bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanical demands and pacing profile adopted by elite mountain bikers during different cross-country events
Authors: Arriel Rhai André , Meireles Anderson , Souza Hiago Leandro Rodrigues , Leite Roberto Carlos De Matos , Marocolo Moacir
Published: March 2024

Different competitive environments appears to affect the physical demands during the sports competitions. Thus, the aim of this study was to report the mechanical demand and pacing behaviour of twelve male elite mountain bikers on cross-country short track (XCC) and cross-country Olympic (XCO). During both competition, total race time, speed, power output (PO) and cadence (CA) were recorded. As the race time in the XCC is shorter (21.0 ± 0.5 vs 84.0 ± 3.0 min; p<0.01), the average speed (26.6 ± 0.6 vs 17.8 ± 0.6 km/h; p<0.01), PO (365.0 ± 26.7 vs 301.0 ± 26.2 watts; p<0.01) and CA (81.2 ± 4.7 vs 77.4 ± 4.3 rev∙min−1; p=0.01) were higher than the XCO. While a variable pacing was adopted during XCC, a positive profile was adopted in XCO. In addition, athletes adopted a more conservative starting pace during XCC (below average race speed) but a faster start during XCO (above average race speed). These findings demonstrated that mechanical parameters and pacing profile adopted by cyclists are different between XCC and XCO. Therefore, mountain bikers and coaches must develop specific strategy and training methods in order to obtain success in each competition.
Is physical activity associated with a higher degree of wisdom? Cross-sectional study with high school students
Authors: Volz Pâmela Moraes , Corrêa Leandro Quadro , Gauze Alexandrino Eduardo , Rodrigues Rodrigo , Silva Michael Pereira , Dumith Samuel de Carvalho
Published: March 2024

The aim of this study was to verify the association between the degree of wisdom and the level of leisure-time physical activity (PA) of students from a federal public school in southern Brazil. Observational cross-sectional study with 462 young people of both sexes between 15 and 18 years old. Data collection was performed using a self-administered questionnaire on the REDCap platform. The independent variable was the “level of leisure PA” (inactive, insufficiently active, and physically active) and the outcome was the “degree of wisdom” evaluated through a validated questionnaire (SD-WISE7). There was a linear trend towards an increase in the wisdom score according to the level of PA. This trend and significant association continued in the adjusted analysis, with active students averaging 1.84 points more in the wisdom score compared to inactive students. In conclusion, the wisest young people are also the most physically active young people. In view of the potential beneficial effects, current studies may consider wisdom as a possible mediator of PA with health outcomes.
SARS-CoV-2 Vaccine-Elicited Immunity after B Cell Depletion in Multiple Sclerosis
Authors: Baxter Ryan M , Cabrera-Martinez Berenice , Ghosh Tusharkanti , Rester Cody , Moreno Miguel Guerrero , Borko Tyler L , Selva Sean , Fleischer Chelsie L , Haakonsen Nicola , Mayher Ariana , Bowhay Emily , Evans Courtney , Miller Todd M , Huey Leah , McWilliams Jennifer , van Bokhoven Adrie , Deane Kevin D , Knight Vijaya , Jordan Kimberly R , Ghosh Debashis , Klarquist Jared , Kedl Ross M , Piquet Amanda L , Hsieh Elena W Y
Published: March 2024

The impact of B cell deficiency on the humoral and cellular responses to SARS-CoV2 mRNA vaccination remains a challenging and significant clinical management question. We evaluated vaccine-elicited serological and cellular responses in 1) healthy individuals who were pre-exposed to SARS-CoV-2 (n = 21), 2) healthy individuals who received a homologous booster (mRNA, n = 19; or Novavax, n = 19), and 3) persons with multiple sclerosis on B cell depletion therapy (MS-αCD20) receiving mRNA homologous boosting (n = 36). Pre-exposure increased humoral and CD4 T cellular responses in immunocompetent individuals. Novavax homologous boosting induced a significantly more robust serological response than mRNA boosting. MS-α CD20 had an intact IgA mucosal response and an enhanced CD8 T cell response to mRNA boosting compared with immunocompetent individuals. This enhanced cellular response was characterized by the expansion of only effector, not memory, T cells. The enhancement of CD8 T cells in the setting of B cell depletion suggests a regulatory mechanism between B and CD8 T cell vaccine responses.
Ethnic Identity and Ethnic Organizations: The Role of Self-Construal in the Psychological Well-Being of Migrants
Authors: Fente L. , Fiske S. T.
Published: March 2024

This study attempted to highlight the role of ethnic organizations in maintaining the ethnic identity and self-construals of migrants and see whether such perpetuations were psychologically healthy or not in a contrasting culture. Two groups of migrants of Asian-Indian origin in the USA participated in the study, one group belonging to their respective ethnic organizations and the other group not belonging to any ethnic organization. Results indicated stronger ethnic identity and interdependent self-construal in members of ethnic organizations as compared to non-members. Self-construals were found to be significant moderators in the relationships between ethnic identity and well-being in members of ethnic organizations but not in non-members. Better well-being was seen in people who were engaged in their respective ethnic organizations and thereby still maintaining their home prototypical self-construal with strong ethnic identity. Non-members showed a match of self-construal to the host culture (independent) as well as weaker ethnic identity and poorer well-being, while the member group showed higher intergroup anxiety. Results were discussed in light of the debates on cultural diversity and role of ethnic organizations and social identity.
Comparison of analgesic effects between programmed intermittent epidural boluses and continuous epidural infusion after cesarean section: a randomized controlled study
Authors: Bang Yu Jeong , Jeong Heejoon , Kang RyungA , Sung Ji-Hee , Choi Suk-Joo , Oh Soo-Young , Hahm Tae Soo , Shin Young Hee , Jeong Yeon Woo , Choi Soo Joo , Ko Justin Sangwook
Published: March 2024

