bluuebunny/crossref_metadata_2025 huggingface dataset:
Alzheimer's Disease Pathophysiology and Novel Treatment: An Update
Authors: Mo Ashley
Published: April 2024

Alzheimer’s disease, a progressive and irreversible brain disorder predominantly affecting the elderly, is influenced by age, smoking, and head trauma. It disrupts memory, cognition, motor skills, speech, and more. Alzheimer’s disease pathophysiology is caused by two main processes: the formation of misfolded amyloid-beta plaques and misfolded tau tangles. While tau is a naturally occurring, microtubule-associated protein, amyloid-beta peptides are cleaved fragments of the transmembrane amyloid precursor protein. Accumulation of these plaques and tangles result in various negative mechanisms. Regarding the relationship between the two proteins, evidence suggests that amyloid beta induces the conversion of tau from a normal to toxic state, but they ultimately work together to contribute to Alzheimer’s disease pathogenesis. As of currently, there is still no cure for the disease, and patients rely on treatment methods that solely alleviate symptoms or benefit early stages to halt the disease’s progression. The main medications for Alzheimer’s disease are cholinesterase inhibitors such as Donepezil and Galantamine, but novel pharmacological and non-pharmacological treatments are being utilized as well, such as β-secretase inhibitors and deep brain stimulation respectively. This review investigates peer-reviewed publications on pathophysiology and treatment of Alzheimer’s disease, with a focus on novel approaches for treatment and intervention.
Subject, Relationship, Temporality: The Social Dimension of Future School Spaces — A Case Study of the “New School Initiative”
Authors: Yu Honglei
Published: April 2024

Facing the update and development of future school space under the background of education reform, combined with the cases of 10 primary and secondary schools in the “New Campus Action Plan” in Shenzhen, China, the connotation and characteristics of the social attributes of primary and secondary school spaces are analyzed, and innovative methods in campus space creation are discussed, thinking about the social attributes of future campus space from the three dimensions of “subject, relationship, and timing”. The design strategies are proposed for the intensive practices of spatial ontology, the adaptive expression of spatial carriers, the fuzzy creation of spatial interface, exploring the shared nature of spatial boundaries, and the diachrony and synchronicity of space.
The Effect of Different Point Systems on European League Positions
Authors: Efthimiou Costas J. , Griffiths Barry J. , Wright David C.
Published: April 2024

The introduction of three points for a win in European football during the 1980s and 90s was intended to promote a more attacking style of play and thus more goal scoring and entertainment for viewers. However, subsequent studies showed that the change did not have the desired effect and led to unexpected outcomes such as a rise in foul play, as measured by the number of red cards. In this paper, we investigate the outcome of assigning points in alternate ways. We consider several modifications of both the current system (with 3 points awarded for a win and 1 point for a draw) and the original system (with 2 points awarded for a win and 1 point for a draw), including the effect of awarding bonus points for large margin victories and a deduction of points for large margin defeats. Combinations of these modifications led to 175 different systems being analyzed. Based on data from the top five European leagues, we conclude that solely modifying the point system does not have a significant impact on the standings, with the average change in the ordinal rankings ranging from 0.44 to 0.95 placings per season, and that the final ranking of the teams at the end of the season is largely independent of the point system and based on the relative playing strength of the teams. However, a much greater variation is seen once bonus and penalty points are added for large margin victories and defeats.
A Study on the Pathway of Chinese Culture Transmission by Digital Media Empowerment—Based on Hall’s Media Culture Theory
Authors: Lian Yijun
Published: April 2024

American scholar Negroponte points out in “Digital Survival” that digital technology’s impact on our lives, work, education, and entertainment and its worth thinking about are the best guides to a new digital world. Nowadays, digital technology has accelerated the evolution and development of human society, and digitization is quietly integrating into all fields of production and life. Through combing the historical origin of Chinese culture and analyzing the practical difficulties faced by Chinese culture in digital age, exploring an effective way to enable Chinese culture to spread.
The Influence of UK Education on Chinese Primary English Teaching through a Cultural Education Perspective
Authors: Hu H. , Shen Z.
Published: April 2024

As the present-day lingua franca, English is increasingly becoming more critical. Schools worldwide have adopted measures to teach non-native students English as part of their national curriculum to provide students with a broader range of opportunities in the global market. This paper investigates the current emergent problems in the Chinese teaching methodology and analyzes the UK teaching methods to seek possible Western solutions. This paper mainly focuses on the English classes taught at primary schools in the UK and China to explore this cross-cultural communication difference. The study will first raise awareness of these problems affecting students, which include a lack of motivation, poor language knowledge, and a poor language environment. Having established the main concerns and better understanding of the broader teaching spectrum, the study will make possible modifications to the traditional Chinese teaching of second language learners.
The Neuroscience of Music Processing and Music Interventions for Mental Illness
Authors: Liao Nicole
Published: April 2024

