bluuebunny/crossref_metadata_2025 huggingface dataset:
Kharkiv school of international law. Establishment and traditions
Authors: Okladna Marina , Uvarova Mariia
Published: July 2021

Problem setting. Without knowledge of previous achievements, scientific achievements and conclusions of international scientists, it would be impossible to master the modern realities of the science of international law. Forgetting the names of researchers and their ideas on the ideological principle, which we encountered in Soviet times, caused great damage to domestic science. The process of restoring historical justice is gradually underway, and the works of past centuries are returning to scientific circulation. This also applies to the history of domestic science of international law.

Analysis of recent researches and publications. The problem of formation and development of schools of Ukrainian international law was studied by scientists N. Ulyanov, Y. Baskin, D. Feldman, V. Semenov, K. Savchuk, A. Dmitriev, U. Butler. Fundamental research in the area of Kharkiv school of international law was conducted by V.A. Yastrzhembsky, M.P. Chubinsky, D.I. Bagatiy, O. V. Butkevich, M. V. Buromensky, O. V. Tarasov.

Target of research. To analyze the history of formation and development of the Kharkiv School of International Law, to study the activities of its representatives and process their scientific works, to generalize and systematize the knowledge about the science of international law as one of the most important branches of law taught in Ukrainian universities during XIX-early XX centuries.

Article’s main body. In the article, the author analyzes certain periods of the existence of the Kharkiv School of International Law, examines in detail both the Faculty of Law as a whole and the Department of International Law. It is also shown how the Department of International Law developed, what positions existed, who were the first teachers of the department, what were their main works on the topic of international law. Also the article provides a comprehensive study about the activities and merits of the main representatives of the Kharkiv school of international law, their main scientific works were briefly described.

Conclusions. The science of international law began to develop in Ukrainian universities in the first half of the 19th century. In Kharkiv, the Faculty of Law and the Department of International Law were first formed at the Kharkiv National University of V. N. Karazin. Representatives of the Kharkiv School of International Law made a contribution to the development of the doctrine of international law in Ukraine, especially V.P. Danevsky, D.I. Kachenovskogo, T.F. Stepanova, V.A. Yastrzhembsky, who broke up the original and advanced ideas for the master of international law and laid the foundation for the modern legal science.
NT - 84 - Diset - O Fomento a Tecnologias Alternativas no Transporte Coletivo por Ônibus para Reduzir a Evasão de Usuários E Ampliar a Segurança Energética Nacional
Authors: Goes George Vasconcelos
Published: July 2021

A segurança energética tem sido um tópico pouco abordado no país, mas representa uma grave vulnerabilidade. A variação dos preços internacionais de combustíveis importados dificulta o planejamento energético nacional e onera as empresas e os usuários dependentes de tecnologias convencionais. Um dos efeitos dessa dependência é a instabilidade social e econômica, evidenciada, por exemplo, na greve dos caminhoneiros em 2018, na qual cerca de 2 milhões de caminhoneiros protestaram contra o aumento do preço do diesel. Tal evento interrompeu o abastecimento de combustíveis, medicamentos, transporte público etc., impactando o desenvolvimento econômico do país (BCB, 2018).
O diesel mineral corresponde a 42% da energia consumida pelo setor de transportes brasileiro (gráfico 1). Considerando apenas o transporte de passageiros por ônibus, a participação do diesel mineral em mistura com biodiesel atinge quase 100% do uso de energia, com poucos experimentos locais que demandam outras fontes como eletricidade, gás natural veicular (GNV), biodiesel (B100) e etanol hidratado.
ACHIEVING CLOSE RANGE PHOTOGRAMMETRY WITH NON-METRIC MOBILE PHONE CAMERAS
Authors: Odumosu Joseph Olayemi , Ajayi Oluibukun Gbenga , Nnam Victor Chukwuemeka , Ajayi Samuel
Published: July 2021

Close range photogrammetry (CRP) has gained increasing relevance over the years with its principles and theories being applied in diverse applications. Further supporting this trend, the current increase in the wide spread usage of mobile phones with high resolution cameras is expected to further popularize positioning by CRP. This paper presents the results of an experimental study wherein two (2) non-metric mobile phone cameras have been used to determine the 3-D coordinates of points on a building by using the collinearity condition equation in an iterative least square bundle adjustment process in MATLAB software environment. The two (2) mobile phones used were Tecno W3 and Infinix X509 phones with focal lengths of 5.432 mm and 8.391 mm respectively. Statistical tests on the results obtained shows that there is no significant difference between the 3-D coordinates obtained by ground survey and those obtained from both cameras at 99% confidence level. Furthermore, the study confirmed the capability of non-metric mobile phone cameras to determine 3D point positions to centimeter level accuracy (with maximum residuals of 11.8 cm, 31.0 cm, and 5.9 cm for the Tecno W3 camera and 14.6 cm, 16.1 cm and 1.8 cm for the Infinix X509 camera in the Eastings, Northings and Heights respectively).
Q-INDETERMINATE CORRELATION COEFFICIENT BETWEEN SIMPLIFIED NEUTROSOPHIC INDETERMINATE SETS AND ITS MULTICRITERIA DECISION-MAKING METHOD
Authors: Du Shigui , Ye Jun , Yong Rui , Zhang Fangwei
Published: July 2021

