bluuebunny/crossref_metadata_2025 huggingface dataset:
A PCCN-Based Centered Deep Learning Process for Segmentation of Spine and Heart
Authors: Uday Kiran K. , Mamidisetti Gowtham , Pittala Chandra shaker , Vijay V. , Vallabhuni Rajeev Ratna
Published: April 2022

The spinal cord and heart in the body are major organs. Diagnosis of diseases in these organs is very complex using MRI and CT images. The conventional methods like post segmentation, pre-image processing, and text feature extraction mechanisms cannot handle accurate diagnosis. Therefore, advanced techniques are needed. In this work, pixel-based convolution neural networks with centered deep learning processes are proposed to cross over the problems. The projected PCNN has four pixel-based convolution neural networks. Here disease objects are identified through grading framework. The entire mechanism is working based on sequential part of PCNN segmentation process. The spinal cord and heart image MRI-based diagnosis process is very difficult with conventional methods. But the proposed method provides accurate results and outperforms the standard methodology performance measures in accuracy, precision, and F1score.
Hybrid Clustering Technique to Cluster Big Data in the Hadoop Ecosystem
Authors: Padmalatha E. , Sailekya S.
Published: April 2022

Big data analytics as well as data mining play vital roles in extracting the hidden statistics. Customary advances for investigation and extraction of hidden information from data may not exert efficiently for big data because of its complex, elevated volume nature. Data clustering is a data mining technique that exacts the useful data from the data by grouping data into clusters. In big data as the data is complex and of very large volume, individual clustering techniques may not consider all the samples, which may lead to inaccurate results. To overcome this inaccuracy, the proposed method is the combination of dynamic k-means and hierarchical clustering algorithms. This proposed method can be called a hybrid method. Being a hybrid method will overcome a few drawbacks like static k value. In this chapter, the proposed method is compared with existing algorithms by using some clustering metrics.
A Forensic Way to Find Solutions for Security Challenges in Cloudserver Through MapReduce Technique
Authors: Usha D. , Raman Reshma
Published: April 2022

Cloud computing is a large and distributed platform repository of user information. But it also extensively serves the security threats in the research aspect. This chapter attempts to find the solution to the security challenges through the MapReduce technique in a forensic way. Four security challenges are included in this chapter: losing the user information during the mapping process for different reasons such as the shutdown of the server, which causes parallel or unrelated services to get interrupted; the velocity of attack, which enables security threats to amplify and spread quickly in the cloud; injecting malicious code; and finally information deletion. MapReduce and dynamic decomposition-based distributed algorithm with the help of Hadoop and JavaBeans in the live forensic method is used to find solution to the problem. MapReduce is a software framework and live forensics is the method attempting to discover, control, and eliminate threats in a live system environment. This chapter uses Hadoop's cloud simulation techniques that can give a live result.
E-Collaboration for Management Information Systems Using Deep Learning Technique
Authors: V. Rajalakshmi , V. Muthukumaran , S. Satheesh Kumar , Koti Manjula Sanjay , V. Vinothkumar , N. Thillaiarasu
Published: April 2022

Universities are currently confronted with changing student needs, a competitive labour market, and a fast-paced environment. The advancement of communication technology has enabled us to address these issues. Collaboration advances are critical to the current learning process because they train students to work in groups on tasks. In this chapter, the authors present a thorough foundation for an e-collaboration platform that was established during the successful implementation of an e-collaboration solution at the management information systems. The solution makes use of cutting-edge web portal technology and a digital asset management system to create a uniform, centralised platform for system users to collaborate, communicate, and exchange information.
Mind the Gap
Authors: Kent Carmel , Akanji Abayomi , du Boulay Benedict , Bashir Ibrahim , Fikes Thomas G. , Rodríguez De Jesús Sue A. , Ramirez Hall Alysha , Alvarado Paul , Jones Jennifer E. , Cukurova Mutlu , Sher Varshita , Blake Canan , Fisher Arthur , Greenwood Juliet , Luckin Rosemary
Published: April 2022

Many universities aim to improve students' 'learning to learn' (LTL) skills to prepare them for post-academic life. This requires evaluating LTL and integrating it into the university's curriculum and assessment regimes. Data is essential to provide evidence for the evaluation of LTL, meaning that available data sources must be connected to the types of evidence required for evaluation. This chapter describes a case study using an LTL ontology to connect the theoretical aspects of LTL with a university's existing data sources and to inform the design and application of learning analytics. The results produced by the analytics indicate that LTL can be treated as a dimension in its own right. The LTL dimension has a moderate relationship to academic performance. There is also evidence to suggest that LTL develops at an uneven pace across academic terms and that it exhibits different patterns in online as compared to face-to-face delivery methods.
A Storied Approach to Learning Data Analytics in a Graduate Data Analytics Program
Authors: Vaughn Brandon
Published: April 2022