Growing research on music and language processing in recent years has simultaneously enabled us to understand its uses and promise in therapeutic settings. This review used recently published peer-reviewed literature to study the neurobiology of music processing, which includes the auditory processing hierarchy and engagement with language processes. Results showed that music has an impact on emotion systems, particularly the reward pathway and the Hypothalamic-Pituitary-Adrenal (HPA) axis. Furthermore, listening to music or music therapy for the treatment of psychiatric and neurological diseases demonstrated effectiveness in improving patient outcomes. Overall, music processing is a sophisticated process with some similarities to language processing. Future randomized controlled trials are required to shed light on the neurocognitive aspect of music processing.
Paediatric fractures at the district teaching hospital of Oueme-Plateau in Benin republic: epidemiology and therapeutic modalities
Authors: Amossou Francois Labissi , Chigblo Pascal , Goukodaja Oswald , Djoi Pascal , Padonou Adebola , Martin Djagbe S. , Hans-Moevi-Akue Aristote
Published: April 2024

Background: Fractures are a common occurrence in pediatric traumatology, accounting for 10 to 25% of all fractures. This study aims was to describe their epidemiological characteristics and specify the therapeutic modalities available at DTH-OP.
Methods: This was a retrospective, descriptive, and analytical monocentric study conducted in the surgery and emergency departments of DTH-OP. Medical records of patients aged 0 to 15 years admitted for fractures and seen between 1 January 2021 and 31 December 2022 were identified.
Results: Two hundred and thirty (230) cases met the inclusion criteria for 266 fractures. The mean age was 7.6. There were 137 (59.6%) males and 93 (40.4%) females, giving a sex ratio of 1.5. The circumstances of occurrence were road accident and home accident in the same proportions (97 cases; 42.2%). Sport accident and work accident occurred in the same proportions (12 cases; 5.2%). The series included 134 fractures (50.4%) of the pelvic limbs and 96 fractures of the thoracic limbs (36.1%). One hundred and seventy-six (176) patients (76.5%) had received orthopaedic treatment. Treatment modalities included cast 149 cases (84.7%).
Conclusions: Fractures in children are common, especially in older children and adolescents. Males were more affected than females. Etiological circumstances are dominated by road and domestic accidents. The treatment is essentially orthopaedic. The surgical treatment is based on thin pins and Metaizeau pins.
Retrospective analysis of the adverse events during intra-operative and post-operative period in patients who received anesthesia at a tertiary care center in India
Authors: Shah Kshama , Tiwaskar Shilpa , Rao Namrata , Kulkarni Vivek , Ranade Rahul , Gore Shivanjali
Published: April 2024

Background: Anesthesia is a critical component of modern surgical procedures ensuring patient comfort and safety during surgery. With the increase in life expectancy, more and more geriatric population with various systemic comorbidities have been coming for surgeries.
Along with the newer advances in surgical fields, there is increasing demand on the anesthetists to handle complicated cases with innovative solutions. Despite all efforts by a skillful anesthetist, adverse events are bound to occur which needs to be analysed to prevent such adverse events in the future. Hence, this study aims to analyse the adverse events occurring in intra-operative and post-operative period who received anesthesia in our tertiary care centre.
Methods: This study is a retrospective cross-sectional study of 5-year duration from January 2018 to January 2023 done at Bhaktivedanta hospital and research institute post obtaining approval from the institutional ethics committee. A total of 163 patients who developed perioperative adverse events were included in the study and their nature of adverse events were analysed. The data was obtained from the registers of the anesthesia department and descriptive statistical analysis of the data was done accordingly.
Results: Most common adverse events were of cardiovascular and respiratory origin, followed by miscellaneous and regional anesthesia adverse events and then, very few drug-related adverse events. The patients who developed these adverse events were evidently of ASA grade I and II, implying no direct correlation between adverse events and grading.
Conclusions: Reporting and analysis of the adverse events will help better understanding of the lacunae of the reporting system as well as in the development of quality improvement strategies in the future.
A prospective observational study of gastrointestinal perforations following blunt trauma abdomen
Authors: Gurav Shrutika P. , Quraishi Abdul Haque M. , Umare Girish , Tongse Pankaj S.
Published: April 2024

Background: Blunt trauma abdomen often presents late leading to increased morbidity and mortality, therefore the challenges in management of such patients warrant a study in this area for early diagnosis and better outcomes.
Methods: A prospective observational study was carried out at a government institute in Central India. All patients having blunt trauma abdomen with GI perforations were observed over 2 years wherein clinical presentation, time of presentation, diagnostic methods and the outcomes were the parameters studied.
Results: Young men (21-30 yrs) were found to be the commonly injured group. Road traffic accidents were the most common cause of blunt trauma abdomen. We found that mechanism of injury is related to the outcome and high energy transfer injuries (76%) led to high morbidity and mortality. Abdominal pain with abdominal tenderness and guarding was the most common presentation. Chest X-ray showed free gas under diaphragm in 58%patients who underwent xray. Other modalities used were FAST (focussed abdominal scan for trauma) scan which showed hemoperitoneum. CT scan had 97% sensitivity in diagnosis. Jejunum was the most common site of perforation. Simple closure of perforation with peritoneal lavage was the most commonly performed operative procedure. Overall, 35 patients developed complications in the postoperative period, wound infection being the most common. Mortality in this study was 26%.
Conclusions: Young men are the most commonly injured in road traffic accidents with jejunum being the commonest organ injured. High velocity trauma, late presentation, multi- organ injury worsens the prognosis hence early diagnosis becomes imperative for better outcome.
Post operative pancreatic fistula associated with failure to rescue on pancreatic cancer undergoing pancreatic resection: a single centre experience
Authors: Ida Bagus Budhi , Bagus Metria Ida , Soewoto Widyanti , Hanis Setyono  , Wibisono  , Yarso Kristanto Yuli
Published: April 2024

