bluuebunny/crossref_metadata_2025 huggingface dataset:
ENDOSCOPIC REMOVAL OF A RARE LARGE OCCLUSIVE TRACHEAL TUMOR WITH LIMITED TECHNICAL CAPABILITIES
Authors: BATYRBEKOV K. , GALIAKBAROVA A. , UALIKHANOV A.
Published: April 2023

Relevance: Tracheal tumors often do not cause symptoms until they grow to a size that causes significant airway obstruction, which is
the reason for the delay in diagnosis. Diagnosis may also be delayed due to non-specific symptoms, such as cough, wheezing, and shortness
of breath, which can occur in other conditions such as asthma and chronic obstructive pulmonary disease. The symptoms that appear may
vary depending on the type and location of the tumor. The literature does not sufficiently cover the experience of treating large occlusive
tracheal tumors using segmental tracheal resection, endoscopic treatment, or radiation therapy. In scientific literature, the number of
published studies with long-term results of endoscopic treatment or radiation therapy of such occlusive tracheal tumors is limited, and this
problem requires further study. This article describes the first recorded case of endoscopic removal of a large occlusive tracheal tumor.
The study aimed to show the possibility and effectiveness of endoscopic treatment using a minimum set of endoscopic equipment.
Methods: This article presents a case of successful minimally invasive endoscopic treatment of a large occlusive tracheal tumor.
Results: A large obstructing tumor of the trachea that almost completely blocked the trachea lumen was removed in one block by
endoscopic loop resection.
Conclusion: The presented clinical case describes the experience of successful endoscopic removal of a rare occlusive tumor of the
trachea, which caused shortness of breath at rest and during exercise. For the first time in Kazakhstan, based on the National Scientific
Cancer Center, we performed a unique minimally invasive operation to remove a tracheal tumor, while other clinics offered thoracotomic
surgical resection methods
UPGRADING OF LAPAROSCOPIC INTERVENTION OF THE PROSTATE GLAND TUMORS
Authors: UMURZAKOV Kh. , KAIDAROVA D. , NURZHANOVA A. , SAIDUALIEV D. , KHAITMAT A. , SAGIDULLIN S. , SHALGUMBAYEVA G.
Published: April 2023

Relevance: Laparoscopic surgery supplies many benefits due to lower postoperative sequelae. Laparoscopic radical prostatectomy has become a first-line treatment for patients with localized prostate cancer worldwide.
The study aimed to compare outcomes after traditional laparoscopic extraperitoneal radical prostatectomy with modified laparoscopic extraperitoneal radical prostatectomy (MLERPE).
Methods: All information about patient treatment for this historical cohort study was obtained from the “Electronic In-patient Registry” of the Republic of Kazakhstan. The study included case records of 94 patients who underwent laparoscopic extraperitoneal radical prostatectomy from 2017 to 2021. Of them, 45 underwent a modified laparoscopic prostatectomy, and 49 – a traditional laparoscopic prostatectomy. Data are presented as the means ± standard deviation or as frequencies and percentages. Pearson’s Chi-square was used for qualitative data. T-test and Mann-Whitney U test were used to compare the means of the two groups. The statistical significance level was 0.05.
Results: We revealed significant differences between the laboratory parameters of both groups after surgery. The mean difference in hemoglobin level between the two groups was 14.04, the mean difference in erythrocyte level was 0.69, the mean difference in leukocyte level was 1.26, and the mean difference in ESR level was 2.01. All differences were statistically significant (p=0.000). We found a statistical difference in the duration of operation and hospital stay between the two groups (p=0.000).
Conclusion: The modified laparoscopic technique avoids adverse worse outcomes such as bleeding, pneumoperitoneum, and decreasing oxygen saturation. This technique is also beneficial in the early postoperative period for excluding peritonitis, and the late postoperative period avoids adhesive processes.
THE VALUE OF METHODS FOR DIAGNOSING ALVEOLAR RHABDOMYOSARCOMA: A CLINICAL CASE
Authors: Baktikulova K. , Kurmangalieva S. , Toimanova V. , Zhumasheva A. , Kuatova G.
Published: April 2023

Relevance: Laparoscopic surgery supplies many benefits due to lower postoperative sequelae. Laparoscopic radical prostatectomy has become a first-line treatment for patients with localized prostate cancer worldwide.
The study aimed to compare outcomes after traditional laparoscopic extraperitoneal radical prostatectomy with modified laparoscopic extraperitoneal radical prostatectomy (MLERPE).
Methods: All information about patient treatment for this historical cohort study was obtained from the “Electronic In-patient Registry” of the Republic of Kazakhstan. The study included case records of 94 patients who underwent laparoscopic extraperitoneal radical prostatectomy from 2017 to 2021. Of them, 45 underwent a modified laparoscopic prostatectomy, and 49 – a traditional laparoscopic prostatectomy. Data are presented as the means ± standard deviation or as frequencies and percentages. Pearson’s Chi-square was used for qualitative data. T-test and Mann-Whitney U test were used to compare the means of the two groups. The statistical significance level was 0.05.
Results: We revealed significant differences between the laboratory parameters of both groups after surgery. The mean difference in hemoglobin level between the two groups was 14.04, the mean difference in erythrocyte level was 0.69, the mean difference in leukocyte level was 1.26, and the mean difference in ESR level was 2.01. All differences were statistically significant (p=0.000). We found a statistical difference in the duration of operation and hospital stay between the two groups (p=0.000).
Conclusion: The modified laparoscopic technique avoids adverse worse outcomes such as bleeding, pneumoperitoneum, and decreasing oxygen saturation. This technique is also beneficial in the early postoperative period for excluding peritonitis, and the late postoperative period avoids adhesive processes.
MODERN CONCEPTS OF ARTIFICIAL LUNG VENTILATION DURING GENERAL ANESTHESIA IN CANCER PATIENTS: А LITERATURE REVIEW
Authors: Abdukhalilov N. , Arynov A. , Baidaulet D. , Mukanova M. , Nurmanova A. , Seidalieva E. , Chursin V.
Published: April 2023