This study considers the construction and application of a storied approach to teaching graduate level data analytics. Although some research stresses replacing traditional lectures with more active learning methods, the approach of this study is to construct an entire data analytics program around a “story” idea of active learning and projects. The results of this study indicate that such a storied approach to learning not only improves student cognition of course material, but student morale as well. An instructional approach that combines active-learning activities in a progressive, storied approach appears to be a better approach than traditional lecturing alone for teaching graduate-level students.
Don't @ Me
Authors: Trajkovski Goran , Fabregat Eduard
Published: April 2022

With the changes in societies and economies, new formats and packaging of educational products have been emerging as alternatives to the traditional degrees and certificates. Most of these offerings emerge outside higher education institutions and aim to alleviate the gap between the supply of skills and the needs of industries which had a big impact on the educational space. The authors studied approximately four hundred thousand tweets discussing educational offerings. They used a combination of topic modeling and network analysis to group topics into wider themes over the topic network. They also used word embeddings to measure semantic similarity of words related to specific educational packagings and further understand the discussion carried out on Twitter. The results of this study show how public opinion on Twitter discussed formal and non-formal educational offerings in ways that stress economic and professional advancement. Finally, the results from the word embeddings analysis revealed a need for common and clear taxonomy that differentiates between educational formats.
Impact of Information and Communication Technology on CO2 Emissions
Authors: Karamikli Aysun , Bayar Yilmaz
Published: April 2022

The significant improvements have been achieved in information and communication technologies. Furthermore, use of information and communication technologies have been spread swiftly in the world with the contribution of globalization. The raising ICT penetration has led many social, economic, and environmental impacts for the countries. In this study, the interaction between ICT indicators and CO2 emissions was analyzed in sample of EU transition countries over the 1996-2018 period through causality analysis with cross-sectional dependency. The causality analysis revealed a unilateral causality from internet usage to CO2 emissions in Croatia, Czech Republic; a unilateral causality from mobile cellular subscriptions to CO2 emissions in panel and in Croatia, Estonia, Romania and Slovak Republic, and a unilateral causality from CO2 emissions to internet usage in Romania. In other words, the ICT had a significant impact on CO2 emissions.
Assessing Climate Change and Predicting Its Effect on Efficiency and Heat Rate of Thermal Power Plants in 2050
Authors: Norouzi Nima
Published: April 2022

Numerous studies on climate change have been conducted in different parts of the world, and many studies have examined the effect of changes in meteorological parameters on the performance of the energy sector. In this study, using the results of climate change calculations in the provinces of Iran, which are obtained from the microscale exponential method with a neural network, its effect on the performance of the energy production sector in the country's power plants in the next decade has been investigated. Calculations show that, on average, the efficiency of gas power plants decreases by about 0.6% for every 1oC increase in temperature. Also, the efficiency of heating and combined power plants decreases by about 0.5 and 0.4% on average. This chapter is aimed to use the P-index reliability index to study the climate change impacts on the thermal power plant performance.
The Effect of Attitudes and Behaviors Towards New Technologies on Performance of Academicians
Authors: Karabetyan Lina
Published: April 2022

Due to the opportunities and conveniences it provides to human life, the use of new technologies is becoming more and more common in daily life, becoming indispensable. With the spread of technology, the increase in the number of people using technology has made it possible to produce new information that creates added value, thanks to the ability to easily access information all over the world to combine and analyze big data. The development of technology and the circulation of knowledge have become important elements of economic and social change. The aim of this study is to determine the effects of attitudes and behaviors towards new technologies on the performance for 450 academicians working in four research universities in Istanbul, for academics who are expected to have high compliance with innovative approaches. As a result of the structural equation model, a positive 38.4% increasing relationship was determined between the attitudes and behaviors towards new technologies and performance.
The Relationship of Technological Change With Economic Growth From the Perspective of Institutional Economics
Authors: Dura Yahya Can , Güler Cengizhan
Published: April 2022

The relationship between economic growth, technological change, and institutions has been the subject of various theoretical evaluations. In this chapter, the relationship in question will be examined in the context of the systematics of thought of two great thinkers, J. A. Schumpeter and T. Veblen. In this study, evaluations are made by theoretically putting Schumpeter, who examines the effects of economic growth and institutional structure as the dominant factor of the change brought about by technological development, at one end of the spectrum and Veblen, who states that the structure of institutions and society is more dominant in technological change, on the other side.
Evaluation of the Development Level of Provinces in Turkey and Incentives for Research and Development
Authors: Tekin Ahmet , Doğan Esra
Published: April 2022