Pancreatic resection was known as the gold standard treatment for resectable pancreatic cancer.  Post operative pancreatic fistula was common following pancreatic resection for tumor of the pancreas (head, body or tail of the pancreas). According to the Clavien-Dindo classification, the presence of the pancreatic fistula after resection was associated with increased rate of morbidity and mortality for the patients. We would evaluate cases of resectable pancreatic cancer (head and tail of the pancreas) undergoing open pancreatic resection in our centre (low volume centre). Post operative pancreatic fistula were evaluated by abdominal CT scanning and increased amylase level from intra peritoneal drain. The patients whose cannot survive after pancreatic resection were classified as failure to rescue.  The presence of cardio-pulmonary morbidity was excluded from this study. Six cases were recorded in this study, 4 cases were head pancreatic cancer and 2 cases was tail pancreatic cancer. The histopathology results were acinar cell pancreatic cancer. Post operative pancreatic fistula was found on 1 case of head pancreatic cancer, classified as Clavien-Dindo grade IV, relaparotomy was done.  This patient had sepsis associated post operative pancreatic fistula and can not survive during evaluation (on 14th post operative days).  For the rest of the patients, there were no pancreatic fistula and had good outcome with no post operative morbidity. The presence of uncontrolled post operative pancreatic fistula was associated with failure to rescue on pancreatic cancer undergoing resection.
The detours of pancreatic ducts, internal pancreatic fistulas: a rare complication of chronic pancreatitis
Authors: Satchithanandha Vysheki , Park Jin-Soo , Sandroussi Charbel
Published: April 2024

Internal pancreatic fistula occurs due to the disruption of the pancreatic duct, resulting in communication with it and another epithelial surface. A rare variant is the pancreaticopleural and pancreaticogastric fistula, typically associated with chronic necrotising pancreatitis, resulting from posterior disruption of the pancreatic duct. It is a complex disease with different aetiologies, varied clinical presentations and multiple management options. Unlike postoperative pancreatic fistula, internal pancreatic fistula lacks guidelines for classification and management. Once an internal fistula is suspected, further imaging work-up and biochemical analysis needs to be performed. Here, we present an unprecedented case of pancreaticopleural fistula on a background of chronic necrotising pancreatitis, and an asymptomatic pancreatico-gastric fistula. To our knowledge, no such case has been previously reported.
Antenatal teratoma sacrococcygeal in a three month old children in Indonesia: a rare case report
Authors: Ibrohim Ibnu Sina , Suwardi  , Haryono Dedy C. , Irwansyah Bambang
Published: April 2024

Sacrococcygeal teratoma is a type of germinal cell tumor in children, usually observed in the prenatal or antenatal phases. In either phase, sacrococcygeal teratoma may cause complications that lead to increased risk of morbidity and mortality. A proper screening and management for sacrococcygeal in children are mandatory for the best outcome. Currently, surgical resection is the most promising treatment to manage antenatal sacrococcygeal teratoma in children. Three-month-old female children were brought to the hospital with a growing 8.4 cm mass since birth in her groin. The mass was painless and soft in consistency. Computed tomography (CT) scan revealed a dominant solid lesion accompanied by multiloculated fluid density arising from right gluteal muscle. The patient planned for surgical excision. Hyperkalemia was observed prior to the operation; hence an appropriate correction was needed before surgery. Germ cell tumors, though uncommon, may develop beyond the gonadal region, such as in the brain, neck, mediastinum, and retroperitoneum. In neonates and fetuses, these tumors frequently originate in the sacrococcygeal area, possibly resulting from the migration of primordial cells and the proliferation of totipotent stem cells in that region. Optimal disease burden outcomes for sacrococcygeal teratoma are often achieved through surgical resection. Sacrococcygeal teratoma, although rare, might possess a mortal threat to patient, hence proper diagnosis and treatment must be done to ensure the best clinical outcome.
Hirschsprung’s disease in adulthood: a case report
Authors: Leal Clara , Fernandes Urânia , Marques Rita , Pinto-de-Sousa João
Published: April 2024

Hirschsprung’s disease (HD) is caused by a gut development anomaly that leads to functional constipation. In most cases, HD is diagnosed and treated during childhood. Abdominal pain, distension and chronic constipation are typical symptoms of adult presentation. An adult HD case is presented, using analysis of electronic medical records and literature review for diagnostic and management insights. A man in his early 40s, with a history of chronic constipation since infancy, presented to the emergency department with an intestinal obstruction. Imaging tests revealed pronounced colonic dilation along with faecal loading. Following favourable progress, the patient was referred for outpatient investigation. Endoscopy revealed rectal scars with biopsy consistent with HD. A laparoscopic Duhamel-Martin procedure was performed in two stages. The postoperative period was uneventful. Adult HD is overlooked and misdiagnosed. Therefore, a high level of suspicion is needed to diagnose and avoid urgent surgeries, often with the need of colostomy and its particularities. When feasible, appropriate management by elective surgery should be the gold standard.
Cystic lymphangioma of the mesentery: a case report
Authors: Brahmi Yasser El , Elfahssi Mohammed , Njoumi Noureddine , Elhjouji Abderrahmane , Ait Ali Abdelmounaim
Published: April 2024