Owing to the indeterminacy, incompleteness, and inconsistency of decision makers’ arguments/cognitions regarding complicated decision-making problems, the truth, falsity, and indeterminacy degrees given by decision makers may imply the partial certainty and partial uncertainty information. In this case, a simplified neutrosophic set (SNS) cannot express the uncertainty degrees of the truth, falsity, indeterminacy arguments. To depict the hybrid information of SNS and neutrosophic (indeterminate) numbers (NNs) together, this study presents a simplified neutrosophic indeterminate set (SNIS) to describe the uncertainty degrees of the truth, falsity, indeterminacy, and then based on the de-neutrosophication technology using the parameterized SNSs of SNISs we introduce the q-indeterminate correlation coefficients of SNISs with a parameter q ∈ [0, 1]. Next, a simplified neutrosophic indeterminate multicriteria decision-making method using the qindeterminate correlation coefficients of SNISs is established along with decision makers’ risk attitudes, such as the small risk for q = 0, the moderate risk for q = 0.5, and the large risk for q = 1, to carry out multicriteria decision-making problems in SNIS setting. Eventually, the proposed decision-making approach is applied in an example of selecting a satisfactory slope design scheme for an open pit mine to indicate the practicality and flexibility in SNIS setting.
The Colliding Winds of WR 25 in High-resolution X-Rays
Authors: Pradhan Pragati , Huenemoerder David P. , Ignace Richard , Pollock A. M. T. , Nichols Joy S.
Published: July 2021

WR 25 is a colliding-wind binary star system comprising a very massive O2.5If*/WN6 primary and an O-star secondary in an eccentric orbit with a 208 day period. These hot stars have strong, highly supersonic winds that interact to form a bright X-ray source from wind-collision shocks whose conditions change with stellar separation. Different views through the winds of Wolf–Rayet and O stars are afforded with orbital phase as the stars move about their orbits, allowing for exploration of wind structure in ways not easy or even possible for single stars. We have analyzed an on-axis Chandra/HETGS spectrum of WR 25 obtained shortly before periastron when the X-rays emanating from the system are the brightest. From the on-axis observations, we constrain the line fluxes, centroids, and widths of various emission lines, including He triplets of Si xiii and Mg xi. We have also been able to include several serendipitous off-axis HETG spectra from the archive and study their flux variation with phase. This is the first report on high-resolution spectral studies of WR 25 in X-rays.
The Three-dimensional Flow Field around Planets on Eccentric Orbits
Authors: Bailey Avery , Stone James M. , Fung Jeffrey
Published: July 2021

We investigate the properties of the hydrodynamic flow around eccentric protoplanets and compare them with the often assumed case of a circular orbit. To this end, we perform a set of 3D hydrodynamic simulations of protoplanets with small eccentricities (e ≤ 0.1). We adopt an isothermal equation of state and concentrate resolution on the protoplanet to investigate flows down to the scale of the protoplanet's circumplanetary disk (CPD). We find enhanced prograde rotation exterior to the CPD for low planet masses undergoing subsonic eccentric motion. If the eccentricity is made large enough to develop a bow shock, this trend reverses and rotation becomes increasingly retrograde. The instantaneous eccentric flow field is dramatically altered compared to circular orbits. Whereas the latter exhibits a generic pattern of polar inflow and midplane outflow, the flow geometry depends on the orbital phase in the eccentric case. For even the modest eccentricities tested here, the dominant source of inflow can come from the midplane instead of the poles. We find that the amount of inflow and outflow increases for higher e and lower protoplanet masses, thereby recycling more gas through the planet’s Bondi radius. These increased fluxes may increase the pebble accretion rate for eccentric planets up to several times that of the circular orbit rate. In response to the eccentric motion, the structure and rotation of the planet’s bound CPD remain unchanged. Because the CPD regulates the eventual accretion of gas onto the planet, we predict little change to the gas accretion rates between eccentric and circular planets.
Antiproliferative Activity of Selected Triterpene Acids from Rosemary on Metastatic Melanoma Cell Line WM-266-4
Authors: Isaković-Vidović Suzana , Dariš Barbara , Knez Željko , Vidović Kristina , Oprić Dejan , Ferk Polonca
Published: July 2021

BACKGROUND: Natural products and their derivatives, particularly secondary metabolites, have been recognized for many years as an important source of therapeutic agents. In this context, pentacyclic triterpene acids including betulinic acid (BA), oleanolic acid (OA), and ursolic acid (UA) are highly valuable triterpenic acids because of their wide range of biological activities.

AIM: Therefore, the aim of our study was to investigate any potential effect of BA, UA, and OA on human melanoma WM-266-4 cells’ proliferation activity.

METHODS: BA, UA, and OA have been prepared in dimethyl sulfoxide in concentration range from 0.002 to 200 μM separately or in selected combination (UA+OA ratio 1:1 or 3.5:1), while cells in cell culture medium served as controls. The rapid colorimetric MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay was used to measure proliferation activity of the metastatic melanoma cell line WM-266-4 after being exposed to selected concentrations of BA, UA, OA, or UA+OA and during different time periods. Student’s t-test was used for single statistical comparisons. Data were analyzed using IBM SPSS 25.0 (IBM Corp., Armonk, NY). To account for multiple comparisons bias, p < 0.001 was considered statistically significant.

RESULTS: Our results showed decreased cell proliferation activity after 4 h of incubation of WM-266-4 cells with BA, UA, OA, and UA+OA. The highest inhibitory effect was noted when cells were incubated with selected triterpenic acids and both combinations of UA+OA during the incubation period of 48 h. When compared to control cells, concentration of 2 μM was the lowest concentration of BA that showed a significant decrease of the cells’ proliferation activity regardless the incubation period (4 h, 24 h, and 48 h) (p < 0.001).

