bluuebunny/crossref_metadata_2025 huggingface dataset:
The greater the proportion of Robinia pseudoacacia in a stand the greater its effect on the population characteristics of Erythronium dens-canis
Authors: Pacsai Bálint , Bognár Emese Anna , Fülöp Bence , Lábadi Vivien , Bódis Judit
Published: April 2024

Management of invasive alien plants is an increasing problem throughout the world. In some cases native rare or protected species can appear or even prefer habitats dominated by invasive alien plants, which raises questions about the optimal treatment of such areas. Erythronium dens-canis in Hungary is a protected species which only have several occurrences in the country and a number of these populations situated in Robinia pseudoacacia stands developed after harvesting native forests. In this study a total of five populations of E. dens-canis were surveyed between 2020 and 2022 in southwestern Hungary examining and comparing the ongoing demographic changes under native and Robinia stands by monitoring individual plants. Two populations were situated in forests composed of native tree species, two in Robinia pseudoacacia-dominated stands and one in a Robinia-native tree species mixed stand. We categorized the plants into five age-state categories: dormant, seedling, juvenile, vegetative adult, and reproductive adult. We found some considerable differences (e.g. leaf size, reproduction rate) between the populations situated in native and in Robinia stands, whereas the population in mixed forest showed intermediate character in most examined factors. Based on our results, R. pseudoacacia have a significant effect on the phenology and life history of E. dens-canis, and this effect is greater with higher proportion of R. pseudoacacia in a forest stand where the E. dens-canis occurs.
The Trichoptera of Panama. XXV. Eight new country records of caddisflies (Insecta, Trichoptera)
Authors: Armitage Brian J. , Aguirre Yusseff P. , Ríos Gonzalez Tomas A. , Rodriguez Viterbo , Blahnik Roger J. , Harris Steven C.
Published: April 2024

Herein we add eight new country records to Panama’s caddisfly fauna (Insecta, Trichoptera): Hydropsychidae – Leptonema turrialbum Flint, McAlpine & Ross, 1987; Polycentropodidae – Polyplectropus bravoae Bueno-Soria, 1990; Hydroptilidae – Mayatrichia ayama Mosely, 1937 and Bredinia selva Harris, Holzenthal & Flint, 2002; Glossosomatidae – Mortoniella stilula Blahnik & Holzenthal, 2008; Anomalopsychidae – Contulma talamanca Holzenthal & Flint, 1995; Helicopsychidae – Helicospyche planata Ross, 1956; and Odontoceridae – Marilia crea Mosely, 1949. The Republic of Panama now has 533 species of caddisflies distributed among 15 families and 56 genera.
Various Diagnostic Methods for Helicobacter pylori Infection
Authors: Jeon Han Jo , Choi Hyuk Soon
Published: April 2024

Helicobacter pylori (H. pylori) is a bacterium that colonizes the human stomach, leading to various gastrointestinal diseases including gastritis, peptic ulcers, and gastric cancer. There is no gold standard test that relies entirely on one method in H. pylori diagnosis. We must be aware of the pros and cons of various testing methods to perform an appropriate test according to the situation. Accurate diagnosis and eradication therapy are essential for disease management. Diagnostic methods include invasive techniques like tissue biopsy and rapid urease test, as well as non-invasive tests such as urea breath test, serology test, and stool antigen test. Each method has its advantages and limitations, requiring careful consideration in clinical practice. Understanding these diagnostic tools is crucial for effective H. pylori management and prevention of associated complications.
Establishing a Practical Loco-Regional Transfer System for Patients with Acute Cardiac Chest Pain
Authors: Bae Jang-Whan
Published: April 2024

Cardiac disease is the second leading cause of mortality in Korea and the main cardiac disease is acute myocardial infarction (MI). Timely primary coronary intervention is the main treatment for acute MI and delay from symptom onset to intervention is the most important determinant of the prognosis and incidence of ischemic cardiomyopathy after acute MI. Treatment delay includes patient delay and system delay. The latter includes transfer and in-hospital delays. In-hospital delay improved greatly after introducing the critical pathway to Korea. However, there is still much room to improve patient and transfer delay.
Sodium-Glucose Cotransporter 2 Inhibitors for Chronic Kidney Disease: A Comprehensive Review
Authors: Song Su Hyun , Bae Eun Hui
Published: April 2024

Chronic Kidney Disease (CKD) is a major global health burden. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have demonstrated potential in slowing CKD progression. We evaluated the expanding role of SGLT2 inhibitors, emphasizing their renoprotective benefits in diabetic and non-diabetic CKD patients. We also investigated the underlying mechanisms, including the reduction of glomerular hypertension via modulation of tubuloglomerular feedback. Our study critically analyzed current indications for SGLT2 inhibitor therapy based on recent clinical trial data. To optimize patient outcomes, we present a comprehensive analysis of practical considerations for the prescription of SGLT2 inhibitors, including the potential initial decline in the estimated glomerular filtration rate and a review of adverse events.
Former les étudiants en droit économique aux enjeux de la transition écologique
Authors: Epstein Aude-Solveig
Published: April 2024

Les établissements d’enseignement supérieur français sont aujourd’hui sommés de former leurs étudiants aux enjeux du développement durable et de la transition écologique. Cette contribution traite de la place de ces enjeux dans l’enseignement du droit économique, telle qu’elle ressort notamment des entretiens réalisés avec 21 enseignants dans le cadre du projet de recherche sur la Transition Écologique du Droit Économique (TEDE). À la lumière de ces entretiens, il semble probable que les enseignements en droit économique dispensés par les Facultés de droit françaises s’ouvrent de plus en plus aux questions écologiques dans les années à venir. Il appartiendra toutefois aux établissements et aux enseignants de choisir entre la pure et simple adjonction de quelques contenus liés à la crise écologique et l’utilisation de la question écologique comme une occasion et un levier de renouvellement de l’orientation et des méthodes d’enseignement du droit économique.
Un exemple d’ouverture formelle à la transversalité : le droit des sociétés
Authors: Parachkevova-Racine Irina
Published: April 2024

