced miniature endplate potential amplitude, thus enhancing the safety factor for neuromuscular transmission at concentrations as low as 0.1% v/v. When examined in the absence of curare, the DMSO-induced increase in quantal amplitude was opposed by a homeostatic reduction in the number of quanta of acetylcholine released by the nerve terminal. In contrast to DMSO, cannabinoids appear to work via cannabinoid receptor type 1 to reduce quantal number, thereby weakening the safety factor. Our results highlight the need to consider the effects of solubilizing agents per se when screening new therapeutics for neurological diseases. They also demonstrate the need to take synaptic homeostasis into account, which can otherwise distort or mask the effects of bioactive agents upon neurotransmission.
Myasthenia research over the last 50 years – a personal perspective
Authors: Vincent Angela
Published: August 2023

Myasthenia gravis (MG) research has, in many respects, been a trail blazer for the growing number of autoantibody-mediated disorders that affect the nervous system. The breakthroughs in MG understanding were made in the 1970s and even 50 years later, MG still remains a topic which scientists, clinicians and, most recently Pharma, return to as the most common and well-studied disorder.  Here, some of the main discoveries will be reviewed very briefly focusing on how the knowledge of the disease evolved during the first decades after the discovery of acetylcholine receptor antibodies.  It should be noted that this is a personal perspective and not a systematic or fully referenced review.
MGFA Meeting Proceedings: Editor's Introduction
Authors: Barnett-Tapia Carolina , O'Connor Kevin , Barohn Richard J.
Published: August 2023

Introduction to the MGFA Meeting Proceedings.
Qiagen RNEasy PowerMicrobiome RNA extraction kit v1
Authors: Dan Siemon Michael
Published: August 2023

The samples were processed using the Qiagen RNeasy PowerMicrobiome kit with the modifications described by Schang et al., 2021. As a substitute for vortexing described in the kit protocol, bead-beating was used. 100ul of phenol-chloroform-isoamyl alcohol was added to the bead beating tubes before the addition of the membranes. Bead-beating was conducted 4x for 30s at 4 m/s. After pelletizing the samples with centrifugation, the supernatant was processed through spin columns. Spin columns were incubated with DNase Digestion Solution for 15 minutes to isolate only RNA. The RNA was eluted from the spin columns by passing 50 uL of DEPC water through twice.
Valoración de la circunferencia de pantorrilla como marcador de riesgo de desnutrición en adultos mayores institucionalizados del Hogar de Reposo Simeona. Estudio piloto en la ciudad de Mariano Roque Alonso, setiembre de 2022
Authors: Meza Paredes Johana Vanessa , Ortiz Soria Lourdes Alicia , Olmedo Pavón Jimena Araceli
Published: August 2023

El envejecimiento es un fenómeno natural e inherente al ser humano, caracterizado por cambios anatómicos, fisiológicos y psicológicos. La desnutrición es un estado patológico común en esta población y puede condicionar la aparición o el aumento de la gravedad de enfermedades propias de la edad. Su valoración puede basarse en medidas antropométricas como la circunferencia de pantorrilla, cuya técnica no invasiva podría reflejar información útil sobre el estado nutricional de este grupo especialmente vulnerable. Con el objetivo de valorar la circunferencia de pantorrilla como marcador de riesgo de desnutrición en adultos mayores institucionalizados del Hogar de Reposo Simeona de la ciudad de Mariano Roque Alonso durante el mes de setiembre de 2022, se realizó un estudio piloto, observacional, descriptivo, de corte transverso, en 15 adultos mayores de 60 años o más, de ambos sexos, residentes en el mencionado hogar. Se respetaron principios éticos, se recolectaron datos sociodemográficos, clínicos y antropométricos como Circunferencia de Pantorrilla (CP). En relación a los resultados de parámetros antropométricos, el riesgo de desnutrición respecto a la circunferencia de pantorrilla fue de 60 %. La frecuencia de riesgo fue mayor en mujeres con un 71.43 %. La circunferencia de la pantorrilla es un marcador de riesgo de desnutrición fiable en población geriátrica que se encuentra institucionalizada, independiente de la edad y el sexo, así mismo constituye una herramienta económica y de fácil interpretación.
The correlation between metabolic syndrome and calcium urolithiasis
Authors: Abdulla Adil , Das Shanmugha , V. Venugopalan A. , T. Rajeevan A. , M. Manikandan
Published: August 2023

