bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the Synergy of Blockchain and Digital Finance for Enhancing Trust in a Cloud-Enabled Economy
Authors: Nuhiu Artor , Aliu Florin
Published: December 2024

The need for transparency, efficiency and trust in business operations and financial mechanisms continues to highlight the role and importance of blockchain technology for optimizing digital business models. As an emerging technology, it is gradually expanding through its applications in various aspects of the financial industry. The chapter investigates the potential synergies between blockchain technology and digital finance for addressing digital security concerns and inefficiencies in financial transactions. The development of decentralized finance (DeFi) platforms and their possible integration with AI and machine learning represent a shift towards significant advancement in the digital finance sector. These combined technologies have the potential to provide decentralized access to financial services, which would be especially beneficial for those who are financially excluded. The chapter sheds light on Blockchain's transformative role in digital finance by providing an overview of the mechanisms needed to enhance digital security and ensure a robust financial system.
A Dynamic Cybersecurity Framework for Energy-Efficient Internet of Things
Authors: Sandhyakumari Golla , Bharathi M. , Madhurima V. , Tabassum Saleha , Neelima Koppla , Kumar N. Ashok
Published: December 2024

Cybersecurity for the Internet of Things (IoT) is a complicated issue in today's networked society. IoT ecosystem security is critical because of the wide range of devices, from industrial sensors to smart thermostats, each with specific vulnerabilities and features. Due to their frequently constrained processing capabilities, these devices are vulnerable to a range of cyberattacks, such as malware insertion, denial of service (DoS), and man-in-the-middle (MitM) assaults. Furthermore, the vast amount of private information that IoT devices ranging from behavioral patterns to personal information underlines how important it is to have effective data privacy safeguards. Ensuring the integrity of the IoT supply chain is another crucial aspect of cybersecurity, as tampering during manufacturing or distribution could compromise the security of devices. Regulatory compliance, such as adherence to standards like GDPR and HIPAA, adds another layer of complexity for manufacturers and service providers.
A Systematic Security Analysis of Existing Sybil Attack-Resilient Defensive Methodologies in Blockchain Network
Authors: Kasana Sparsh , Sharma Monika , Gupta Shashnak
Published: December 2024

Decentralized and distributed systems, like those based on Blockchain technology, are vulnerable to a form of attack called as the Sybil attack. It leads to initiate acute effect as well as initiate numerous other attacks like Denial of Service, Distributed Denial of Service, and majority attack etc. In Sybil attack, an adversary or a malicious user creates multiple fake “identities” in the system. Preventing Sybil attacks is a difficult in systems without a central trusted node. Various protocols based on social networks have been proposed by the research community to mitigate the influence of malicious nodes creating multiple identities, which differ in multiple ways in their approaches and guarantees. We explore these protocols in depth, including their assumptions, procedure, and results. Bitcoin and other traditional blockchain architectures use protocols like Proof of Work and Proof of Stake to make Sybil attacks expensive and impractical. This article provides a comprehensive survey of such techniques as applied in various cryptocurrencies.
Cybersecurity, Cloud Computing, Edge Computing, Cloud Security, Data Protection and Encryption in Cloud Networks
Authors: Sissodia Rajeshwari , Rauthan Man Mohan Singh , Barthwal Varun , Dwivedi Vinay
Published: December 2024

Cloud and edge computing have revolutionized data storage, processing, and service delivery across industries. However, these advancements have introduced significant cybersecurity challenges, particularly in safeguarding sensitive data and maintaining privacy. This chapter provides an in-depth analysis of cybersecurity issues in both cloud and edge computing environments, emphasizing the importance of robust data protection strategies. It discusses key topics such as data encryption techniques, multi-factor authentication, network security, and the emerging role of AI in threat detection. The chapter also explores the decentralized nature of edge computing, presenting unique security concerns like device management and data privacy in distributed environments. The insights presented aim to guide organizations in strengthening their cybersecurity measures and enhancing the protection of data across cloud and edge computing platforms.
Ethical Implications and Mitigation Strategies for Public Safety and Security in Smart Cities for Securing Tomorrow
Authors: Swain Bibhukalyani , Raj Prachi , Singh Kanan , Singh Yashwant , Singh Shruti , Mohapatra Hitesh
Published: December 2024

This study focuses on the revolutionary influence of IoT technology on improving public safety and security in smart cities, with an emphasis on surveillance systems, emergency response mechanisms, and crime prediction models. IoT-enabled surveillance systems, which use connected devices, sensors, and advanced analytics, enable proactive monitoring of public spaces with features such as facial recognition and anomaly detection, while IoT-driven emergency response mechanisms allow for faster and more informed responses to critical incidents. However, worries about privacy and data security, interoperability difficulties across IoT devices and systems, and the need for successful integration into existing urban infrastructure persist. Furthermore, the scalability and durability of IoT implementations in smart cities present considerable challenges. Nonetheless, after thorough research, the report emphasizes how IoT contributes to producing safer smart cities that may transform urban surroundings by revolutionizing public safety and security measures.
Improved Security in Mobile Cloud Computing Using Modern Cryptographic Approaches
Authors: Davanam Ganesh , Avanija J. , Madhavi K. Reddy , Dhanalakshmi P. , Balaji Viswaksena , Sree K. P. N. V. Satya
Published: December 2024