Background: This study aimed to compare the analgesic effects of programmed intermittent epidural boluses (PIEB) and continuous epidural infusion (CEI) for postoperative analgesia after elective cesarean section (CS).Methods: Seventy-four women who underwent elective CS were randomized to receive either PIEB or CEI. The PIEB group received 4 ml-intermittent boluses of 0.11% ropivacaine every hour at a rate of 120 ml/h. The CEI group received a constant rate of 4 ml/h of 0.11% ropivacaine. The primary outcome was the pain score at rest at 36 h after CS. Secondary outcomes included the pain scores during mobilization, time-weighted pain scores, the incidence of motor blockade, and complications-related epidural analgesia during 36 h after CS.Results: The pain score at rest at 36 h after CS was significantly lower in the PIEB group compared with that in the CEI group (3.0 vs. 0.0; median difference: 2, 95% CI [1, 2], P < 0.001). The mean time-weighted pain scores at rest and during mobilizations were also significantly lower in the PIEB group than in the CEI group (pain at rest; mean difference [MD]: 37.5, 95% CI [24.6, 50.4], P < 0.001/pain during mobilization; MD: 56.6, 95% CI [39.8, 73.5], P < 0.001). The incidence of motor blockade was significantly reduced in the PIEB group compared with that in the CEI group (P < 0.001).Conclusions: PIEB provides superior analgesia with less motor blockade than CEI in postpartum women after CS, without any apparent adverse events.
Lymphomatoid Papulosis: A Case Report
Authors: Verma Damini , Lakhani Ridhima , Mendiratta Vibhu , Chatterjee Priti
Published: March 2024

Lymphomatoid papulosis (LYP) is a chronic CD 30 + lymphoproliferative disorder (LPD) which is characterized by chronic, recurrent, and self-healing papulonecrotic or papulonodular skin eruptions, which are clinically benign and histopathologically malignant. It can resolve spontaneously; however, long-term follow-up is essential as it can progress to malignant lymphoma in 10–20% of the patients. We hereby report a case of a 42-year-old male presenting with recurrent papulonecrotic lesions over the face, trunk, and extremities from the last 3 years which heal with post-inflammatory hyperpigmentation and atrophic scars with a history of treated pulmonary tuberculosis one year back. There was no systemic involvement. LYP, involving cosmetically sensitive area like face, is an infrequent finding.
The Key Areas and Unmet Need of Mentorship Programs in Indian Dermatology: A Survey Based Analysis
Authors: Narayan R Vignesh , Katoch Saloni , Sarkar Rashmi
Published: March 2024

Background:

Mentorship programs for dermatologists have been in vogue in the West for many years, but have been on a hiatus in India. Recently, there is renewed interest, and mentorship programs are gaining momentum across the country to guide and nurture young dermatologists to attain their full potential. However, what constitutes an ideal mentorship program is still an enigma.

Materials and Methods:

We developed a multiple-choice questionnaire (Google-form), enquiring post graduates and dermatologists about their general opinion of mentorship, its key areas and what constituted an ideal mentorship-program. These were distributed via email and WhatsApp and responses were collected over a month’s period. The statistical analysis was carried out using Statistical Package for Social Sciences (SPSS) for Windows.

Results:

We received 202 responses and majority of the respondents were private practitioners (32.2%) and post graduate students (29.7%). Respondents felt that mentorship should be undertaken at the beginning of postgraduation (37.1%) or just after its completion (23.8%), and should focus on academic and research related issues (55.0%). Communication (95.5%) was an important factor for the program to be successful, and on an average, must be of seven weeks duration, with a mentor : mentee ratio of 1:2. We found a significant association between the designation of the respondent and their perceived ideal time for a mentorship program (P<0.001, Chi Square Test), seeking of mentorship beyond the program duration (P<0.01, Chi Square Test) and the type of mentorship program (P=0.01, Chi square test).

Conclusion:

Our survey concluded that a well-planned short mentorship program of six to eight weeks duration with a low mentee to mentor ratio with an informal style of mentoring in the formative years of one’s career would be suitable in the Indian Dermatology scenario. Communication and availability emerged as important elements for a successful mentor mentee relationship. The positive effects of a well-planned mentorship program extend beyond its duration and enrich both the mentor and mentee.
High-Resolution Ultrasound in Evaluation of Peripheral Neuropathy in Patients of Hansen’s Disease
Authors: Rai Tulika , Singh Atul M. , Indal Manish , Kumar Ishan
Published: March 2024

Introduction:

Hansen’s disease (HD) is a major public health problem in developing countries. It causes peripheral neuropathy, and if left untreated, it leads to deformities. It is important to diagnose such cases early, and prompt treatment should be given to patients to preserve nerve function.

Materials and Methods:

A total of 40 patients with HD who were already on multi-drug therapy (MDT) or treatment-naive were included in this study. These were clinically diagnosed cases of HD as per the Ridley–Jopling classification, and these patients were subjected to high-resolution ultrasonography (HRUS). A total of 19 controls were also included. The patients were clinically evaluated, and HRUS of bilateral ulnar nerves (UNs) was performed in all cases and controls. The other peripheral nerves, if clinically thickened, were evaluated using HRUS.