Background: Urolithiasis affects about 12% of the global population. This study helps us to find the correlation between metabolic syndrome, its components and the risk of calcium stone urolithiasis.
Methods: A cross-sectional study was conducted on 140 patients who underwent surgery for urolithiasis and whose stones were calcium-containing. A group of subjects who never had a history of urolithiasis was taken as control. Various anthropometric and biochemical parameters were studied to estimate and compare the prevalence of metabolic syndrome in both the groups.
Results: The study showed that the central obesity of the study population was higher. However, even though prevalence of hypertension was more in the stone group compared to the control population, this difference was not statistically significant. On analysis of biochemical parameters like fasting blood sugar, triglycerides and HDL, abnormal triglycerides and HDL were significantly higher in the stone group when compared to the control. On consideration of all parameters as per international diabetes federation (IDF) definition, prevalence of metabolic syndrome in stone group was 40% which was higher than the control group with 25% and the difference was statistically significant. While summing up the number of parameters of metabolic syndrome an individual has in each group it is evident that the proportion of patients in the stone group had a greater number of parameters compared to the control group.
Conclusions: This study could conclude that there is a significant correlation between calcium urolithiasis and metabolic syndrome.
The epidemiology of burns in a tertiary care center of Rajasthan
Authors: Khushalani Asha , Srivastava Sunil
Published: August 2023

Background: The aim of the present study is to determine the epidemiological pattern and outcome of burn injuries in a tertiary care centre of Rajasthan so that effective evidence based burn prevention programs can be generated and strong burn emergency health system can be established.
Methods: This study includes retrospective data analysis of patients conducted over 2 years from January 2020 to December 2021 at burns and plastic surgery department of Sawai Man Singh (SMS) Hospital Jaipur situated in Rajasthan.
Results: Total patients managed in SMS hospital were 2007 in 2 years. 65% were males and 35% were females. Most commonly affected age group was 25-39 years with 29% patients. Flame burns was most common mode with 49.6% cases among all age groups and both genders. Median TBSA was 35% as per this study. 37% patients were operated in same admission and definitive reconstruction was done. Mortality was there in 26.7% cases.
Conclusions: Our study addresses the need of not only increasing the expenditure over prevention and education programs but also developing resources to improve the survival of burn patients in Rajasthan state. This study may contribute to establishment of strong infrastructure to prevent and treat severe burn injuries.
Severe gastroenteritis as presentation of a neuroendocrine tumor of pancreas
Authors: Lourenço Rita , Santos Teresa , Carvalho Ana C. , Moreira Ricardo , Magalhães Jorge , Longras Catarina , Magalhães André , Matos Diana , Pinto Rui , Alpoim Carlos
Published: August 2023

Pancreatic neuroendocrine tumors (PanNETs) are a very rare entity, corresponding to 1-2% of all pancreatic neoplasms, although incidence and prevalence are rising. According to hormonal production, they can be functional or nonfunctional, leading to a subset of symptoms. A 45-year-old man, came to our emergency department complaining of vomiting and profuse non-bloody diarrhea for a week, with asthenia and no improvement with medication. He presented with diminished muscular strength and severe electrolytic changes with electrocardiographic repercussion. Patient was admitted to our intensive care unit (ICU) for hypovolemic and distributive shock due to a severe gastroenteritis. Further research studies were carried out which have shown a nodular structure of 5x4cm in the pancreas tail on computed tomography scan. A biopsy was made, and a histopathological exam revealed a pancreatic well differentiated neuroendocrine tumor. Hormonal analysis showed an elevation on vasoactive intestinal polypeptide (VIP). On 68Ga-DOTA-NOC PET/CT, there were 2 nodular lesions with anomalous overexpression of somatostatin receptors, one in the pancreatic tail near splenic hilum and another in the pancreatic head. Patient underwent a total pancreaticoduodenectomy with en bloc splenectomy. Postoperative period was uneventful. Mostly, this kind of pancreatic neuroendocrine tumors are indolent, but till 39% can have an aggressive course, so they have variable prognosis.
Amyand's hernia complicated with cecal necrosis: presentation of a case and surgical treatment
Authors: Martínez-Martínez Humberto Gustavo , Pulido-López Ricardo Alberto , Flores-Ávila Jaime Enrique , Manzano-Tamez Marcela , Núñez-Chiriboga Dafhne Patricia
Published: August 2023