CONCLUSION: Our encouraging results could be a good starting point for further studies on possible use of BA, UA, and OA in prevention and treatment of metastatic melanoma.
Uncrossmatched Blood Transfusion for Resuscitation Patients at the Emergency Department
Authors: Apiratwarakul Korakot , Chanthawatthanarak Sivit , Klawkla Piyathida , Ienghong Kamonwon , Bhudhisawasdi Vajarabhongsa , Suzuki Takaaki
Published: July 2021

BACKGROUND: Patients with uncontrolled blood loss often require immediate blood transfusion after the bleeding is stopped. If it is an emergency situation, blood that has not been tested for compatibility (uncrossmatched red blood cell [URBC] products) can be used. However, no studies have been conducted to evaluate the effectiveness of this protocol.

AIM: The aim of the study is to evaluate the effectiveness of URBC transfusion in Srinagarind Hospital’s emergency department (ED).

METHODS: This was a cross-sectional study that reviewed the medical records of ninty Thai patients over 18 years of age who received at least one unit of blood through URBC transfusion in the Srinagarind Hospital ED from September 2016 to August 2018.

RESULTS: The average age of the patients was 47.23 ± 18.2 years, and 73.3% were male. A total of 149 units of URBC were provided, with 54.44% of recipients being trauma patients and 27.78% being gastrointestinal bleeding patients. The 24-h and in-hospital mortality rates were 58.89 and 72.22%, respectively. There were no cases of acute blood transfusion complications or inappropriate URBC transfusion.

CONCLUSIONS: The transfusion of URBC necessary in patients with uncontrolled bleeding. No complications were found due to acute blood transfusion.
Expérience des nouvelles pédagogies en droit public
Authors: Noël Johanna , Matala-Tala Léonard
Published: July 2021

Si la matière juridique a longtemps été hermétique à des pratiques pédagogiques innovantes, une partie des enseignants en droit entend repenser le cours magistral en souhaitant que l’apprenant redevienne au centre de ses études. Le cours magistral peut aussi être un moment privilégié où l’étudiant n’est pas qu’un scribe et ce, en privilégiant une pédagogie davantage centrée sur les interactions entre l’enseignant et les étudiants. Plusieurs exercices sont en ce sens possibles pour modifier la situation d’apprentissage classique dite magistrocentrée. Il est à noter que la multiplication des exercices différents peut permettre aux étudiants de consolider les compétences et les connaissances acquises par d’autres biais.
Perception de l’égalité de genre chez les étudiants en management : une analyse des supports visuels Powerpoint utilisés par les étudiants
Authors: Jebli Fedwa , Majdouline Ilias , Elbaz Jamal
Published: July 2021

Plusieurs études se sont intéressées aux enjeux de formation et de sensibilisation des étudiants en management sur l’égalité de genre au travail. Cette recherche a comme objectif d’explorer la perception des étudiants en sciences de gestion de l’égalité de genre et d’évaluer leur positionnement vis-à-vis de la nécessité d’inclure les préoccupations de l’égalité de genre dans les discours et pratiques organisationnels. Dans cette recherche, une étude qualitative auprès de 33 étudiants a été menée dans laquelle des supports visuels des présentations orales des étudiants ont été analysés. Aussi, 2 focus groups auprès de ces mêmes étudiants ont été organisés pour discuter des implications de leurs choix visuels sur l’égalité de genre au Maroc. Les résultats exploratoires montrent que : les étudiants n’étaient pas conscients du sens véhiculé par leurs supports sur la femme au travail, notamment en termes d’égalité ; une domination des figures masculines qui reprennent des stéréotypes de genre et un écart de pouvoir ; les participantes affichent une neutralité surprenante vis-à-vis du débat sur l’égalité de genre en entreprise dans le contexte marocain.
The Do-It-Yourself Artificial Pancreas
Authors: Palmer Walter , Greeley Siri Atma W. , Naylor Rochelle
Published: July 2021

A growing number of people with diabetes are turning to self-built systems to dose and deliver insulin. These do-it-yourself artificial pancreas systems (DIY-APS) use commercially available insulin pumps and continuous glucose monitors and add an algorithm that independently modulates insulin dosing. Frustrated by the pace of diabetes technology development, a group of patients and diabetes advocates developed this technology without formal safety studies and without approval by the US Food and Drug Administration (FDA). Loop, OpenAPS, and AndroidAPS are the three available platforms, and patients worldwide are choosing them over other options. Patients generally report positive outcomes, but in May 2019, the FDA publicly warned against the use of such systems. Endocrinology providers are, therefore, faced with a difficult decision of whether to support patients interested in using a DIY-APS. This article describes the current state of DIY-APS, regulatory considerations, and our recommendations for endocrinology providers regarding this technology.