Since2009, the term “Mobile Cloud Computing,” which refers to a hybrid model that blends cloud computing with mobile computing, has been a hot topic in the information technology sector. Being in its infancy, MCC requires a solid grounding in the technology before researchers may suggest avenues for further study. Mobile cloud computing is quickly becoming the norm, both for consumers and major companies like Amazon, Google, Facebook, and Apple. The mobile environment is anticipated to witness a growth in cloud computing due to the rapid improvements in wireless access technology. A foundation in mobile cloud computing underpins these applications on mobile devices. Despite the convenience and scalability that come with cloud storage services—users may access their data from anywhere at any time—and from any device—including mobile devices—new security concerns have recently come to light. Correct data processing can fix these security risks.
Zero Trust Architecture in Cloud Security
Authors: Rajendran Rajesh Kanna , Mohana Priya T. , Goundar Sam , Madhavi K. Reddy , Avanija J. , Avula Basi Reddy
Published: December 2024

Zero Trust Architecture (ZTA) represents a paradigm shift in cloud security by challenging the outdated model of implicitly trusting internal networks. Instead of assuming trust based on network location, ZTA treats every access request—whether from inside or outside the network—as potentially malicious. This approach is crucial in cloud environments, where resources are accessed from diverse locations and devices. Implementing ZTA involves rigorous identity verification, robust multi-factor authentication (MFA), and the principle of least privilege, which restricts access to only what is necessary for users and devices. For example, deploying micro-segmentation in cloud environments can reduce the attack surface by up to 80%, effectively isolating workloads and limiting lateral movement during breaches. Advanced threat detection systems, often powered by artificial intelligence and machine learning, are employed to enhance anomaly detection and automate responses to security incidents.
Integrating Digital Literacy to Enhance Emotional and Social Skills in Education
Authors: Demirdis Bahaddin
Published: December 2024

As educational paradigms evolve to meet the demands of the 21st century, integrating digital literacy with emotional and social skills development is increasingly crucial. This chapter explores how digital literacy can serve as a powerful tool to enhance students' emotional intelligence, social competencies, and overall well-being. It examines key pedagogical approaches, such as guided discovery learning, digital storytelling, and project-based learning, that effectively combine digital proficiency with emotional and social growth. By highlighting the role of teachers as facilitators in emotionally supportive digital learning environments, this chapter underscores the importance of holistic education. It also addresses the challenges posed by the digital divide and the need for teacher training, offering insights for educators, policymakers, and researchers on fostering well-rounded, digitally competent, and emotionally resilient learners for the future.
Towards an Adaptive Learning Ecosystem in Higher Education
Authors: Musendekwa Menard
Published: December 2024

This chapter explores the transformative potential of an adaptive learning ecosystem (ALE) in higher education. It examines the integration of personalized learning paths, cutting-edge technology, collaborative learning environments, skill development, innovative assessment methods, and supportive educational environments. Through case studies and theoretical analysis, the chapter provides a roadmap for institutions aiming to implement ALE, highlighting best practices, challenges, and future directions.
Making Way for Young People to Participate in Civic Activities and Experience Autonomy
Authors: Yadati Nymisha , Thomas Jisa Ann , Prakasha G. S.
Published: December 2024

The United Nations Convention on Child Rights (1990) considers children as active participants capable of contributing to building a better future. Engaging children in decision-making and civic activities is a part of the 2030 Sustainable Development Agenda. Although children are recognized as agents of change at the policy level, they often do not receive meaningful opportunities to participate in decision-making. Previous research has established that metacognitive abilities develop throughout childhood. Hence, adults need to recognize these abilities by providing meaningful opportunities for children to engage in civic activities. This study explores the methods that schools can adopt to engage adolescents in civic activities and create opportunities to experience autonomy. These methods are identified and synthesized by reviewing the available literature. The four methods identified are school student councils, youth-led participatory action research, service learning, and the photovoice approach.
The Secret of Flourishing
Authors: Akgül Gülten
Published: December 2024

Education is a process that endures in the lives of human beings from cradle to grave. However, conventional educational methods do not provide enough real-life experiences. Therefore, the significance of the educational approach of the famous American pedagogue John Dewey is increasing. A vocational school is a type of school that provides practical education rather than theory. In this context, the purpose of this chapter is to raise social awareness among students by allowing them to participate in social life. Students employed this project under the umbrella of improving their feelings of moral and cultural values. The study is qualitative, longitudinal, and comparatively validates students' attitudes towards their vocational education. Data analysis was collected through observation, student interviews, and the researcher's diary. The findings of the study indicated that students applied what they found out about their profession by rehearsing their future professional lives outside the classroom walls in an attempt to shed some light on their learning process.
Moving With Times
Authors: Netshakhuma Nkholedzeni Sidney
Published: December 2024

