bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of Physical and Chemical Activation of Coconut Shell Applied to Reduce Free Fatty Acids of Used Cooking Oil in Biodiesel Plant
Authors: Prasetya Fandi Angga , Areta Mikrimah Belva , Arjani Ervan , Prasetyo Johan , Kurniati Yuni
Published: January 2024

This research was conducted to compare the characteristics of activated carbon that synthesized via different methods, physical and chemical activation. It was applied to reduce Free Fatty Acids (FFA) in used cooking oil which will be used in the manufacture of biodiesel. Physical activation was carried out by heating dried coconut shell in a tube furnace at 900°C in N2 gas flowing, by varied the holding time; 2 hours, 3 hours, and 4 hours. Meanwhile, chemical activation was conducted using phosphoric acid solution with various concentrations: 9%, 10%, and 11%. The BET (Brunauer-Emmett-Teller) test was processed to determine the surface area of ​​the activated carbon. The FFA test was conducted to determine the FFA content in treated used cooking oil. The activated carbon with chemical activation has a surface area of ​​260.57 m2/gram, 323.55 m2/gram, and 162.21 m2/gram at concentrations of phosphoric acid 9%, 10%, and 11%, respectively. Meanwhile, for physical activation, the surface area were 278.58 m2/gram, 448.368 m2/gram, and 444.74 m2/gram with variations in heating holding time of 2 hours, 3 hours, and 4 hours, respectively. The lowest levels of FFA are found in cooking oil with a phosphoric acid concentration of 11%, which is 1.505%. The higher the concentration of chemical activator, the greater the adsorption power of an activated carbon. The lowest levels of fatty acids are found in cooking oil with a holding time of 4 hours, which is 1.805%. FFA (Free Faty Acid) test results show that the longer the heating holding time, the better the activated carbon will be.
Modeling the Influence of Intake Air N2 Content on Internal Combustion Exhaust Gases Output
Authors: Hossi Januario Da Costa , Nkazi Diakanua , van der Merwe Josias , Harding Kevin
Published: January 2024

The work presented here explores how air pollutants form and the prominent thermodynamic opportunities to reduce pollutants formation and emission during internal combustion process. The paper reviews the internal combustion engine operating cycles and discusses the relationship between the formation of pollutants and the engine’s energy management. Octane was used to model gasoline along with a petrol generator used to represent 4-stroke petrol engines. A set of thermodynamic equations were used to approximate the rate of heat transfer and the composition of exhaust gases at varying nitrogen-to-oxygen feed composition. Lowering the N2content in the feed air significantly decreases the overall exhaust content of NOxand CO and improves the engine’s power output. The model emphasizes the ability of retrofitting traditional internal combustion engines with a molecular air filter as a promising strategy for reducing the exhausts’ emissions whilst improving the energy performance of the internal combustion process.
The Effect of Power Rate Microwave Heating on Limestone Carbonated Hydroxyapatite Scaffold Using Gas Foaming Method
Authors: Widyastuti Dyah Aris , Yusuf Yusril
Published: January 2024

Microwave heating was used with a gas foaming method for fabricating limestone carbonated hydroxyapatite scaffold (SCHA). Carbonated hydroxyapatite (CHA) was produced from limestone as a calcium source using the co-precipitation method. For further treatment, 0.6 gr CHA powder was mixed in 1 ml H2O2 solution as a blowing agent. The slurry-foam-like CHA was heated in a microwave with different levels of heating power from 180 W to 720 W. The SCHA samples were characterized using X-ray diffraction (XRD), Fourier-transform infrared (FTIR), and Scanning electron microscope (SEM). The crystallinity and crystallite size were affected due to different rates of heating power in the microwave-assisted method. The increasing temperature decreased the crystallite size from 37.49 to 33.97(nm). However, other crystallinity trends were observed at 180 W because the lower power heating needed a longer time to be formed SCHA. The different power rates have an insignificant contribution to the morphology of the scaffolds.
The Acrylic Compensation Filter Design Enhances the X-Ray Image of the Ossa Manus in Posteroanterior Projection
Authors: Effendi Mukhtar , Maryanah Sri , Sholeh Agus , Fatchurohmah Wiwiek
Published: January 2024

This study aims to obtain a better contrast in the film image on X-ray examination of the ossa manus in posteroanterior projection with the addition of an acrylic compensating filter. An investigation was carried out using the phantom manus object on the Quantum CS-2 X-ray apparatus in the examination room 1 of the Margono Soekarjo Hospital (RSMS) by adding acrylic material on the outside of the collimator with a thickness ranging from 2 mm to 22 mm as a determinant of the thickness of the compensation filter. The radiographs were processed by a CR reader and imported into the Weasis software version 2.0.7 to analyze their pixel values. The results showed different compensatory filter thicknesses in the carpal and distal phalanges. An acrylic compensation filter with a thickness of 2.32 cm was considered optimal to compensate for the distal phalanges area and 0.08 cm for the carpal area in the phantom manus with an exposure factor of 55 kV and five mAs.
Application of Digital Lean Manufacturing System in Additive Manufacturing Industries: A Review
Authors: Alabi Micheal
Published: January 2024