Relevance: Among patients who have undergone extensive surgical interventions under general anesthesia with artificial ventilation (ventilator), various postoperative respiratory complications of an obstructive or restrictive nature are often found
The study aimed to generalizе current data from systematic reviews, meta-analyses, and scientific publications on the use of preventive and therapeutic strategies for lung ventilation to improve the quality of anesthetic care for cancer patients.
Methods: The PubMed Electronic Database (NCBI) was searched to identify randomized controlled and prospective observational studies, systematic reviews, and meta-analyses, as well as scientific articles published in English between 2016 and 2023 that focused on the results of application and comparison of lung protective ventilation strategies with conventional mechanical ventilation in patients undergoing major and prolonged surgery.
Results: As a result of a comparison of data from a review of large-scale scientific studies and articles, a relationship was established between the use of a protective lung ventilation strategy with a low tidal volume (6-8 ml/kg of ideal body weight), in combination with individualized PEEP, periodic lung recruitment maneuvers and significant improvement in clinical outcomes, respiratory complications, early mortality and length of hospital stay in patients undergoing surgery.
Conclusion: Using protective lung ventilation during anesthesia during major surgical interventions reduces the incidence of postoperative pulmonary complications.
PET/CT DISADVANTAGES IN PATIENTS WITH LYMPHOMA: А LITERATURE REVIEW
Authors: Bayembaev F. , Rakhimzhanova R. , Dautov T. , Saduakasova A. , Temirbekov A.
Published: April 2023

Relevance: Positron emission tomography combined with computed tomography (PET/CT) is a young and promising technique for lymphoproliferative diseases’ primary detection, staging, and evaluation of the treatment results. However, at this stage of nuclear medicine development, some shortcomings in PET/CT diagnostics of lymphomas using 18Fluorodeoxyglucose (F18-FDG) affect its reliability to a certain extent.
The study aimed to evaluate the physical and technical weaknesses of F18-FDG PET/CT in diagnosing lymphomas and review the analytical methods that affect opinion accuracy.
Methods: The articles on the use of F18-FDG PET/CT in diagnosing lymphomas, its reliability, and methods for optimizing were searched in the PUBMED database for 2012-2022.
Results: One of the main shortcomings of F18-FDG PET/CT in diagnosing lymphomas is the Deauville 5-point scale, which does not fully meet clinical requirements. This scale has some disadvantages, including low inter-reader agreement and an unreliable reference organ for F18-FDG accumulation. Mathematical algorithms for correction to the patient’s weight also require optimization.
Conclusion: Some of the existing deficiencies can be improved at the software level and through educating staff about the importance of changing the SUV calculation method. However, other deficiencies, such as classifications that do not meet clinical requirements, require more efforts at the level of international experts and much more in-depth study of this issue to avoid such shortcomings of new staging methods. However, even considering all the shortcomings described, at the moment, PET/CT with F18-FDG is one of the most reliable modalities available, both for the initial detection and for evaluating the therapy effectiveness in patients with lymphomas.
Folk music in cinematographic formulas
Authors: Olărescu Dumitru
Published: April 2023

Th e folk music, being a complete sociocultural phenomenon, expresses over the centuries the most diverse emotional-psychic states about the inner wealth of man, his emotional relationships with other people, with society, with his native lands. Th e local documentary fi lm managed to record the images and voices of several popular music performers in order to preserve and capitalize on this art, which contains priceless samples of our spiritual culture, of our identity valences. Several fi lmmakers devoted their fi lms to the creation of popular music performers: Emil Loteanu, Anatol Codru, Andrei Buruiană, Petre Ungureanu, Iacob Burghiu, Vlad Druc, Ion Mija, Ștefan Bulicanu et al. Th e director Vlad Druc got interested in the universe of folk music and through the creation of several professional and amateur singers in the fi lm Ploi de dor (Rain of Longing) (1975) manages to prove to us that our people created songs for all the events of human life: from birth to death. Director Andrei Buruiana’s fi lm about the distinguished performer Nicolae Sulac, whose creation constituted an era in our folk music, is also of interest.
The culinary of the gypsies / roma in Bulgaria — intangible cultural heritage between tradition and modernity
Authors: Ivanova Evgenia , Krastev Velcho
Published: April 2023