The presence of the vermiform appendix, inflamed or not, within a hernial sac is known as Amyand's hernia (AH). This represents 1 percent of all inguinal hernias and one third of these are associated with acute appendicitis. This presentation is a rare entity and most of the times it presents as a finding during the surgical event. We report a male patient in his fifth decade of life who consulted for a 10-day history of increased volume in the right inguinal region associated with pain and inability to reduce. An exploratory laparotomy was performed that required a right hemicolectomy. AH represents a diagnostic challenge, in most cases it is considered an incidental intraoperative diagnosis. There is no protocolized treatment, however, the inflammatory degree of the appendix is ​​what will guide the surgical approach.
Solid pseudopapillary epithelial neoplasm of pancreas presenting as an abdominal lump: a case report
Authors: Gupta Niraj , Kumar Rohit , Verma Amar , Nabh Rishi , Sharma Vivek , Rathaur Arun
Published: August 2023

Solid pseudopapillary epithelial neoplasm (SPEN) of the pancreas is a rare cystic exocrine tumour of the pancreas that predominantly affects women between 30 and 40 years of age. This case report aims to describe clinical presentation and management of SPEN. We report a case of 20 years old female who presented with palpable lump in upper abdomen and continuous dull aching pain. Preoperative contrast enhanced computed tomography (CECT) abdomen was suggestive of large solid mass of size 11×10×10 cm with liquified content in relation to tail of pancreas with a possibility of retroperitoneal tumour or gastrointestinal tumour (GIST). Spleen sparing distal pancreatectomy with segmental resection of transverse colon with colo-colic anastomosis was performed and the diagnosis of SPEN was subsequently confirmed on histopathology examination. SPEN is a slow-growing tumour with a low-grade malignant potential found incidentally in asymptomatic patients. The average tumour size is about 4 to 6 cm in diameter at presentation. Distal pancreatectomy with splenectomy is the procedure of choice as described in literature. SPEN should be kept as a differential diagnosis in a young female patient presenting with vague abdominal pain and retroperitoneal lump in relation to the pancreas. Complete surgical resection is the definite treatment with a 5-year survival rate of 95%.
Employing machine learning to predict adverse acute post-surgical outcomes following elective ulnar collateral ligament reconstruction
Authors: Case Trevor R. , Rice Richard C. , Cabrera Andrew J. , Kricfalusi Mikayla , Dasari Prathyusha , Jesurajan Jose , Ruckle David E. , LaFleur Adam , Jobe Christopher M. , Syed Hasan M.
Published: August 2023

Background: Ulnar collateral ligament reconstruction ameliorates valgus elbow instability in various patient populations, including overhead athletes, patients with acute UCL rupture following high energy trauma, and those with chronic, subclinical elbow laxity. This study aims to explore machine learning algorithms to identify risk factors in patients undergoing elective UCL reconstruction in the ambulatory setting to predict postoperative outcomes.
Methods: RStudio was used to create a filtering code to identify adult patients who underwent elective UCL reconstruction from 2008 to 2018 in the American college of surgeons national surgical quality improvement program database. Patients were analyzed using six ML algorithms, which were trained to predict outcomes such as extended length of stay, non-home discharge, and adverse events based on various patient characteristics and surgical variables. Algorithmic performance was then assessed and top performing algorithms underwent further analysis to determine relative feature importance using a permutation feature importance method.
Results: ML exhibited excellent performance in predicting LOS, with an average AUC of 0.953, similar to that of logistic regression. Regarding NHD, ML demonstrated a 60.8% increase in AUC compared to LR. In predicting AAE, ML achieved an average AUC that was 12.7% higher than LR.
Conclusions: The highly predictive capability of ML indicates the possibility to represent a procedure-specific complementary tool for the preoperative risk stratification process. This study provides a comprehensive analysis of UCL reconstruction in the management and outcomes of any patient, regardless of age or activity level.
Traumatological emergencies: epidemiological and problematic aspects of care in the orthopedics traumatology department of the CHU Ignace Deen in Conakry
Authors: Camara Tafsir , Bah Mohamed Lamine , Sidibe Mohamed , Sylla Fode Mahamoud , Madjirabe Hippolyte Nassaaradenger , Bah Mamadou Alpha , Youla Mohamed , Keita Karinka , Diallo Mamadou Moustapha , Lamah Leopold
Published: August 2023