[
Pediatr Ann
. 2021;50(7):e304–e307.]
Collective Memory and the Rhetorical Power of the Historical Fiction Film
Authors: Plantinga Carl
Published: July 2021

As tools to establish collective memory, historical fiction films either connect or don’t connect with audiences depending on the historical context in which they are seen. It also makes sense, however, to account for their function psychologically as prompts for experience. In that regard, at least the following three sources account for their rhetorical power. First, for most viewers, they have an ambiguous reference to historical reality that puts into play the “sleeper effect,” which inhibits counterarguing and thus promotes the establishment of historical memory. Second, historical fiction films are mass media disseminated widely to millions of viewers. They also possess medium characteristics that foster viewer immersion and a sense of “presentness.” Third, the ritualized use of conventional narrative schemas elicits emotions that assist memory formation. To make these points, I draw on both media theory and social science research. I give examples and analyze scenes from films such as Selma (2014), Lincoln (2012), and BlacKkKlansman (2018) to illustrate my points. Finally, I conclude with a discussion of the ethics of the historical fiction film, arguing that a blanket dismissal of mainstream historical fictions would be wrong, for it would deny the possibility of establishing beneficial collective memories that have to do, for example, with antiracism or other values that should be widely embraced.
Using Digital Games in Virtual Classrooms to Make Attitudinal Learning Motivating and Engaging
Authors: Janakiraman Shamila
Published: July 2021

The COVID-19 global pandemic has made it difficult for schools to conduct in-person learning, pushing educators to think innovatively to create digital classrooms and engage K-12 learners. This chapter will provide best practices and pedagogical reasoning into the use of digital game-based learning (DGBL) for attitudinal instruction in virtual classrooms of middle and high school students. When it comes to teaching socio-scientific topics, providing cognitive knowledge is not the only goal of education. Young learners need to develop appropriate attitudes and behaviors to ensure the holistic development of their personality. This is where DGBL has been found to be an effective instructional activity. Although the focus of this chapter is on using DGBL in environmental sustainability education, it provides implications that are applicable to other socio-scientific topics as well.
Designing Virtual Collaborations in Case-Based Science Learning
Authors: Mardi Fatemeh , Walsh-Rock Elizabeth , Balcerzak Phyllis
Published: July 2021

This chapter focuses on the design components and layout of digitally engaging high school students in high level thinking activities during virtual synchronous science sessions. By integrating digital tools and applying case-based lessons that target "engaging in argument from evidence,” learning experiences that engage all students in an online setting are described. Two virtual experiences from a high school anatomy class related to making a diagnosis and justifying it using evidence are presented in this chapter. In the bell ringer and summative case study diagnosis activities, Zoom breakout room, Google Slides, and Google Docs are used. From a biomedical science course, two other learning experiences are described which utilize career-oriented role play and cases studies to have students collaborate and authentically apply their content knowledge. In the contact tracing and genetic counseling activities, Padlet and FlipGrid are used respectively. The related pedagogical reasoning, successes, and challenges follow the explanations of the four experiences.
Anomaly-Based Intrusion Detection Systems for Mobile Ad Hoc Networks
Authors: Valiveti Sharada Ramakrishna , Manglani Anush , Desai Tadrush
Published: July 2021

Ad hoc networks are used in heterogeneous environments like tactical military applications, where no centrally coordinated infrastructure is available. The network is required to perform self-configuration, dynamic topology management, and ensure the self-sustainability of the network. Security is hence of paramount importance. Anomaly-based intrusion detection system (IDS) is a distributed activity carried out by all nodes of the network in a cooperative manner along with other related network activities like routing, etc. Machine learning and its advances have found a promising place in anomaly detection. This paper describes the journey of defining the most suitable routing protocol for implementing IDS for tactical applications, along with the selection of the related suitable data set. The paper also reviews the latest machine learning techniques, implementation capabilities, and limitations.
Visualization of Resident Memory CD8 T Cells in the Lungs of Young and Aged Influenza Memory Mice and after Heterosubtypic Challenge
Authors: Cookenham Tres , Lanzer Kathleen G , Tighe Mike , Ward Jerrold M , Reiley William W , Blackman Marcia A
Published: July 2021

Memory T cells that are resident in the tissues (T resident memory [Trm]) serve as frontline responders to prevent reinfection by pathogens. Trm in the lung protect against respiratory viruses. Although these cells have been well characterized, little is known about the impact of immune aging on the establishment, maintenance, function and recall of lung-resident Trm in the context of an influenza virus infection. Aging is associated with a progressive decline in immune function and a generalized inflammatory syndrome, referred to as inflammaging. In this study, we analyzed inflammation in the lung and assessed numbers and function of lung Trm after primary influenza infection and heterosubtypic challenge of young and aged mice. Our analysis showed that aged mice had more severe and sustained lung inflammation than young mice. Analysis of Trm numbers by flow cytometry and direct imaging showed comparable or higher numbers of Trm in aged compared with young mice, with a similar rate of decline over time in both groups of mice. Furthermore, influenza virus-specific Trm from young and aged memory mice were both functional in vitro, and the mice were protected from heterosubtypic challenge. Finally, there were enhanced numbers of T cells resident in the lungs of aged compared with young mice after heterosubtypic viral challenge. The data suggest that the generation, maintenance, and function of Trm in aged mice are not severely impaired and the increased numbers in aged compared with young mice after heterosubtypic challenge may be associated with enhanced lung inflammation in the aged mice.
Laboratory and demographic findings among patients with coronavirus disease 2019: A review
Authors: Mir Atefeh , Kalan Farmanfarma Khadijeh , Salehiniya Hamid , Shakiba Abolfazl , Mahdavifar Neda
Published: July 2021