This chapter aims to assess the inclusion of Fourth Industrial Revolution (4IR) technologies in the South African public sector. The public sector lags behind businesses in so far as innovation is concerned. This chapter focuses on the issues, challenges, and opportunities faced by the public service in South Africa in the area of 4IR skills development and training. While 4IR is projected to have transformative impacts on public service delivery, little research has explored the capability of 4IR technologies on the capacity development of the public sector in South Africa.
The Transformation of the Labor Market and Its Impact on Workers' Skills
Authors: Muzulon Nádya Zanin , de Resende Luis Mauricio Martins , Pontes Joseane
Published: December 2024

Digital transformation has revolutionized several industrial sectors, requiring professionals to constantly adapt to these changes. Therefore, identifying emerging skills and competencies in the era of digital transformation is extremely important for workers to remain competitive in the job market, since changes in the skills required by employees cannot be overlooked. If professionals are not well prepared and constantly training themselves, this can have serious consequences throughout their careers. Therefore, seeking to analyze publications on the subject over the years and with the general objective of identifying and classifying into dimensions these new skills required of workers in the digital age, a literature review was carried out using the method ordiatio. Thus, the final framework consists of 8 transversal competencies, 19 personal competencies, 5 cognitive competencies, 7 methodological competencies, 9 technological and digital competencies, 3 green competencies, and 4 technical competencies.
Role of AI Innovations Towards Service Marketing
Authors: Sharma Deepa
Published: December 2024

AI helps marketers understand the activities, signals, and behavior of their customers as well as target the appropriate approach to the right person timely and effectively. AI in marketing allows marketers to efficiently handle large amounts of data from email, social media, and the internet. The role of AI innovations in the service sector is the main topic of the present study. Innovation in the service sector itself helps the company which is driven by consumer needs. An AI innovation in the service marketing is the need and foundation of the present time. Consumers demand different services according to their needs. If any company makes timely AI innovations in the service sector as per the needs of the consumers, then it can easily defeat its competitors and can also create a positive image for itself and capture the market. During the study, special attention was given to the following areas: utilization of resources and creating products using new service AI innovation strategies, marketing capabilities, and organizational efficiency.
Sustainable Development and Institutional Theory
Authors: Özkan Ahmet Murat
Published: December 2024

Sustainable development can be defined as the formulation of economic, social and political development policies that meet the needs of the present without compromising the ability of future generations to meet their own needs. The concept of sustainable development in the twentieth century was associated with the rapid degradation of the natural environment, the depletion of natural resources and the environmental and economic side effects of increasing industrialization. Over time, it expanded to include concepts such as fighting poverty and hunger, clean energy, gender equality, public health, access to education, responsible production and consumption. In this chapter of the book, a compilation of sustainable development research based on institutional theory is presented to the readers. One can argue that studies examining sustainable development through institutional theory show a wide range of diversity. A significant portion of the studies focuses on the normative, coercive and mimetic isomorphism pressures and mechanisms of isomorphism originating from the institutional environment and/or organizational field. Institutional pressures related to sustainable supply chain management practices and sustainability reporting stand out as other prominent topics in the research. However, studies on institutional entrepreneurship actions and the demands and pressures of different institutional logics represented by stakeholders on organizational actors are currently rare. Considering that the research agenda is relatively new, it is possible to say that in the future, institutional theory will provide more effective, fruitful and efficient outputs in explaining the relationship between sustainable development and organizations.
A Bibliometric Analysis of the Relationship Between Sustainable Development and Ecological Theory in Organizations
Authors: Karafakioğlu Engin , Karaaslan Nimet
Published: December 2024

The relationship between the concepts of sustainable development and ecological theory has become two issues of increasing importance on a global scale (Majeed & Abaas, 2023; Liang & Li, 2020; Ruggerio, 2021). Goals such as adaptation to environmental factors, increasing social welfare, economic growth, and protection of natural resources are considered stages realized in sustainable development and ecological theory (Alves et al., 2022; Gui-rui et al., 2022). The present study has two purposes. The first purpose is to contribute to the literature by examining studies discussing the concepts of sustainable development and ecological theory within the scope of international literature. The second purpose is to identify the gaps in the field and to reveal academic trends over the years, through visual network maps, by performing a bibliometric analysis with quantitative data on the studies on both sustainable development and ecological theory.
Sustainable Development and Organizational Networks
Authors: Bahcelerli Nesrin , Akyurek Salim
Published: December 2024

Organizational network analysis focuses at the dynamics, consequences, and structure of networks within and surrounding organizations. This study investigates the characteristics of organizational networks and formation of alliances, the diffusion and impact of innovations, and the process of achieving sustainable development goals. Scholars can gain a deeper comprehension of organizational networks and their influence on strategy, innovation, and performance by using several theories. The method of the research was carried out based on field research. The literature was scanned in line with the keywords determined for the purpose of the research and the findings obtained were presented. It was concluded that organizational network theory advances and supports the understanding of sustainable development both within and between organizations. It was determined that organizational network theory provides insights that will help organizations create a positive impact on society and make a change.
The Learning Organization Theory in the Context of Sustainable Development
Authors: Karadayı Damla
Published: December 2024