Application of lean manufacturing (LM) principles within the manufacturing industry extends back several decades to drive efficiency and reduce waste across complex production lines. The advent of the Fourth Industrial Revolution, known as “Industry 4.0” technology is transforming the LM processes to promote the manufacturing industry. Additive Manufacturing (AM) has been identified as a technology with great potential to create a longstanding impact on the manufacturing world and is a core component of the Fourth Industrial Revolution. Many successful industries have achieved outstanding performance by integrating LM principles at the core of their corporate transformation. Of recent, AM and 3D printing has been identified as a technology that is revolutionizing LM principles in the following ways: easier prototyping, easily customize products, shorter lead times, local on-demand manufacturing, and lower cost production. Despite the exceptional success of LM principles across different industries and sectors, still many companies LM journeys fail due to many obvious reasons. The emergence of Industry 4.0 digital technologies has created an enabling environment for different manufacturing industries currently using LM principles to identify the need to embrace or add digital technologies to their lean manufacturing transformation journey. The intersections between LM and digital technologies are termed as “Digital Lean” or “Lean 4.0”. There are limited studies and literature gaps on lean manufacturing within the context of AM industry. More so, there is no study that examines the application of digital lean manufacturing in an AM industry. The paper presents a review of the concept of lean manufacturing principles and how it is revolutionizing the AM industry. This paper investigates the concept of digital lean manufacturing and its future potential impact in the AM industry. Finally, this paper develops a digital lean manufacturing system or tools considered suitable for the AM industry.
Tensile, Flexural and Hardness Properties of Guava Leaves (Psidil guajava) Extract Modified Coconut (Cocos nucifera) Shell Powder-Polymethyl Methacrylate Base Denture Composites
Authors: Obiekwe Chidimma Sonia , Okeke Kenneth Nkemdilim , Uzoechi Samuel Chidi , Azeez Oladimeji Taofik
Published: January 2024

Denture wearing requires loss of teeth through trauma or natural phenomena. The activation of polymerization of polymethyl methacrylate (PMMA) denture base material by methylmethaacrylate (MMA) caused cytotoxic effect and biofilm formation at undercut hindered the mechanical properties and durability of denture. In this study, the effect of guava leaf extract modified coconut shell powder on mechanical properties of hybrid CSP-PMMA denture base composites was investigated. The coconut shell powder (CSP) was obtained from its extracted fiber after dried, grinded and sieved using 80 μm. Guava leaf extract was obtained using ethanolic method. PMMA composites were prepared at variable weight fraction of PMMA+CSP: GLE+MMA using rule of mixture in ratio. The flexural strength, tensile strength, hardness, and toughness properties of the composites at different levels were determined using Universal testing machine of AMETEK EZ 250 model and a shore scale D durometer in accordance with ASTM D – 2240, respectively. The modification of CSP-PMMA by GLE improved the tensile strength, toughness, elongation and hardness by 18.23, 10.52, 68.14 and 1.35 %. Hence the use of GLE in PMMA denture base composites not only enhanced the mechanical behaviours but protect the PMMA denture against biofilm formation. Keywords: Mechanical properties; Guava leave extract, PMMA; Coconut shell fillers.
Renewable Energy Technologies: Opportunities and Challenges for South Africa
Authors: Imoisili Patrick Ehi , Jen Tien Chien
Published: January 2024

One of Africa's biggest problems, which has an impact on its social and economic growth, is its lack of access to electricity. Due to its reliance on coal, South Africa (SA) has been acknowledged as one of the nations in Sub-Saharan Africa that has had difficulty developing its energy infrastructure. South Africa is the biggest emitter of carbon dioxide (CO2) in Africa due to its dependence on coal. The nation has been forced to switch to cleaner energy technologies like solar energy, wind energy, biomass energy, and hydropower. However, as South Africa made the move from an energy based on fossil fuels to renewable energy technology (RET), it encountered both obstacles and opportunities. The review will examined the difficulties that South Africa faces, including governmental regulations, budgetary restrictions, technological issues, lack of awareness, and cultural issues. Furthermore, some of the enormous prospects for RET that exist in the nation, including solar, wind, and biomass, was also discussed.
Effect of Flame Remelting on the Microstructure, Wear and Corrosion Resistance of HVOF Sprayed NiCrBSi Coatings
Authors: Liu Cheng Wei , Qin En Wei , Chen Guo Xing , Wei Shao Chong , Zou Yang , Ye Lin , Wu Shu Hui
Published: January 2024

As a post treatment, thermal remelting is an effective method to eliminate pores and establish a metallurgical bonding for thermal sprayed coatings. However, it is rather difficult to obtain simultaneously high corrosion and wear resistance, since additional energy input usually leads to more homogeneous microstructure in coatings, which deteriorates mechanical hardness. In this work, flame remelting has been imposed to high velocity oxygen-fuel sprayed self-flux NiCrBSi coatings. The remelting effects on microstructure were characterized in terms of porosity and phase analysis. The microhardness, wear resistance and corrosive behaviors were compared among substrate steel, as-sprayed and as-remelted coatings. Results show that the lamellar boundaries and internal defects in the as-sprayed coatings have been eliminated by remelting. The coating porosity has substantially reduced from 7.36% to 0.75%, and a metallurgical bonding at the coating/substrate interface has been formed. Comparing with the as-sprayed coatings, the microhardness of the remelted coatings increases about 21% and the wear weight loss reduces about 42%. By flame remelting, the wear mechanism changes from furrow and abrasive wear to micro-cutting and local fracture. The remelted coatings have also exhibited better corrosion resistance by means of salt spraying and potentiodynamic tests.
Concurrent chemoradiotherapy for cardiac metastasis after oesophageal carcinoma resection
Authors: Hama Y. , Tate E.
Published: January 2024