Cystic lymphangioma of the mesentery is a rare benign malformative tumor of the lymphatic vessels. Mesenteric lymphangioma is predominantly encountered during infancy, yet in uncommon instances, it can manifest in adults. Their clinical expression is polymorphic but nonspecific. Diagnosis is suggested by radiology but only histological examination will confirm the diagnosis. Treatment is surgical and the prognosis is good. Complete resection should be performed whenever possible. Intracystic sclerotherapy is possible for unresectable lymphangiomas. The rarity of these tumors, their diagnostic challenges, and the fact that this case involves an adult patient, prompted us to report the following observation.
Pancreatic endometriosis a rare entity in surgery: a case report
Authors: Gutiérrez Carlos Durán , Rios Muñoz Braulio
Published: April 2024

Endometriosis is a rare entity that occurs in 2 to 10% of women of childbearing age. It may be rarer if it occurs in extrapelvic organs and extremely rarely in pancreatic tissue, and it may be confused with other causes of pancreatitis or pancreatic pathologies. In the following case we present a young woman of childbearing age who is admitted with abdominal pain. She mentions having recently had elevated pancreatic enzymes. At the time of evaluation within normal parameters, a pancreatic cyst is suspected, which is why it is She underwent surgical treatment, however, due to clinical signs, a cyst with the appearance of endometriosis was punctured, and the histopathological report confirmed pancreatic endometriosis, an entity little known in surgery, however, with a favorable outcome after surgical intervention.
The silent stent ascent: asymptomatic retrograde migration of pancreatic duct stent post-pancreaticoduodenectomy
Authors: Satchithanandha Vysheki , Stephen Lau Ngee-Soon , Huynh Roy , Sandroussi Charbel
Published: April 2024

Transanastamotic stents are used to maintain pancreatic duct patency post Whipple’s procedure to manage postoperative fistulas. We present a rare case of a 54-year-old male who presented with recurrent epigastric pain and vomiting post pancreaticoduodenectomy. Imaging demonstrated incidental pancreatic stent migration through the hepaticojejunostomy into the left biliary tree, without evidence of cholangitis. Pancreatic stent in a Whipple’s procedure, demonstrates benefits in maintaining pancreatic duct patency and reduces pancreatic fistulisation. However, it is associated with potential complications including proximal stent migration into the biliary tree. In our case, the patient remained asymptomatic which makes it a unique case. The necessity of stent removal in asymptomatic cases remains a subject of consideration. However, the endoscopic retrieval is in preference to avoid surgical intervention to avoid the risks and complications of invasive procedures.
Amyloid goiter with diffuse thyrolipomatosis: a rare entity
Authors: Vallathai Silpa , Kuruvilla Shalini , Kanhirangad Lakshmi , Kanjirakadu Parameswaran Kavitha , Ahmed Abdulla Faheem
Published: April 2024

Diffuse thyroid lipomatosis with amyloid deposition is a rare entity. We report a case of a 42-year-old lady who presented with progressive enlargement of the thyroid gland with compressive symptoms. Her thyroid hormone levels were within normal limits. Imaging revealed enlarged thyroid gland with multiple fat density lesions. She underwent total thyroidectomy, and histopathology revealed diffuse infiltration of thyroid stroma by mature adipose tissue and an associated amyloid deposition. A diagnosis of amyloid goiter with diffuse lipomatosis of the thyroid gland was rendered. Only a few cases of diffuse lipomatosis with concurrent deposition of amyloid protein have been reported in the literature.
A case report on choledochotomy with t-tube in rare case of oriental cholangiohepatitis in 33-year-old male patient
Authors: Kavad Harshad M. , Patel Hardik , Patel Tejas , Astik Hardik
Published: April 2024

A 33-year-old male patient presented in OPD with c/o abdominal pain in right hypochondrium since 1 month which is mild in nature and intermittent on and off type and yellowish sclera since 1 year which is gradually increases. On CECT abdomen shows CHD dilated (15 mm) and sludge within it, RHD dilated (15 mm) and sludge within it, LHD dilated (11 mm) and calculus within it. patient is operated with choledocotomy with T-tube insertion in CBD, post operatively patient had significant improvement in clinical symptoms and lab findings also suggestive of better outcome.
Successful salvage of upper extremity following severe crush injury associated with vascular compromise using a supra thin free anterolateral thigh flap
Authors: Jangra Mahesh , Kumar Ajay , Sharma Nipun , Singh Heishnam S. , Gupta Tarush , John Jerry R.
Published: April 2024