Il a toujours existé plusieurs façons d’enseigner le droit des sociétés. Le choix lui-même interroge profondément la vision que l’on a de l’enseignement du droit. Cette différence dans la façon d’enseigner n’est donc pas nouvelle. Ce qui est, en revanche, très nouveau est la transformation normative spectaculaire du droit des sociétés à l’aune de la transition écologique. De toutes les matières dans le giron des activités économiques, le droit des sociétés a été probablement le plus fortement écologisé au cours de ces dernières années. Une autre nouveauté change également la donne : les étudiants sont le pilier générationnel d’une opinion publique qui place dans l’entreprise des attentes nouvelles. Il ne fait aucun doute qu’il y a là un potentiel pour le renouvellement de l’enseignement du droit des sociétés. La question est de savoir comment ce potentiel peut être exploité. À l’évidence, la réponse dépend de l’enseignant et les difficultés sont importantes. Il est certain en même temps que cette écologisation est un terreau fertile pour un enseignement de droit économique, au sens d’école, susceptible de décloisonner la matière et de l’appréhender par une hauteur de vue stimulant la créativité nécessaire pour la manier.
Un exemple de résistance à la transversalité : le droit de la concurrence
Authors: Chaiehloudj Walid
Published: April 2024

Le droit de la concurrence a pendant longtemps été rétif à l’intégration des préoccupations environnementales dans son enseignement. Des résistances lourdes justifiaient l’absence d’un enseignement spécifique. Les évolutions du contentieux et l’adoption du Green Deal changent la donne. Les résistances identifiées doivent et peuvent aujourd’hui être dépassées.
Le rôle des cliniques juridiques dans la formation sur la transition écologique : l’évolution de la clinique juridique EUCLID de l’Université Paris Nanterre
Authors: Grosbon Sophie
Published: April 2024

La clinique juridique EUCLID, traditionnellement spécialisée dans la protection des droits et libertés fondamentaux est de plus en plus sollicitée sur des questions variées en lien avec la protection de l’environnement, en raison de la multiplication du recours au droit par les associations environnementalistes d’une part, et de l’imbrication grandissante des préoccupations de droits fondamentaux et de protection de l’environnement d’autre part.
Que fait le numérique à la recherche patristique ?
Authors: Cassin Matthieu
Published: April 2024

Dans le domaine des études patristiques, le tournant numérique a apporté un certain nombre de changements, d’ampleur variable, sans modifier fondamentalement la nature des travaux menés. Sont envisagés successivement la préparation des éditions critiques, l’utilisation des corpus de textes et des répertoires électroniques de citations, puis diverses autres facettes. La question de la gratuité de l’accès aux ressources, ainsi que de la pérennité des ressources numériques concernées, est évoquée de manière transversale.
Nonexistence of asymptotically free solutions for nonlinear Schrödinger system
Authors: Chang Yonghang , Liao Menglan
Published: April 2024

In this paper, the Cauchy problem for the nonlinear Schrödinger system

   \begin{document}$ \begin{equation*} \begin{cases} i\partial_tu_1(x, t) = \Delta u_1(x, t)-|u_1(x, t)|^{p-1}u_1(x, t)-|u_2(x, t)|^{p-1}u_1(x, t), \\ i\partial_tu_2(x, t) = \Delta u_2(x, t)-|u_2(x, t)|^{p-1}u_2(x, t)-|u_1(x, t)|^{p-1}u_2(x, t), \end{cases} \end{equation*} $\end{document}

was investigated in $ d $ space dimensions. For $ 1 < p\le 1+2/d $, the nonexistence of asymptotically free solutions for the nonlinear Schrödinger system was proved based on mathematical analysis and scattering theory methods. The novelty of this paper was to give the proof of pseudo-conformal identity on the nonlinear Schrödinger system. The present results improved and complemented these of Bisognin, Sepúlveda, and Vera(Appl. Numer. Math. 59(9)(2009): 2285–2302), in which they only proved the nonexistence of asymptotically free solutions when $ d = 1, \; p = 3 $.
A non-local traffic flow model for 1-to-1 junctions with buffer
Authors: Chiarello F. A. , Friedrich J. , Göttlich S.
Published: April 2024

In this paper, we introduce a non-local PDE-ODE traffic model devoted to the description of a 1-to-1 junction with buffer. We present an existence result in the free flow case as well as a numerical method to approximate weak solutions in the general case. In addition, we show a maximum principle, which is uniform in the non-local interaction range. Further, we exploit the limit models as the support of the kernel tends to zero and to infinity. We compare them with other already existing models for traffic and production flow and presented numerical examples.
Le chantier de l’aqueduc de Traslay à Bourges. Dernières recherches et apport d’une étude pétroarchéologique des mortiers
Authors: Rivière Frédéric , Surgent Marianne
Published: April 2024