Background: A trauma emergency is any aggression (direct or indirect) external to the body for which no therapeutic delay is allowed at the risk of endangering the patient's life or the functional prognosis of his limbs. The objective of this study was to report the results of the management of traumatological emergencies.
Methods: This was a descriptive cross-sectional study from 11 January 2021, to 11 July 2021. It focused on patients seen for traumatological emergencies in the CHU Ignace Deen Orthopaedics-Traumatology department.
Results: Trauma emergencies constitute 75.2% of admissions to the emergency department. The average age of the patients was 32.2 years, with extremes of 1 and 91 years. There was a predominance of 76.3% males with a ratio (M/F) of 3.2. Road traffic accidents were the most found aetiology in 82.9%, and motorcycles were involved in 68.7%. Limb fractures were found in 34.7%. The treatment time was ≤6 hours in 67.5%, and 203 patients received drug treatment, i.e., 49.7%.
Conclusions: Trauma emergencies constitute, by their frequency and seriousness, a real public health problem in Africa in general and in Guinea in particular.
Comparative study between deltoid split approach versus delto pectoral approach for proximal humerus fracture fixation
Authors: Basavanagowda Prabhu , Jain Prerak , Bisaleri Jayanth , Jakhar Bhupender
Published: August 2023

Background: Proximal humeral fracture is defined as fractures occurring at or proximal to the surgical neck of the humerus. It affects 2.4% of women over the age of 75 years. It is the commonest fracture affecting the shoulder girdle in adults and its incidence is rising. For displaced fractures that meet surgical indications, deltopectoral approach is the most common approach for plate fixation of proximal humeral fractures. Deltoid splitting approach offers advantages of better exposure and implant placement for fixation of the fracture and early mobilization of the shoulder joint.
Methods: This is a comparative study of 30 cases of proximal humerus fractures treated by surgical fixation through deltoid splitting approach and 30 cases treated by delto pectoral approach. Patient of both sexes belonging to adult age group in general population presenting with proximal humerus fracture to the orthopaedic department of Bapuji Hospital and Chigateri General hospital attached to J.J.M. Medical College, Davangere. The period of survey extends from December 2020 to December 2022. The final results were evaluated using constant Murley score periodically. This constant Murley score ranges from 0 to 100 points representing worst and shoulder function respectively.
Results: No statistically significant difference was observed in outcome with regard to mechanism of injury, side of fracture and type of fracture with both deltoid splitting approach and delto pectoral approach.
Conclusions: The treatment of proximal humeral fractures with a proximal locking plate is reliable using both approaches. No significant difference found in functional outcome of proximal humerus fracture following deltoid split and deltopectoral approach on serial follow up.
Analysis of results of huge segmental bone loss of tibia treated with Ilizarov external fixator: our experience in Indian population
Authors: Patil Vishal , Reddy Sandeep , Patil B. Sujith , Patil Sahana , Kolli Karthik , K. Prajwal , Kotian Ronak N.
Published: August 2023

Background: Orthopaedic surgeons face challenges in treating complex tibial fractures with bone loss due to complications like infection, repeat surgeries, and patient psychological burden. The Ilizarov external fixator approach offers better clinical and radiological results, addressing these issues. The purpose of this study was to examine the outcome of tibial segmental loss treated with the Iliazrov external fixator.
Methods: The study was done between January 2015 to December 2021. It’s a prospective as well as retro-prospective study. The age group of 18-65 years was considered. Patients were monitored monthly, up to nine months post-surgery, or until bone union. Functional and bone outcomes of the patients were evaluated using ASAMI criteria, knee society score, and St. Pierre ankle scoring system.
Results: The study included 20 patients, all of them were male and had a mean age of 34.1±10.1. Bone union was achieved in all cases. After ilizarov application, the average bone defect was 82.6±42.9 mm. The final regeneration attained was 75.1±47.5 mm. The average limb length difference was 20.41±6.55 mm after achieving union. Out of 20 patients, 13 and 4 had good and fair ASAMI score, 1, 4, and 13 had fair, good, and excellent knee society score, and17 had fair St. Pierre score and 3 patients were lost to follow-up.
Conclusions: Ilizarov technique is an excellent way for treating complicated tibial fractures. The difficulties, challenges, and complications associated with Ilizarov external fixation are negligible compared to the significant difficulties associated with open techniques.
Figure of eight suturing technique with fiber wire for patella fracture: a novel approach
Authors: Gandhi Malay P. , Kapadiya Shubham S. , Vadodaria Gaurav M. , Agrawal Aditya K.
Published: August 2023