Traumatic injuries of the upper limbs can often result in serious and challenging wounds involving multiple compartments such as skin, bone, tendons and neurovascular structures. These type of injuries of the upper extremity pose several challenges to the plastic surgeon. The main difficulty is to provide a stable, long lasting and aesthetically acceptable coverage that enables joints excursion so that patient can return to work at the earliest. Here, we present a case of 45 years old gentlemen who sustained severe crush injury associated with avulsed radial and ulnar artery of left upper limb following road traffic accident. At presentation, there was no pin prick in his hand and hand was pale. At first surgery, hand was revascularized using a vein graft in radial artery and skin grafting was done over the forearm defect as a temporary cover. After 12 hours, when the viability of hand was reassured, the defect was covered with free supra thin anterolateral thigh (ALT) flap. Patient’s hand and flap both survived and he was discharged in a satisfactory condition.
Does patient-specific instrumentation in primary total knee arthroplasty improve long-term satisfaction or function? A randomized trial with a 9-year follow-up
Authors: Caldeira-Dantas Sofia , Gonçalves Marta , Vaz-Pinto Gonçalo , Dias Pedro , Marreiros Ana , Fontes Ana Paula , Sousa João P.
Published: April 2024

Background: Patient-specific instrumentation (PSI) aims to increase the accuracy of total knee arthroplasty (TKA). However, the long-term benefit compared to conventional instrumentation (CI), is still controversial. This randomized controlled trial compares the long-term outcomes between PSI and CI in TKA.
Methods: Patients submitted to PSI or CI TKA with a minimum follow-up of 8 years were evaluated. Satisfaction levels, forgotten joint score (FJS) and Western Ontario and McMaster university osteoarthritis index (WOMAC) scores were compared. Regarding descriptive statistics, mean, standard deviation and frequencies were obtained. For inferential statistics we used the t test for independent samples the Mann-Whitney test and the Wilcoxon Test.
Results: A total of 50 TKA were included (48% CI; 52% PSI) with an average follow-up time of 9.3 years. At the final follow-up the WOMAC score was similar between groups (p=0.846; CI:26.8±22.5; PSI:26.8±25.3). Similarly, no differences were seen for the FJS (p=0.785; CI:59.6±35.1; PSI:57.1±36.2) or satisfaction (p=0.486; CI:8.1±2.8; PSI:9.1±1.4). However, at the final follow-up, the total WOMAC score had worse results when compared to the previous evaluations (p=0.013 for CI group; p=0.009 for PSI group). No significant differences in the satisfaction levels were detected regarding the initial and final evaluations (p=0.581 for CI group; p=0.936 for PSI group).
Conclusions: Nine years after TKA, PSI and CI patients reported similar levels of satisfaction and functioning. Both groups achieved similar results concerning the WOMAC, FJS scores and satisfaction levels. This study suggests that long-term satisfaction and functioning levels are similar in both PSI and CI.
Evaluation of optimizing Monteggia fracture-dislocation care: surgical innovations, radiological insights, and functional rehabilitation in adult patients
Authors: Al-Maruf M. Abdullah , Islam Shahidul , Asaduzzaman M. , Hasan M. Mainul , Hoque M. Zahidul , Mollick Raju
Published: April 2024

Background: Monteggia fractures, rare in adults, involve proximal ulna fracture and radial head dislocation. Managing these injuries poses challenges, fueling historical debates and driving advancements in internal fixation. Watson Jones' frustration highlights the ongoing pursuit of effective surgical approaches for optimal outcomes and functional limb restoration. his study aims to evaluate Monteggia fracture-dislocation treatment by analyzing radiological outcomes for structural insights and alignment post-surgery.
Methods: This prospective observational study, conducted at Swapno general hospital, Mirpur-2, Dhaka, Bangladesh from 1st January 2021 to 31 January 2024, enrolled 30 patients with radiologically confirmed Monteggia fracture-dislocation. Surgical procedures involved creating an interval, anatomical reduction, and fixation, with regular follow-ups assessing outcomes, including range of motion, X-rays, and VAS scores, while statistical analysis utilized SPSS version 23.
Results: The highest frequency percentage in the age distribution was observed among individuals aged 41-45, constituting 20% of the total sample, while the lowest frequencies were recorded in the 31-35 and >51 age groups, each representing 10% of the sample. Physical assault emerged as the leading cause of injury, accounting for 40% of cases, followed by road traffic accidents at 36.66% and falls at 23.33%. In terms of final outcomes, the majority of patients (43.33%) achieved a good outcome, while the lowest percentage (10%) resulted in poor outcomes. 
Conclusions: In conclusion, addressing Monteggia fracture-dislocation in adults requires navigating inherent complexities. Modern internal fixation methods prove impactful, emphasizing the need for precise classification and stable anatomical reduction.
The role of diabetes in low back pain compared to non-diabetics
Authors: Aghara Denish S. , Patil Sanjay N. , Mirchandani Nishant
Published: April 2024

Background: Type 2 diabetes is a prevalent non-communicable disease, affecting significant proportion of the global population, with an estimated 382 million individuals affected. There exists a correlation among diabetes and low back pain. The objective of this investigation was to examine the potential association linking diabetes and low back pain by utilising the Oswestry disability Index as a gauge of the intensity of persistent lower back pain.
Methods: The study was conducted by cross sectional method in which 200 patients with low back pain were included from period of October 2020 to September 2022. Oswestry disability index questionnaire was used for the intensity of lower back pain. Statistical package for the social sciences was used for data analysis.
Results: In this study, out of 200 patients, 59 (29.5%) had diabetes and 141 (70.5%) were without diabetes, with a average age of 53.61±15.07 years. Overall, according to gender, patients were equally distributed, while female and male predominance was seen in diabetics and non-diabetics, respectively.
Conclusions: The distribution of patients as per gender and ODI score did not differ, although more diabetics had a significantly higher ODI score than non-diabetics. A significant increase in blood glucose, HbA1c, microalbuminuria, and ODI score was noted in diabetics compared with non-diabetics, with significant positive associations of ODI with age, blood glucose, and HbA1c. The increased levels of the diabetic profile parameters and their association with the ODI indicate the possible role of diabetes with low back pain.
Quantification of anterior translation of tibia over femur using Lachmeter in anterior cruciate ligament reconstruction with hamstring tendon autograft
Authors: K. D. Vishnu , Samuel E. Samson , John P. S.
Published: April 2024