Des fouilles récentes ont été réalisées sur l’un des aqueducs (celui de Traslay) qui alimentaient la ville antique d’Avaricum/Bourges. Elles ont permis de caractériser certaines techniques de construction employées pour la réalisation d’équipements hydrauliques dans la cité des Bituriges Cubi. Les données archéologiques et métriques obtenues renseignent sur l’ampleur et la puissance de l’ouvrage. En parallèle, une étude technique et pétro-archéologique des liants architecturaux a permis de restituer les gestes, les choix techniques et économiques liés au chantier de construction. L’ensemble de ces données permet de dresser un premier aperçu de l’organisation du chantier d’un aqueduc. La construction de cet ouvrage spécifique, car linéaire, entraînait de nombreuses contraintes, qui n’apparaissaient pas sur des chantiers de bâtiments par exemple, et que l’étude des mortiers met considérablement en avant.
Photocatalytic Activity and Antibacterial Properties of ZnO/CNTs Composites
Authors: Zhu Hong Wu , Pan Yu Song , Wang Yuan Qing , Xiang Yan Lei , Han Rong , Huang Run
Published: April 2024

Photocatalytic technology is one of the promising technologies for wastewater treatment. Herein, zinc oxide/multi-walled carbon nanotubes (ZnO/CNTs) photocatalyst was successfully prepared by hydrothermal method with combining in-situ synthesis technology. The micro-morphology, crystalline structure, surface chemical elements, and optical properties were characterized by SEM, TEM, XRD, FTIR, UV-Vis, and DRS technologies. The ZnO/CNTs photo-catalyst exhibited enhancement photo activity for degradation of organic pollutants under simulated light irradiation. Specifically, the photo-catalytic activity of the ZnO/CNTs catalysts improved with the rise of CNTs content in the composites. Investigation on the photo-degradation mechanism verified that the presence of CNTs in the catalyst not only optimized the band structure of ZnO semiconductor but also contributed to the transfer of photo-generated electrons and reducing the recombination of electron-hole pairs due to its excellent conductivity. Moreover, the active radical groups such as superoxide radical (O-2), hole (h+), and hydroxyl radical (·OH) played the dominated role for the pollutants degradation under the simulated sunlight irradiation. In addition, ZCT20 catalysts and light irradiation had synergistic effects on antibacterial activity, whose antibacterial rates against E. coli and S. aureus were up to 99.96% and 99.94%, respectively. Investigation on antibacterial mechanisms revealed that the existence of ROS and the continuous release of Zn2+ played an important role for improving the antibacterial activity of the ZCT20 catalyst under the simulated sunlight irradiation.
Room Temperature-Built Gas Sensors from Green Carbon Derivative: A Comparative Study between Pristine SnO2 and GO-SnO2 Nanocomposite
Authors: Amoh Prince Oppong , Elwardany Ahmed , Fujii Manabu , Shokry Hassan
Published: April 2024

Room temperature-built gas sensors were fabricated from graphene oxide (GO), pristine and doped SnO2 nanostructures. The as-synthesized green carbon derivative (GO) nanomaterials were prepared from waste plastic precursor using Modified Hummer’s methodology. Pristine SnO2 and GO-SnO2 nanocomposite were synthesized employing a wet synthesis technique known as co-precipitation. The as-prepared nanoparticles were investigated for structural crystallographic and morphological features using X-ray diffractometry (XRD) and Transmission electron microscopy (TEM) analytical techniques. High-angle annular dark field (HAADF) and elemental quantifications of the nanopowders were investigated with the Energy dispersive X-ray spectroscopy (EDX). Textural features were determined with the assistance of Brunauer-Emmett-Teller (BET) analyzer. Thermogravimetric analysis (TGA) was performed to ascertain the material stability and degradability of the synthetic materials. Functional group and bond structure analysis was conducted using Fourier-transform infrared (FTIR) spectroscopy. Gas sensor devices were tested for responses towards CH4, H2, LPG, and CO2 gases at 20 ppm concentrations of each. GO-SnO2 nanocomposite sensing device showed optimal detection response towards the respective analyte gases with values of 5.00, 5.08, 4.90 and 3.41 respectively. The prepared nanocomposite showed stability and selectivity towards the target gases in an order of magnitude of H2 > CH4 > LPG > CO2. The optimal gas sensor device’s dynamic gas sensing response was ascribed to the GO doping effect which relatively increased its surface area (46.48 m2g-1) and absorption sites.
A Study of Nanostructured FeO Thin Film-Based Allure Red and Direct Blue 15 Azo Dyes Sensing Scheme
Authors: Gunduz Sumeyra , Alayli Azize , Guney Harun , Coban Omer , Ertugrul Mehmet , Nadaroglu Hayrunnisa
Published: April 2024

This study reports on the amperometric sensing properties of FeO/Fe2O3 thin films for the detection of Allura Red (AR) and Direct Blue 15 (DB15) Azo dyes. The FeO/Fe2O3 thin films were produced using the Sequential Ionic Layer Adsorption and Reaction (SILAR) method and Na+-doping. The morphological and structural properties of the nanocomposites produced at pH of 10.5 showed good properties for the detection of azo dyes. The linear curve fit equations for AR and DB15 droplet applications onto Na+-doped FeO nanocomposite thin film samples were found to be y = -0.0002x + 0.0043 (R² = 0.9143) and y = -7E-05x + 0.0005 (R² = 0.9809), respectively. The findings reveal that adding Na+ doping to FeO/Fe2O3 thin films can effectively increase the detection response for the target azo dyes and enhance the sensitivity of the sensing system. The results suggest that the SILAR method can be used to produce low-cost and reusable FeO/Fe2O3 thin film devices, which can be promising candidates for the detection of toxic azo dyes in liquid samples.
Thermal Buckling of FG Nanobeams via an Indeterminate Integral Variable with Trigonometric Displacement Models in Conjunction with the Gradient Elasticity Theory
Authors: Ellali Mokhtar , Zenkour Ashraf M. , Bouazza Mokhtar , Benseddiq Noureddine
Published: April 2024