Th e cuisine of the Gypsies living in Bulgaria is part of their cultural heritage and more specifi cally of the knowledge and customs related to nature and the universe. Th e aim of the paper is to present the safeguarding of the ethnic culinary traditions as part of the intangible cultural heritage of the group and their current state of preservation. Our fi eld work, conducted for over 20 years, provided an opportunity to search for and systematize information about the changes in the cuisine in the second half of the twentieth and in the early twenty-fi rst century as a result of new socio-economic conditions, infl uenced by the environment, mobility and migration in the modern global world. Examples of the dynamic of the changes are presented for diff erent periods and various Gypsy groups. Our research shows that Gypsies manage to preserve their traditional cuisine mainly through the continuity of the family setting. Th e dishes are passed down through the generations by the women in the family. Gypsy cuisine, despite the infl uence of various social and economic processes, is one of the preserved elements of the ethnic cultural heritage.
The evolution of the image of Chisinau: the role of traditional culture
Authors: Иванова Нина
Published: April 2023

Traditional rural culture remains one of the constant elements of Chisinau image starting from the fi rst editions of photographic albums of the city. Despite its important role in the daily life of a major part of urban population it was rendered a somewhat transitional “festive” features specifi cally in the images of Chisinau of Soviet times. Nevertheless, in the editions of the fi rst decade of XXI the traditional culture gradually came to the fore and dag in to its positions in the following albums. Th e symbolic return to the ethnic roots in Chisinau and country in general and popularization of traditional culture became a real trend in a set of branches — from scientifi c events to art and fashion. Globalization played a certain part in this process, stimulating the identity search and actualizing the traditionally rural Moldovan culture, which is being viewed as the origins of nation. Th us, the ethnic rural culture became one of the sources of urban culture, contributing to the identifi cation processes from the one hand, though maintaining rurality of the major part of population in Chisinau, from the other, and thereaft er opposing in some of its aspects to modernization.
Romanian harnic ‘industrious, hardworking’ and Ukrainian [гарник] ‘cart worker’ as a key to the etymology of Ukrainian гарний ‘beautiful, good’
Authors: Романчук Алексей
Published: April 2023

Th e author suggests a new etymology of Ukrainian гарний ‚beautiful, good‘ and Romanian harnic ‘industrious, hardworking’. He thinks that a Slavic (of the Proto-Slavic time) verb with the meaning ‘to work hard’ was the source of both mentioned lexeme. Th e origin of this Slavic verb can be explained through the analysis of two other Ukrainian dialectal words, that are semantically close to each other, but diff ering in phonetics and, as some researchers believe, by origin. Th e mentioned words are [гара] и [ґара], with the meaning ‘a cart with a box for transporting earth or sand; a sledge for transporting large loads’. Th e semantic identity of both words (that are very close in phonetics also) do not allow us to consider their origin separately. Th e phonetic diff erence has to be explained by the diff erence in the time of borrowing. Th us, the author thinks that the ProtoSlavic verb, which become the source for Ukrainian [гарувати], гарний (as well as [гарник] ‘cart worker’), and Romanian harnic, came from a word borrowed during the Proto-Slavic time with the meaning ‚cart’. Th e author thinks that this borrowed word comes not from German Karre ‘kart, wheelbarrow’, but Romanian car ‚cart‘.
Optimizing warehouse operations for environmental sustainability: A simulation study for reducing carbon emissions and maximizing space utilization
Authors: Sadeghi Mona , Nikfar Mohsen , Rad Faeze Momeni
Published: April 2023

Loading and unloading operations for Stock Keeping Units (SKUs) in warehouses are critical to logistics management systems. However, these operations also have a significant impact on the environment, particularly in terms of carbon dioxide (CO2) emissions. As such, warehouse management must consider not only operational efficiency but also environmental impact. The reduction of CO2 emissions in warehouses is becoming increasingly important, both for legal compliance and to meet sustainability targets. In this article, we will emphasize the environmental impact of warehouse operations, particularly on CO2 emissions, and explore ways to minimize them while still maximizing warehouse performance. We will review various optimization models proposed to address this issue and highlight the importance of considering environmental objectives when designing warehouse operations. We will also describe a simulation study conducted to determine the Pareto optimal frontier for a warehouse design, considering transportation, space utilization, and CO2 emissions. The outcomes of implementing this simulation's results include reduced CO2 emissions and increased space utilization, which demonstrate the potential benefits of considering environmental objectives in warehouse design and management.
Evaluating the Current Energy-Cleanability Position and its Impact on the Economic Sustainability
Authors: Akhtar Muhammad Javeed , Hafeez ur Rehman  , Qaisar Abbas
Published: April 2023

The transition from traditional to sustainable energy is nothing without easy access to clean energy. Therefore, different economies have made smooth transitions but still there is gap in energy cleanability across the world. Here, this study adopted two stage-analyses; initially it presents an overlook of energy cleanability transition through applying Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) with entropy weightage in low middle & upper middle income countries. Therefore, the fallout of TOPSIS discloses the outcomes and found more divergence trends in lower middle income countries. Furthermore, the current study examined the impact of energy cleanability gap on economic development in selected panels from 2000 to 2019. Then, unclean energy is to blame for the declining trend in economic development. Furthermore, sustainability in the energy transition is more required as it has its costs and benefits and needs more government commitment and regulatory changes. So, avoiding such vulnerabilities requires massive financing to tackle it and improve flexibility to economic development.
Scaling Laws for the Energy Transfer in Space Plasma Turbulence
Authors: Marino Raffaele , Sorriso-Valvo Luca
Published: April 2023