Background: The anterior cruciate ligament (ACL) is an important restraint on anterior tibial translation of the knee. Arthroscopic ACL reconstruction using hamstring tendon autograft is the most widely accepted surgical procedure for ACL insufficiency. This study is assessing the effect of ACL reconstruction by hamstring tendon autograft on the anteroposterior stability of the knee joint by measuring the side-to-side difference of anterior tibial translation using the Lachmeter. We are also assessing the functional outcome of the same surgery using international knee documentation committee (IKDC) score.
Methods: The study included 30 patients who were admitted for ACL reconstruction with hamstring tendon autograft. The side-to-side difference of anterior tibial translation was assessed by using Lachmeter preoperatively and postoperatively at the end of the 1st, 3rd, and 6th months. The IKDC score was assessed preoperatively and postoperatively at the end of 6th month.
Results: The mean Lachmeter value of respondents in the current study was 4.31±0.56 mm during the preoperative period. Lachmeter values were 2.79±0.42 mm, 2.09±0.42 mm, and 1.29±0.39 mm, respectively, at the end of the first, third, and sixth months postoperatively. Mean preoperative and postoperative 6th month IKDC scores were 55.83±7.7 and 89.20±5.3 respectively.
Conclusions: There is significant serial improvement in the side-to-side difference of anterior tibial translation in the 6 months of post operative period following ACL reconstruction using hamstring tendon autograft. The improved IKDC score from preoperative to postoperative level is also indicating a positive functional outcome.
Functional outcome after arthroscopic mosaicplasty for localized osteochondral defects in the knee
Authors: Singh Pravendra , Chahal Jashandeep Singh , Aggarwal Nipun , Kumar Harsh
Published: April 2024

Background: Articular cartilage is complex tissue that is able to withstand tremendous amount of force over many cycle but does not have the ability to heal even after minor injury. Treatment recommendation for articular cartilage injury and arthritis includes non-operative and operative management. Mosaicplasty is a reconstructive osteochondral grafting procedure for the treatment of articular defects of the knee. Mosaicplasty entails transplantation of small cylindrical osteochondral grafts from the non-weight bearing area of the femoral condyles and transplanting them in a mosaic like fashion into a prepared defect site on the weight-bearing surfaces of the same knee.
Methods: The present study was carried out in 30 patients in our hospital prospectively to determine the functional outcome results after arthroscopic mosaicplasty for localized osteochondral defects in the knee. We conducted a prospective study on 30 patients of osteochondral defect of knee. Patients were presented with pain and recurrent swelling in the knee after sustaining twisting injury in the knee. Diagnostic arthroscopy was done and the osteochondral defects is localized and treated with mosaicplasty. The graft is harvested arthoscopically from the non-weight bearing part of the femoral condyles using a harvester. Follow up of these patients is done according to Tenger Lysholm knee scoring scale at 03 months, 06 months after surgery.
Results: In our study 93.33% patients showed good to excellent results and 7% patients had fair and poor results.
Conclusions:  Advantage of arthroscopic mosaicplasty includes implantation of hyaline cartilage without the need for any suture or adhesive, need for smaller incision minimally invasive and very less complications. Associated injuries like ACL/PCL or meniscal tear can be addressed in the same procedure. To conclude arthroscopic mosaicplasty is excellent procedure to address the focal articular cartilage injuries of knee.
Functional outcome of mini external fixator in hand injuries: an observational study in a tertiary care hospital
Authors: P. Saravanakumar , B. Arun Kumar , N. Kanchan
Published: April 2024

Background: Metacarpal and phalangeal fractures are one of the common fractures of the upper extremity that account for about 10% of total body fractures. The distal parts of the hand are the most common parts to be injured. Outcome is also influenced by other factors such as patient’s age, occupation, socio economic status, systemic illness, surgeon’s skill and the patient’s compliance.
Methods: We are doing an observational study with 40 patients included according to the inclusion and exclusion criteria for a period of six months with age group between 20 and 60 years. We use mini external fixators with JESS clamps, 1.8 mm threaded pins and k wires. Patients were followed up periodically with required radiograph for the union of the fracture.
Results: Out 40 patients, most of the patients were between the age of 21 to 40 years with male preponderance, open fractures were more when compared with closed fractures. Functional outcome was excellent and good on the higher side which was analysed with Strickland score. Radiological union were also in greater side with 17.5% of them with delayed union.
Conclusions: Simple surgical technique will minimize complications and an aggressive rehabilitation will ensure best result. In general, mini external fixator is a good treatment for management of fractures with best functional outcome.
Functional outcome of patients presenting with isolated medial condyle fractures of femur in a tertiary care hospital
Authors: Bose Gourab , Roy Rahul , Mukherjee Saptarshi , Datta Sunandan
Published: April 2024