This contribution presents a new methodology and a new indeterminate integral variable of displacement field using trigonometric deformation in conjunction with gradient elasticity theory. The aim, for the first time, is to explore the thermal buckling behavior of functionally graded (FG) nanobeam thus elastic gradient theory takes into account the size effect on the critical thermal buckling load of FG nanobeams. Secondly, the impact of various factors, such as nonlocal coefficient, porosity parameter, material index, thermal loading type, and aspect ratio on the critical thermal buckling load of FG nanobeams. The material characteristics are considered to vary in thickness as the power law varies and the pore network is assumed to be empty or filled with low-pressure air.
TCF1highPD-1+Ly108+CD8+ T Cells Are Associated with Graft Preservation in Sensitized Mice Treated with Non–Fc Receptor–Binding CD3 Antibodies
Authors: Ota Takuji , Goto Ryoichi , Harada Takuya , Forgioni Agustina , Kanazawa Ryo , Ganchiku Yoshikazu , Kawamura Norio , Watanabe Masaaki , Fukai Moto , Shimamura Tsuyoshi , Taketomi Akinobu
Published: April 2024

The non–Fc-binding anti-CD3 Ab [anti-CD3F(ab′)2] can induce graft acceptance depending on the therapeutic window in a rodent heart transplant model. The delayed protocol allows for early graft infiltration of lymphocytes, which may behave in an inhibitory manner. We investigated the most effective protocol for anti-CD3F(ab′)2 in sensitized conditions to confirm the evidence for clinical application. C57BL/6 mice were sensitized with BALB/c tail skin grafts and transplanted with BALB/c heart grafts at 8–12 wk after sensitization. Fifty micrograms of anti-CD3F(ab′)2 was administered daily for 5 consecutive days on days 1–5 (day 1 protocol) or days 3–7 (delayed protocol). In nonsensitized mice, the delayed protocol significantly prolonged graft survival after transplantation from BALB/c to naive B6 (median survival time [MST], >100 d). In contrast, the delayed protocol was unable to prevent graft rejection in sensitized mice (MST, 5 d). A significantly increased percentage of granzyme B+ CD8+ T cells was observed in the graft on day 3 posttransplantation in sensitized conditions. Further, the day 1 protocol significantly prolonged graft survival (MST, 18 d), even in sensitized conditions. Day 1 treatment significantly increased the percentage of Foxp3+CD25+CD4+ T cells and phenotypically changed CD8+ T cells in the graft (i.e., caused a significant increase in the proportion of Ly108+TCF1highPD-1+CD8+ T cells). In conclusion, different timings of delayed anti-CD3F(ab′)2 treatment promoted allograft preservation in association with phenotypic changes in CD4+ and CD8+ T cells in the graft under sensitized conditions.
The Impact of Pharmacist Medication Reviews on Geriatric Patients: A Scoping Review
Authors: Yaacob Nor Liana Che , Loganathan Mathumalar , Hisham Nur Azwa , Kamaruzzaman Habibah , Isa Khairil Anuar Md , Ibrahim Mohamed Izham Mohamed , Ng Kwok-Wen
Published: April 2024

Medication review is an intervention with the potential to reduce drug-related problems (DRPs) in the elderly. This study aimed to determine the effect of pharmacists’ medication reviews on geriatric patients. This study accessed two online databases, MEDLINE Complete and Scopus, and examined all studies published in English between 2019 and 2023, except for reviews. The studies included (1) participants over 65 years of age and (2) medication reviews conducted by pharmacists. The titles, abstracts, and full texts were reviewed for data extraction to determine whether the studies satisfied the inclusion and exclusion criteria. Forty-four of the initial 709 articles were included in this study. The articles included discussions on the incidence rates of DRPs and potentially inappropriate medications (PIMs) (n=21), hospitalization (n=14), medication adherence (n=9), quality of life (QoL) (n=8), and falls (n=7). Pharmacist medication reviews were associated with a reduced incidence of DRPs and PIMs, and improved adherence to medications. Patients’ overall QoL is also increasing. However, pharmacist medication reviews were not strongly associated with decreased hospitalization or falls. A pharmacist’s medication review may be a feasible intervention for reducing the incidence rates of DRPs and PIMs, regardless of whether it is performed as a sole intervention or supplemented with other interventions. The intervention was also effective in increasing medication adherence and QoL.
Determination of Reference Interval for Serum Homocysteine, Magnesium, and Uric Acid from Tertiary Care Hospital Data By the Bhattacharya Method
Authors: Peter Monica , Bhaskar Arunachalam Vijaya , Kamble Videeta Avinash , Lazaras Gaikwad Abhishek , Christudoss Pamela , Varghese Joe , Venkatesan Padmanaban
Published: April 2024

Introduction:

Direct ways of establishing reference intervals for analytes are time-consuming and costly. Bhattacharya analysis is an indirect way to mathematically derive reference intervals from the results of analytes in a hospital database and is practically a simple and inexpensive alternative to direct methods.

Methods:

Data of serum uric acid, magnesium, and plasma homocysteine levels measured in the department of clinical biochemistry over 3 years were extracted from the hospital database along with the age, gender, and location of the patients. Bhattacharya analysis was performed by identifying underlying Gaussian distribution within the non-Gaussian distribution of the patient data by log transformation of the distribution of the data. Reference intervals for each of the analytes were calculated from the identified Gaussian distribution.