Coronavirus disease 2019 (COVID-19) is the third known animal coronavirus, after severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome coronavirus (MERS-CoV). The mean age of the infected patients was estimated to be between 50 and 69 years old. Accordingly, the COVID-19 mortality rate was calculated as 15%. In this regard, the essential component of prevention and planning is knowledge of laboratory and demographic findings among COVID-19 patients; therefore, the present study was conducted to investigate laboratory and demographic findings among these patients worldwide. This systematic review was performed on the articles published in English between January 1, 2019 and May 4, 2020, using MeSH-compliant keywords such as "COVID-19", "Laboratory, coronavirus disease-19 testing", and " demography " in international databases (PubMed, and web of science Scopus). Thereafter, the articles relevant to laboratory and demographic findings among COVID-19 patients were included in the final review. Reviewing the included articles showed changes in the mean lymphocytes count ranged from 0.7 to 39 in hospital or severe cases. Moreover, Leukopenia was not observed in patients with thrombocytopenia. In addition, C-reactive protein (CRP), leukocytes, D-dimer, FDP, FIB, neutrophils, AST, serum creatinine, t-troponin, troponin I, and blood bilirubin levels showed increasing trends in most studies conducted on COVID-19 patients. Notably, the elevated LDH level was more common among children than adults. According to the results of the present study, and by considering the clinical characteristics of COVID-19 patients on the one hand, and considering the changes in laboratory samples such as lymphocytes and other blood markers due to the damaged myocardial, hepatic, and renal tissues on the other hand, it is recommended to confirm the diagnosis of this infection by evaluating the patients’ blood samples using other diagnostic methods like lung scan.
Bilateral Visual Loss Caused by Pneumosinus Dilatans
Authors: Aghdam Kaveh Abri , Aghajani Ali , Sanjari Mostafa Soltan
Published: July 2021

Purpose:

To report a rare case of primary pneumosinus dilatans (PSD) and to specify the cardinal imaging findings associated with this condition.

Methods:

A 20-year-old patient presented with bilateral profound visual loss as a result of primary PSD. A detailed review of clinical findings and presumed pathophysiological basis of vision loss was performed.

Results:

Other than undiagnosed primary hypothyroidism, no other abnormalities were found. With the diagnosis of PSD, the patient underwent optic nerve decompression through transnasal sphenoidotomy. However, after nine months of follow-up, no improvement in the patient's vision was attained.

Conclusion:

Unlike previous reports of favorable visual results after sphenoidotomy and bilateral decompression of the optic nerves, vision recovery was not achieved in this case.
Femtosecond laser-assisted arcuate keratotomy for correction of postkeratoplasty astigmatism
Authors: Anis Mohamed , Howaidy Ahmed , Azzam Sarah
Published: July 2021

Purpose

The aim of this study was to evaluate the effect of femtosecond laser-assisted arcuate keratotomy (FS-AK) for correction of postkeratoplasty astigmatism.

Patients and methods

This is an interventional prospective clinical study that included 15 patients with postkeratoplasty corneal astigmatism more than 4 D for whom FS-AK was performed between January 2016 and September 2019 for correction of astigmatism. Femtosecond laser was used to perform paired arcuate incisions 1.00 mm inside the graft. Patients’ uncorrected visual acuity and astigmatic change were recorded with follow-up of up to 6 months after surgery.

Results

The mean magnitude of corneal astigmatism improved from 8.18±2.11 D preoperatively to 3.31±1.18 and 4.00±1.29 D at 2 and 6 months after FS-AK, respectively (P=0.000), with a significant improvement in uncorrected visual acuity from 0.72 LogMAR preoperatively to 0.36 and 0.38 LogMAR at 2 and 6 months, postoperatively (P=0.000). However, surgically induced astigmatism was 5.05±1.31 and 4.43±1.26 D at 2 and 6 months, postoperatively.

Conclusion

FS-AK is an effective and safe technique in reducing astigmatism following keratoplasty and in improving the visual outcome. Although regression may occur, the visual outcome is still satisfactory.
Treatment of dry eye disease due to meibomian gland dysfunction using intense pulsed light and low-level light therapy
Authors: Khalifa Ali A. , Ibrahim Mohamed M.A. , Abdelrahman Mahmoud S.A.
Published: July 2021

Background

Meibomian gland dysfunction (MGD) is an abnormal chronic state of meibomian glands in which there is quality and quantity alternations in the meibum glandular secretion or terminal duct obstruction. Patients with MGD show imbalance in the tear film components because of the lipid layer deficiency.

Objectives

The aim of this study was to assess the changes in the tear film after using intense pulsed light and low-level light therapy (IPL-LLLT) according to the Dry Eye Workshop classification.

Patients and methods

The study enrolled 80 eyes of 40 patients of both sexes with dry eye disease caused by MGD, with age range from 23 to 74 years. They showed symptoms of unilateral or bilateral dryness, diagnosed as MGD, with a meibum grade more than or equal to 1 and with a Fitzpatrick skin type of two to five appearance dependent and sensitivities to sun light. They were studied by comparing the pretreatment and posttreatment session values.

Results

The Dry Eye Workshop score showed a significant reduction after 4 weeks of the IPL-LLLT treatment in comparison with the baseline (P<0.001). The meibomian gland evaluation scores (meibum grade and meiboscale) showed a significant improvement after 4 weeks of treatment (P<0.001). Moreover, the Standard Patient Evaluation of Eye Dryness significantly decreased after the treatment (P<0.001). No undesirable events were observed except for four cases, all of which showed transient redness. In addition, one patient showed an obvious improvement in Schirmer test I, the second showed deterioration in the meibum grade, and the third showed deterioration in visual acuity, Schirmer test I, tear break-up time, corneal fluorescein staining, meibum grade, and Standard Patient Evaluation of Eye Dryness.