Oesophageal cancer can rarely metastasize to the heart. We present a case report of a 48-year-old male patient who was diagnosed with cardiac oligometastasis six months after resection of the oesophageal cancer. The patient was treated with rotational intensity-modulated radiation therapy and concurrent chemotherapy, which was well-tolerated and resulted in complete tumor remission after three months of follow-up. Our findings suggest that this treatment approach may be effective for treating cardiac oligometastasis after oesophageal cancer surgery. Early detection and timely treatment may improve patient outcomes.
Pulmonary artery filling defects - Not all are pulmonary emboli
Authors: Wettasinghe M. C. , Perera S. , Wickramasinghe N. D.
Published: January 2024

Differentiating pulmonary artery sarcoma from pulmonary artery emboli is challenging since the clinical presentation and imaging features of both conditions are often similar. Timely differentiation of the two conditions is important as delayed diagnosis often results in the progression of pulmonary artery sarcoma leading to poor prognosis and unnecessary anticoagulant therapy. We describe a case of a middle-aged male, who was initially diagnosed with pulmonary embolism, but later diagnosed with a pulmonary artery sarcoma. The case report emphasizes the importance of early imaging findings, which may raise the suspicion prompting further assessment of alternative diagnoses such as pulmonary artery sarcoma.
Pancreatic adenocarcinoma in a Sri Lankan patient with neurofibromatosis 1
Authors: Nitharshan T. , Kumanan T. , Sirisena N. D. , Anandagoda G. , Dissanayake V. H. W. , Navaneethakrishnan S. , Sujanitha V. , Sutharhan V. , Mathangi N.
Published: January 2024

A 27-year-old Sri Lankan man with Neurofibromatosis-1 (NF-1) [MIM:162200] who presented with vague abdominal pain associated with loss of weight and appetite for 1-year duration is described. He had multiple cutaneous neurofibromas, café-au-lait macules and bilateral Lisch nodules. An abdominal contrast-enhanced computed tomography scan showed a mass lesion in the retro pancreatic region with mild enhancement. Diagnostic laparotomy showed multiple liver metastases. Liver biopsy showed an immune morphology which is compatible with deposits of ck17 and ck19 weakly positive adenocarcinoma which led to the probable diagnosis of a pancreatic carcinoma. Genetic testing identified a germline heterozygous pathogenic variant in exon 12 of the NF-1 gene [NM_001042492.3: c.1307C>A]. The substitution creates a nonsense variant at codon position 436, which changes a Serine to a premature stop codon in the NF-1 protein [NP_001035957.1: p.Ser436Ter]. Patients diagnosed with NF-1 may rarely develop malignancies including pancreaticneuroendocrine tumors and pancreatic adenocarcinomas.
Primary malignant melanoma oesophagus: A rare cause of dysphagia
Authors: Zacharia G. S. , Rajendran A. , Jacob A.
Published: January 2024

Primary malignant melanoma, though rare, is believed to be the most common non-epithelial neoplasm of the oesophagus. Compared to epithelial esophageal malignancies, melanoma is more aggressive and metastatic, resulting in poor therapeutic response and prognosis. Immunohistochemical staining is often diagnostic; conventional staining classically reveals epithelioid cells with pigment deposits. We report a case of primary esophageal melanoma in an elderly male who presented with dysphagia, treated palliatively with esophageal stenting.
Comparison of Weekly Training Load and Acute: Chronic Workload Ratio Methods to Estimate Change in Training Load in Running
Authors: Cloosterman Kyra L. A. , Vos Robert-Jan de , van Oeveren Ben , Visser Edwin , Bierma-Zeinstra Sita M. A. , van Middelkoop Marienke
Published: January 2024

Context

Before examining the impact of training load on injury risk in runners, it is important to gain insight into the differences between methods that are used to measure change in training load.

Objective

To investigate differences between 4 methods when calculating change in training load: (1) weekly training load; (2) acute : chronic workload ratio (ACWR), coupled rolling average (RA); (3) ACWR, uncoupled RA; (4) ACWR, exponentially weighted moving average (EWMA).

Design

Descriptive epidemiology study.

Setting

This study is part of a randomized controlled trial on running injury prevention among recreational runners. Runners received a baseline questionnaire and a request to share global positioning system training data.

Patients or Other Participants

Runners who registered for running events (distances 10–42.195 km) in the Netherlands.

Main Outcome Measure(s)

The primary outcome measure was the predefined significant increase in training load (weekly training loads ≥ 30% progression and ACWRs ≥ 1.5), based on training distance. Proportional Venn diagrams visualized the differences between the methods.

Results

A total of 430 participants (73.3% men; mean age = 44.3 ± 12.2 years) shared their global positioning system training data for a total of 22 839 training sessions. For the weekly training load, coupled RA, uncoupled RA, and EWMA method, respectively, 33.4% (95% CI = 32.8, 34.0), 16.2% (95% CI = 15.7, 16.6), 25.8% (95% CI = 25.3, 26.4), and 18.9% (95% CI = 18.4, 19.4) of the training sessions were classified as significant increases in training load. Of the training sessions with significant increases in training load, 43.0% from the weekly training load method were different than the coupled RA and EWMA methods. Training sessions with significant increases in training load based on the coupled RA method showed 100% overlap with the uncoupled RA and EWMA methods.