One characteristic trait of space plasmas is the multi-scale dynamics resulting from non-linear transfers and conversions of various forms of energy. Routinely evidenced in a range from the large-scale solar structures down to the characteristic scales of ions and electrons, turbulence is a major cross-scale energy transfer mechanism in space plasmas. At intermediate scales, the fate of the energy in the outer space is mainly determined by the interplay of turbulent motions and propagating waves. More mechanisms are advocated to account for the transfer and conversion of energy, including magnetic reconnection, emission of radiation and particle energization, all contributing to make the dynamical state of solar and heliospheric plasmas difficult to predict. The characterization of the energy transfer in space plasmas benefited from numerous robotic missions. However, together with breakthrough technologies, novel theoretical developments and methodologies for the analysis of data played a crucial role in advancing our understanding of how energy is transferred across the scales in the space. In recent decades, several scaling laws were obtained providing effective ways to model the energy flux in turbulent plasmas. Under certain assumptions, these relations enabled to utilize reduced knowledge (in terms of degrees of freedom) of the fields from spacecraft observations to obtain direct estimates of the energy transfer rates (and not only) in the interplanetary space, also in the proximity of the Sun and planets. Starting from the first third-order exact law for the magnetohydrodynamics by Politano and Pouquet (1998), we present a detailed review of the main scaling laws for the energy transfer in plasma turbulence and their application, presenting theoretical, numerical and observational milestones of what has become one of the main approaches for the characterization of turbulent dynamics and energetics in space plasmas.

Copyright permission for the seminar banner granted by [ESA/ATG medialab](https://www.esa.int/ESA_Multimedia/Images/2020/06/Solar_Orbiter_reaches_first_perihelion).
Thermodynamics of unfolding mechanisms of pseudoknotted RNA from a coarse-grained loop-entropy model and absorbance/fluorescence measurements
Authors: Liang Jie
Published: April 2023

Pseudoknotted RNA molecules play important biological roles that depend on their folded structure. To understand the underlying principles that determine their thermodynamics and folding/unfolding mechanisms, we carried out a study on a variant of the mouse mammary tumor virus pseudoknotted RNA (VPK), a widely studied model system for RNA pseudoknots. Our method is based on a coarse-grained discrete-state model and the algorithm of PK3D (pseudoknot structure predictor in three-dimensional space), with RNA loops explicitly constructed and their conformational entropic effects incorporated. Our loop entropy calculations are validated by accurately capturing previously measured melting temperatures of RNA hairpins with varying loop lengths. For each of the hairpins that constitutes the VPK, we identified alternative conformations that are more stable than the hairpin structures at low temperatures and predicted their populations at different temperatures. Our predictions were validated by thermodynamic experiments on these hairpins. We further computed the heat capacity profiles of VPK, which are in excellent agreement with available experimental data. Notably, our model provides detailed information on the unfolding mechanisms of pseudoknotted RNA. Analysis of the distribution of base-pairing probability of VPK reveals a cooperative unfolding mechanism instead of a simple sequential unfolding of first one stem and then the other. Specifically, we find a simultaneous “loosening” of both stems as the temperature is raised, whereby both stems become partially melted and co-exist during the unfolding process. (Joint work with Ke Tang, Jorjethe Roca, Rong Chen and Anjum Ansari)
血清尿酸值在中老年族群中與骨密度之相關性： 一篇回溯性橫斷式研究
Authors: 孫崇峰 孫崇峰 , Chong-Fong Sun 薛蓁蓁 , Chen-Chen Hsueh 陳朝棟 , Chao-Tung Chen 潘柏霖 , Bo-Lin Pan 黃志芳 , Chih-Fang Huang 陳昭源 , Jau-Yuan Chen 陳暉明
Published: April 2023

目的：隨著台灣人口快速老齡化和生活習慣的改變，骨質疏鬆症的盛行率日益增加，可能嚴重影響患者的生活品質，並且是重要的公共衛生問題。因此，尋找並理解造成骨密度降低的危險因素，對於預防及早期診斷骨質疏鬆症十分重要。本研究旨在探討血清尿酸與骨密度之間的關係。

方法：在2016年1月至2016年12月期間，本研究共納入2,564名接受過雙能量X光吸收儀骨密度掃描健康檢查的參與者。經過篩選條件排除後，共有1,540名大於等於50歲之個案被納入分析，本研究使用多元羅吉斯迴歸分析用於檢查血清尿酸值和骨質減少/骨質疏鬆症與結果的關聯性。

結果：簡單羅吉斯迴歸顯示血清尿酸值較高的族群其低骨質密度（包含骨缺乏或骨質疏鬆症）風險比較低(OR 0.82, 95% CI 0.76-0.88)。在亞組分析中，依據血清尿酸值進行分組並調整干擾變項後，血清尿酸值較高的族群仍有較低的低骨質密度風險。

結論：本研究發現在中老年族群中，血清尿酸值較高者其低骨質密度的風險較低。

 

Background/Purpose: The prevalence of osteoporosis is rising along the rapid population aging in Taiwan, posing a grave public health concern due to its negative impacts on the quality of life among older adults. Identifying and understanding the risk factors of decreased bone mineral density is therefore essential for osteoporosis prevention and early diagnosis. The study aimed to investigate the associations between serum uric acid (sUA) and bone mineral density.

Methods: Between January 2016 and December 2016, 2,564 participants who had undergone health examinations with a dual-energy X-ray absorptiometry scan were recruited. After exclusion, the study was conducted with 1,540 eligible subjects aged 50 years and order. Multiple logistic regression was used to examine associations of sUA and osteopenia/osteoporosis with outcomes.