Conclusions

IPL-LLLT combination could be used as a safe and efficient way for MGD treatment. However, it does not completely cure the MGD.
The effect of trabeculectomy and deep sclerectomy on the choroidal thickness
Authors: Tolba Doaa A. , Abdelrahman Ahmed M. , El-Saied Heba M. , Kotb Mohamed S.
Published: July 2021

Purpose

The aim of this study was to compare the changes in subfoveal choroidal thickness (SFCT) following trabeculectomy and nonpenetrating deep sclerectomy (NPDS) in cases with primary open-angle glaucoma (POAG).

Patients and methods

This is a prospective interventional comparative randomized study that was carried out on 42 eyes of 32 patients with chronic POAG who were divided into two groups: group A included 22 eyes that underwent trabeculectomy, and group B included 20 eyes that underwent NPDS. SFCT was measured preoperatively and was repeated on the third day and at 1 month postoperatively using spectral domain optical coherence tomography.

Results

In group A, there was a statistically significant increase in the SFCT on the third postoperative day and after 1 month, with a mean value of 42.86±38.08 and 28.5±27.91 μm, respectively, when compared with the preoperative SFCT (P<0.05). In group B, the increase in SFCT was statistically significant on the third postoperative day, with a mean value of 38.45±24.33 μm when compared with the preoperative SFCT (P=0.0001). However, after 1 month, the increase in SFCT became nonsignificant, with a mean value of 13.25±6.55 μm when compared with the preoperative SFCT (P=0.19). There was a positive correlation between the amplitude of intraocular pressure reduction and the change in the SFCT in both groups.

Conclusion

Both trabeculectomy and NPDS caused a significant increase in SFCT in the early postoperative period, which might be related to postoperative hypotony maculopathy. SFCT went back near to normal values after NPDS earlier than after trabeculectomy in cases with POAG.
Clinical Implications of Undernutrition in Childhood Cancer
Authors: Sakthikumar Lakshmanan , Sneha Latha M. , Chandran Shobana , Scott Julius , Soundarapandiyan Lakshmipriya , Kumar Yogesh
Published: July 2021

Introduction:

Coexisting malnutrition is one of the known influencing factor of the survival rates in childhood cancer. Malnutrition contributes to poor immune function, altered drug metabolism—thereby causing drug toxicities and adverse clinical outcome. This study was done to assess the impact of undernutrition during treatment for childhood cancer, among the children diagnosed at our center.

Methods:

All children ≤18 years diagnosed with cancer between June 2011 and June 2019 treated at our institution were included in this study. Nutrition was assessed using body mass index (BMI) Z-score and a Z-score < −2SD was classified as undernourished. Weight loss of more than 10% or a decrease in BMI Z-score by ≥1SD below the previous Z-score was considered significant. All adverse effects and outcomes were compared between malnourished and adequately nourished children.

Results:

Three hundred six patients were included in this study, 114 (37.2%) were undernourished at diagnosis. One hundred two (33.3%) of 306 had significant weight loss. Malnutrition at diagnosis and significant weight loss was associated with an increased risk of febrile neutropenia, anemia, dosage modifications, and mucositis. Patients undernourished and those with significant weight loss showed a worse outcome (death or relapse) (P < 0.001).

Conclusion:

Nutritional status represents a modifiable risk factor long suggested to affect survival and treatment-related toxicity in pediatric malignancies and hence early nutritional intervention should be an essential part of the multi-disciplinary treatment protocol.
HHOM-051608 A Whey Protein Formulation Fortified with Herbal Actives Improves Exercise Performance and Muscle Strength
Authors: Vishwakarma Kamlesh K. , Narendra Madan M. , Azeemuddin Mohammed M. , Shankar Poornima , Babshet Prathibha , Rafiq Mohamed , Babu Uddagiri V.
Published: July 2021

Context:

The lifestyle of individuals is changing rapidly in today’s world and physical fitness is an essential requirement to keep oneself fit and healthy. Nutritional supplements could improve physical fitness by modulating energy metabolism, oxidative processes, and perceived fatigue.

Aim:

This study aimed to evaluate the effects of HHOM-051608, which is a first-of-its-kind whey protein supplement, packed with naturally rich essential amino acids and herbal ingredients to improve the exercise performance, energy metabolism, and physical endurance.

Setting and study design:

Thirty-two male Wistar rats were divided into four groups of eight each. Group 1 served as sedentary control; group 2 was sedentary rats treated with HHOM-051608 (2 g/kg b.w.); group 3 was exercise training control, and group 4 was exercise training rat treated with HHOM-051608 (2g/kg b.w.).

Methods:

The exercise training rats were trained on a motorized rat treadmill at a constant speed for 8 weeks. After 8 weeks, all animals were subjected to a grip strength test followed by a treadmill endurance test.

Statistical analysis:

The results were statistically analyzed by one-way analysis of variance followed by Tukey comparison test, using Prism GraphPad 6.07 (GraphPad Software Inc, San Diego, CA, USA). A P value < 0.05 was considered statistically significant.

Results:

HHOM-051608 supplemented animals showed a significant increase in grip strength and run time on the treadmill.

Conclusion:

HHOM-051608 has improved the exercise performance, muscle strength, and muscle glycogen. Thus can be recommended to enhance exercise performance, build muscle mass and decrease muscle soreness.
Efficacy of Posterior Cervical Laminectomy for Multilevel Cervical Ossification of Posterior Longitudinal Ligament
Authors: Asati Sanjeev , Kundnani Vishal G. , Sagane Shrikant S. , Jain Sanyam , Raut Saijyot
Published: July 2021

Study Design:

This study design includes retrospective study of prospectively collected data.