The aim of this study is to reveal the relationship between the support provided for research and development (R&D) within the scope of the investment incentive system and innovation registration on the basis of spatial differences, taking into account regional development differences. In this direction, an empirical evaluation is made to reveal whether the level of incentives provided for R&D and the level of innovation in Turkey on the basis of 81 provinces differ in the context of socio-economic development level. As a result of the analysis, it is seen that 81 provinces are divided into five clusters.
The Transformation Framework
Authors: Trad Antoine
Published: April 2022

It is known that geopolitical knowledge, conflicts, wars, and military investments are the backbone for flourishing global economies' evolution, stagnation, or failure. Military and defence organizations are those who drive major intelligence-based technology transformation and innovation trends. Countries, military environments, and organizations (or simply entities) are increasingly using complex and intelligent technologies, like artificial intelligence (AI). One of the most complex military tasks and geopolitical risks is using AI to balance and coordinate in real-time the following military technology artefacts: autonomous and fixed objects, financial and resources capabilities, combative and morale statuses, mass management, information technology and data, developing military scenarios, evolution of demography, and others. Therefore, the stability and evolution of an entity depends on the role of artificial intelligence for military strategies (RAI4MS).
Role of Carbon Nanotube on Multi-Length Scale Tribological Properties of Al2O3-Based Thermal Barrier Coating
Authors: S. Ariharan , Maurya Rita
Published: April 2022

Magnificently developed Al2O3, 3YSZ, 8YSZ, and CNT-based thermal barrier coatings (TBCs) were subjected to study multi-length scale tribological behaviour (fretting wear and micro-scratch) of the composite coatings. Subsequently, the role of constituents of the composite on the tribological behaviour of the coatings has been recognized. Fretting wear rate and the dominative wear mechanism are identified. The fretting wear behaviour is evaluated with a distinct representation (frictional force mapping) to understand the transition of regimes. Further, micro-scratching is used to assess the composite coatings against the sharp edges. The critical load of failure and scratch characteristics (scratch hardness, toughness, and scratch resistance) are appraised to find the suitability of the composite in TBC. Notably, the role of CNT in a multi-length scale is reported quantitatively. Thus, the chapter provides a comprehensive overview of the Al2O3-based composites that deal with the understanding of the multi-length scale tribological properties at room temperature.
Recent Advances in Design and Fabrication of Wear Resistant Materials and Coatings
Authors: Kumar Santosh , Kumar Rakesh
Published: April 2022

In recent years, the demand of wear resistance material and coating is increasing very rapidly as it reduces substantial energy losses resulting from wear and friction. To overcome these energy losses, surface engineering is employed. Surface engineering is the process of coating or modifying the surface of part to minimize wear, friction, corrosion, as well as to enhance the lifespan of machine components and reduce the manufacturing cost. Recently, numerous coating methods are available for distinct material (pure metals to alloys, carbides, composites, and ceramics) applications. Hence, this chapter provides an overview on the prevention of tribo-surfaces through distinct methods of surface modification such as thermal, physical, and chemical methods of coating. Further, distinct coating properties, applications, future scope, and challenges are described.
Tribological Performance of Coatings Obtained by PVD Techniques
Authors: Dinu Mihaela , Pana Iulian , Parau Anca C. , Vladescu Alina
Published: April 2022

The chapter presented a short review related to the factors that dictate the wear and friction behavior of various coatings obtained by PVD techniques used for various applications. An important parameter with high impact on the final properties of the coatings prepared by cathodic arc evaporation is the reactive atmosphere. The friction and wear performance of the carbide coatings were strongly dependent on the carbon content which can be controlled by varying the C2H2 mass flow rate and the arc current on the cathode. Regarding the carbonitrides coatings, the ratio of C/N plays an important role; the coating with a low C/N ratio showed reduced friction coefficients, while for the coatings with a high C/N ratio the wear was improved. For biomedical applications, the magnetron sputtering deposition technique was employed to enhance the tribological performance of Ti6Al4V alloy in Ringer solution using various types of coatings such as carbonitrides, carbide, or hydroxyapatite.
The role of mismatch repair proteins expression in colorectal cancer
Authors: Bertolina C. , Erra S. , Ranzato E.
Published: April 2022