In this article, the historical background of sustainable development concepts, principles and basic sustainable development practices all over the world is discussed. Sustainable development provides an inclusive mechanism aimed at achieving the three basic pillars of sustainability; economic, social and environmental. Therefore, economic sustainability looks at the current state of economic growth and the impact of this growth on future generations. Green technologies, combined with sustainable business models and environmental legislation, are Decoupling a reasonable path between economic development on the one hand and environmental protection on the other. The social qualities of sustainability include; education, health, women and poverty eradication, all with the aim of full social equality. However, environmental sustainability, as its name suggests, is the protection or prevention of degradation of the environment.
Optimization of CNC Machining Tool Paths Using Reinforcement Learning Techniques
Authors: Juraev Musurmon , Abrorov Akbar , Akhmedova Khalima , Abdullayev Shokhjakhon
Published: December 2024

This Reinforcement learning (RL) techniques are increasingly employed for optimal tool path planning in CNC machining to improve efficiency and reduce costs. Traditional RL algorithms, like Policy Iteration, encounter challenges due to the vast design parameter search space. This has led to the development of innovative approaches such as auto-tuner-based ordinal regression methods, offering accelerated parameter exploration and faster convergence towards optimal policies. Lin et al. present a systematic solution for complex cavity milling tool path generation using RL, demonstrating superior speed and quality compared to evolutionary computational techniques. The shift towards RL-based approaches signifies a paradigm change in tool path optimization, emphasizing its potential to enhance machining efficiency and accuracy. This paper compares various RL algorithms and approaches, showcasing their effectiveness in optimizing tool paths. Results indicate improvements in machining efficiency, accuracy, and operational costs through the integration of RL models into CNC systems. Overall, RL-based optimization offers competitive advantages, aiding stakeholders in making informed decisions for efficient CNC machining operations.
Enhancing Mechanical Properties of M30 Grade Concrete through Ceramic Waste as Coarse Aggregate Replacement
Authors: Narasimhulu E. , Munichandu M. , Keerthi L. , Lalusab K. , Reddy K. Pavan Kumar , Pradeep G. Sai , Meghana N.
Published: December 2024

This research study explores the possible of ceramic waste (CW) as a substitute for gravel in M30 grade concrete to enhance its mechanical properties. Concrete mixes were prepared with varying % of ceramic waste replacement (0%, 5%, 10%, and 15%) to explore the impact on compressive, split tensile, and flexural strengths. The compressive strength test assesses the concrete ability to withstand axial loads, while the split tensile strength test assess the worth of its resistance to tensile forces. Additionally, the flexural strength test measures the concrete's capability to resist bending stresses. The results reveal that as the percentage of ceramic waste substitution become greater, there are variations in the mechanical properties of the concrete. This study aims to give valuable insights to the construction industry regarding sustainable practices by utilizing waste materials in concrete production. The findings suggest that incorporating ceramic waste as a replacement for coarse aggregate in M30 grade concrete has the possible to improve strength characteristics while addressing environmental concerns. Overall, this research highlights the feasibility of incorporating ceramic waste in concrete mixtures to enhance sustainability and reduce the reliance on natural resources.
A Study on Antenatal Clinic Referrals of Medical Officer of Health Office, Navithanveli
Authors: Silmy M. B. M. , Hilmy M. A. M. , Ashmah A. F. F.
Published: December 2024

Introduction: Timely referrals are crucial for improving maternal and child health, as delays can have adverse consequences. Understanding the factors affecting referrals is essential for improvement.Objectives: To assess the timeliness and outcomes of referrals from antenatal clinics, and to identify the factors influencing the outcomes.Methodology: This retrospective descriptive study reviewed data from 39 referrals made in the last quarter of 2023 at the Medical Officer of Health Office Navithanveli, Sri Lanka. Data sources included patient records, referral books, and semi-structured interviews with healthcare providers.Results:• Referral timing: Most referrals (66.7%) were made in the third trimester.• Patient characteristics: The majority of mothers were aged 20-35 years, studied up to Ordinary Level, and were accompanied by a person to the clinic.• Referral reasons: The most common reasons were anemia (28.2 %), high blood pressure and fundal height issues.• Referral outcomes: Two-thirds of mothers reached the hospital on time. Others went to private care, delayed seeking care, or refused referral.• Reasons for delay: Transport/financial barriers (38.4%) and lack of a companion (23%) were the main reasons for delay or not seeking care.Conclusion: While most referrals were timely, there is room for improvement. Transport and financial problems, and lack of a companion were key barriers.
Students' Perception on Collaborative Learning Activity in Healthcare Education
Authors: Janane N. , Sihnas M. A. F.
Published: December 2024