Conclusions

The difference in the change in training load measured by weekly training load and ACWR methods was high. To validate an appropriate measure of change in training load in runners, future research on the association between training loads and running-related injury risk is needed.
Early Gait Biomechanics Linked to Daily Steps After Anterior Cruciate Ligament Reconstruction
Authors: Büttner Christin , Lisee Caroline , Buck Ashley , Bjornsen Elizabeth , Thoma Louise , Spang Jeffrey , Blackburn Troy , Pietrosimone Brian
Published: January 2024

Context

Gait biomechanics and daily steps are important aspects of knee-joint loading that change after anterior cruciate ligament reconstruction (ACLR). Understanding their relationship during the first 6 months post-ACLR could help clinicians develop comprehensive rehabilitation interventions that promote optimal joint loading after injury, thereby improving long-term knee-joint health.

Objectives

To compare biomechanical gait waveforms throughout stance at early time points post-ACLR in individuals with different daily step behaviors at 6 months post-ACLR and to examine how these gait waveforms compare with those of uninjured controls.

Design

Case-control study.

Setting

Laboratory.

Patients or Other Participants

A total of 32 individuals with primary ACLR assigned to the low-step group (LSG; n = 13) or the high-step group (HSG; n = 19) based on their average daily steps at 6 months post-ACLR and 32 uninjured matched controls.

Main Outcome Measure(s)

Gait biomechanics were collected at 2, 4, and 6 months post-ACLR for the ACLR groups and at a single session for the control group. Knee-adduction moment, knee-extension moment (KEM), and knee-flexion angle (KFA) waveforms were calculated during gait stance and then compared via functional waveform analyses. Mean differences and corresponding 95% CIs between groups were reported.

Results

Primary results demonstrated less KFA (1%–45% versus 79%–92% of stance) and greater KEM (65%–93% of stance) at 2 months and greater knee-adduction moment (14%–20% versus 68%–92% of stance) at 4 months post-ACLR for the HSG compared with the LSG. Knee-adduction moment, KEM, and KFA waveforms differed across various proportions of stance at all time points between the step and control groups.

Conclusions

Differences in gait biomechanics were present at 2 and 4 months post-ACLR between step groups, with the LSG demonstrating an overall more flexed knee and more profound stepwise underloading throughout stance than the HSG. The results indicate a relation between early gait biomechanics and later daily step behaviors post-ACLR.
Restorative Physical Function and Patient-Reported Outcomes After Acute Lateral Ankle Sprain in High School Athletes
Authors: Schnittjer Amber J. , Biello Nick , Craner Christina , Simon Janet E.
Published: January 2024

Context

Limited longitudinal data exist on patient-reported outcomes (PROs) after acute lateral ankle sprain (LAS). The impact of prospective hop testing on PROs at return to play (RTP) and 6 months post-RTP is unclear.

Objective

To determine if high school athletes with an LAS who return to baseline physical function as measured by a single-leg hop for distance (SLHOP) have better PROs relative to individuals who return to symmetry.

Design

Cohort study.

Setting

Ten high schools over 2 years.

Patients or Other Participants

Two hundred six high school athletes who sustained an LAS were included. Baseline SLHOP testing was completed preinjury. Patient-reported outcomes were recorded at time of injury, RTP, and 6 months post-RTP. Participants were classified as symmetry (n = 134) or restorative (n = 72). Symmetry was defined as achieving an SLHOP performance within 10% of the uninjured limb at RTP. Restorative was defined as achieving an SLHOP performance within 10% of preinjury levels.

Main Outcome Measure(s)

The Foot and Ankle Ability Measure (FAAM)–Activities of Daily Living, FAAM-Sport, Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety, and PROMIS Depression were analyzed using a 2-way nonparametric analysis of variance. The interaction term of group by time was the main comparison of interest and was interpreted if significant. Post hoc multiple comparisons were performed using the Tukey-Kramer test.

Results

The restorative group reported better FAAM scores at RTP and 6 months post-RTP (P < .05) relative to the symmetry group. There were no differences in PROMIS Anxiety scores at time of injury, RTP, or 6 months post-RTP between groups (P > .05). There were no differences in PROMIS Depression scores at time of injury between groups (P = .34), but the restorative group had worse PROMIS Depression scores at RTP (P = .03).

Conclusions

The restorative group reported better FAAM-ADL and FAAM-Sport scores at RTP and 6 months post-RTP relative to the symmetry group. Restoring individuals to baseline physical function rather than limb symmetry may ensure better PROs after an LAS.
Healthcare coaching program for youth with type 1 diabetes in South Korea: a pilot study
Authors: Lee Dae Eun , Lee Haejung , Cheon Chong Kun , Yoon Ju Young
Published: January 2024

Purpose: This pilot study aimed to assess the feasibility, preliminary efficacy, and effects of a mobile app healthcare coaching program developed based on self-regulation theory among youths with type 1 diabetes.Methods: A mixed-method design was utilized. Participants were randomly assigned into intervention (n=23, 12-week coaching program) or control groups (n=16, usual care). Pre- and post-intervention assessments included self-efficacy, diabetes management behavior, and health outcomes (quality of life, depression, and HbA1c). Quantitative data were analyzed with SPSS/WIN ver. 26.0. The narrative information from the participants in the healthcare coaching program underwent content analyzed.Results: The intervention group had significantly lower depression scores (t=2.57, p=.014) than the control group. No significant differences were observed in self-efficacy, diabetes management behavior, and health outcomes between the two groups. The average frequency of health behavior monitoring per week among the participants was 1.86±1.60. The qualitative findings indicated that participants perceived improved diabetes self-management with the intervention; however, challenges during vacations, dietary control difficulties, and a lack of disease awareness were identified.Conclusion: The healthcare coaching program improved psychological aspects for youth with type 1 diabetes. Further research is needed to develop and implement mobile app interventions aimed at enhancing compliance with diabetes management in pediatric and adolescent populations.
Ovarian Yolk Sac Tumors: Is Fertility Preservation Possible?
Authors: Behnamfar Fariba , Nazemi Maryam , Mohamadi Behnoosh
Published: January 2024