In the present study, carried out during the internship in Surgical Pathology of Santo Spirito Hospital in Casale Monferrato, a score based on the quantification of mismatch repair proteins (MMR) in patients with colorectal adenocarcinoma was devised, to determine whether a different expression in these proteins could correlate with some morphological parameters, and therefore whether it was possible to define a prognostic stratification for these patients. Objective During this period, 73 cases of colorectal adenocarcinoma referred from 01/01/2020 to 31/03/2021 were analyzed. The cases were investigated by immunohistochemical examination to assess the expression of mismatch repair proteins. Subsequently, the immunohistochemical preparations were observed by light microscopy, evaluating a total percentage of expression in the tumor tissue, in order to perform a correlation study between the expression of mismatch repair proteins and some morphological characteristics of the tumor at diagnosis. The total expression of MLH1 protein, as representative of the MLH1/PMS2 heterodimer, and of MSH6 protein, as representative of the MSH2/MSH6 heterodimer, was quantified. Methodology Evaluation of microsatellite instability was obtained by immunohistochemical investigation using ROCHE's automated VENTANA Bench-Mark Ultra platform. Correlation study, between tumor morphological data at diagnosis and expression of mismatch repair proteins, was performed by use of parametric and nonparametric tests.Results Total expression of MSH6 protein was higher than MLH1 expression in 60 of 73 cases. MSH6 protein is more frequently associated with high expression (from 75% to 100%) than MLH1, which is characterized by a lower expression range. The correlation test of MLH1 expression per- centage with perineural invasion gave a statistically significant results, with a p-value below the limit of significance (p=0.007191). In the case of MSH6, statistically significant p-values were shown for tumor budding (p=0.02577), perineural invasion (p=0.007498) and growth margin (p=0.04664). Conclusions Quantifying MMR protein expression in MSS tumors could be a valuable aid in therapeutic choice, as well as in prognostic stratification of MSS patients between subjects with high expression, and thus less aggressive tumors, and subjects with low expression lesions of MLH1 and/or MSH6, and thus more biologically aggressive tumors. If a different expression in mismatch repair proteins correlates with morphological characteristics of greater or lesser malignancy, it could be hypothesized that patients with MSS colorectal cancer, treated with the same therapy, may have a greater or lesser response, depending on the percentage of expression of mismatch repair proteins, estimating a more effective adjuvant therapeutic response in subjects with high expression.
Design of a satisfaction survey aimed at Contract Research Organizations
Authors: Masini A. , Penpa S. , Betti M. , Gatti D. , Como M. , Roveta A. , Maconi A.
Published: April 2022

In the health research system, multiple actors are confronted daily with the common goal of promoting scientific development in the clinical field. The Clinical Trial Center of the Alessandria Hospital has as its vision to become an attractive center for clinical research and for this reason has decided to design a Satisfaction Survey to be sent to the main intermediary with the bodies that promote research: the Contract Research Organizations (CRO). The Survey consists of two distinct questionnaires: one to be sent cyclically to CROs and one dedicated to monitors following a monitoring visit. REDCap was used to send the Surveys and collect and analyze the results; a web-based software already in use at the Hospital. The data collected will refer to three thematic areas: the role of the recipient within the CRO, relations with the Hospital, and the degree of general satisfaction. The process of sending and collecting data also has the purpose of retaining CROs and consolidating a communication network, as well as being a useful tool for the formulation of quality indicators.
Psychological effects of COVID-19 outbreak in hospital workers during the Italian third phase
Authors: Sterpone Rossella , Manfredi Valentina , Cassinari Antonella , Franscini Monica , Betti Marta , Bertolotti Martinella , Pelazza Carolina , Giribone Simona , Pepoli Antonio , Valorio Patrizia , Maconi Antonio
Published: April 2022

Objectives: The aim of the study was to explore the psychological impact of COVID-19 outbreak, during the so-called phase three of the infection in Italy, in healthcare workers and other professionals working in the Public Hospital “SS Antonio e Biagio e Cesare Arrigo” in the Piedmont Region.Methods: A monocentric prospective observational study was conducted on 113 hospital workers by completing an online survey. Data were collected from 29th June to 20th July 2020. The survey assessed self-reported socio-demographic, clinical, work and COVID-19 related information and risk perception. Moreover, it included an online version of validated questionnaires in the Italian language: Impact of Event Scale-Revised (IES-R), Depression, Anxiety and Stress Scale (DASS-21), Insomnia Severity Index (ISI), Coping Orientation to the Problems Experienced: COPE-NVI-25, and the Professional Quality of Life scale (ProQOl-5).Results: The exploratory analysis revealed that hospital workers showed a high percentage of post-traumatic stress symptoms in the months following the beginning of the pandemic. In general, having higher levels of education seems to be associated with less anxiety, stress, depression insomnia e post-traumatic stress symptoms. Those symptoms were reported among those who had higher risk perception, previous psychological problems, or suffered from a chronic disease. Workers with more than 10 years experience and low risk perception reported less insomnia symptoms.Conclusions: The assessment of psychological effects of COVID-19 outbreak might help to create good practices that could be used and improved to implement focused interventions on workers’ well-being, especially during COVID-19 and post COVID-19 periods.
Placement and management of Peripherally Inserted Central Catheters (PICC): Which complications? A retrospective 2-year single-centre experience
Authors: Bolgeo T. , Di Matteo R. , Gardalini M. , Gambarini L. , Riccio C. , Pesce A. , Arcidiacono S. , Toselli P. , Ferretti L. , Piccio F. , Maconi A.
Published: April 2022