Results:

The reference interval for serum uric acid was 1.49–8.97 mg/dL in men and 2.13–6.14 in women, serum magnesium in adults was 1.19–3.21 mg/dL, and plasma homocysteine in adults was 4.6–21 μg/dL.

Conclusion:

Using Bhattacharya analysis, we were able to derive reference intervals for analytes from our hospital data.
Health of Tribal Population in India: A Glimpse of the Current Scenario
Authors: Linda Angel Ivy , Pal Debkumar , Murmu Nisha , Taywade Manish
Published: April 2024

Article 366(25) of the Indian constitution refers to indigenous people as “scheduled tribes,” which constitute 8.6% of the country’s population. For decades, the health of the tribal people had remained neglected and incorporated in rural health care because of incorrect assumptions of their similar health needs to that of the rural population. An expert committee coordinating with the Ministry of Health and Family Welfare and the Ministry of Tribal Affairs provided a detailed report on the current scenario and recommendations related to tribal health in India. They considered the health-care needs of the tribal population, highlighted their specific health problems, and gave a roadmap of best approaches. The tribal population has a unique and higher burden of health problems than the mainstream population, influenced by their health-seeking behavior, lack of awareness and education, sociocultural and magico-religious beliefs, customs, and practices. The current health-care system incorporates their health needs with approaches such as differing population norms in tribal areas, nonmonetary incentives to staff, mobile medical units, identification of high-priority districts, and the emergence of the “Swasthya” portal. However, tribal health is transitioning as with the rest of the population. Moreover, the present health-care services are unable to address this. Legal recognition of indigenous peoples’ rights to self-determination, their land, natural resources, and their knowledge is a need of the hour.
Dyke–Davidoff–Masson Syndrome – A Case Series
Authors: Sheetal S. , Sujan Joel Varghese , Das Athira , Mathai Vivek
Published: April 2024

Dyke–Davidoff–Masson syndrome (DDMS) refers to variable degrees of atrophy of one cerebral hemisphere, resulting from brain injury in intrauterine or early years of life. Clinical features of this rare syndrome include varying degrees of contralateral hemiplegia, facial asymmetry, seizures, and mental retardation. Specific neuroimaging findings include unilateral brain volume loss, ventriculomegaly, and compensatory bone hypertrophy. In addition to this, calvarial thickening and hyperpneumatization of frontal sinuses may occur. We hereby report three cases of this syndrome, with varied clinical and radiographic features, to highlight the wide spectrum of this syndrome.
Utility of Sensate Pedicled Medial Thigh Perforator Flaps in Treating Recurrent Ischial Ulcers in Individuals with Cauda Equina Lesions and Spinal Dysraphism – A Retrospective Analysis
Authors: Chalageri Prashanth H , Augustine Thomas Anand , Magimairaj Henry Prakash , Yadav Bijesh Kumar
Published: April 2024

Background:

Ischial pressure ulcers pose a significant challenge due to their high recurrence rates. It is imperative to provide or establish a reliable, well-vascularized soft-tissue cover over the ischial area to prevent recurrences. The objective of the study was to study the utility and complication rates associated with pedicled medial thigh perforator (P-MTP) sensate flap procedures in managing recurrent ischial ulcers and perineal lesions.

Methods:

A retrospective cohort study was conducted at Christian Medical College, Vellore, a tertiary care center in South India. This study involved 30 patients with ischial pressure sores. Of these, 13 patients underwent P-MTP flaps, while 17 underwent alternative surgeries for ulcer closure (January 2014–June 2020).

Results:

Among 13 patients who underwent P-MTP sensate flaps, 1 major complication (full-thickness flap necrosis) necessitated flap revision, while 6 minor complications occurred in the postoperative period. Three patients (23.08%) reported late recurrence of ulcers at the same postoperative site. In contrast, among the 17 patients who underwent the other (alternative) methods of surgical closure, 3 patients had wound dehiscence in the postoperative period. Four patients reported recurrence of ulcer at the postoperative site within 6 months and another four after 6 months of surgical closure. The surgical outcomes in sensate flap surgeries (P-MTP flaps) were comparable to other approaches for surgical closure. Sensation in the P-MTP flap transposed over the ischial region remained intact in all 13 patients at 6-month follow-up.

Conclusion:

The P-MTP sensate flap is a feasible and reliable treatment strategy for regional soft-tissue reconstruction in ischial and perineal lesions with postoperative complications comparable to other surgical methods for ischial ulcer closure. The sensate flap surgeries offer the additional benefit of maintaining intact sensation over the pressure injury vulnerable ischial region.
Prevalence of Depression, Anxiety, and Stress along with Coping Strategy and Work-related Sense of Coherence in Anesthesia Care Providers during the COVID-19 Pandemic in a Tertiary Care Hospital: A Cross-sectional Study
Authors: Jiwanmall Meghna , Joel Jerry Joseph , Williams Aparna , Jiwanmall Stephen Amarjeet , Kumar Bharath , Rai Ekta
Published: April 2024

Background:

Numerous studies have reported the prevalence of psychological issues in anesthesia professionals during stressful situations like the COVID-19 pandemic; however, there are limited data exploring the coping strategies and work satisfaction in this workforce during the pandemic.

Methodology:

In this observational cross-sectional study, three validated questionnaires, namely, the Depression, Anxiety and Stress Scale 21, the Brief-Coping Orientation to Problems Experienced inventory, and the Work-related Sense of Coherence (Work-SoC) scale, were handed out to 150 anesthesia health-care providers (doctors and allied health staff [AHS]). The prevalence of depression, anxiety, and stress; Work-SoC conditions; and coping strategies were compared between groups of participants based on age (<30 years vs. ≥30 years), gender (males vs. females), and occupation (doctors vs. AHS).