Introduction:

The purpose is to determine the efficacy of posterior cervical laminectomy for multilevel cervical ossified posterior longitudinal ligament (OPLL). Laminectomy has been a preferred surgical treatment for multilevel cervical OPLL since a long time. Because of the risk associated with progressive kyphosis, the trend is shifted from laminectomy alone to laminoplasty and laminectomy with fusion. The data regarding the efficacy of laminectomy alone in terms of clinical and radiological parameters in multilevel cervical OPLL are scanty.

Materials and Methods:

We reviewed 82 patients with multilevel cervical OPLL who underwent posterior cervical laminectomy from January 2008 to December 2014. Patients with age ≥45 years, C2–C7 Cobb’s angle ≥ 10º, compression at ≥3 levels, and a minimum of 5 years of follow-up were included in the study. Demographics, pre and postoperative clinical parameters (visual analog scale (VAS), Nurick’s grading, and modified Japanese orthopedic association (mJOA) score), radiological parameters (C2–C7 Cobb’s angle, C2–C7 sagittal vertical axis (SVA)), perioperative parameters, complications, and recovery rate were evaluated.

Results:

The mean age of the patients was 56.4 (46–72) with M: F of 52:30. The mean blood loss and mean operative time were 93.9 mL and 96.6 min, respectively. There was significant improvement (P < 0.05) in VAS (3.6 ± 1.4 to 1.8 ± 0.8), Nurick’s grading (3.2 ± 0.9 to 1.9 ± 0.6), and mJOA score (8.4 ± 1.4 to 13.8 ± 1.9). C2–C7 Cobb’s angle increased from [FIGURE DASH]14.4 ± 1.7º preoperatively to [FIGURE DASH]8.2 ± 1.5º postoperatively and C2–C7 SVA from 18.4 ± 12.5 to 29.8 ± 15.8. Intraoperatively four patients had a dural tear. Three patients showed neurological deterioration postoperatively and three had unilateral C5 palsy which improved within a period of 6 months. 18.3% had an excellent outcome, 40.3% had good, 34.1% had fair, and 7.3% of the patients had a poor outcome.

Conclusion:

Multilevel cervical laminectomy is an effective surgical procedure in properly selected patients with multilevel OPLL. The outcomes are satisfactory in terms of radiological and clinical parameters. The risk of postlaminectomy kyphosis is not too high, and we found no correlation of kyphosis with clinical affection.
Sugammadex and anaphylaxis
Authors: Arslan Baris , Sahin Tuna , Ozdogan Hatice
Published: July 2021

In this study, the published sugammadex-induced anaphylaxis reports were reviewed to determine similarities in their presentation during anesthesia. PubMed was searched for sugammadex-induced anaphylaxis without time limitation. Reports were evaluated if they were in English and met the criteria of anaphylaxis determined by the World Allergy Organization. Two independent reviewers extracted and assessed the data using predesigned data collection forms. In total, 23 suitable articles were found and 33 sugammadex-induced anaphylaxis cases were included in the study. The mean age was 43.09 years (from 3–89 years) and 17 (51.5%) of the patients were female. Considering all reported cases, the average onset time of anaphylaxis was 3.08 min, with a median of 3 min (range 1–8 min). The most common signs and symptoms were hypotension, tachycardia, erythema, and desaturation. Of the 20 patients who underwent confirmatory skin testing, 15 had a positive skin reaction for sugammadex. Epinephrine was not given when indicated in about 25% of cases. Sugammadex-induced anaphylaxis onset time was less than 5 min in 92.3% of all the reported cases. Rapid diagnosis and early recognition of signs and symptoms of anaphylaxis are essential for a favorable prognosis. Treatment needs to be started as soon as possible to ensure the best outcome for the patient.
Ease of lumbar epidural catheter insertion with prepuncture ultrasound as guidance compared with conventional palpatory technique when performed by anesthesiology residents
Authors: Jagadish Anguraj , Swaminathan Srinivasan , Bidkar Prasanna U. , Gupta Suman L. , Adinarayanan Sethuramachandran
Published: July 2021

Background and Aims:

Lumbar epidural catheter insertion is conventionally performed by anesthesia residents by palpation of anatomical landmarks with relatively blind localization of epidural space which may lead to an increase in failure rate. We aim to compare the ease of lumbar epidural catheterization using prepuncture ultrasound as guidance with that of conventional palpatory technique. Comparisons were made with reference to number of insertion attempts, total time taken for the procedure, frequency of dural puncture, and overall satisfaction score as assessed by Likert's scale.

Material and Methods:

Eighty, ASA 1-3, patients undergoing elective surgeries requiring lumbar epidural catheterization were recruited for the study. Study participants were randomized into two groups. In group P, epidural catheterization was performed using the conventional palpatory method and in group U, it was performed with the help of ultrasound determined parameters. Number of insertion attempts, total time taken for successful insertion of epidural catheter, frequency of dural puncture, and overall satisfaction of ease of insertion as determined by Likert's scale were compared between both the groups. Data were analyzed using SPSS statistical software version 17 and P value <0.05 was considered statistically significant.

Results:

The number of insertion attempts was significantly lesser in Group U (P = 0.019). The total procedure time was significantly higher in group U (P < .001). There was no significant difference in ease of insertion score, as measured by Likert's scale between both the groups (P = 0.45).