Introduction: Peripherally inserted central catheters (PICCs) are catheters placed in the central venous system, through a peripheral vein. PICCs’ are devices designed for intermediate to long-term use, which are usually implanted for long periods and may be subjected to mechanical and infectious complications as well as thrombosis and acute bleeding during insertion or maintenance procedures. The aim of this study is to investigate and describe the various types of complications resulting from placement and management of PICC catheters in patients admitted to the SS Antonio e Biagio e Cesare Arrigo Hospital wards. Methods: Data was collected from the medical records of patients undergoing PICC implantation from June 2018 to December 2019.Results: Data from 320 patients were included in the study. 55% of patients did not develop complications. 34% of all patients with complications had minor complications and 86% of devices were not removed before the end of treatment.Conclusions: PICCs’ appear to be safe devices for use, with acceptably low rates of infectious or thrombotic complications. The most common complications have been minor causes, potentially avoidable with adequate prevention measures.
Implementation of primary nursing at Pediatric Department, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
Authors: Mignone A. , Gambarini L. , Grassi E. , Bolgeo T. , Di Matteo R. , Bertolotti M. , Roveta A. , Betti M. , Viazzi F. , Maconi A.
Published: April 2022

Introduction: The principles of assistance that consider man in his entirety also apply to the child but the differences with respect to adult assistance lie in the specific needs of the child, in his dependence and capacity for development. One cannot think of the child without the parents; the whole family is involved in the care plan and in particular the parents must have an active role within the care plan.Methods: The pediatric nurse has two interlocutors and therefore must adopt two different modes of communication: parents and children, both of which must be taken care of. In this regard, the functional care model is no longer responsive to the needs of personalized care, the need to find new strategies to respond to the health needs of the child, has directed the nursing management of the Alessandria Hospital towards the project of implementation of the Primary Nursing model at the Complex Structure of Pediatrics.Results: Completion of the experimental implementation period on time. User customer satisfaction will be assessed through the questionnaires already in use at the company. Staff satisfaction will be assessed through the monitoring of indicators such as continuous feedback between staff, project representative and Coordinator, active participation in team meetings, suggestions and proposals by nurses about the management of critical issues and improvement. Any periods of absence and transfer requests will also be monitored. A Pre-post research study is also planned on the impact of Primary Nursing on the nursing team and on patients and their families.Conclusions: Overall, patients, families, and nurses value care continuity and meaningful nurse-patient relationships, which is fundamental to primary nursing.
Hearing the invisible: The ears of Job, a psychoanalytic perspective
Authors: Van der Zwan Pieter
Published: April 2022

Job’s body is ‘portrayed’ in a text that can be nothing more than audible. Compared with the eyes of Job (mentioned 49 times explicitly), his ears (mentioned 13 times, i.e., four times less than his eyes, perhaps because his ears are less visible) play a much more subtle role, underlying even his final confession in 42:5-6, where it seems/sounds that his eyes gave him (only) his final in-‘sight’. That leaves the impression that his ears give him access to the second-hand testimony of tradition but his eyes to his own, personal experience. The hypothesis of this study is that a psychoanalytical perspective can give additional meaning to this polarity and cooperation of the senses for both the main character and recipient of the book of Job in that Job’s (in)sight depends on the foundation of the aural experience, even the musical experience.Contribution: A psychoanalytical perspective adds to the breadth and depth of insight gained from studying the role of the sensory experience in the narrative about the psychic and spiritual development of the protagonist in the Book of Job.
Accuracy of emergency physicians’ interpretation of computed tomography for urgent-emergent diagnoses in nontraumatic cases
Authors: Karakoyun Omer Faruk , Kozaci Nalan , Avci Mustafa , Uzunay Huseyin
Published: April 2022

OBJECTIVE:

The aim of this study is to evaluate the accuracy levels of the emergency physicians (EPs) managing the patient in the interpretation of the urgent-emergent pathological findings in thoracic and abdominal computed tomography (CT) scans.

METHODS:

The EPs interpreted the CT scans of patients who visited the emergency department because of nontraumatic causes. Then, a radiology instructor made final assessments of these CT scans. Based on the interpretation of the radiology instructor, the false-positive rate, false-negative rate, sensitivity, specificity, positive predictive value, negative predictive value, and kappa coefficient (κ) of the EPs’ interpretations of the CT scans were calculated.