Results:

The cross-sectional area (CSA) of the UN in cases was significantly thickened as compared to controls. There was no difference in the CSA of patients on MDT as compared to treatment naïve patients. In two patients with pure neuritic HD, the clinical examination missed the bilateral nerve enlargement, and only unilateral nerve thickening was clinically appreciated. However, bilateral thickening was detected on HRUS.

Conclusion:

HRUS is a non-invasive and sensitive diagnostic tool that gives significant information on nerve structure and morphology. HRUS adds a new dimension to diagnosing HD, particularly the pure neuritic type, with the assessment of early nerve damage, which can prevent disabilities. HRUS is an objective diagnostic tool that can complement the clinical examination.
Dermoscopic Perspective of Pityriasis Versicolor in a Cross-Sectional Study
Authors: Vishwanath Tejas , Kapadia Farida M. , Mahajan Sunanda A. , Kharkar Vidya D. , Chikhalkar Siddhi B. , Gole Prachi V. , Iyer Mihir , Shah Avani J.
Published: March 2024

Background:

Pityriasis versicolor is a common superficial fungal infection which is usually easily diagnosed with Wood’s lamp examination and 10% potassium hydroxide mount. However, these modalities have varying sensitivity and specificity.

Aims and Objectives:

This study aimed to ascertain the dermoscopic features of pityriasis versicolor lesionally as well as perilesionally using dermoscopy, a non-invasive diagnostic tool.

Materials and Methods:

In this cross-sectional study, consecutive patients with pityriasis versicolor underwent dermoscopic examination of lesions and 2 cm around lesions, noting lesional and perilesional features. Semi-objective grading of pigmentation, scaling, and vascularity was done. The association between parameters was determined using heat maps and violin plots with Kolmogorov–Smirnov test. Lesional analysis was performed since lesions at different sides showed disparate features.

Results:

A total of 353 lesions from 233 patients (males = 150/233; 64.38% and females = 84/234; 36.05%) were studied. On lesional dermoscopy, pigmentary and scaling abnormalities were universal. 258/353 (73.1%) of lesions showed vascular abnormalities. Perilesionally, scaling (223/353; 63.17%) followed by pigmentation (205/353; 58.07%) and vascular changes (111/353; 31.44%) constituted the most common dermoscopic abnormalities and were noted in 294/353 (83.29%) of lesions overall. Increased disease duration corresponded with increased intensity of perilesional pigmentation alterations, perifollicular (P = 0.04), and follicular scales (P = 0.02).

Conclusion:

Awareness of dermoscopic features could improve the diagnostic accuracy in doubtful cases of pityriasis versicolor. Vascular findings are common and may point to an underlying inflammatory pathogenesis. Perilesional findings constitute early dermoscopic features of pityriasis versicolor and hint at the need for treatment beyond the confines of lesions. Larger follow-up studies and research into immunopathogenesis may be of further benefit.
Efficacy of Oral, Topical, and Intradermal Tranexamic Acid in Patients with Melasma — A Meta-Analysis
Authors: Panchal Viraj S. , Patel Yatri S. , Dalal Yagnya D. , Parikh Amrita P. , Dalal Archana D. , Rana Devang A.
Published: March 2024

Background and Objective:

Tranexamic acid (TXA) has recently shown promising results in the treatment of melasma. The objective of this study was to generate statistical evidence on the efficacy of TXA with different routes.

Materials and Methods:

We searched studies in PubMed, Cochrane, ClinicalTrials.gov, and Scopus using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. A change in melasma area and severity index (MASI)/modified MASI score from the baseline at the end of 8 and 12 weeks was seen. Inverse variance method was used for continuous data to measure standard mean difference (SMD) at a 95% confidence interval (CI). RevMan version 5.4 was used for analysis, and statistical heterogeneity across studies was reported using I2 statistics. P < 0.05 was considered significant.

Results:

Totally, 28 randomized control trials were included. At 8 weeks, oral TXA showed a significant change in SMD of 1.61, 95% CI 0.44–2.79, P = 0.007; at 12 weeks, oral TXA showed SMD of 2.39, 95% CI 1.42–3.35, P < 0.00001 compared to adjuvant treatment. At 8 weeks, topical TXA did not show a significant change with SMD of -0.05, 95% CI -1.08–0.97, P = 0.92; at 12 weeks, topical TXA did not show a significant change with SMD of 0.66, 95% CI -0.10–1.42, P = 0.09 compared to adjuvant treatment. Similarly, for intradermal TXA at 8 weeks, results were not significant with SMD of 1.21, 95% CI -0.41–2.83, P = 0.14, and at 12 weeks, SMD was -0.55, 95% CI -2.27–1.18, P = 0.54 compared to adjuvant treatment.

Conclusion:

Tranexamic acid in an oral formulation can be used along with adjuvant treatment for the management of melasma. Data are still required for topical and intradermal routes. Owing to the fact that our included studies had a lot of heterogeneity, more research is needed along with addressing the adverse effects of tranexamic acid as well as its variation in different skin colors.
Prescription Practices Regarding the use of Systemic Drugs in the Management of Patients with Chronic Pruritus amongst Indian Dermatologists – A Questionnaire Based Survey
Authors: Vyas Kapil , Maheshwari Kriti , Reddy Praveen K. Shanmugam , Verma Rajesh , Hasan Iffat , Mittal Asit
Published: March 2024

Background:

Chronic pruritus poses a significant challenge to treating physicians due to multitude of underlying causes and varying treatment strategies. Several topical, systemic, and physical modalities have been tried with variable success. Prescription practices in chronic pruritus are influenced by differential knowledge and experience of physicians, patient-related factors, and resource availability.