Modified tension band wiring (TBW) is the most commonly used technique for the management of patella fractures. However, all patella fractures are not-amenable to TBW. Tension band wiring, inter-fragmentary screw fixation, and the combination of cerclage wiring and screw fixation are used for internal fixation of these fractures. Surgical treatment is recommended for fractures that either disrupt the extensor mechanism or have greater than 2 to 3 mm of step-off and greater than 1 to 4 mm of displacement. In this series, we present ten cases managed with open reduction and internal fixation with figure of eight suturing technique using fiber wire. This series included ten patients with fractured patella and managed with open reduction and internal fixation with Tension band wiring with fiber wire. Patient demographics, fracture type, time to union, functional outcome, and complications were recorded. Patients were followed up for minimum of 6 months. All fractures went on to unite with average fracture healing time of 13.8 weeks. Mean Lysholm score and Bostman score were 85 and 27 respectively. Nine patients had excellent to good outcomes. One patient had poor outcome because of knee stiffness. Open reduction and internal fixation with figure of eight suturing technique using fiber wire are an efficient method for the management of severely comminuted and multi-fragmentary patella fractures with minimum complications.
Short term results of endoscopic discectomy in lumbar spine
Authors: Tiwari Atit , Sonone Sandeep V. , Jaiswal Nishant P.
Published: August 2023

A recent modification to lumbar discectomy involves the use of a micro-endoscope instead of an operating microscope for visualization. Percutaneous endoscopic lumbar discectomy (PELD) uses a rigid operating spinal endoscope that allows direct visualization and excision of contained and non-contained herniated disc fragments. The advantages of Endoscopic lumbar discectomy are remarkable due to minimal bone resection, no damage to paravertebral muscles, rapid recovery, minimally procedure related morbidity, cost-effectiveness and high patient satisfaction rate. Aims and objectives is to study and evaluate clinical and radiological outcomes of endoscopic lumbar discectomy over a period of 6 months.24 patients underwent endoscopic lumbar discectomy proven with MRI in a span of 3 years from 2018 to 2021. Every patient was followed up for 6 months in an observational, retrospective and prospective type of study and assessed on the basis of MacNab criteria, VAS pain score, Oswestry low back pain questionnaire. Mean preoperative Oswestry disability score (ODS) was 74.38 while mean postoperative ODS was found to be 29.25. Preoperative, while analyzing through Macnab criteria, poor results were seen in 95.83% of patients while fair results were seen in 4.17% of patients. Postoperatively excellent results were seen in 16.67% of patients while good results were seen in 83.34% of patients. Mean preoperative VAS was 7.33 while mean postoperative VAS was found to be 2.91. Endoscopic discectomy is a safe and effective procedure where patient satisfaction and pain relief are not compromised. It may be an effective and alternative treatment option for the upward migration of disc herniation in the upper lumbar area and offers additional advantage for early mobilization and faster improvement.
Total hip replacement in a patient with contralateral hemipelvectomy: a case report
Authors: Caicedo Mazabel Pablo Andrés , Gaitán-Lee Hernando , Guzmán Nalus Felipe , Sardi Barona Leon Alberto
Published: August 2023

Total hip arthroplasty is one of the most frequently performed surgeries today with excellent clinical and functional results for patients with advanced stages of hip osteoarthritis. Performing this surgical procedure in patients with a history of lower limb amputation is rare, so some important considerations must be taken for surgical planning, positioning on the operating table, and rehabilitation. There are very few case reports described in the literature. We present the case of a patient with symptomatic stage III Tonnis hip osteoarthritis and a history of contralateral external hemipelvectomy, who underwent total hip replacement. Preoperative planning, surgical technique, and 6-year follow-up are described.
Proximal humeral interlocking system plate for pediatric subtrochanteric femur fracture: a case report
Authors: Mankar Pratik , Pundkare Gopal
Published: August 2023

Hip fractures are rare in the pediatric age group and they contribute about 1% of all fractures in children. Subtrochanteric femur fractures are the rarest form of hip fractures in children. The treatment for children between the ages 6-12 years is controversial. The treatment options for pediatric subtrochanteric femur fracture include traction followed by hip spica cast, immediate spica casting, cast bracing, internal fixation and external fixation. We report a case of a subtrochanteric femur fracture in a 7-year-old girl following a fall of heavy object over her leg. The fracture was fixed with an adult 3.5 mm proximal humeral interlocking system (PHILOS) plate. The purpose of this report is to provide an alternative mode of management for paediatric subtrochanteric femur fracture.
Unforeseen consequence: heterotopic ossification following traumatic brain injury and acetabulum fracture-a case report
Authors: Samria Kartik , Bhardwaj Krati , Shekar Dheeraj D. , Lamoria Ravindra K.
Published: August 2023