Results: Participants with higher sUA levels had significant lower risk of osteopenia/osteoporosis in simple logistic regression (OR 0.82, 95% CI 0.76-0.88). On subgroup analyses, stratified by sUA level, groups with higher sUA still had lower risk of osteopenia/osteoporosis after adjusting for other confounders.

Conclusion: The study reveals that middle-aged and older adults with higher sUA levels had significant lower risk of osteopenia/osteoporosis.

 
Is Serum Human Epididymis Protein HE4, More Specific than Cancer Antigen 125 in Patients with Benign Gynecological Diseases?
Authors: Aziz Sonia , Amir Sahar Salahuddin , Ullah Ihsan , Shams Hina , Shams Saba , Khan Umair Amir
Published: April 2023

Background: The cancer antigen 125 “CA125” and Human Epididymis protein 4 “HE4” are among some well worked out markers for recognition of malignancy in ovarian tumors. Their different cutoffs are determined and reported by various studies and mostly used recommended cutoffs are 35.0 U/mL for CA125 and 140pmol/L for HE4. They are both reported to recognize the malignancy well, but how specific they are for benign gynecological diseases is still needed to be worked out. Aim: To determine and compare the performance of CA125 and HE4 for benign gynecological pathologies. Methodology: A cross-sectional study was performed at Gajju Khan Medical College in collaboration with Armed forces Institute of pathology (AFIP). A total of 76 women of age above 18 years age, with benign ovarian pathology, confirmed through histological evaluation were enrolled. All these were examined on both markers, i.e. CA125 and HE4. Standard cutoffs of CA125 >35.0 U/mL and HE4>140 pmol/L were used to see if the case was labeled malignant, incorrectly. SPSS 20.0 was used to manage and analyze the data. Performance of the two markers were compared by using some descriptive analysis and using chi-square test. P-value ≤0.05 was considered significant. Results: The median age of these women was 40 years ranging between 18 and 71. Majority (86.8%) was premenopausal, The CA125 had no difference between pre and post-menopausal women but HE4 had a significant difference with p-value 0.029. there were 10.5% incorrect labeling of malignancy when evaluated for CA125, while only 2.6% incorrect on HE4. This difference was found statistically significant between two markers with p-value 0.05. Conclusion: HE4 is better and more specific marker for benign gynecological pathologies as compared to CA125 Keywords:Benign Ovarian Epithelial, Human epididymisprotein (HE4), Cancer Antigen 125 (CA125), Specificity
Hepatotoxic Effect of Methotrexate on Serum Hepatic Enzymes with Amendment by Sulforaphane in Albino Rats
Authors: Fatima Kaneez , Sundus Sadia , Khan Erum , Aijaz Asma , Khan Abdul Samad , Khan Bisma Samad
Published: April 2023

Objective: To evaluate the variations in serum levels of hepatic enzymes in methotrexate damaged hepatic tissue with improvement by sulforaphane. Design of research study: Experimental research study. Duration of research study: this research study was piloted in BMSI, JPMC & total period was one week & three days. Materials and Methods: For research work 40 adult albino rats of 0.2-0.3kg were selected. Time period for final study was 1 week and 3 days because animals started dying after 10 days due to hepatotoxic effect of methotrexate. Animals were separated into 4 groups, A1 was control, B1 animals were Injected Methotrexate intraperitoneally. C1 animals were Injected Methotrexate intraperitoneally along with sulforaphane by N/G. D1 animals was given sulforaphane by N/G. At the end of study, animals were sacrificed & blood was taken by direct cardiac puncture and send for lab investigation. Results: B1 animals presented with significant increase in serum levels of hepatic enzymes while C1 animals had slightly raised serum levels of hepatic enzymes. Practical Implication: These findings contribute further support to the hypothesis that variations in serum levels of hepatic enzymes in methotrexate damaged hepatic tissue are improved by sulforaphane administration. Conclusion: Research accomplishes that sulforaphane altered the unfavorable effects of methotrexate. Group B1 had substantial raise in serum levels of hepatic enzymes whereas Group C1 serum had substantial decrease in serum levels of hepatic enzymes So our recommendation is that sulforaphane should be use with methotrexate to reduce its side effects. Keywords: Aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), reactive oxygen species (ROS), methotrexate(MTX), glutathione (GSH), NADPH (nicotinamideadenine dinucleotide phosphate).
Incidence of Post-Operative Pulmonary Complications in Patients Undergoing Cardiac Surgery with Low Tidal Volume Ventilation
Authors: Hassan Asif , Riaz Wasim , Gul Saira , Qasim M. , Rehman Zargham Ur , . Zaigham
Published: April 2023