Aim:

The purpose of this survey was to observe the current pattern of practice in Indian dermatologists in the management of chronic pruritus and to identify practice gaps particularly regarding the use of various systemic agents as antipruritics.

Materials and Methods:

A previously validated questionnaire was sent to consultant dermatologists across India between January 2020 and July 2020. The questionnaire was comprised of six questions (multiple-choice questions as well as open-ended questions) regarding the use of antidepressants, cyclic gamma-aminobutyric acid (GABA) analogues, opioid antagonists, antihistamines, and alternate therapies in the management of chronic pruritus.

Results:

A total of 700 dermatologists completed the questionnaire (response rate 70%). Overall, antihistamines were the most common drug prescribed in chronic pruritus (more than 95% respondents). Other systemic agents such as opioid antagonists, gabapentinoids, and antidepressants were prescribed by 22.42%, 71.85%, and 75.29% respondents, respectively, in chronic pruritus as either monotherapy or in combination with antihistamines in specific types of itches. Among antidepressants, tricyclic antidepressants (TCAs) (69.29%) were prescribed most often, followed by selective serotonin reuptake inhibitors (SSRIs) (32.29%) and serotonin and norepinephrine reuptake inhibitors (SNRIs) (9.14%). Other treatment options such as omalizumab, thalidomide, ondansetron, ursodeoxycholic acid (UDCA), and rifampicin were used by 10% respondents to alleviate pruritus in special situations.

Conclusion:

This survey revealed the redundant practice of prescribing antihistamines in chronic pruritus irrespective of etiology among Indian dermatologists. It also revealed a differential approach regarding use of systemic agents such as gabapentinoids, opioid antagonists, and antidepressants, in academic and non-academic institutions. The survey emphasized a barrier in writing prescription of systemic agents such as opioid antagonist and SNRIs due to lack of knowledge and experience, fear of side effects, and inadequate available evidence.
A Clinico-Epidemiological Study of Fixed Drug Eruption with a Special Focus on the Causative Agent and the Clinical Patterns
Authors: Halder Dishari , Das Sudip , De Abhishek
Published: March 2024

Background:

Fixed drug reaction (FDE) is characterized by the development of well-circumscribed, round, erythematous macules and plaques on cutaneous or mucosal surface following ingestion of the offending drug.

Aim and Objectives:

To study the etiological agents responsible for FDE and to study the clinical patterns of FDE due to different drugs.

Materials and Methods:

It was a hospital-based observational cross-sectional clinical study. The study period was 24 months. Fifty patients were included. The study was done after a literature search, hypothesis generation, protocol write-up, ethical submission, ethical clearance, patient enrollment, data collection, data analysis, and research. The patients were selected on the basis of the Naranjo scoring system. The patients with a history of combination drug intake were not included in the study.

Results:

A total of 0.11% patients presented with FDE in the study period. Out of them, 52% of the patients belonged to 20–39 years age group, having sex ratio of 1.6:1. About 64% of the patients presented with multiple lesions, whereas 36% had a single lesion. A total of 46% patients presented with first episode and 54% had recurrent episodes. The mean time intervals of first and subsequent episodes were 6.5 days and 4.3 hours, respectively. Also, 16% patients had a history of herpes infection. Extremities were more affected followed by trunk and mucosa. Fluoroquinolones were the most common etiological agent found in 56% patients having cutaneous (48%) and mucosal lesions (14%). The most common drug was norfloxacin (36%) followed by both paracetamol (12%) and metronidazole (12%). Fluoroquinolones were the most common drugs implicated in bullous lesions and generalized bullous FDE.

Limitations:

The study population was small and the study was for a limited period of time.

Conclusion:

The patient should be aware of the offending drug and opt for any alternative agent after visiting the physician.
IADVL SIG Recalcitrant Dermatophytosis Position Statement on Super Bioavailable Itraconazole
Authors: Patel Nayankumar H. , Sardana Kabir , Shenoy Manjunath M. , Rengasamy Madhu , Khurana Ananta , Ghate Sunil , Venkata Chalam Konakanchi , Marfatiya Yogesh , Bhunia Deblina , Jayaraman Jyothi , Das Anupam , Jain Akshay Kumar
Published: March 2024

Itraconazole (ITZ) has been the mainstay of oral antifungal treatment for the current epidemic of recalcitrant dermatophytosis (RD) in India. Recently, a newer formulation of ITZ, super bioavailable itraconazole (SUBA-ITZ), is made available in the market by many pharmaceutical companies. It is important for dermatologists to understand the pharmacokinetic properties of SUBA-ITZ vis-a-vis conventional pellet formulation to use it effectively and safely. Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) has established a special interest group for recalcitrant dermatophytosis (SIG-RD) to strengthen research, continuing medical education, and industry collaboration on the subject. This position statement on SUBA-ITZ by SIG-RD is an attempt to address current pieces of evidence and the position of this new formulation in the management of RD.
Hyalohyphomycosis (Fusariosis): Atypical Presentation in an Immunocompetent Individual Responding to Itraconazole
Authors: Konda Deepthi , Balasubramanian Pradeep , Mohanan Saritha , Chandrashekhar Laxmisha
Published: March 2024