Isolated medial condyle fractures of the femur with an intact lateral condyle are a rare entity. These fractures require prompt diagnosis and anatomical restoration of joint surface to prevent post traumatic arthritis. Till date no suitable implant is available for fixation of these fractures. In this study we have used 4.5 recon plates and CC screws to fix these fractures. We aim to study the functional outcome of these fractures in a group of patients fixed with the above implants. The study was conducted in a group of patients presenting with isolated medial condyle fractures of femur in a tertiary care hospital. An ORIF was done and fractures were fixed with recon plates and lag screws and various parameters were evaluated such as range of motion of knee, average time to weight bearing, Lysholm knee scores, pain perception etc 20 patients were evaluated in the age group of 20-70 in a 5 year period. Majority of the patients had a very good functional range of motion of the knee and nearly 75% achieved union by 12-16 weeks. 70% of the patients had a low VAS score. Overall early diagnosis and prompt anatomical restoration of joint surface in isolated medial condyle fractures of femur led to favourable range of motion of knee, early radiological healing and low VAS score.
Case report of a new technique for with posterior cruciate ligament avulsion fractures treated with a mini transverse incision
Authors: Kuknadu Bhaskar Shetty , Shetty Anvith S.
Published: April 2024

Posterior cruciate ligament (PCL) is a strong stabilising ligament of the knee joint originating from posterior part of Intercondylar eminence oof tibia and attaches to the anterior part of medial surface of lateral condyle of femur. The PCL plays a major role in knee stabilization, and are statistically one of the rarest injuries around the knee. Due to the surrounding neurovascular elements in the popliteal space, very few open approaches to repair such injury were performed. The ‘‘safe transverse mini-incision approach’’ to PCL avulsion fracture is a simple approach, does not require exploration of the neurovascular elements, and produced satisfactory results in the majority of patients.
Tibial tuberosity fracture in adult as an unusual pattern of injury
Authors: Jain Mohit H. , P. N. Kartik , Iyer Nandhini
Published: April 2024

Tibial tuberosity avulsion is an uncommon fracture in adults, such lesions typically seen in adolescent male with well-developed quadriceps, ligaments when they are stronger than growth plate. We described a case of 51-year-old gentlemen had direct trauma to left knee, no risk factors were identified, not able to walk, difficulty in straight leg raise test, radiograph of left knee showed tibial tuberosity avulsion fracture. The fracture was treated with open reduction and internal fixation, f/u with successful rehabilitation which results in good range of motion and excellent function at knee joint. The aim of study is present unusual and rare case of tibial tuberosity Avulsion fracture in adult, early diagnosis, surgical mode of treatment, post-surgery rehabilitation and possible complications.
Chondroblastoma of the anterior process of calcaneus: a case report
Authors: Nishani Manjunath , Thami Tarkik , Singh Tarvinder , Singh Siddhartha
Published: April 2024

Chondroblastoma of the calcaneus is a fairly uncommon tumour. Despite being a benign and indolent lesion, chondroblastoma of the calcaneus can lead to functional limitations, due to its location in such a weight-bearing bone. This report presents a rare case of chondroblastoma affecting the anterior process of the calcaneus, which was successfully treated with extended curettage and synthetic bone graft substitute, resulting in favourable functional outcomes at 13 months post-surgery. This case underscores the importance of timely recognition and appropriate management of this uncommon tumour to achieve optimal patient outcomes.
On the use of anthropogenic materials in nest building of House Wren (Troglodytes aedon), a report from Parque Los Algarrobos, Cumbayá, Ecuador
Authors: Davila Mateo , León-E. Roberto J. , Guerrero-Campoverde Ariel
Published: April 2024

Urbanization has prompted shifts in avian nesting behaviors, with some bird species incorporating anthropogenic nest materials (ANMs) into their nests. This study focuses on Troglodytes aedon (House Wren) in Ecuador, exploring the factors influencing their use of ANMs. Observations in Parque Los Algarrobos revealed a House Wren carrying a piece of transparent plastic, entering a street lamp and emergind from it without the plastic. Additional data from iNaturalist showcased widespread ANM use in House Wren nests across Ecuador.
Sustainable Organic Farming Maturity Model
Authors: Kunsook Kritiyaporn , Thammaboosadee Sotarat , Chuckpaiwong Rojjalak
Published: April 2024