RESULTS:

A total of 268 thoracics and 185 abdominal CT scans were assessed in our study. The overall sensitivity and specificity of the EPs’ interpretation of the thoracic CT scans were 90% and 89%, respectively, whereas the abdominal CT interpretation was 88% and 86%, respectively. There was excellent concordance between the EPs and the radiology instructor with regard to the diagnoses of pneumothorax, pulmonary embolism, pleural effusion, parenchymal pathology, and masses (κ: 0.90, κ: 0.87, κ: 0.71, κ: 0.79, and κ: 0.91, respectively) and to the diagnoses of intraabdominal free fluid, intraabdominal free gas, aortic pathology, splenic pathology, gallbladder pathology, mesenteric artery embolism, appendicitis, gynecological pathology, and renal pathology (κ: 1, κ: 0.92, κ: 0.96, κ: 0.88, κ: 0.80, κ: 0.79, κ: 0.89, κ: 0.88, and κ: 0.82, respectively).

CONCLUSION:

The EPs are successful in the interpretation of the urgent-emergent pathological findings in thoracic and abdominal CT scans.
Defective barcode sign – A newer sonographic sign in hydropneumothorax
Authors: Mahalingam Sasikumar , Rajendran Gunaseelan , Sadasivam Anuusha , Ayyan Manu , Pillai Vivekanandan Muthu
Published: April 2022

Effusive pneumothorax can be hemopneumothorax, pyopneumothorax, or hydropneumothorax depending on the type of fluid compartment within the pleural cavity. Hydropneumothorax is the abnormal collection of air and serous fluid within the pleural cavity. Here, we report a case of a 34-year-old male who presented to the emergency department with cough and breathlessness. We did bedside point-of-care ultrasound-assisted clinical evaluation as the patient was vitally unstable, which showed “hydro point” and “defective barcode sign,” which suggested hydropneumothorax. We present these clinical evaluation details, imaging/sonographic findings, and patient management in this case report.
Messenger ribonucleic acid vaccine-associated immune thrombocytopenia
Authors: Islamoglu Mehmet Sami , Dokur Mehmet , Uysal Betul Borku , Gunduz Mehmet
Published: April 2022

Coronavirus disease-2019 continues to have a serious impact in countries with the effect of new variant viruses emerging with mutations. While the effectiveness and protection of the vaccine have been determined all over the world, some vaccine-related side effects can be detected in the form of cases. In our case, the patient was admitted to the emergency department of our hospital with complaints of weakness and progressive rash on his legs. Diffuse petechiae purpura on the legs of the patient was observed and complete blood count revealed thrombocytopenia. Peripheral blood smear supported the blood count test results with thrombocytopenia, secondary causes of thrombocytopenia were excluded, and the patient was diagnosed with vaccine-induced immune thrombocytopenia.
Intraoperative Evaluation of Renal Resistive Index with Transesophageal Echocardiography for the Assessment of Acute Renal Injury in Patients Undergoing Coronary Artery Bypass Grafting Surgery
Authors: Kajal Kamal , Chauhan Rajeev , Negi Sunder Lal , Gourav KP , Panda Prashant , Mahajan Sachin , Sarna Rashi
Published: April 2022

Background:

Acute kidney injury (AKI) is a common complication after on pump coronary artery bypass grafting (CABG) surgery and is associated with a poor prognosis. Postoperative AKI is associated with morbidity, mortality, and increase in length of intensive care unit (ICU) stay and increases the financial burden. Identifying individuals at risk for developing AKI in postoperative period is extremely important to optimize outcomes. The aim of the study is to evaluate the association between the intraoperative transesophageal echocardiography (TEE) derived renal resistive index (RRI) and AKI in patients undergoing on-pump CABG surgery.

Methods:

This prospective observational study was conducted in patients more than 18 years of age undergoing elective on pump CABG surgery between July 1, 2018, and December 31, 2019, at a tertiary care center. All preoperative, intraoperative, and postoperative parameters were recorded. TEE measurement was performed in hemodynamically stable patients before the sternum was opened. Postoperative AKI was diagnosed based on the serial measurement of serum creatinine and the monitoring of urine output.

Results:

A total of 115 patients were included in our study. Thirty-nine (33.91%) patients had RRI >0.7 while remaining seventy-six (66.08%) patients had RRI <0.7. AKI was diagnosed in 26% (30/115) patients. AKI rates were significantly higher in patients with RRI values exceeding 0.7 with 46.15% (18/39) compared to 15.75% (12/76) in RRI values of less than 0.7. Multivariate analysis revealed that AKI was associated with an increase in RRI and diabetes mellitus. The RRI assessed by receiver operating characteristic (ROC) curve and the area under the curve (AUC) to distinguish between non-AKI and AKI groups were 0.705 (95% CI: 0.588–0.826) for preoperative RRI. The most accurate cut-off value to distinguish non-AKI and AKI groups was a preoperative RRI of 0.68 with a sensitivity of 70% and specificity of 67%.