Objective: This study sought to determine if low-tidal ventilation during CPB was superior to a resting-lung strategy with no ventilation in terms of pulmonary complications following surgery. Study Design: This was a retrospective study. Place and Duration: This study was done at the Punjab Institute of cardiology, Lahore from 1st May 2021 to 1st Nov, 2022. Methodology: A total of 1348 patients were enrolled in this study following inclusion criteria. They were divided into two groups equally. SPSS version 24 was used to enter and analyzed collected data. For qualitative variables was presented in frequency(%). For quantitative variables i.e., age, height, weight, preoperative FEV1/FCV, tidal volume, PEEP, PaO2 and PaCO2 mean ±SD was calculated. Chi-square was applied to compare post-operative outcomes between the groups. P-value of <0.05 was taken as significant. Results: The mean age of the cases in Group A was 55 ± 9.08 while in Group B was 56 ± 9.19. There were 75% male and 25% females in Group A while 84% male and 16% females in Group B. In our data there were 67% diabetic and 59% smokers in Group A however 62% diabetic and 58% smokers were enrolled in Group B. Mean tidal volume given to Group A was 8.5 ± 1.8 while in Group B was 7.5 ± 1.3. Peak respiratory pressure in Group A was 18 and in Group B was 16. Mean perfusion time, cross clamp time and anesthesia duration was significant between the groups p-value 0.01. Mean tidal volume given to Group A was 8.5 ± 1.8 while in Group B was 7.5 ± 1.3. Peak respiratory pressure in Group A was 18 and in Group B was 16. Mean perfusion time, cross clamp time and anesthesia duration was significant between the groups p-value 0.01. Conclusion: This study found that continuing low tidal volume ventilation was not superior to no ventilation during CPB in terms of the rate of reintubation, pleural effusion, and pulmonary congestion, although there was a significant difference between pneumonia, atelectasis, and prolong ventilation. Keywords: PEEP, CPB, FEV1/FCV ,Pulmonary Complications, Ventilation, Tidal Volume
Contemporary Aspects of Judicial Administration Training in the Context of the Digitalization of the Educational Process
Authors: Andreeva Andriyana , Dimitrova Darina
Published: April 2023

The article examines issues related to the training in the specialty of “Judicial Administration” for the acquisition of the profession of judicial officer. On the one hand, the authors analyze in retrospect the emergence of the need to train judicial administration employees, the introduction of the profession and the creation of the specialty “Judicial Administration” in the Bachelor's degree in higher education. On the other hand, in connection with the identification of the current trends concerning the educational needs of the judicial administration, related to the acquisition of digital knowledge, skills and competences, anonymous surveys were conducted with judicial officers from the structure of the courts in the city of Varna and students from the Judicial Administration specialty studying at the University of Economics – Varna. For this purpose, questionnaires with questions were constructed and the data obtained were summarized and analyzed. On the basis of the research, topical issues concerning the need for modern approaches to training, corresponding to the digitalization of social relations, including the judicial system, are put on the field of scientific debate. It formulates summaries and conclusions with a view to updating the training documentation and linking it to the needs of practice.
Sociolinguistics of Names of Hotels in Accra
Authors: Agbaglo Ebenezer , Afful Joseph Benjamin Archibald
Published: April 2023

In recent times, the language in public spaces (as seen in street names, school names, names of buildings, names of metro stations, names of tourist attractions, and commercial signs) has attracted scholarly attention in onomastics, with the focus on how it reflects the linguistic situation of urban landscapes and how it can be used to construct several identities. The present study aimed to investigate names of hotels in Accra – the capital city of Ghana, with considerable financial, cultural, and industrial significance – using Landry & Bouris’s (1997) Linguistic Landscape as a theory. The data comprises 160 hotel names accessed from the website of Yello Ghana, a well-known business directory. The analysis revealed, first, that most of the hotels deployed English monolingual names, with a few utilising bilingual names. Closely allied to this finding is the trend towards globalisation, as captured in some names of hotels. These key findings have implications for the scholarship in onomastics, urban landscape, language policy and planning, and further research.
Beyond the Classroom
Authors: Lao Trixie M. , Catalan Amy Luz U.
Published: April 2023

The present study investigated the common challenges of learners in the new mode of learning and their frequency, if there would be a significant difference in the performance of the participants after using Google Sites, the acceptability of the Google Sites in terms of its content quality, instructional quality, and technical quality, and the experience of the respondents in using Beyond the Classroom as supplementary material for the Third Quarter. This action research used the survey questionnaires, evaluation tool, pre-tests, and posttest as instruments in answering the research questions. Respondents were 15 Grade 8 High School learners who have internet access. Results indicated always and sometimes characterized their experience on challenges such as understanding the lessons after reading the discussion found in the modules and that there is a significant difference between the pre-test and post-test scores for lessons that are easy for them to understand and learn alone. Results also revealed that Beyond the Classroom is very acceptable in terms of its content, instructional, and technical quality, and respondents found it helpful in understanding their lessons. Finally, this study showed that learners struggle to cope with the changes in the new normal, and online supplementary material helps them understand their lessons and activities for the Third Quarter of the academic year 2021-2022.
Ecological evidence for later dementia diagnosis in areas with higher rates of bilingualism: Evidence fromY Fro Gymraegin Wales
Authors: Saville Christopher W.N. , Patterson Christopher W. , Owen Rhian Russell , Kelly-Rhind Joanne
Published: April 2023

Background

Bilingualism has been proposed as a protective factor against dementia, putatively delaying onset by several years. However, evidence is equivocal. One possibility is that the pattern of confounding varies across contexts, with confounders such as socioeconomic status, rurality, and migrant status being positively associated with bilingualism in some settings and negatively in others. The present study examines this in Welsh-speaking Wales, where the confounding structure differs from much of the literature.

Methods

Routine clinical data from the Memory Clinic service covering the counties of Gwynedd and Ynys Môn were used to examine the ecological correlation between Welsh-speaking rates and dementia diagnosis rates by lower super output area. Analyses were conducted using Poisson generalised linear mixed effects models with spatial auto-correlation terms.