Yolk sac tumors make up 14% to 20% of all malignant ovarian germ cell tumors. Serum alpha-fetoprotein (AFP) levels are elevated in a significant number of patients and are useful for monitoring the response to treatment and for post-treatment surveillance. Surgery is required for diagnosis, staging, and treatment. The first case is a 12-year-old girl presented with abdominal pain. The ultrasonography (US) showed a huge pelvic tumor. AFP level was high (1000 mg/ml). Right salpingo-oophorectomy and pelvic lymphadenectomy were done. Histopathology reported yolk sac tumor of ovary. She received 3 courses of bleomycin, etoposide, cisplatin (BEP). The second case is a 25-year-old G1AB1 presented with pelvic pain and distension. The US showed a huge pelvic tumor in the right abdominopelvic region. AFP level was high (1000 mg/ml). Right salpingo-oophorectomy, omentectomy, and appendectomy were done. Histopathology reported yolk sac tumor of ovary. The patient received four cycles of BEP protocol; AFP level decreased to 10 mg/ml after the four cycles of chemotherapy. The third case is a 21-year-old girl presented with abdominal pain. The US showed a huge pelvic tumor in the right adnexa. AFP level was high (8700 mg/ml). Right salpingo-oophorectomy and pelvic lymphadenectomy were done. Yolk sac tumor is rare in children and it could be cured usually. In this study, we described three patients with ovarian yolk sac tumors and their fertility preservation treatments.These cases has reminded that in young age with high AFP levels and rapidly growing ovarian mass, diagnosis of the yolk sac tumor has to be kept in mind.
The Effect of Rivaroxaban in the Complementary Therapy of Sudden Sensorineural Hearing Loss
Authors: Rogha Mehrdad , Moshtaghi Ehsan
Published: January 2024

Background:

Due to the importance of sudden sensorineural hearing loss (SSNHL) and the possible role of blood coagulation in its mechanism and the likely therapeutic effect of anticoagulants and also the lack of studies in this field, this study aimed to evaluate the effect of rivaroxaban (RXA) in the treatment of this disease.

Materials and Methods:

The present double-blind randomized clinical trial study was performed on 34 patients with SSNHL. Patients were randomly divided into two groups. In the first group, in addition to corticosteroid therapy (CST), RXA 10 mg tablets were used daily for 10 days (RXA group), and in the second group, only CST (CST group) treatment was prescribed. Hearing recovery was then assessed and recorded according to the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) criteria.

Results:

This study showed that the grade of hearing recovery in the RXA group (58.8%) was higher than the CST group (47.1%), but this difference was not significant (P value >0.05). Also, RXA treatment increased the odds of hearing recovery, and this difference was not statistically significant (odd ratio (95% confidence interval)(OR (95% CI): 2.327 (0.180–18.082); P value = 0.518). In contrast, delay to treatment, more increased PTA (pure tone average (PTA)), and having vertigo reduced the odds of hearing recovery by 0.138-, 0.019-, and 0.069-fold, respectively (P value <0.05).

Conclusion:

According to the results of this study, although the percentage of hearing recovery was higher in the RXA group, in general, the results of the two treatments were not significantly different.
CTNS Mutations Causing Autosomal Recessive Cystinosis in a Subset of Iranian Population: Report of Two New Variants
Authors: Mohammadi Chermahini Zahra , Salehi Mansoor , Gheissari Alaleh , Ahmadi Beni Faeze , Khosravian Farinaz , Kazemi Mohammad
Published: January 2024

Background:

Nephropathic cystinosis (NC) is an uncommon autosomal recessive disease with abnormality in lysosomal storage that appearances in patients with mutations in the CTNS gene encoding a lysosomal transporter cystinosin. Disrupted function of this transporter is followed by accumulation of cysteine crystals in cells of many various organs. This study aimed to investigate the mutations of the CTNS gene in 20 Iranian patients suffering from NC.

Materials and Methods:

Twenty Iranian cystinosis patients referring to Imam Hossein Hospital of Isfahan were employed in this case-series study. After extraction of genomic DNA, the promoter and entire coding regions of CTNS were analysed using sanger sequencing in all patients. Gap–Polymerase Chain Reaction was used to detect 57 kb deletion in the CTNS gene. In silico study was performed to analyse variants.

Results:

The large deletion was not seen in any NC patients. Molecular analysis which conducted to screen the CTNS gene of patients, identified eight different mutations, including two new mutations, c.971_972insC and c.956_956delA, which have not been reported before, and c.681G>A mutation, which was identified as a frequently founded mutation in the Middle East and was observed in 35% of patients. In this study, five other mutations including c.1015G>A, c.922G>A, c.323_323delA, c.433C>T, and c.18_21delGACT were also observed, which have been reported in previous studies.