Heterotopic ossification (HO) is a rare pathological condition characterized by the formation of bone in soft tissues outside the normal skeletal system. HO can result in restricted joint mobility, nerve compression, and pain. We present a case report of a 34-year-old male who developed HO. There is a history of neurological injury and fracture acetabulum (left). Imaging studies revealed extensive HO with complete bony bridging of the hip joint, leading to severe functional impairment and chronic pain. The patient had previously undergone multiple medical treatments with non-steroidal anti-inflammatory drugs, and physiotherapy with limited success. Ultimately, he underwent a complex surgical intervention involving resection of HO, release of joint contractures, resulting in significant improvement in joint mobility and pain control. Here we discuss a rare and debilitating presentation of HO and the treatment options available for such patients. Clinicians should be aware of this challenging condition and manage patients through a multidisciplinary approach.
Diversity in orthopaedic surgery for pacific islanders: the battle continues
Authors: Ruan Tiffany
Published: August 2023

It’s no secret that orthopaedic surgery is the specialty with the least diversity when it comes to race and gender. More than likely, patients from different ethnic backgrounds desire to be treated by physicians ethnic backgrounds desire to be treated by physicians who look like them but due to the lack of diversity in the field of orthopaedic surgery, it makes it difficult to find physicians who fully understand the cultural barriers to medicine. A systemic review was completed by reviewing research from The American Journal of Surgery, the Journal of the AAOS, and The Journal of Bone and Joint Surgery, among others. Since the rapid immigration into the United States in the early 2000s, Pacific Islanders have begun to make up an increasing portion of the US population, yet a significant increase in the representation of Pacific Islanders in orthopaedic surgery has not reflected this. This acute problem can cause long-term negative effects on the community of Pacific islanders as they continue to be treated by physicians who do not look like them and who do not completely understand the cultural barriers faced by their communities.
Enhanced recovery protocols in total hip and knee arthroplasty: what are the recent trends
Authors: Wagh Aniket A. , Lalaram Vikram , Tandel Jignesh Y.
Published: August 2023

Perioperative management of hip and knee arthroplasty patients has evolved significantly over the past few years, almost hand in hand with the advancement of the surgical technique itself. The notion of enhanced recovery protocol is rapidly being accepted by various establishments to reduce the hospital stay and perioperative morbidity. It consists of application of aggressive perioperative interventions aiming for a speedy recovery with least complications, while maintaining good patient care. We reviewed various published articles to understand the importance of each of these interventions. Components that showed improvement in the outcomes were patient education and counselling, pre-operative supplementation to improve wound healing and reduce length of hospital stay. Intra-operative use tranexamic acid and avoidance of drains reduce operative blood loss and subsequent transfusion. Multimodal analgesia, early mobilization with pharmacological and mechanical prophylaxis to reduce venous thromboembolism showed a positive correlation with rapid recovery.
State of School Feeding in Latin America and the Caribbean: 2022: Executive Summary
Authors:   Inter American Development Bank,   World Food Programme
Published: August 2023

This joint publication by the Inter-American Development Bank (IDB) and the World Food Programme (WFP) presents the state of school feeding programmes in Latin America and the Caribbean (LAC) as of 2022. Amidst the challenges posed by the COVID-19 pandemic and compounding challenges, the publication highlights the critical role of school feeding programs for the region. The publication offers comprehensive insights into the state of school feeding in LAC: scale, coverage, components, and impacts. It emphasizes the need to reach vulnerable children to prevent dropouts and promote holistic development. The publication emphasizes the importance of integrating health and nutrition interventions along with school meals programmes via multisectoral approaches. Key findings indicate that 80.3 million children across the region received school meals in 2022. Political commitment and investment in these initiatives is high with at least 19 countries having either a specific school feeding or school nutrition policy or law. Coverage ranges from 30 to 100 percent across the countries in the region. The publication recommends strengthening coverage and programme quality as well as regulatory frameworks, implementing local food procurement, investing in intercultural approaches, and enhancing multisectoral collaboration and partnerships. Moreover, it underscores the significance of crisis preparedness for school feeding programs, which were proven to be resilient and indispensable during the pandemic. The publication offers specific recommendations to support countries to effectively tackle challenges and ensure that school feeding programs continue to contribute to childrens development, education, and overall wellbeing.
Rok Norwidowski
Authors: Brajerska-Mazur Agata
Published: August 2023