Hyalohyphomycosis includes infections caused by various fungal species that produce hyaline, septate, branched hyphae. Fusarium is one such species which usually causes multiple papulo-nodules, ecthyma gangrenosum-like ulcers in immunocompromised individuals. Also, fusariosis is usually difficult to manage and responds favorably to amphotericin B, voriconazole, and posaconazole in disseminated cases. Here, we report an atypical case of cutaneous fusariosis in an immunocompetent individual who presented with multiple large cystic swellings, psoriasiform plaques, and palmoplantar keratoderma, and the patient responded completely to itraconazole.
Udgharshana (an Ayurvedic therapeutic intervention) in improving vibration perception threshold in diabetic distal symmetric polyneuropathy: An observation
Authors: Ravindran Vyshna , Binitha A.
Published: March 2024

Diabetic Distal Symmetrical Polyneuropathy (DSPN), affects the sensation of vibration, a major risk factor for diabetic foot ulcers that raises the likelihood of lower limb amputation among the diabetic population. The effectiveness of existing therapeutic approaches in its management is limited, necessitating exploring alternative therapy approaches. A 61-year-old female, a known Type 2 Diabetic for five years, presented with complaints of numbness and tingling sensation in bilateral lower limbs below the knee joint associated with aching pain in the bilateral foot region for the last two years. On assessment, she was found to be positive on the Michigan Neuropathy Screening Instrument that indicates the probable diagnosis of diabetic DSPN. The patient was treated with an Ayurvedic topical therapeutic intervention, Udgharshana (~therapeutic coarse powder massage) with a combination of Triphala (~a polyherbal Ayurvedic formulation) powder and Dhanyamla (~fermented sour liquid prepared from gruel of husked grains). Improvement in clinical features was observed on Neuropathy Total Symptom Score-6 and in Semmes-Weinstein monofilament reading in the bilateral foot (right 7/10 vs. 9/10 and left 7/10-10/10). The intervention also improved the vibration perception threshold bilaterally (right 31.5V vs. 20.1V; left 30.5V vs. 22.8V). Inferring the observations, it is suggested that early disease management of diabetic DSPN with Ayurveda might arrest further disease progression and help in reversing the pathogenesis, with a positive effect on improving vibration perception threshold.
Rehabilitation of patient using a patient-specific implant with bar-retained maxillary obturator and orbital prosthesis postoperated rhino-orbital mucormycosis
Authors: Jain Vaibhav , Nagori Shakeel
Published: March 2024

The “black fungus” or Mucor mycosis affected a significant number of COVID patients during the pandemic. Aggressive surgical intervention of these cases resulted in large palatal & orbital defects that required prosthetic rehabilitation. This is a painstaking process due to compromised retention and minimum residual bone. In this dental centre, two case was rehabilitated with 3D printed titanium patient specific implants (PSI) followed by prosthetic rehabilitation.A 36-year-old male diabetic COVID patient was diagnosed with mucormycosis and underwent right orbital exenteration & maxillectomy. Upon recovery, a PSI was designed and 3D printed to provide support for orbital and maxillary prosthesis. PSI was fixed to the orbital rims and remaining zygomatic bone for supporting the prostheses and Bar-clip retained prostheses were fabricated using the conventional method.During COVID-19 pandemic, patients who contracted Mucormycosis had a poor prognosis with conventional prostheses since all the supporting structures had been affected by the infection. Conventional prostheses for maxillofacial defects do not have adequate supporting hard & soft tissues to provide retention and support. The PSI with Bar retained protheses have been selected as a treatment option for such types of defects.PSIs can be valuable aids in rehabilitating patients with large maxillofacial defects.
Evaluation of the three different doses of cisatracurium during general anaesthesia: A prospective randomized study
Authors: Kumar Prashant , Vats Jyoti , Kaur Kiranpreet , Sharma Jyoti , Johar Sanjay
Published: March 2024

Background and Aims:

The present study was conducted to determine the optimal dose of cisatracurium for intubating conditions and onset and offset of neuromuscular blockade. Data in Indian population are scarce, and hence, the present study was planned to evaluate different doses of cisatracurium.

Material and Methods:

The prospective randomized double-blind study was conducted on 180 patients of either sex in the age group of 20-60 yrs., having physical status class I to III, scheduled for surgery under general anesthesia. After exclusion 154 patients were randomly divided into three groups comprising 52, 51, and 51, respectively, in Group A, Group B, and group C. They received 0.1 mgkg-1, 0.2 mgkg-1, and 0.3 mgkg-1 of cisatracurium, respectively, to facilitate endotracheal intubation. Time of onset, intubating conditions, hemodynamic parameters, signs of histamine release, and recovery time were noted.

Results:

Mean time to onset was maximum in group A (4.37 ± 0.48 minutes) and minimum in group C (2.33 ± 0.43 minutes). Intubating conditions were found excellent in 88% patients in group. Change in HR was found to be non-significant at all time periods, but decrease in MAP was found between 2 and 10 minutes in group C. Duration of action was longest in group C.