Conclusion:

The mutational spectrum in the Iranian patients is the same as previously reported mutations except that two new mutations were found. The present findings will present suggestions for regular molecular diagnosis of cystinosis in Iran.
The effectiveness of neurodynamic techniques in patients with diabetic peripheral neuropathy: Study protocol for a randomized sham-controlled trial
Authors: Ashoori Mahdi , Pourahmadi Mohammadreza , Hashemi Seyed Ebrahim , Dadgoo Mehdi , Hosseini Mahboobeh Sadat
Published: January 2024

Background:

Diabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes mellitus (DM). DPN is the primary risk factor for diabetic foot ulcers that can cause amputation. Although several observational studies have investigated the morphological and biomechanical characteristics of peripheral nerves in DPN, interventional studies regarding the effectiveness of neurodynamic techniques (NDT) in DPN patients are confined to a handful. The effects of NDT on neuropathy severity, nerve conduction parameters, quality of life (QoL), and mechanosensitivity have not been explored yet in this population.

Materials and Methods:

Forty type 2 DPN (T2DPN) patients, diagnosed based on an electrodiagnosis study, will be recruited into two groups. The experimental group will receive the tibial nerve’s real proximal and distal slider techniques in addition to DPN standard treatment as a basic treatment, and the control group will receive the tibial nerve’s sham proximal and distal slider techniques along with the basic treatment for eight sessions twice a week. Baseline and post-intervention assessments will be based on the Michigan diabetic neuropathy score (MDNS) (primary outcome), tibial nerve conduction parameters, neuropathy-specific quality of life (Neuro QoL) questionnaire, and straight leg raising range of motion (SLR ROM) (secondary outcomes).

Results:

This study is expected to last approximately seven months, depending on recruitment. The results of the study will be published in a peer-reviewed journal.

Conclusions:

The present study will evaluate the efficacy of NDT on the primary and secondary outcome measurements in DPN patients.
Co-Occurrence Analysis of COVID-19 Publications with an Emphasis on the Global Health Governance (GHG)
Authors: Allahbakhshian Farsani Leili , Riahinia Nosrat , Danesh Farshid , Azimi Ali
Published: January 2024

Background:

Analyzing co-occurrence is an effective way to monitor the overview of topic spreading. The present study aimed to conduct a co-occurrence analysis of scientific publications related to COVID-19, emphasizing Global Health Governance (GHG).

Materials and Methods:

This applied research with an analytical approach was carried out on all the scientific publications related to COVID-19, emphasizing GHG (51056 records), extracted from PubMed Central on 26/01/2022. The research population consisted of all the scientific publications related to COVID-19, emphasizing GHG (51056 records), extracted from PubMed Central on 26/01/2022. The data were analyzed using BibExcel, UCINET, Excel, and SPSS software, and Spearman’s test was used to confirm correlations.

Results:

The co-word network of the thematic area of COVID-19 includes 226 nodes and 7292 edges. COVID-19 and the pandemic formed the most co-word pairs with 2224 connections. The COVID-19* mental health and COVID-19* anxiety, with 1019 and 925 connections, are ranked next, respectively. The term COVID-19 is ranked first with a centrality index of 225. The keywords of pandemic and public health are ranked second and third with the centrality index of 217 and 206, respectively.

Conclusion:

The global approach of studies related to COVID-19 is more inclined to the epidemiological and public health fields. Assuming the GHG, detailed and comprehensive planning should be performed to strengthen these studies and pave the way for international cooperation, determining research requisites, and developing applied research studies.
Relationship between dietary niacin intake and erectile dysfunction: a population-based study
Authors: Lin Wei-Long , Zheng Cheng , Wang Hao-Xu , Zhang Wei , Lin Ming-En
Published: January 2024

Existing research on the precise link between dietary niacin intake and erectile dysfunction (ED) is scarce. Thus, this study aimed to investigate the potential association between dietary niacin intake and the risk of ED. Multivariate logistic regression and restricted cubic splines (RCSs) were used to examine the relationship between dietary niacin intake and ED. Subgroup interaction analysis was performed to assess the impact of different subgroups on the study outcomes. In addition, 1:1 propensity score matching (PSM) was employed to adjust for potential confounding factors, ensuring the reliability of the results. The analyzed data were collected from the 2001–2004 National Health and Nutrition Examination Survey (NHANES) in the USA. The study encompassed 3184 adults, among whom 863 participants were identified as having ED. Following adjustments for potential confounders, the findings revealed that higher niacin intake, specifically in the highest tertile, was associated with a decreased risk of ED compared to that in the lowest tertile, showing an odds ratio (OR) of 0.56 (95% confidence interval [CI]: 0.37–0.85). Analysis of dose–response curves illustrated a negative correlation between dietary niacin intake and the risk of ED. Subgroup and interaction analyses fortified the consistency of these results. Furthermore, PSM corroborated the validity of the findings. This study suggests an inverse association between dietary niacin intake and the risk of ED. However, establishing a cause-and-effect relationship remains elusive, and defining the safe threshold of niacin intake to prevent ED requires further investigation.
Does routine partial lateral sphincterotomy with open hemorrhoidectomy improve postoperative pain?
Authors: Abdraboh Osama H. , Saber Sherif A. , Mousa Gamal , Eissa Mahmoud A.
Published: January 2024

Objective

In this study we aimed to detect the difference regarding the postoperative pain and continence in patients with third and fourth degree hemorrhoidal disease who underwent either hemorrhoidectomy alone or combined hemorrhoidectomy with partial internal sphincterotomy for the treatment of hemorrhoidal disease.