Introduction: Collaborative Learning is an active learning strategy in which students work in small groups to optimize their teaching-learning activities. It encourages the students to help and support each other by working as a team. Collaborative Learning is important in Health Care education since health professionals work as a team to solve complex problems and serve their community. Objective: This study assessed the students’ perception of Collaborative Learning in the Faculty of Health-Care Sciences, Eastern University, Sri Lanka.Methods: A total of 52 Medical undergraduates and 23 BSc Hons (Nursing) undergraduates participated in this cross-sectional descriptive study following a small group discussion. A self-administered questionnaire was used to collect the data by using Google Forms. The questionnaire consisted of five perception statements with a 5-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). Results: The majority of the participants preferred collaborative learning over traditional teaching methods. Almost 60% of medical and nursing undergraduates strongly agreed that Collaborative Learning improves their active participation in the classroom. While 98.1% of medical undergraduates perceived that they could build strong relationships with their peers while attending Collaborative Learning, the majority of the BSc Hons (Nursing) undergraduates (>90%) strongly agreed or agreed that Collaborative Learning helps to sustain their attention throughout the lesson. Conclusion: This study revealed that the undergraduates of the Faculty of Health-Care Sciences, Eastern University, Sri Lanka have a positive perception of Collaborative Learning.
Assessment of Knowledge on Probiotics among State Pharmacists in Northern Province, Sri Lanka
Authors: Nasrifa M. H. F. , Kalki P. , Surenthirakumaran R. , Sathiadas M. G.
Published: December 2024

Introduction: Among nutraceuticals, probiotics, and prebiotics are highly recommended for various diseases. As they are newly introduced into the pharmaceutical world, patients may have difficulties finding reliable information on them. So, knowledge of healthcare professionals, especially pharmacists, on probiotics and prebiotics may help the patients receive scientific evidence-based advice rather than obtaining it from unreliable sources.Objective: The objective of this study is to assess the knowledge of probiotics and prebiotics among state pharmacists in Northern Province, Sri Lanka.Method: A descriptive cross-sectional study was conducted among all state pharmacists (N=114) in Northern Province, Sri Lanka by using a structured validated self-administered questionnaire. Data was analyzed by using the SPSS and the bivariate analysis was done by using the chi-square test and Fisher exact test.Results: The response rate was 92.9%. Among the participants in this study, only 51.9% had adequate knowledge of prebiotics, and 53.8% had adequate knowledge of probiotics. Conclusion: So, nearly half of the population have inadequate knowledge on probiotics and prebiotics. Introducing more education and training about probiotics and prebiotics could improve the knowledge.
Transforming Healthcare Through Collaboration: The Partnership of Sri Sathya Sai Sanjeevani Hospital, Eastern University, and Teaching Hospital, Batticaloa
Authors: Sundaresan K. T.
Published: December 2024

No abstract available
Short Review on Respectful Maternal Care (RMC)
Authors: Thirukumar M.
Published: December 2024

Respectful Maternity Care (RMC) is a human rights-focused approach ensuring dignity, autonomy, privacy, and compassionate support for women during childbirth. Critical in reducing maternal and neonatal mortality, RMC emphasizes informed decision-making, cultural sensitivity, and protection against mistreatment. Despite its importance, many women experience disrespectful treatment, including abuse, neglect, and discrimination, especially in low-resource settings. Key principles of RMC—such as freedom from harm, maintaining dignity, and continuous support—promote trust and better health outcomes. Addressing factors like provider burnout, implicit bias, and inadequate empathy training, alongside organizational improvements, can foster a positive and respectful maternity care environment, benefiting both patients and providers.
The cellular distribution of P2X7, P2Y6, and P2Y12 during or after pilocarpine-induced status epilepticus and literature review
Authors: Li Yue , Tang Fengru , Luo Yumin
Published: December 2024

BACKGROUND:

When a seizure occurs, the distribution of purine receptors in different cell types at various time points remains poorly understood. Our literature review revealed that P2X7, P2Y6, and P2Y12 are expressed in different cells during epilepsy pathogenesis. Therefore, we studied the protein expression patterns of the purinergic receptors P2X7, P2Y6, and P2Y12 in the normal mice hippocampus, as well as during or after pilocarpine-induced status epilepticus (DPISE or APISE).

MATERIALS AND METHODS:

Immunohistochemical staining and double-labeling immunofluorescence staining were used to study the cellular distribution of various purinergic receptors across several groups: control, 2-hour DPISE, 1-day APISE, 2-day APISE, 3-day APISE, and 1-week APISE.

RESULTS:

In the normal mouse brain, P2X7, P2Y6, and P2Y12 were predominantly expressed in the neurons. Microglia and astrocytes were found to express these receptors at the onset of seizures. Immunofluorescence analysis showed that P2X7 and P2Y12 are expressed in microglia, whereas P2Y6 is mainly expressed in astrocytes.

CONCLUSION:

Different purinergic receptors are expressed in neurons, microglia, and astrocytes, mediate their interactions, and are involved in epileptogenesis.
Weight status influences the effect of hyperglycemia at admission on clinical outcomes after endovascular thrombectomy
Authors: Tang Tao , Zhao Xu-Sheng , Chen Zhong-Jun , Fan Tie-Ping , Thomas Aline M. , Zhao Man-Hong , Li Di , Li Shen
Published: December 2024

BACKGROUND:

Insulin resistance is more prevalent in the overweight population, which can affect their glucose metabolism. This study explores whether weight status influences the relationship between admission hyperglycemia and outcomes after thrombectomy.