Results:

Participants aged <30 years reported more depression (P = 0.0134) and stress (P = 0.0453) compared to participants aged ≥30 years. Younger participants used emotion-focused and avoidant coping styles, whereas older participants used coping styles that were emotion focused and problem focused. Similarly, a problem-focused coping style was observed frequently among both doctors and AHS. Work-SoC assessment showed that younger participants (P = 0.0088) and more AHS respondents (P = 0.000) attributed poor meaningfulness, but doctors reported poor comprehensibility (P = 0.058) to their working conditions.

Conclusion:

Younger professionals were more susceptible to stress and depression during the pandemic. Similar to AHS, they perceived work conditions as unrewarding and less meaningful. Doctors perceived working conditions as unmanageable, unpredictable, and unstructured. There were age-related differences in coping strategies where older adults engaged in more proactive coping.
Concordance of breast cancer services in an urban tertiary care institute in India to EUSOMA guidelines: An audit of Indian breast cancer practices
Authors: Kadayaprath Geeta , Gupta Sandhya , Gupta Neerja
Published: April 2024

The provision of breast cancer care tends to vary substantially from one breast unit to another. To provide state-of-the-art patient-centered care to women diagnosed with breast cancer, adoption and adherence to structured treatment algorithms, protocols, and international guidelines are essential. In this review, we endeavor to audit breast cancer care at our tertiary cancer center against published EUSOMA guidelines. This was a retrospective study with an observational design. All patients who completed recommended treatment for breast diseases at our institute from January 1, 2018 to December 31, 2018 were included and evaluated. Data were retrieved from patient e-prescriptions and medical records. Analysis was performed using Microsoft Office 2010 to measure how our practices compared to EUSOMA quality indicators (QIs). Clinical assessments, imaging, and preoperative work-up of breast cancer patients met EUSOMA standards. Prognostic and predictive characterization of tumors was performed in all cases. Surgical management of invasive cancer and ductal carcinoma in situ (DCIS) was in accordance with the guidelines. Adherence to postoperative radiation and adjuvant endocrine therapy was adequate. More mastectomies were performed in patients with invasive cancers measuring <3 cm. Overtreatment was avoided in every other subgroup. Adjuvant and neoadjuvant chemotherapy and targeted adjuvant therapy were adequately utilized unlike neoadjuvant targeted therapy. Minimal attrition was noted in patient follow-up. This extensive audit has set a benchmark for future annual audits and helped highlight areas where improvement of service delivery is needed.
Comparative evaluation of bond strength of diode and neodymium-doped:Yttrium aluminum garnet-assisted bleached enamel with nanofilled composite: An in vitro study
Authors: Dube Ridhi , Tandale Anita , Talreja Twinkle Kishor , Krishnakumar Karishma , Kokate Prajakta , Mulay Sanjyot
Published: April 2024

Background:

The world of esthetic dentistry is constantly making efforts toward the management of tooth staining. Laser-assisted bleaching is needed before adhesive restorations and has become common and advantageous as it accelerates bleaching action, reduces postoperative sensitivity, and promotes recrystallization of enamel.

Aim:

The study aimed to evaluate and compare the bond strength of diode (Biolace: EpicX) and neodymium-doped:yttrium aluminum garnet (Nd:YAG) (LightWalker, Fotona, Slovenia) assisted bleached (Pola Office, SDI) enamel with nanofilled composite (GC Solare Sculpt).

Materials and Methods:

The samples were divided into three groups (n = 11): Group A – Conventionally bleached enamel, Group B – Diode laser-assisted bleached enamel, Group C – Nd:YAG laser-assisted bleached enamel. After storing samples in Artificial Saliva for 2 weeks, bonding was performed, and nanofilled composite resin was applied through an incremental method. Samples were subjected to shear bond strength (SBS) analysis.

Conclusion:

The use of Nd:YAG laser on bleached enamel significantly increases the bond strength with nanofilled composite resin.
Feasibility of opioid-free anesthesia in laparoscopic radical prostatectomy: A retrospective, quasi-experimental study
Authors: Tejedor Ana , Bijelic Lana , García Marta
Published: April 2024

Background and Aims:

Opioid-free anesthesia (OFA) provides adequate analgesia minimizing opioids. OFA has not been evaluated in laparoscopic radical prostatectomy (LRP). Our aim was to evaluate OFA feasibility and its effectiveness in LRP.

Material and Methods:

A quasi-experimental retrospective study of 55 adult patients undergoing LRP was performed from September 2020 until December 20223. Predefined protocols for either opioid-based anesthesia (OBA; with continuous remifentanil infusion) or OFA (continuous lidocaine, dexmedetomidine, and ketamine infusion) were followed. In both groups, wound infiltration was performed before skin incision. Primary outcome was postoperative pain management (numerical rating scale [NRS]) in the first 24 postoperative hours. Secondary outcomes were opioid consumption, start to sitting and ambulation, postoperative complications, and length of hospital stay.