Conclusion:

We conclude that cisatracurium in dose of 0.2 mgkg-1 and 0.3 mgkg-1 provides good-to-excellent intubating conditions within less than 3 minutes.
The usefulness of stellate ganglion block with ultrasound-guided lateral paracarotid approach in ventricular arrhythmias: A case series
Authors: Ryu Hansung , Kim Hyuckgoo
Published: March 2024

Ventricular arrhythmias are life-threatening cardiac events. Sympathetic nervous system blockade represents a crucial therapeutic method for refractory ventricular arrhythmias. Ultrasound (US) imaging for stellate ganglion block (SGB) suggests potential for its application to safer and more accurate methods. We had thirteen patients diagnosed with refractory ventricular arrhythmia and referred to the pain clinic for SGB. We visited the intensive care unit (ICU) and performed SGB with the lateral paracarotid approach technique in the ICU. Using a new approach, we easily performed SGB and felt the convenience of the procedure in the ICU. In eleven cases, we also confirmed that the effect of the block with the new technique was satisfactory. SGB, with the new technique, revealed efficiency in the recovery process of the patients. We recommended the lateral paracarotid approach technique for SGB when a patient in an ICU showed ventricular arrhythmias and should be treated with SGB.
Anesthetic management of a patient with incidental left atrial myxoma for proximal femur nailing: A case report
Authors: Anne Namita , Anandaswamy Tejesh C , Govindswamy Suresh , Ravichandran Gowshik
Published: March 2024

Cardiac myxomas are rare tumors with risks of cardiac outflow obstruction and embolic events. Surgical excision of the tumor at the earliest is the definitive treatment. We report the successful anesthetic management of a 65-year-old female patient with incidental left atrial myxoma for right proximal femur nailing. The patient was asymptomatic with no significant cardiac history. Since fracture reduction cannot be deferred for a prolonged period, the case was taken up under general anesthesia with invasive blood pressure monitoring.
Installation of dental implants in distracted anterior alveolar bone
Authors: Harouna Mohamed S. , Shoushana Mohamed M. , Nowaira Ibrahim M. , Ibrahim Marwa T.
Published: March 2024

Purpose

This study was planned to evaluate the success of dental implants installed in distracted alveolar bone using extra-osseous vertical distractor.

Patients and methods

This is a prospective noncontrolled clinical study that was carried out on eight patients with age range from 20 to 50 years old who complained from vertical alveolar defect in anterior area and underwent vertical alveolar distraction osteogenesis using extra-osseous distractor device followed by implant installation.

Results

Clinically there was a significant increase in vertical height of alveolar bone after distraction at P value of 0.007. Radiographically, by cone-beam computed tomography there was a significant increase in alveolar bone height and implants installed in distracted anterior alveolar bone were successful.

Conclusion

Alveolar distraction osteogenesis was a predictable method for restoring alveolar ridge height prior to implant placement. Distraction osteogenesis is ideally suited for recreating missing tissues in the anterior esthetic zone. The bone gain reached at the end of distraction appears to be lasting.
Evaluation of time-dependent ion-release and antibacterial activity of three adhesive resin cements
Authors: Gamal Susan M. , Masoud Gaber I. , El-Dessouky Radwa A.
Published: March 2024

Aim

This in-vitro study aimed to evaluate time-dependent ion-release and antibacterial activity of three self-adhesive resin cements.

Materials and methods

Sixty cement discs of the three tested self-adhesive resin cements were fabricated according to the manufacturer’s instructions in a plastic transparent mold, their dimensions were 6 mm in diameter and 2 mm in height. They were divided into three main experimental groups according to the self-adhesive resin cement type: group A (Thera-Cem), group B (G-Cem), and group C (RelyX Unicem 2) (20 each). Then, each main group was further subdivided into subgroup 1 (n = 10) for antibacterial assessment against Streptococcus mutans and subgroup 2 (n = 10) for ion-release assessment of fluoride and calcium. Direct contact test was used to monitor the bacterial outgrowth. Fluoride and calcium ions release were measured by ion chromatography and atomic absorption spectrometer respectively. All results were analyzed by one-way analysis of variance then multiple comparison Tukey’s test.

Results

All the evaluated cements exhibited antibacterial effects against S. mutans; fluoride and calcium were released by all the three cements in varying concentrations after aging.

Conclusion

Based on the results of this in-vitro study and within its limitations, it can be concluded that self-adhesive resin cements seem to provide promising antibacterial and remineralizing effects as being bioactive materials.
Institutional Quality, Government Expenditure and Economic Growth Nexus in Nigeria
Authors: Emmanuel Nathan , Usifoh Kingsley Stanley , Adu Melford Jonathan
Published: March 2024

Low economic growth often correlates with the escalation of poverty, deindustrialization,  unemployment, a decline in living standards, inadequate investments in human capital, and heightened social and economic disparities. Therefore, comprehending the factors that contribute to economic growth is essential for steering an economy in the correct direction. The economic literature has identified  institutional quality and government expenditure as factors that drive economic growth. This study specifically examines the impact of  government expenditure and institutional quality on economic growth. The study employed the Dynamic Ordinary Least Squares (DOLS) method to analyse time series data from 1990 to 2022. The findings indicate that government spending has a substantial and favourable  effect on economic growth. Furthermore, the findings demonstrated that the presence of institutions had a substantial and favourable  impact on the economic development of Nigeria. According to these findings, the study suggests that government spending should be  consistently increased, but this should be accompanied with fiscal discipline through the execution of the regulatory framework of the  Nigerian government.
Recent advances in smart manufacturing: a case study of small, medium, and micro enterprises (SMME)
Authors: Bello K. A. , Kanakana-Katumba M. G. , Maladzhi R. W. , Omoyi C. O.
Published: March 2024