Conclusions:

An increased intraoperative RRI is an independent predictor of AKI in the postoperative period in patients undergoing CABG surgery. The cutoff value of TEE-derived RRI in the intraoperative period should be >0.68 to predict AKI in the postoperative period.
Management of Perioperative Anticoagulation in a Patient with Antiphospholipid Antibody Syndrome Undergoing Cardiac Surgery
Authors: Malviya Sanjana A. , Deng Yi , Gilani Sayyed O. , Hendon Alec A. , Nikolaidis Melissa A. , Moseley Micah S.
Published: April 2022

Patients with Antiphospholipid syndrome (APLS) are at high risk for both bleeding and thrombotic complications during cardiac surgery involving cardiopulmonary bypass (CPB). In this case we present a patient with APLS and Immune Thrombocytopenic Purpura who successfully underwent aortic valve replacement (AVR) with CPB despite recent craniotomy for subdural hematoma evacuation. Anticoagulation for CPB was monitored by targeting an Activated Clotting Time (ACT) that was 2× the upper limit of normal. A multidisciplinary approach was essential in ensuring a safe and successful operation.
Vascular Access Complications in Patients Undergoing Veno-Arterial ECMO and Their Impact on Survival in Patients With Refractory Cardiogenic Shock
Authors: Singh Vikrampal , Singh Gurmeet , Arya Rajesh Chand , Kapoor Samir , Garg Arun , Ralhan Sarju , Gupta Vivek K. , Mohan Bishav , Wander Gurpreet Singh , Gupta Rajiv K.
Published: April 2022

Introduction:

Veno-arterial extracorporeal membrane oxygenation (ECMO) is well-recognized treatment modality for patients with refractory cardiogenic shock. Uncomplicated cannulation is a prerequisite and basis for achieving a successful outcome in ECMO. Vascular access is obtained either by surgical cut-down. Common vascular access complications are bleeding and limb ischemia.

Objective:

To evaluate cannulation technique, the incidence of vascular complications, and their impact on the outcome.

Methods:

A retrospective data analysis conducted on 95 patients receiving ECMO from 2013 to 2020 was done. The patients were divided into two groups: no vascular access complications (non-VAC group) and vascular access complications (VAC group). The groups were compared related to the hospital and ICU stays and blood transfusion.

Results:

The patients in both groups were demographically and clinically comparable. The Non-VAC group had 75 patients, whereas the VAC group had a total of 20 patients. The main complication observed in the VAC group was bleeding from the cannulation site which required more blood transfusion than the non-VAC group (6.8 ± 1.02 vs 4.2 ± 1.26). Limb ischemia was another complication seen in the VAC group (4.2%, n = 4). Two patients had delayed bleeding after decannulation. The overall average length of stay in the hospital was statistically similar in both the groups (22 days in the VAC group vs 18 days in the non-VAC group), but the average ICU stay was more in the VAC group compared to the non-VAC group (18 days vs 12.06 days).

Conclusion:

Bleeding and limb ischemia are the important vascular access site complications, which increase blood transfusion requirements, ICU stay, and overall hospital stay.
Bronchial Blocker and Double-Lumen Endotracheal Tube Combination to Facilitate Lung Isolation during Esophagectomy
Authors: Liang Hong , Thomas Mathew , Renew J. Ross
Published: April 2022

Lung isolation is an essential anesthetic technique utilized in thoracic surgeries. We present a patient undergoing esophagectomy that developed an iatrogenic injury to the left mainstem bronchus that damaged the bronchial cuff of a left-sided double-lumen endotracheal tube (DLETT). A bronchial blocker (BB) was placed in the tracheal lumen of the DLETT as a rescue method to facilitate continued lung isolation. This unusual combination of a DLETT and a BB proved useful once the bronchial cuff was compromised and may serve as a viable solution to maintain lung isolation in similar circumstances.
An Unanticipated Prolonged Baseline ACT During Cardiac Surgery Due to Factor XII Deficiency
Authors: Apostel Heleen J.C.L. , Bie Ben De , Kats Suzanne , Schreiber Jan-Uwe
Published: April 2022