Results:

OFA protocol patients had better median pain scores during movement at 1, 18 and 24 h, that is, 1 (interquartile range [IQR] 0–3) versus 2.5 (IQR 0–4), P = 0.047; 0 (IQR 0–1) versus 1 (IQR 0–2), P = 0.017; and 0 (IQR 0–0.25) versus 1 (IQR 0–2), P = 0.013, respectively. At 6 and 12 h, there were no statistically significant differences, that is, 0.5 (IQR 0–2) versus 1 (IQR 0–2), P = 0.908 and 1 (IQR 0–2) versus 0.5 (IQR 0–2), P = 0.929, respectively. Lower morphine requirements were recorded in the first 18 and 24 postoperative hours, that is, 0 (IQR 0–0) versus 1 (IQR 0–2.75) mg, P = 0.028 and 0 (IQR 0–2) versus 1.5 (IQR 0–3) mg, P = 0.012, respectively. Start to sitting and ambulation occurred earlier in the OFA group (P = 0.030 and P = 0.002, respectively). Linear regression showed that ambulation was independently associated with the analgesic technique (P = 0.034). Only one patient had postoperative nausea and vomiting (PONV) and belonged to the OBA group. There was no difference in total complications or the length of stay.

Conclusion:

In this study, OFA strategy was found to be safe, feasible, and provided adequate analgesia, minimizing the use of postoperative opioids, and was independently associated with earlier ambulation.
Safety of perioperative intravenous lidocaine in liver surgery – A pilot study
Authors: Grassin Pierre , Descamps Richard , Bourgine Joanna , Lubrano Jean , Fiant Anne-Lise , Lelong-Boulouard Véronique , Hanouz Jean-Luc
Published: April 2024

Background and Aims:

Perioperative lidocaine infusion has many interesting properties such as analgesic effects in the context of enhanced recovery after surgery. However, its use is limited in liver surgery due to its hepatic metabolism.

Material and Methods:

This prospective, monocentric study was conducted from 2020 to 2021. Patients undergoing liver surgery were included. They received a lidocaine infusion protocol until the beginning of hepatic transection (bolus dose of 1.5 mg kg−1, then a continuous infusion of 2 mg kg−1 h-1). Plasma concentrations of lidocaine were measured four times during and after lidocaine infusion.

Results:

Twenty subjects who underwent liver resection were analyzed. There was 35% of preexisting liver disease before tumor diagnosis, and 75% of liver resection was defined as “major hepatectomy.” Plasmatic levels of lidocaine were in the therapeutic range. No blood sample showed a concentration above the toxicity threshold: 1.6 (1.3–2.1) μg ml−1 one hour after the start of infusion, 2.5 (1.7–2.8) μg ml−1 at the end of hepatic transection, 1.7 (1.3–2.0) μg ml−1 one hour after the end of infusion, and 1.2 (0.8–1.4) μg ml−1 at the end of surgery. Comparative analysis between the presence of a preexisting liver disease or not and the association of intraoperative vascular clamping or not did not show significant difference concerning lidocaine blood levels.

Conclusion:

Perioperative lidocaine infusion seems safe in the field of liver surgery. Nevertheless, additional prospective studies need to assess the clinical usefulness in terms of analgesia and antitumoral effects.
Ultrasound-based assessment of tongue thickness for prediction of difficult laryngoscopy and intubation
Authors: Furia Jhanvi Sunil , Nadkarni Manali Mohan
Published: April 2024

Background and Aims:

Predicting difficult airway and preparedness for the same can help prevent catastrophic situations while handling the airway. With the increasing familiarity of anaesthesiologists to the use of ultrasound machine and its easy availability and non-invasiveness, we sought to study its utility in airway assessment, by measuring the thickness of tongue, to predict difficult laryngoscopy and intubation.

Material and Methods:

A total of 85 patients undergoing elective surgeries under general anaesthesia with endotracheal intubation were examined preoperatively. Tongue thickness was measured using submental ultrasonography in the median sagittal plane along with other tests of airway assessment. Cormack Lehane grade on laryngoscopy and Intubation Difficulty Scale Score was recorded. The sensitivity, specificity, positive and negative predictive value, and accuracy was calculated for tongue thickness for predicting difficult intubation.

Results:

The tongue thickness in those with difficult intubation (4.83 ± 0.62) was significantly higher than those without difficult intubation (4.38 ± 0.65). The ratio of tongue thickness to thyromental distance was also significantly higher in difficult intubation group. The area under the receiver operating characteristic curve for predicting difficult laryngoscopy and intubation was higher for tongue thickness as compared to other clinical parameters. The sensitivity and specificity of tongue thickness to predict difficult laryngoscopy was 100% and 83%, respectively, and to predict difficult intubation was 72% and 59%, respectively, with an accuracy of 72%.

Conclusion:

Ultrasound based assessment of tongue thickness can be a useful predictor of difficult airway along with clinical assessment of the airway.
Patch testing in suspected allergic contact dermatitis to cosmetics: a retrospective study from a tertiary care center in South India
Authors: Mohan Parvathy , Thyvalappil Anoop , Sridharan Rajiv , Ajayakumar Sreenivasan
Published: April 2024

Background: Commonly used cosmetics such as soaps, face creams, lipsticks, sunscreens, perfumes, and eye, hair, and nail cosmetics can cause allergic contact dermatitis (ACD). Gold standard for diagnosis of ACD is the patch test. Aim: We conducted this retrospective study to find the common allergens in cosmetics causing ACD. Methods: Patients who underwent patch test with both cosmetic and fragrance series as well as Indian standard series, for suspected cosmetic dermatitis were included in this study. Data were collected from patch test register maintained in the department of dermatology. Results: The study included a total of 74 patients out of which 45 (60.8%) were males and 29 (39.2%) were females. Patients with positive and negative patch test had no statistically significant difference with respect atopy (P = 0.521). Of 74 patients included in the study, 59 patients (79.7%) had positive patch test to at least one allergen. In our study, the most common allergen with positive patch test was fragrance mix (n =19; 25.7%) followed by paraphenylenediamine (PPD) (n = 18; 24.3%) and thiomersal (n = 10; 13.5%). A significant correlation was observed between suspected hair-dye allergy and PPD positivity (P < 0.001). Conclusion: Cosmetics are not very safe as claimed by the manufacturers, as it may contain many allergens. Contact sensitivity from cosmetics is becoming an important health problem.
Comparison of MELASQOL and DLQI in female patients suffering from melasma and nonmelasma facial melanosis: a cross-sectional study
Authors: Dabbas Disha
Published: April 2024