The digital revolution is the future pathway to experiencing business evolution. It will be difficult for any organization to remain in business without deploying fourth industry revolution (4IR) techniques. This review guides prospective business owners on the need to embrace Smart Manufacturing (SM) timely and appropriate to enhance their business performance indicators. Many manufacturing companies are facing challenges in adopting SM tools in their organization due to a lack of essential resources despite the benefits associated with SM. Therefore, this study systematically reviewed the criteria evaluation techniques in implementing digital factories. This work has analysed small, medium, and micro enterprises (SMME), with the view to enumerate the appropriate criteria to determine the level of digital technology tools adoption framework. It also highlights how to compensate for the inadequate technical and financial resources in SM. The guidelines for SM implementation adoption in SMME is a research gap that was missing in previous studies. SM benefits, challenges, applications, significance, impact, and future perspectives, are discussed. Evaluation Criteria for SM Adoption practices were also expounded. The framework used in this study will help SMME owners to adopt SM.
A review on CO2 capture over novel adsorbents: Progress in robust zeolite adsorbent development
Authors: Hambali H. U. , Jimoh T. , Peng T. L. , Umar A. A. , Mutiullah B. T. , Okolie J. A.
Published: March 2024

Indubitably, the combustion of fossils fuels has really hampered the preservation of the environment as it raises the content of CO2 in the atmosphere which consequentially results in global warming. Adsorption process remains the popular technique owing to its cost-effectiveness, faster reaction rates and flexible design. This review detailed the research progress in preparation of modified zeolite-based and novel adsorbents towards enhanced CO2 capture. In addition, the review presents an overview on available techniques of capturing CO2 and mechanism of reaction. Large surface area, distinctive mechanical characteristics and uniform dispersion of the exchangeable cations in the porous framework is prerequisite for high adsorption capacity and stability over zeolite materials. Novel nanostructured and polymeric zeolite composite materials seem promising because they offer solutions to energy-related problems while also contributing to environmental preservation. It is anticipated that this review could offer a conclusive roadmap in the pursuit of a cost-effective, industrially potent adsorbent suited for enhance CO2 capture.
Tarantula cubensisalcohol extract enhances the tumoricidal effect of capecitabine via multiple pathways in azoxymethane-induced colorectal cancer in rats
Authors: Akcakavak Gokhan , Celik Zeynep , Karatas Ozhan , Dogan Osman , Ozdemir Ozgur , Tuzcu Mehmet
Published: March 2024

Purpose: To evaluate the effect of a combination of Tarantula cubensis alcohol extract (TCAE) and capecitabine (CAP) in the treatment of azoxymethane (AOM)-induced colorectal cancer (CRC).

Methods: Forty-two Wistar albino rats were divided into 7 groups with 6 rats in each group. The groups consisted of Control (C), Control+TCAE (C-TCAE), Control+CAP (C-CAP), Cancer control (CC), Cancer+TCAE (CC-TCAE), Cancer+CAP (CC-CAP) and Cancer+CAP+TCAE (CC-CAP+TCAE). To induce CRC, AOM (15 mg/kg) was administered to rats subcutaneously (sc) twice at a one-week interval to all the groups except control. From the 15th week, TCAE (0.2 mL/rat sc) was administered to CC-TCAE group every 3 days for 4 weeks, and CAP (40 mg/kg/day) was administered by gavage to CC-CAP group for 4 weeks. In CC-CAP+TCAE group, TCAE (0.2 mL/rat sc) was administered every 3 days for 4 weeks, and CAP (40 mg/kg/day) was administered gavage for 4 weeks. Animals were treated for 18 weeks. Aberrant crypt foci (ACF) were evaluated histopathologically among CC, CC-TCAE, CC-CAP, and CC-CAP+TCAE groups. β-catenin, CD15, Proliferating Cell Nuclear Antigen (PCNA), and Nuclear Factor kappa B (NF-κB) expression levels were immunohistochemically compared among all groups.

Results: Histopathologically, ACF scores were significantly increased in CC group, while a significant decrease in the relevant scores (p < 0.001) was observed in CC-CAP and CC-CAP+TCAE treatment groups, and the lowest scores were in CC-CAP+TCAE group. Immunohistochemically, in CC group, β-catenin, Nuclear Factor kappa B (NF-κB), Proliferating Cell Nuclear Antigen (PCNA) and CD15 expressions were highly irregular. CC-CAP and CC-CAP+TCAE groups had significantly reduced expressions (p < 0.001), and the lowest expressions were in CC-CAP+TCAE group.

Conclusion: The combined use of TCAE and CAP in treatment of CRC has a synergistic effect and increases the anticancer efficacy of TCAE, and CAP. More studies at the molecular level are needed in the future to demonstrate the clinical benefit of TCAE supplementation during the treatment of CRC with CAP.
Topics in elliptic problems: from semilinear equations to shape optimization
Authors: Tavares Hugo
Published: March 2024

In this paper, which corresponds to an updated version of the author's
Habilitation lecture in Mathematics, we do an overview of several topics in
elliptic problems. We review some old and new results regarding the Lane-Emden
equation, both under Dirichlet and Neumann boundary conditions, then focus on
sign-changing solutions for Lane-Emden systems. We also survey some results
regarding fully nontrivial solutions to gradient elliptic systems with mixed
cooperative and competitive interactions. We conclude by exhibiting results on
optimal partition problems, with cost functions either related to Dirichlet
eigenvalues or to the Yamabe equation. Several open problems are referred along
the text.
Ensemble Based Approach: Evaluating network and Model Performance Tackling DDOS attack
Authors: Amit Dogra  , Taqdir
Published: March 2024