METHODS:

Four hundred and fifty-two patients with acute anterior circulation ischemic stroke undergoing thrombectomy were retrospectively analyzed. Hyperglycemia at admission was described as venous blood glucose ≥7.8 mmol/L and overweight as body mass index ≥24 kg/m2. The outcomes included the rates of functional independence (90-day modified Rankin Scale 0–2), symptomatic intracranial hemorrhage within 24 h after thrombectomy, and mortality at 90 days.

RESULTS:

Overall, hyperglycemia at admission decreased the likelihood of functional independence (adjusted odds ratio [OR] 0.50, 95% confidence interval [CI] 0.30–0.83, P = 0.008). Weight status modified the efficacy of admission hyperglycemia on functional independence (P = 0.022 for interaction). Hyperglycemia at admission was negatively associated with functional independence among overweight patients (adjusted OR 0.30, 95% CI 0.15–0.60, P = 0.001) but not among normal-weight patients (adjusted OR 1.13, 95% CI 0.48–2.70, P = 0.776). Weight status did not influence the efficacy of hyperglycemia at admission on mortality (P = 0.201 for interaction) or symptomatic intracerebral hemorrhage (P = 0.105 for interaction).

CONCLUSIONS:

Weight status influenced the effect of hyperglycemia at admission on functional independence after thrombectomy. Hyperglycemia at admission was related to functional independence among overweight patients but not among normal-weight patients. Our findings suggest tight control of glucose may be needed for overweight patients in the thrombectomy setting.
Prevalence of atrial fibrillation in ischemic stroke and associated risk factors: A hospital-based study in Indonesia
Authors: Nathan Theodore Amadeo , Wibowo Raisa , Sasongkojati Radhitya , Hartoko Budhi , Butarbutar Debora Theresia
Published: December 2024

CONTEXT:

The prevalence of ischemic stroke increases each year. One such important factor is the presence of atrial fibrillation (AF), but data regarding this are scarce in Indonesia.

AIMS:

This study aimed to understand the prevalence of AF in ischemic stroke and its associated risk factors.

SETTINGS AND DESIGN:

A cross-sectional study was conducted from January 2021 to 2023 in Fatima Hospital, through medical records.

SUBJECTS AND METHODS:

Subjects were ischemic stroke patients aged ≥18 years. Additional data included demographic characteristics, congestive heart failure (CHF), hypertension, diabetes mellitus, stroke history, vascular disease, AF, dyslipidemia, Glasgow Coma Scale, and anticoagulant usage.

STATISTICAL ANALYSIS USED:

Data were analyzed using Chi-square, Fisher, Student’s t-test, Mann–Whitney, and logistic regression.

RESULTS:

Out of 148 subjects, AF was detected in 16 (10.8%). Among these, 14 (87.5%) had a CHA2DS2-VASc score of ≥2 and were given anticoagulant therapy. A higher proportion of subjects aged over 75 years was observed in the AF group (31.2% vs. 3.8%; P < 0.001). A similar pattern was seen with CHF and dyslipidemia (CHF: 56.3% vs. 8.3%; P < 0.000; dyslipidemia: 93.7% vs. 58.3%; P < 0.005). CHF and dyslipidemia increased the risk of AF by 27-fold (P = 0.001, odds ratio [OR]: 27.400) and 21-fold (P = 0.013, OR: 21.812), respectively.

CONCLUSIONS:

These findings underscore the importance of vigilant screening for AF in ischemic stroke, particularly in patients with CHF and dyslipidemia, to guide appropriate anticoagulation therapy and reduce the risk of recurrent stroke. This study was limited by its single-center design and small sample size. A larger, multicenter study is recommended.
Moyamoya disease manifesting with bilateral involvement of the proximal vertebral arteries: A case report
Authors: Alwakaa Omar , Ramirez-Velandia Felipe , Filo Jean , Young Michael , Ogilvy Christopher S. , Granstein Justin H.
Published: December 2024

Moyamoya disease (MMD) is a cerebrovascular disorder characterized by progressive occlusion of intracranial arteries, often leading to stroke and intracerebral hemorrhage. While MMD classically affects the intracranial vasculature, we present an unusual case of bilateral vertebral steno-occlusion, resulting in vertebrobasilar insufficiency in a 37-year-old man with MMD and treated with angioplasty and stenting of the dominant vertebral artery. Review of the literature demonstrates proximal vertebral artery involvement to be a rare manifestation of moyamoya disease. This report contributes to the understanding of the clinical spectrum of MMD and emphasizes the need for vigilance and awareness of the possibility of extracranial vascular complications in affected individuals.
Cerebral arterial collateral status, but not venous outflow profiles, modifies the effect of intravenous tissue plasminogen activator in acute ischemic stroke
Authors: Gencer Elif Sarionder , Yilmaz Ezgi , Arsava Ethem Murat , Gocmen Rahsan , Topcuoglu Mehmet Akif
Published: December 2024

BACKGROUND:

The role of arterial collateral and venous outflow status on the response to intravenous tissue plasminogen activator (IV-tPA) has not been sufficiently clarified in acute major cerebral occlusions.