Background: Facial melanosis is a common clinical problem and results in impaired quality of life. Aims: The aim of the study was to compare the quality of life in female patients suffering from melasma and nonmelasma facial melanosis (NMFM) using melasma quality of life (MELASQOL) and dermatology life quality index (DLQI). Methods: It was a prospective cross-sectional study conducted in a dermatology outpatient department of tertiary care center. Modified melasma area severity index (mMASI), MELASQOL, and DLQI were calculated in female patients meeting inclusion criteria of the study. The statistical analysis was performed using statistical package for social sciences (SPSS version 20; Chicago, IL, USA). Categorical data are presented as number with percentage and continuous data as mean with standard deviation. Quantitative data were compared using independent t test and categorical data using Chi-square test. All statistical tests were two sided and were performed at a significance level of α = 0.05. Results: A total of 119 patients were included in the study and consisting of 50 (42%) patients with melasma and 69 (58%) patients with NMFM. The impairment of quality of life was more in NMFM when compared with melasma group. The severity of pigmentation (mMASI) did not show any significant correlation with MELASQOL or DLQI in either of the groups. There was strong correlation between DLQI and MELASQL (Spearman rho = 0.886; P < 0.001). Conclusion: Facial melanosis impacts quality of life adversely. The impact of NMFM is more when compared with melasma. MELASQOL and DLQI should be performed in these patients to understand true impact of these diseases on quality of life.
Knowledge and attitude of general public toward vitiligo: a study from a tertiary care hospital from South India
Authors: Rangegowda Suresh Mahadevarahalli , Afshan Gouhare , Channakeshavaiah Ravikumar Banavase , Hegde Soumya Gajanana , Nirvanappa Vinay K. , Nagesha Parvathi Chikkaballapur
Published: April 2024

Background: Vitiligo is a common, autoimmune acquired disorder of the skin, which causes milky white depigmented macules on various parts of the body. These macules are commonly aesthetically disfiguring, which may significantly decrease their quality of life. Common peoples’ misconceptions and undue apprehension associated with vitiligo are the result of inadequate knowledge about this otherwise benign and harmless condition. Aims and objectives: To document the prevalent knowledge, attitude, and practices of general population on vitiligo. Materials and methods: It is a cross-sectional study of 3 months duration. A total of 500 people from the general public visiting hospital who satisfied the inclusion criteria were recruited and were provided with a questionnaire devised in local language (Kannada) which included questions related to knowledge and attitude toward vitiligo patients. The collected data were tabulated and assessed using descriptive statistics. Results: Statistically significant difference was noted in mean knowledge and attitude score between urban and rural subjects (P = 0.008, P < 0.001), respectively. Regression analysis showed gender, education, and age are the predictors of knowledge (P = 0.001, P < 0.001, P < 0.001), respectively. Education and domicile were the predictor of attitude (P < 0.001, P < 0.001), respectively. Conclusion: The study highlights that the availability of the different treatment options in the urban areas has increased the knowledge and attitude of public toward the condition. Thereby we conclude that the need of the hour is awareness program regarding knowledge and treatment options of vitiligo.
Evaluation of auditory and ophthalmic abnormalities in adult vitiligo patients: a case-control study
Authors: Devi Reeta , Rather Shagufta , Wani Junaid S , Latoo Manzoor A , Hassan I
Published: April 2024

Background: The association of vitiligo with autoimmune disorders and affliction of auditory and ocular melanocytes in vitiligo patients suggests that a systemic autoimmune process directed against pigment cells might play a role in the development of the disease. Aim: The aim of our study was to find out associated ocular and auditory abnormalities in patients with vitiligo and correlate the same with the extent and duration of vitiligo. Methods:An analytical, case-control study was undertaken in 100 newly diagnosed cases of vitiligo (age >18 years) and an equal number of age- and sex-matched non-vitiligo controls. A detailed cutaneous examination was carried out taking note of the type, duration, and extent (vitiligo extent tensity index) of vitiligo. All relevant baseline laboratory investigations, complete ophthalmic examination, and a thorough auditory evaluation using pure tone audiometry were carried out in all cases and controls. Statistical analysis: Statistical analysis was done using the chi-square test and Fisher exact probability test and a P < 0.05 was considered statistically significant. Results:Fifteen cases (15%) and five controls (5%) had ocular abnormalities (P = 0.018). No statistically significant correlation between ocular abnormalities and the duration, extent, or anatomic location of the disease in vitiligo cases was observed (P > 0.05). Sensorineural hypoacusis was found in 22% of vitiligo cases and 2% of non-vitiligo controls (P < 0.001). A statistically significant association was found between sensorineural hearing loss and the duration of the disease in vitiligo cases (P = 0.019). No association between age of onset of vitiligo and auditory alterations was observed. Hypothyroidism was seen in 16% cases versus 3% in controls (Pp = 0.004). Diabetes mellitus was present in 14% versus 3% in controls (P = 0.012). Conclusion: The results of our study add more evidence to the auditory and visual involvement and the presence of systemic associations in patients suffering from vitiligo.