Patients and methods

This prospective comparative randomized clinical trial was conducted at hospitals of Tanta University during the period from March 2021 to August 2022 on 100 patients with third or fourth degree hemorrhoids who were randomly assigned either to group A, patients who only underwent hemorrhoidal excision by the classical technique of Milligan–Morgan or group B, with added partial lateral sphincterotomy to the classic technique. All patients in both groups underwent anorectal manometry both preoperatively and postoperatively. Pain following surgery was analyzed by using visual analog scale system at 24 h, 48 h, and on 10th postoperative day, other complications including incontinence, infection, hematoma, bleeding, and anal stricture were evaluated at 24 h, 48 h, 10th postoperative day, 1 month, and after 3 months.

Results

Total 100 patients were divided among both groups. The mean age of the patients was 37.7±11.3 and 36.3±11.3 years in group A and group B, respectively. Thirty-two males and 18 females were in group A in comparison to 33 males and 17 females in group B. During follow-up periods, patients in group B had less postoperative pain than those in group A with statistically significant difference. None of the patients developed fecal incontinence for solid or liquid stools in both groups, except for nine patients developed only mild degree of incontinence for flatus in the first week that improved gradually till completely resolved before the end of the 3 months follow up.

Conclusion

The addition of partial internal sphincterotomy to the classical haemorrhoidectomy technique significantly improves postoperative pain without increasing overall related morbidity.
Arterial Hypertension, Heart Failure, Angina Pectoris, Myocardial Infarction, and Atrial Fibrillation after COVID-19: A Narrative Review
Authors: Brito Joana , Caldeira Daniel , Gregório Catarina , Plácido Rui , Pinto Fausto J.
Published: January 2024

COVID-19 infection is associated with significant complications affecting multiple organs other than the respiratory system. In fact, there seems to be a bidirectional relation between cardiovascular disease and viral infection, as patients with prior cardiac comorbidities are at a higher risk of adverse events during infection, and COVID-19 infection seems to exponentiate the risk of acute and long-term cardiac events. In this review, the authors will discuss the acute and long-term impact of COVID-19 infection in arterial hypertension, heart failure, angina pectoris, myocardial infarction, and atrial fibrillation.
A Scoping Review of Possible Solutions for Decreasing Socioeconomic Inequalities in Type 2 Diabetes Mellitus
Authors: Gharacheh Laleh , Amini-Rarani Mostafa , Torabipour Amin , Karimi Saeed
Published: January 2024

Background:

As socioeconomic inequalities are key factors in access and utilization of type 2 diabetes (T2D) services, the purpose of this scoping review was to identify solutions for decreasing socioeconomic inequalities in T2D.

Methods:

A scoping review of scientific articles from 2000 and later was conducted using PubMed, Web of Science (WOS), Scopus, Embase, and ProQuest databases. Using the Arksey and O’Malley framework for scoping review, articles were extracted, meticulously read, and thematically analyzed.

Results:

A total of 7204 articles were identified from the reviewed databases. After removing duplicate and nonrelevant articles, 117 articles were finally included and analyzed. A number of solutions and passways were extracted from the final articles. Solutions for decreasing socioeconomic inequalities in T2D were categorized into 12 main solutions and 63 passways.

Conclusions:

Applying identified solutions in diabetes policies and interventions would be recommended for decreasing socioeconomic inequalities in T2D. Also, the passways could be addressed as entry points to help better implementation of diabetic policies.
The Effects of Curcumin Administration on Carotid Intima-Media Thickness and Pulse Wave Velocity in Diabetic Hemodialysis Patients: A Randomized, Double-Blinded, Placebo-Controlled Trial
Authors: Ghasemiadl Mojtaba , Ghasemi Soheil , Soleimani Alireza , Esfahani Mahsa M. , Azadbakht Javid , Gilasi Hamid R. , Talari Hamid R.
Published: January 2024

Background:

Prior studies have reported that curcumin is inversely associated with reduced markers of atherosclerosis risk, including carotid intima-media thickness (CIMT). This study was designed to assess the effects of curcumin on CIMT and pulse wave velocity (PWV) in diabetic hemodialysis (HD) patients.

Methods:

This randomized, double-blinded, placebo-controlled trial was conducted on 39 diabetic HD patients. People were assigned to receive curcumin or placebo (starch) for 24 weeks. Individuals in the curcumin group (n = 26) received 80 mg/day. CIMT and PWV levels were taken at baseline and after 24 weeks of intervention.

Results:

After 24 weeks of intervention, curcumin intake did not affect mean levels of left (P = 0.83) and right (P = 0.47) CIMT and maximum levels of left (P = 0.84) and right (P = 0.11) CIMT, and PWV (P = 0.12) compared to the placebo. Furthermore, within-group difference demonstrated a significant reduction in mean levels of PWV (P = 0.01) in the curcumin group. We did not observe any significant change in C-reactive protein (CRP) concentrations after curcumin intake (P = 0.69).

Conclusions:

Curcumin intake did not affect mean levels of left and right CIMT and maximum levels of left and right CIMT, PWV, and CRP levels compared to the placebo. Additionally, within-group difference demonstrated a significant reduction in mean levels of PWV in the curcumin group.