PATIENTS AND METHODS:

A total of 130 patients (mean age: 71 years; 73 females) with acute middle cerebral artery M1/M2 segment or terminal internal carotid artery occlusion treated solely with IV-tPA were analyzed. Regional leptomeningeal score (rLMC) was used for cerebral arterial collateral scoring, and the cortical vein opacification score (COVES) and modified Prognostic Evaluation based on Cortical vein score difference In Stroke (PRECISE) superficial and deep scores were used for venous outflow profile. Exploratory logistic models for response to IV-tPA [positive response: National Institutes of Health Stroke Scale (NIHSS) decrease 4 (or decrease to 0) at 24 h; dramatic response: NIHSS decrease ≥8 (or decrease to 0 or 1)], functional outcome (modified Rankin’s score 0–1 as “excellent” and 0–2 “good”) and tPA-associated hemorrhagic transformation were constructed.

RESULTS:

IV-tPA efficacy was positive in 47% and dramatic in 32%. Dramatic response was linked to better arterial collateral status (exp[B] =1.115 [95% confidence interval (CI), 1.016–1.223]). Excellent outcome was noted in 26% and good in 45%. One-point increase in rLMC score independently increased good prognosis (exp[B] =1.209 [1.034–1.412]). Patients with good prognosis had higher (by 0.5 points) modified PRECISE deep score (P = 0.047) and less frequent nonsufficient modified PRECISE deep score (0–2) (P = 0.017) in univariate analyses. However, these associations failed to survive in multiple regression. Any type tPA-associated cerebral hemorrhagic transformation was observed in 23% and parenchymal hemorrhage type 2 in 5.4%. While rLMC score showed a borderline strength correlation to hemorrhage (exp[B] =0.899 [95% CI, 0.808–1.001]), outflow scores not.

CONCLUSION:

While arterial collateral status modifies the effect of tPA in acute anterior circulation major artery occlusions, venous outflow capacity is not so critical.
Ethical Pitfalls in Scientific Publishing
Authors: Thulasingam Mahalakshmy , Karthikeyan Bindhya
Published: December 2024

Ethical integrity is crucial for scientific research and publishing. The four ethical principles of research are autonomy, beneficence, nonmaleficence, and justice. These ethical standards must be followed to ensure trust in the scientific inquiry process and to guarantee that the research benefits society or the scientific community. However, the rapid growth and competitive nature of scientific publishing have led to numerous ethical pitfalls. Evidence suggests that a considerable proportion of scientists engaged in questionable research practices while 1 in 50 acknowledged having either fabricated or falsified data at least once in their career. This article explores the common ethical pitfalls in scientific publishing, with respect to authorship issues, plagiarism, data fabrication, challenges in peer review, conflicts of interest, duplicate publication, and predatory journals. The article aims to provide insight into the best practices to maintain scientific integrity and offers recommendations for best practices in scientific publishing.
Quantitative and qualitative assessment of evaporative dry eye post intense pulsed light therapy, a prospective study
Authors: Patwardhan Sourabh D , Sangle Ankita , Patwardhan Nidhi S , Mane Seema
Published: December 2024

Purpose:

This study aimed to determine the effect of intense pulsed light (IPL) treatment on meibomian gland disease.

Settings and Design:

This is a prospective interventional study.

Methods:

Seventy eyes of patients with dry eye disease undergoing three sessions of IPL therapy, 15 days apart, were included. Each patient completed the dry eye questionnaire (SPEED) for symptomatic assessment. Dry eye evaluation tests were performed, including Schirmer’s 1 test, meiboscopy, noninvasive tear break-up time (NIBUT) and interferometry. These tests were repeated before each IPL session.

Statistical Analysis Used:

Data analysis was performed using IBM SPSS Statistics software (Version 20, Inc., Chicago, Illinois, USA). To Kolmogorov–Smirnov test was used to assess the normality of the variables. The Chi-square test was applied for statistical analysis. Level of significance was set at p ≤ 0.05.

Results:

The mean symptom score from the dry eye questionnaire (SPEED) showed a significant reduction of 24.5% (p < 0.001) in symptoms. Schirmer’s 1 test showed an improvement of 16.43% on day 15 and 40.13% on day 45. Meiboscopy grade improved by 13.54% on day 45. NIBUT improved from 53.29% on day 15 to 135.53% on day 45. Interferometry showed an improvement of 58.91% on day 45.