Organic farming is of the utmost importance in promoting environmentally sustainable agricultural practices, minimizing environmental contamination, and avoiding using chemical fertilizers and genetically modified organisms (GMOs). Even inexperienced and seasoned farmers frequently encounter formidable obstacles when attempting to authenticate their organic farming status by acquiring organic agriculture certification. The current level of agricultural land maturity is accurately assessed by a comprehensive model presented in this study, which also provides a framework for the transition to organic farming standards. These maturity models were formulated through an exhaustive analysis of agricultural standards, an extensive review of pertinent literature, and expert interviews conducted in 15 distinct locations, with each expert holding certification in a minimum of three organic agricultural standards. Identifying characteristics germane to organic standards, integrating them into maturity models, and establishing maturity items and dimensions are also components of the study. The outcome of our investigation is the Sustainable Organic Farming Maturity (SOFaM) model, which consists of five levels and eight dimensions, as well as a standard operating procedure manual for organic agricultural standard certification applications. This model's potential as an assessment instrument for determining the maturity level of agricultural land has been validated by experts who hold credentials in three distinct domains and three locations. The SOFaM model has the potential to function as a paradigm shift in the agricultural sector, streamline the certification process following organic farming standards, and guarantee adherence to predetermined criteria.
Toxicity Detection of Pollutants in the Tallo River Using Simple Biomarkers of Oryzias celebensis Embryo
Authors: Yaqin Khusnul , Rahim Sri Wahyuni , Parawansa Basse Siang , Kudsiah Hadiratul , Tambaru Rahmadi , Sari Dwi Kesuma , Riani Etty , Hardiana Andi Dina , Meimulya  , Lalombo Yulia Indasari
Published: April 2024

The current research demonstrated the use of simple biomarkers from Oryzias celebensis embryos to detect the effects of pollutants from the Tallo River. The biomarkers used in this research were somite number, egg biometrics, heart rate, survival rate, and hatching time. Pollutants were sampled from three hot spots in the Tallo River (Station 1 (S1), Station 2 (S2) and Station 3 (S3)). Two exposure models were used in this study: in situ and semi-in situ exposure. In situ exposure was carried out by placing ten embryos (stage 17) at each station for six days. Semi-in situ embryos (10 animals) were exposed to polluted water from each station and embryo rearing media (ERM) as a control at stage 17 until hatching in the laboratory. Biomarker data were analyzed using ANOVA (Analysis of variance) to determine the sensitivity of each biomarker used.  Almost all the embryos used as model animals in the in situ experiment died, except for two embryos placed in stations 2 and 3. The embryos from station 2 hatched after 18 days. The embryos from station 3 died after 18 days.  The semi in situ experiment showed that the number of somites and heart rate showed statistically significant differences between embryos exposed to water from S1 and control embryos (p < 0.05).  Other endpoints did not show potential as biomarkers.  This study suggested that the number of somites and heart rate of O. celebensis embryos could potentially be used as biomarkers in effect-based monitoring.
La diligencia debida de las plataformas en línea dentro del reglamento europeo de servicios digitales
Authors: De Nova Labián Alberto José
Published: April 2024

El presente trabajo analiza los aspectos más relevantes del Reglamento UE 2022/2065 relativo a un mercado único de servicios digitales, haciendo especial hincapié en el sistema de diligencia debida vinculado a las plataformas en línea y las principales obligaciones que les resultan de aplicación. De igual modo y relacionado con lo anterior, se ha analizado el régimen de responsabilidad de los prestadores de servicios intermediarios. Para ello, se ha acudido a múltiples referencias jurisprudenciales que han ayudado a configurar los criterios hoy vigentes a través del presente Reglamento. Por otro lado, se ha realizado un ejercicio comparativo entre el rumbo legislativo de EE. UU. y la UE en materia de responsabilidad de las plataformas en línea, que nos permite identificar el diferente grado de exigencia en cuanto a las obligaciones y responsabilidad de dichos prestadores de servicios.
Recibido: 21 noviembre 2023Aceptado:  09 febrero 2024
Crónica de la Jurisprudencia del Tribunal de Justicia de la Unión Europea Segundo semestre de 2023
Authors: Ordóñez Solís David
Published: April 2024

Sumario: I. Introducción.—II. Primera parte. Los desarrollos jurisprudenciales del derecho de la Unión Europea. 1. La independencia y la promoción de los jueces en Rumanía y en Polonia. 2. El derecho a la tutela judicial efectiva y las jurisdicciones contable y contencioso-administrativa. 3. La aplicación retroactiva de la ley penal más favorable. 4. La vestimenta vinculada a creencias religiosas de los empleados públicos. 5. El derecho fundamental a las vacaciones de quien ha sido despedido ilegalmente y en pandemia. 6. La protección de los datos personales. 7. Los límites del derecho a la información medioambiental y la cosa juzgada. 8. Las limitaciones a los derechos fundamentales como consecuencia de la pandemia. 9. Las plataformas digitales en el mercado interior europeo. 10. El seguro obligatorio de vehículos y las bicicletas con pedaleo asistido. 11. El control judicial en materia de función pública europea.—III. Segunda parte. La jurisprudencia europea provocada por los jueces españoles y sus efectos en el derecho interno. 1. El suplicatorio de Puigdemont ante el Tribunal General. 2. Non bis in idem, euroorden y ejecución de condenas penales en el espacio de Schengen. 3. El derecho a las vacaciones retribuidas como principio social europeo y su compensación. 4. La transmisión de una notaría y el mantenimiento de los derechos de su personal. 5. El contumaz incumplimiento por la Seguridad Social española de la jurisprudencia europea. 6. Las cláusulas abusivas de los contratos bancarios y las dudas de los jueces españoles. 7. El derecho de la competencia y el fútbol europeo: sentencia European Superleague Company. 8. La devolución de las ayudas ilegales y el principio de confianza legítima: deducciones del impuesto de sociedades aplicado en España.—IV. Relación de las sentencias comentadas.