Conclusion:

Prepuncture ultrasound guidance improves the first attempt success rate of lumbar epidural catheterization with reduced incidence of dural puncture with similar overall satisfaction score but increases the total time taken for the procedure when compared to conventional palpatory technique.
Containment of varicella outbreak in intensive care unit of a tertiary level hospital
Authors: Sharma Raman , Goyal Kapil , Bhatia Nidhi , Rana Vikas , Singh Mini P. , Bhalla Ashish , Singh Gurpreet , Kumar Ashok , Jain Kajal
Published: July 2021

Background:

Varicella–Zoster virus (VZV) infection in healthcare organizations, especially in intensive care units (ICU), having admitted immunocompromised patients, is of serious concern as well as poses threat to healthcare workers working in such critical areas. The present report defines the transmission and infection control measures initiated to curtail VZV infection spread in the trauma ICU of a tertiary care hospital of North India.

Outbreak Report:

At the infection outset, there were 12 patients admitted in ICU and 54 healthcare workers were posted to manage these critical patients. After confirmation of VZV infection, all susceptible patients as well as healthcare workers were quarantined and fresh intake of patients was restricted. Out of the total healthcare workers, 14 (25.92%) were found susceptible (as per protective VZV IgG titers) and were vaccinated. Of the 12 patients admitted in the ICU, six patients were discharged and sent home directly, four patients expired due to their critical disease state, one patient left against medical advice, and one patient remained admitted in ICU till the incubation period was over. Epidemiologically, line listing for index case reporting was done. The efficacy of control measures was re-evaluated to strengthen existing infection control practices and general measures viz. strict hand washing, adherence to aseptic protocols and intensification of environmental cleaning.

Conclusions:

Established varicella surveillance measures ensure VZV outbreaks are identified in a timely manner and control measures implemented to prevent further transmission. Also, vaccination policy among HCWs is the utmost requirement despite having huge financial implications.
Risk Factors for Ocular Surface Disease in Tunisian Users of Preserved Antiglaucomatous Eye Drops
Authors: Lajmi Houda , Hmaied Wassim , Achour Besma Ben , Zahaf Amin
Published: July 2021

Purpose:

To study the clinical and the functional findings in glaucomatous patients under preserved eye drops having ocular surface alterations and to analyze their risk factors.

Methods:

A cross-sectional study of 155 glaucomatous patients was conducted. All of them answered the “Ocular Surface Disease Index” (OSDI) questionnaire and had a complete and precise evaluation of the ocular surface state including a Schirmer I test, a tear break-up time evaluation, eyelid, conjunctival, and corneal examination with a Fluorescein and a Lissamin green test. We studied factors that could influence the OSDI score and each type of ocular surface alteration (age, sex, glaucoma treatment duration, number and type of the active principle, and Benzalkonium Chloride [BAK] use).

Results:

BAK was used in 80% of cases. The OSDI score was ≥13, in 61.3% of cases. The biomicroscopic signs of ocular surface disease were at least minimal in 87.1% of cases. The main predictors of OSDI score increase were the glaucoma treatment duration (P = 0.01, t = 2.618), the number of molecules used (P = 0.018, t = 2.391), and the use of BAK (P = 0.011, t = 2.58). The severity of the biomicroscopic signs correlated with these same risk factors. Fixed combination was statistically associated with a lower incidence of superficial punctate keratitis (SPK) and corneal and conjunctival staining in the Lissamine green test (P < 0.001). Beta-blockers were associated with a significantly higher risk of SPK and corneal or conjunctival staining in the Lissamine green test (P < 0.001).

Conclusions:

Preserved antiglaucomatous eye drops alter the patients' ocular surface. The main risk factors were advanced age, duration of glaucoma treatment, multiple therapies, and the use of BAK.
Autologous Activated Omental Versus Allogeneic Adipose Tissue-Derived Mesenchymal Stem Cells in Corneal Alkaline Injury
Authors: Shadmani Athar , Razmkhah Mahboobeh , Jalalpoor Mohammad Hassan , Lari Sina Yazdanpanah , Eghtedari Masoomeh
Published: July 2021

Purpose:

To compare the effects of two types of mesenchymal stem cells (MSCs), activated omental cells (AOCs), and adipose tissue-derived stem cells (ADSCs) in the healing process of animal model of ocular surface alkali injury.

Methods:

An alkaline burn was induced on the ocular surfaces of eighteen rats divided randomly into three groups. The first and second groups received subconjunctival AOCs and ADSCs, respectively. The control group received normal saline subconjunctival injection. On the 90th day after the injury, the eyes were examined using slit-lamp biomicroscopy. Corneal neovascularization and scarring were graded in a masked fashion. Histological evaluation of the corneal scar was performed, and the number of inflammatory cells was evaluated.

Results:

Corneal neovascularization scores revealed higher neovascularization in the control (0.49 ± 0.12) than the AOC (0.80 ± 0.20, P = 0.01) and ADSC groups (0.84 ± 0.24, P = 0.007). There were no statistically significant differences between the neovascularization score of the AOC and ADSC groups (P > 0.05). According to histologic evaluation, stromal infiltration was significantly more in the control group compared to AOC and ADSC groups (P < 0.05).

Conclusions:

Our results suggest that MSCs, even with different sources, can be used to promote wound healing after corneal chemical burns. However, the ease of harvesting ADSC from more superficial fat sources makes this method more clinically applicable.