Results

A total of 404 cases were identified. No overall association was observed between dementia diagnosis rates and Welsh-speaking rates, but the association was moderated by age band, such that Welsh-speaking rates were protective in 65–74 year-olds but a risk factor in 75+ year olds (rate ratio=.71, .53-.94). This was robust to adjustment for area-level poverty.

Conclusion

Although causation cannot be inferred, the findings are consistent with bilingualism delaying dementia onset. Welsh-English bilingualism provides a useful complement to research on this topic elsewhere in the world, as the confounding structure is unusual.
Dificuldades no uso de novas tecnologia no varejo alimentar
Authors: Leal Alexandre Schalch
Published: April 2023

O varejo alimentar tem passado por grandes transformações com a adoção de novas tecnologias, desde sistemas de gestão de estoque até soluções de pagamento digital. No entanto, apesar dos benefícios que essas tecnologias podem trazer, sua implementação pode enfrentar algumas dificuldades...
COMPARISON OF SAFETY AND EFFICACY OF RIVAROXABAN AND ENOXAPARIN FOR TREATMENT OF CANCER ASSOCIATED VENOUS THROMBOEMBOLISM
Authors: KHAN RAA , MASOOD AI , SAFDAR A , MANAN A
Published: April 2023

The retrospective study was conducted in Nishtar Medical Hospital from January 2022 to January 2023 to compare the safety and efficacy of Rivaroxaban with low molecular weight heparin (LMWH) such as enoxaparin for the treatment of cancer-associated venous thromboembolism (VTE). A total of 250 patients were included in the study. The participants were divided into a control group (who received LMWH (enoxaparin)) and a study group (who received Rivaroxaban). The primary outcome was the occurrence of symptomatic VTE and major bleeding events during the follow-up period. After 3 months, VTE recurred in 1 (1.6%) patient in the rivaroxaban group and 6 (3.1%) patients in the enoxaparin group. After 3 months, Rivaroxaban had 4 (6.6%), and the enoxaparin group had 5 (2.6%) major bleeding events. During the 3 to 12-month period, there was no significant difference regarding treatment outcomes in groups. Based on the results, we can conclude from this study that Rivaroxaban offers effective therapy for cancer-associated VTE, but its bleeding complications are higher than LMWH.
Immunization training modules: Identifying student nurse learning
Authors: Robinson Michael S. , Bates Katie , Luthy Karlen E. , Macintosh Janelle L.B. , Beckstrand Renea L.
Published: April 2023

Background and objective: Despite the importance of vaccination in disease prevention some people choose to remain unvaccinated. Nurses are influential in the choice to vaccinate. Considering the possibility of poor public understanding of vaccines and need for continued improvement in vaccination rates, it is essential for nurses to be knowledgeable and adept at addressing vaccine concerns, especially since the COVID-19 pandemic. Vaccination education formally begins in nursing school. The objective of this study was to identify nursing students’ vaccine understanding by exploring information learned from formal online vaccine education specifically the Nursing Initiative Promoting Immunization Training Modules (NIP-IT).Methods: Nursing students enrolled in a Community Health Nursing course were required to complete three online, self-study, modules entitled Vaccine Preventable Diseases, Vaccine Concerns, and Nursing Roles. The nursing students who completed these modules responded, in writing, to an open-ended prompt asking them to identify what new piece of information they learned. Responses gathered from 244 nursing students between September of 2016 and April of 2018 were categorized and grouped according to theme using a first and second cycle coding process. Responses containing more than one idea were considered separate responses and categorized accordingly totaling 273 responses.Results: Nursing student responses revealed five major themes regarding new information learned from the online modules: (1) barriers to vaccination; (2) components of vaccines; (3) the influence of nurses; (4) vaccine-preventable diseases; and (5) community immunity.Conclusions: Formal vaccine education is a critical component of a comprehensive nursing program. The nursing students in this study described information they learned when completing the NIP-IT modules, thus it was inferred the nursing students did not have a full understanding of vaccine concepts prior to viewing the modules. Formal nursing school vaccine education is essential in developing nurses capable of navigating vaccine issues and promoting health and preventing disease through vaccination advocacy.
The Relationship Between the Timing of Knee Osteoarthritis Diagnoses and Arthroscopic Partial Meniscectomy
Authors: Thamer Semran B. , Resnick Corey T. , Werth Paul M. , Jevsevar David S.
Published: April 2023

Background:

There is ongoing debate regarding the efficacy of arthroscopic partial meniscectomy (APM) for meniscus tears in patients with knee osteoarthritis (OA). Some insurance payers will not authorize APM in patients with knee OA. The purpose of this study was to assess the timing of knee OA diagnoses in patients undergoing APM.

Methods:

A large commercial national claims data set containing deidentified information from October 2016 to December 2020 was used to identify patients undergoing arthroscopic partial meniscectomy. Data were analyzed to determine whether patients in this group had a diagnosis of knee OA within 12 months before surgery and for the presence of a new diagnosis of knee OA at 3, 6, and 12 months after APM.

Results:

Five lakhs thousand nine hundred twenty-two patients with a mean age of 54.0 ± 8.52 years, with the majority female (52.0%), were included. A total of 197,871 patients underwent APM without a diagnosis of knee OA at the time of the procedure. Of these patients, 109,427 (55.3%) had a previous diagnosis of knee OA within 12 months preceding surgery, and 24,536 (12.4%), 15,596 (7.9%), and 13,301 (6.7%) patients were diagnosed with knee OA at 3, 6, and 12 months after surgery, respectively.