With in the dynamic realm of cyber threats, distributed denial of service (DDoS) attacks pose a serious threat. They can undermine network infrastructures and bring about service interruptions that cost money. Our research proposes an ensemble-based technique for DDoS attack detection in response to this problem. By combining the strengths of three distinct classifiers—Random Forest, K-Nearest Neighbors (KNN), and Adaboost—we create a powerful ensemble model. To ensure superior performance, we employ a Multi-Layer Perceptron (MLP) for intricate feature extraction and data normalization in the pre-processing stage. Together with individual classifiers, the ensemble's efficiency is carefully evaluated, verifying that it can accurately identify and counteract DDoS attacks. Motivated by the dynamic nature of DDoS attacks and their inability to be defended against by conventional defense mechanisms, our work is the first to apply machine learning to enhance detection. Ensemble approaches hold promise in addressing the evolving DDoS threat landscape because they combine multiple classifiers to enhance overall performance. The research adds a new dimension by combining MLP-based feature extraction with the Adaboost, KNN, and Random Forest classifiers to increase the discriminatory power of the model. Some of our objectives include building an ensemble-based DDoS attack detection system, evaluating individual classifier performance, comparing ensemble performance with individual classifiers, and using data normalization and MLP-based feature extraction. The research is methodically organized, with a literature review, methodology, performance analysis, ensemble approach analysis, and a concluding summary. The outcomes show the value of the recommended ensemble approach and pave the way for more advancements in DDoS attack detection methods, enhancing online service security and availability in the face of evolving cyber threats.
Исследование геотермального энергетического потенциала Апшеронского района для производства электроэнергии с использованием технологии бинарного цикла
Authors: Mammadov P.Y.
Published: March 2024

Relevance. Geothermal energy offers a clean and sustainable alternative to fossil fuels for electricity and heat generation. This study explores the potential for utilizing geothermal energy alongside existing oil production in the Bibiheybat field, Azerbaijan. The aim of this work is to assess the geothermal energy potential of the Bibiheybat field and evaluate its feasibility for electricity generation. Methods. The study analyzes well flow rates, temperatures, and pressure distributions within the X stratum of the field. Temperature and pressure distribution models are developed using Surfer software. Geothermal energy potential is calculated based on well data and formula application. Binary cycle technology is proposed for electricity conversion. Results.The X stratum exhibits an anticlinal fold structure with varying well depths and temperatures (46-24°C). The geothermal energy potential of the field is estimated at 307,578.56 kWh, with 25,090.15 kWh carried by oil and 282,488.41 kWh by water. Utilizing a binary cycle power plant, approximately 107,652.49 kWh of electrical energy could be generated.

Актуальность работы. Геотермальная энергия представляет собой экологически чистую и устойчивую альтернативу ископаемому топливу для производства электричества и тепла. В данном исследовании рассматривается потенциал использования геотермальной энергии наряду с существующей добычей нефти на месторождении Бибихейбат, Азербайджан. Целью данной работы является оценка геотермального энергетического потенциала месторождения Бибихейбат и его целесообразности для производства электроэнергии. Методы. В исследовании анализируются дебиты скважин, температура и распределение давления в пласте X месторождения. Модели распределения температуры и давления разработаны с помощью программы Surfer. Потенциал геотермальной энергии рассчитан с применением формул на основе данных скважин. Для преобразования электроэнергии предложена технология бинарного цикла. Результаты. Пласт X демонстрирует антиклинальную складчатую структуру с различной глубиной скважин и температурой (24–46°C). Геотермальный энергетический потенциал месторождения оценивается в 307578,56 кВт ч, из которых 25090,15 кВт ч приходится на нефть, а 282488,41 кВт ч – на воду. При использовании электростанции бинарного цикла может быть выработано около 107652,49 кВт ч электроэнергии.
VALIDATING AN ENVIRONMENTAL MANAGEMENT ACCOUNTING PRACTICES FRAMEWORK FOR THE GREENING OF ZIMBABWEAN GOLDMINING
Authors:   University of South Africa, NYAKUWANIKA MOSES , VAN DER POLL HUIBRECHT MARGARETHA ,   University of South Africa, VAN DER POLL JOHN ANDREW ,   University of South Africa
Published: March 2024

The impact of gold mining on the environment remains a challenge despite its footprint being less than other mineral mining or farming. Through a comprehensive literature review, a conceptual framework was previously developed based on qualitative propositions to integrate environmental management accounting practices to address the impact of gold mining on the environment and other stakeholders. This work aims to enhance and validate our framework through interviews at mining companies and validate the resultant framework via a focus group at one of the mining companies. Some important findings from the interviews and the focus group are that government should play an active role in encouraging innovation in greening the sector, managing the environment, and providing safe water. The sector should be regulated and monitored; waste should be reduced through EMAPs, including Activity-Based Costing. Participants were less knowledgeable of other EMAPs, such as Material Flow Cost Accounting and Life Cycle Costing. Regarding sustainability, the sector’s negative impacts outweigh its positive contribution through failure to invest in greener technology. Illegal mining has further damaged the image of gold mining. Implications for theory and practice, management and policymakers are considered. Future work will involve case studies in Zimbabwean gold mines.