Artykuł przedstawia obszerną listę licznych wydarzeń kulturalnych i naukowych, które uświetniły obchody Roku Norwidowskiego, uzupełnioną o ich krótkie omówienie. W podsumowaniu zostaje podjęta próba oceny znaczenia tych wydarzeń dla ugruntowania miejsca artysty w zbiorowej pamięci oraz upowszechniania jego postaci i twórczych dokonań.
Poezja i filozofia. O zasługach Profesora Władysława Stróżewskiego dla badań nad Norwidem
Authors: Niewczas Łukasz
Published: August 2023

Artykuł poświęcony jest norwidologicznym dokonaniom wybitnego filozofa Władysława Stróżewskiego. Autor artykułu zwraca uwagę na specyfikę filozoficznego podejścia do poetyckich utworów Norwida. Podkreśla elementy zbliżające myśl Stróżewskiego do twórczości Norwida na polu epistemologii i aksjologii, z których najważniejszym wydaje się wspólne obydwu rozumienie prawdy oraz dążenia do niej jako podstawowego imperatywu ludzkiego działania.
„…i jeśli mi pozwolą tragedie moje, chcęż jeszcze Panią widzieć”. Łucji Rautenstrauchowej dekada z Norwidem
Authors: Abramczyk Magdalena
Published: August 2023

Artykuł stanowi próbę rekonstrukcji relacji Łucji Rautenstrauchowej z Cyprianem Norwidem. Na podstawie analizy biografii pisarki oraz znanej korespondencji Cypriana Norwida autorka podejmuje próbę odtworzenia początków znajomości z poetą, która została zawarta we Włoszech w latach 40. XIX w. a także dalszego przebiegu relacji, kontynuowanej w trakcie wizyt pisarki w Paryżu w latach 50. i 60. XIX wieku.
Method Development Through Landmark Point Extraction for Gesture Classification With Computer Vision and MediaPipe
Authors: Suherman Suherman , Suhendra Adang , Ernastuti Ernastuti
Published: August 2023

Examining the physical movements of students during their educational quests holds great significance as these nonverbal cues can exert a substantial influence on academic performance, and boost, learning outcomes, Consequently, numerous researchers are engaged in exploring the domain of gesture categorization employing machine learning techniques. Initially, we conducted an observation of students’ movements in a virtual learning environment during face-to-face interactions with their teachers. This procedure yielded a roster of thirteen motion-based behaviors, encompassing actions such as tilting the head towards either direction, lowering and lifting the head, as well as gesturing with the right and left hand towards the head and neck area, and positioning the shoulders in a front and lateral direction. This research offers a technique for establishing a set of criteria for categorizing students’ gesticulations in online learning by utilizing the comprehensive MediaPipe holistic library and OpenCV to detect, pose and extract salient landmarks. This endeavor culminated in the attainment of a percentage-based metric indicative of gesture identification efficacy pertaining to the aforementioned thirteen motion-based activities.
Deep Learning With Processing Algorithms for Forecasting Tourist Arrivals
Authors: Mukhtar Harun , Remli Muhammad Akmal , Wan Salihin Wong Khairul Nizar Syazwan , Mohamad Mohd Saberi
Published: August 2023

The DL (Deep Learning) method is the standard for forecasting tourist arrivals. This method provides very good forecasting results but needs improvement if the data is small. Statistical data from the BPS (Central Bureau of Statistics) needs to be corrected, resulting in forecasts that tend to be invalid. This study uses statistical data and GT (Google Trends) as a solution so that the data is sufficient. GT data has a lot of noise because there is a shift between web searches and departures. This difference will produce noise that needs to be cleaned. We use monthly data from January 2008 to December 2021 from BPS sources combined with GT. Hilbert-Huang Transform (HHT) is proposed to clean data from various disturbances. The DL used in this study is long short-time memory (LSTM) and was evaluated using the root mean squared error RMSE and mean absolute percentage error (MAPE). The evaluation results show that the HHT-LSTM results are better than without data cleaning.