Conclusion:

Despite evidence against APM in patients with knee OA, more than half of the patients (55.3%) had a previous diagnosis of OA within 12 months of surgery and 27.0% received a new diagnosis of knee OA within one year of surgery. A notable number of patients had a diagnosis of knee OA either before or shortly after APM.
Comprehensive Review of Multidirectional Instability of the Shoulder
Authors: Hippensteel K.J. , Uppstrom Tyler J. , Rodeo Scott A. , Warren Russell F.
Published: April 2023

Multidirectional instability of the shoulder can result from underlying atraumatic laxity, from repetitive microtrauma, or from a traumatic injury and often occurs in association with generalized ligamentous laxity or underlying connective tissue disorders. It is critical to differentiate multidirectional instability from unidirectional instability with or without generalized laxity to maximize treatment success. Although rehabilitation is still considered the primary treatment method for this condition, surgical treatment in the form of open inferior capsular shift or arthroscopic pancapsulolabral plication is indicated if conservative treatment fails. Recent biomechanical and clinical research has shown that there is still room for improvement in the treatment methods offered to this specific patient cohort. Potential treatment options, such as various methods to improve cross-linking of native collagen tissue, electric muscle stimulation to retrain the abnormally functioning dynamic stabilizers of the shoulder, and alternative surgical techniques such as coracohumeral ligament reconstruction and bone-based augmentation procedures, are brought forth in this article as potential avenues to explore in the future.
Trends in Race and Sex Representation Among Entering Orthopaedic Surgery Residents: A Continued Call for Active Diversification Efforts
Authors: Wang Jennifer C. , Chang Stephanie W. , Nwachuku Ikenna , Hill William J. , Munger Alana M. , Suleiman Linda I. , Heckmann Nathanael D.
Published: April 2023

Introduction:

Multiple studies have analyzed the diversity of surgical subspecialties, in which orthopaedic surgery consistently lags behind in female and minority representation. This study aims to examine contemporary data on trends in sex and racial representation among entering orthopaedic surgery residents.

Methods:

The American Association of Medical Colleges' Graduate Medical Education Track data set was queried for all individuals entering surgical residencies in the United States from 2001 to 2020. Deidentified data on self-reported sex and race (American Indian or Alaska Native [AIAN]; Asian; Black or African American, Hispanic, Latino, or of Spanish Origin; Native Hawaiian or Other Pacific Islander [NHOPI]; White; and Other) for individuals across all surgical subspecialties were collected. Sex and race proportions for newly matriculating surgical residents were analyzed and aggregated across the study period.

Results:

From 2001 to 2020, there was a 9.2% increase in the proportion of new female orthopaedic surgery residents, with approximately one in five identifying as such in 2020. By contrast, surgical specialties in aggregate saw a 16.3% increase. A 11.7% decrease was observed in entering orthopaedic residents who identified as White with a corresponding increase in representation by multiracial (9.2%) individuals and those identifying as “Other” (1.9%). The proportion of Asian (range: 10.4 to 15.4%), Black (2.5 to 6.2%), Hispanic (0.3 to 4.4%), AIAN (0.0 to 1.2%), and NHOPI (0.0 to 0.5%) new trainees has largely remained unchanged throughout the study period. A similar trend was observed among surgical specialties in aggregate. Of the identities most represented by the multiracial cohort, the most common were Asian (range: 7.0 to 50.0%), Hispanic (0.0 to 53.5%), and White (30.2 to 50.0%).

Conclusion:

Although orthopaedic surgery has improved in sex diversity in its entering class of residents, measures to increase racial diversity have been less successful. Efforts at improving the recruitment of a diverse class of trainees are necessary and will require acknowledging the importance of both racial and sex representation diversity metrics.
Postoperative Spinal Hematoma and Seroma
Authors: Butler Alexander J. , Mohile Neil , Phillips Frank M.
Published: April 2023

Fluid collections after spine surgery are rare complications, although potentially grave, and may be broadly grouped into two major categories. Symptomatic postoperative epidural hematomas have some known risk factors and can present with a widely variable profile of signs and symptoms. Treatment involves emergent surgical evacuation to reduce the risk of permanent neurologic deficit. Postoperative seroma may lead to disruption of wound healing and deep infection and has been associated with the use of recombinant human bone mineral protein. These diagnoses may present diagnostic challenges; thorough understanding of the involved pathophysiology, meticulous clinical evaluation, and radiographic interpretation are critical to appropriate management and optimal outcome.
Periarticular Injection in Total Knee Arthroplasty
Authors: Schwartz Andrew , Cochrane Niall H. , Jiranek William A. , Ryan Sean P.
Published: April 2023

Optimal pain management after total knee arthroplasty (TKA) can expedite postoperative recovery, improve perioperative outcomes, and increase patient satisfaction. Periarticular injections (PAIs) have become increasingly used to improve pain management after TKA. Similar to peripheral nerve blocks, the use of intraoperative PAIs can lower pain scores and expedite discharge from the hospital. However, there is notable variability in the ingredients and administration techniques of PAIs. Currently, no standard of care exists for PAIs, especially in the setting of adjuvant peripheral nerve blocks. This study seeks to evaluate the ingredients, administration techniques, and outcomes of PAIs used during TKA.