This trial was registered at www.irct.ir as http://www.irct.ir: IRCT20200527047584N1.
Saphenous vein graft aneurysm – Unusual cause of hemoptysis
Authors: Khan BJ , Khanolkar U , Raj V , Ashok KG
Published: January 2024

Hemoptysis due to saphenous venous graft (SVG) aneurysm is an extremely rare condition and published literature has described the role of conservative management, surgical resection, and covered stent. Here, we report a successful placement of a covered stent for SVG aneurysm in a 56-year-old male who presented with hemoptysis. He was a known diabetic and had undergone a coronary artery bypass grafting 5 years ago. Computed tomography (CT) chest and fiberoptic bronchoscopy performed in another local hospital had revealed blood in the left lingula with spillover into the left lung parenchyma. Hence, he had received empirical anti-tuberculosis medication for 2 months without any improvement. He was referred to our hospital for further management of hemoptysis. Multidetector CT (MDCT) angiography of the chest covering coronaries performed at our hospital revealed SVG aneurysm that was managed with covered stent placement.
Impact of oxygen therapy algorithm on oxygen usage in the emergency department
Authors: Abhilash KPP , Acharya H , Dua J , Kumar S , Selvaraj B , Priya G
Published: January 2024

Background:

Although oxygen is one of the oldest drugs available, it is still one of the most inappropriately administered drugs leading to over utilization of this very expensive resource.

Materials and Methods:

This prospective observational study was done in a large emergency department (ED) in India. The pattern of oxygen usage was studied before and after the strict implementation of an oxygen treatment algorithm. The algorithm was taught to all doctors and nurses and its implementation was monitored regularly. The main outcome measures were proportion of patients receiving oxygen therapy, inappropriate usage, and avoidable direct medical cost to the patient.

Results:

The 3-week pre-protocol observation phase in April 2016 included 3769 patients and the 3-week post-protocol observation phase in April 2017 included 4608 patients. The baseline demographic pattern was similar in both the pre-protocol and post-protocol groups. After the strict implementation of the algorithm, the number of patients receiving oxygen therapy decreased from 9.63% to 4.82%, a relative decrease of 51.4%. The average amount of total oxygen used decreased from 55.4 liters per person in pre-protocol group to 42.1 liters per person in the post-protocol group with a mean difference of 13.28 (95% CI 5.30-21.26; P = 0.001). Inappropriate oxygen usage decreased from 37.2% to 8.6%. There was a significant decrease in inappropriate oxygen use for indications like low sensorium (60.8% vs 21.7%) and trauma (88.5% vs 15.8%). The mortality rate in the pre-protocol phase was 2.7% as compared with 3.2% in the post-protocol phase. The total duration of inappropriate oxygen usage significantly decreased from 987 h to 89 h over the 21-day study period.

Conclusion:

The implementation of an oxygen therapy algorithm significantly reduces inappropriate oxygen use and decreases treatment cost to the patient with no additional mortality risk.
Plus-minus lid syndrome with ataxia and severe apathy—A rare manifestation of midbrain infarct
Authors: Sheetal S , Thomas R , Kumar AS , Tomy LG
Published: January 2024

Plus-minus lid syndrome is a rare manifestation of midbrain infarct, characterized by ptosis of one eye and lid retraction in the other eye. It has also been described in ocular myasthenia gravis, orbital myositis, or after lesions of the oculomotor nerve. Our patient was a 55-year-old man with hypertension and atrial fibrillation, who presented to us with acute onset left-sided ptosis and right-sided eyelid retraction. He was apathic and had right-sided ataxia. His MRI of the brain showed acute infarct involving the paramedian midbrain. To our knowledge, severe apathy and resultant executive function disorder have not been described previously in a patient having plus-minus lid syndrome with ataxia.
Head-to-Head Comparison of Tazarotene and Calcitriol with or without Sequential Therapy in Mild-to-Moderate Psoriasis: A Randomized Open-label Study
Authors: Sidhu Jaspreet Kaur , Matreja Prithpal Singh , Gupta Ashwani Kumar , Singh Amandeep , Singh Surjit
Published: January 2024

Objective:

Psoriasis is an autoimmune disease that causes rapid turnover of skin cells. It is a chronic disease that affects a patient’s quality of life significantly and frequently requires long-term treatment. The study on sequential therapy with tazarotene 0.1% and calcitriol 0.0003% has not been tried so far; hence, we designed this study to compare the safety and efficacy of sequential therapy with tazarotene 0.1% cream and calcitriol 0.0003% ointment versus monotherapy in mild-to-moderate stable plaque psoriasis (SPP). The objective of this study was to compare the safety and efficacy of topical sequential treatment with tazarotene followed by calcitriol, topical calcitriol followed by tazarotene, tazarotene monotherapy, calcitriol monotherapy, and compare the safety and efficacy of the sequential therapies with monotherapies.

Methods:

The study was a single center, prospective parallel-group, active control, randomized study of 16 weeks duration (treatment for 8 weeks and follow-up for 16 weeks), randomized to either of the four groups, i.e., tazarotene 0.1% for 4 weeks followed by calcitriol 0.0003% for 4 weeks or calcitriol 0.0003% for 4 weeks followed by tazarotene 0.1% for 4 weeks or tazarotene 0.1% for 8 weeks or calcitriol 0.0003% for 8 weeks. Both tazarotene and calcitriol were applied once daily in all the groups.

Findings:

There was no significant difference with regard to age and duration of illness among the four treatment groups. Statistically significant improvement was observed in erythema, scaling, and induration scores, and Physician`s global assessment scale at 8 weeks and 16 weeks as compared to baseline in tazarotene – calcitriol, calcitriol – tazarotene, and calcitriol versus tazarotene groups.

Conclusion:

This study concluded that topical treatment with tazarotene 0.1% and calcitriol 0.003% was efficacious in treating mild-to-moderate SPP as both sequential and monotherapy. However, topical treatment with tazarotene as monotherapy was the least efficacious.