Conclusions:

The various investigative tests demonstrated both qualitative and quantitative improvements in dry eye disease, and patients reported symptomatic relief. The effects of IPL therapy, in terms of symptomatic relief, continued to improve with each session. The quality of the tear film also improved progressively. IPL therapy is a potential therapeutic option for MGD.
Outcomes of non-penetrating deep sclerectomy combined with mitomycin C in advanced open-angle glaucoma in Indian eyes
Authors: Maheshwari Devendra , Goyal Rinkal , Pillai Madhavi Ramanatha , Gupta Shivam , Chautani Drishti , Ramakrishnan Rengappa
Published: December 2024

Purpose:

To assess the safety and efficacy of non-penetrating deep sclerectomy (NPDS) in advanced open-angle glaucoma patients.

Design:

Retrospective observational study.

Methods:

Forty-two eyes of 38 patients with advanced glaucoma who underwent NPDS surgery combined with mitomycin-C with or without phacoemulsification were evaluated for up to 12 months at a tertiary eye care center in South India. Patients with intraoperative perforation of the trabeculo-Descemet membrane who did not meet the follow-up criteria were excluded. The primary outcome measured was intraocular pressure (IOP) reduction postoperatively on day 1, week 2, and months 1, 3, 6, and 12. The secondary outcomes measured were the need for antiglaucoma medications (AGMs), postoperative complications, and interventions.

Results:

Patients enrolled had a mean age of 61.08 ± 10.2 years. There was a statistically significant reduction (P < 0.001) of IOP from 29.48 ± 10.89 mmHg (baseline) to 11.58 ± 6.29, 11.90 ± 5.99, 13.60 ± 7.06, 14.03 ± 8.00, 13.94 ± 4.65, and 13.19 ± 3.29 mmHg at day 1, week 2, and months 1, 3, 6, and 12, respectively. The number of AGMs reduced from 3.14 ± 1.03 preoperatively to 1.85 ± 0.83 at 12 months postoperatively (P < 0.001). Nd: YAG laser goniopuncture was done in 21.4%, bleb needling in 11.9%, and one patient underwent 260° trabeculotomy after NPDS. There were no cases of choroidal detachment or wipeout.

Conclusion:

NPDS with or without phacoemulsification has good safety for managing advanced open-angle glaucoma.
Real-world use of integrated intraoperative OCT in pediatric cataract
Authors: Kaur Savleen , Sukhija Jaspreet , Nischal Ken K
Published: December 2024

Purpose:

To study the utility of integrated intraoperative OCT (i2OCT) in pediatric patients with cataracts in the real world.

Methods:

It was a retrospective case series. We included patients aged 0–12 years with unilateral or bilateral cataracts who underwent cataract surgery or membranectomy for visual axis opacification between July 2022 and December 2023, where intraoperative OCT was used. We matched the clinical data with i2OCT images and tried to identify any useful information i2OCT provided. Intraoperative notes were reviewed to analyze any changes in the surgical plan or steps after doing i2OCT.

Results:

The mean age of the children undergoing surgery was 5.9 ± 2.4 years (range: 6 months–9 years). OCT provided valuable insights into the anterior, posterior capsule, and vitreolental surface morphology. The surgical decision was modified in 10 cases after doing the intraoperative OCT (31.3%).

Conclusions:

The study adds to the database of pediatric patients imaged using i2OCT in the real world. i2OCT complements the preoperative examination and aids intraoperative decision-making in cases of white cataracts with excellent real-time delineation of the vitreolental interface in children.
miR-124, miR-126-3p, and miR-200b: Potential therapeutic targets for VEGF-mediated complications in proliferative diabetic retinopathy
Authors: Akaray Irfan , Ozal Sadık Altan , Sancar Hilal , Ozal Ece , Ayaz Lokman
Published: December 2024

Introduction:

This study aimed to investigate alterations in intravitreal microRNA and vascular endothelial growth factor (VEGF) levels in patients with proliferative diabetic retinopathy (PDR) as these factors are implicated in PDR pathogenesis.

Methods:

Fifty-two participants, including 26 patients with PDR and 26 controls without diabetes, were included in this study. VEGF levels were assessed using ELISA, and seven microRNAs (miRNAs) (miR-19a, miR-20b, miR-27a, miR-124, miR-126-3p, miR-146a, and miR-200b) were analyzed using quantitative real-time PCR.

Results:

PDR patients exhibited significantly higher miR-124 and miR-126-3p levels in the vitreous material compared to controls (P < 0.05). Conversely, miR-200b levels were significantly lower in the PDR group (P < 0.05). VEGF-A levels were markedly elevated in PDR patients compared with controls (P < 0.05). A nonsignificant positive correlation was found between miR-124 and miR-126-3p levels and VEGF levels (r = 0.361, P = 0.076 and r = 0.168, P = 0.422, respectively), whereas a nonsignificant negative correlation was observed between miR-200b and VEGF levels (r = −0.145, P = 0.488).

Conclusion:

Our study demonstrated a significant upregulation of miR-124 and miR-126-3p, along with a downregulation of miR-200b, in vitreous samples from patients with PDR, accompanied by elevated VEGF-A levels. These findings provide valuable insights into the pathogenesis of PDR. Further research is needed to evaluate the potential diagnostic and therapeutic implications of these molecular changes and to explore their viability as potential therapeutic targets.