Factor XII (FXII) deficiency is a congenital disorder inherited as an autosomal recessive condition. In his heterozygous form, it is relatively common in the general population. However, a total absence of FXII as seen in homozygous patients, is rare, with an incidence of approximately 1/1,000,000 individuals. Surprisingly, FXII deficiency is rather associated with thromboembolic complications. Patients do not experience a higher risk of surgical bleeding despite a markedly prolonged activated partial thromboplastin time. Given its low incidence in the general population, the finding of an unknown FXII deficiency is rare during cardiac surgery. This unique case describes a patient with an unanticipated prolonged baseline activated clotting time (ACT) during cardiac surgery in which his bleeding history and rotational thromboelastometry tracings lead us to the diagnosis of a FXII deficiency. The finding of a hypocoagulable INTEM tracing and a concurrent normal EXTEM tracing in a sample of a patient with prolonged ACT and adverse anamnestic bleeding history should prompt clinicians to consider a FXII deficiency. It may help clinicians in further perioperative management where there is not enough time to wait for the results of individual coagulation factor testing.
Tobacco Use and Its Association with Adverse Childhood Experiences in Adolescents
Authors: Datar Shrinidhi Sanjay , Devi P. Savithri , Raka Simran , Mankar Cheryl , Ture Priyadarsh , Raut Abhishek V.
Published: April 2022

Background:

Tobacco use is the most important modifiable determinant for prevention of noncommunicable diseases. Tobacco use is often initiated during adolescence, and understanding the factors associated with it is vital to prevent initiation. Our objective was to assess the prevalence of tobacco use and its association with adverse childhood experiences (ACE).

Materials and Methods:

An analytical cross-sectional study was conducted on 200 randomly selected students from a rural school. The World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test tool and WHO ACE international questionnaire were used to assess ever users of tobacco and ACE, respectively.

Results:

The prevalence of “ever” and “current” use of tobacco was 20.5% (95% confidence interval [CI] = 14.8–26.2) and 14.5% (95%CI = 9.5–19.5), respectively. Majority (65.9%) of the tobacco users had moderate level of tobacco addiction, whereas around 15% had severe addiction. All (100%) the participants had replied in affirmative to at least one of the questions related to the ACEs. On bivariate analysis, male students (prevalence odds ratio [POR] = 10.62, 95% CI = 3.62–31.21]), mothers with <10th grade education (POR = 2.19, 95% CI = 1.08–4.42), parental awareness regarding free time (POR = 0.21, 95% CI = 0.10–0.42), parents not giving enough food even when possible (POR = 5.28, 95% CI = 1.53–18.29), problem drinker in family (POR = 2.12, 95% CI = 1.05–4.29), having divorced or separated parents (POR = 3.26, 95% CI = 1.22–8.74), and being in a physical fight (POR = 2.41, 95% CI = 1.19–4.87) had significantly higher odds of tobacco use. Adolescent boys (adjusted odds ratios [AOR] = 8.42, 95% CI = 2.60-26.60) and parental awareness regarding free time (AOR = 0.40, 95% CI = 0.17–0.94) were the significant predictors for tobacco consumption (P < 0.05) on binary logistic regression.

Conclusions:

Tobacco use is prevalent among adolescents and is significantly associated with experiencing ACEs.
Central nervous system manifestations of hematological malignancies
Authors: Khera Rachna , Ahmed Faiq , Mundada Manasi Chetan , Kommu Venkateswara Rao , Murthy Sudha S. , Challa Sundaram , Rajappa Senthil J. , Mallavarapu Krishna Mohan , Santa Ayyagari , Kumar Pavan B.
Published: April 2022

Objective:

Hematological malignancy presenting primarily with central nervous system (CNS) manifestations is rare and often portends a worse prognosis. The aim of this study is to report the spectrum of hematological malignancies presenting primarily with CNS symptoms.

Materials and Methods:

All histologically verified hematological malignancies involving CNS from January 2016 to December 2018 were included. The presence of lymphadenopathy, organomegaly, and bone marrow (BM) examination results was recorded to rule out a spread from systemic disease. The diagnosis was aided by special stains (reticulin) and immunohistochemistry (IHC) as appropriate. Antibodies used were CD20, CD3, CD10, Bcl 2, Bcl 6, MUM 1, CD138, CD68, MPO, PCK, and Ki67. The Hans algorithm was used to classify diffuse large B cell lymphoma (DLBCL) into germinal center B-cell (GCB) and non-GCB types.

Results:

During the study period, 18 DLBCLs, 4 plasmacytomas, and 3 myeloid sarcomas (MSs) were diagnosed. DLBCLs included 16 primary central nervous system lymphomas (PCNSLs) and 2 systemic lymphomas with evidence of lymphadenopathy. PCNSLs had male predominance and a mean of 46 (14–67) years. Frontal lobe was the most common location. Seven (70%) PCNSLs were non-GCB type and 3 (30%) were GCB type. One was a primary spinal T cell/histiocyte-rich large B cell lymphoma (a variant of DLBCL). Two were diagnosed as corticoid-mitigated lymphoma. One of the three MS cases had acute myeloid leukemia on BM examination and the rest two were isolated spinal masses with normal BM study. There were four spinal plasmacytomas, presenting with cord compression.

Conclusion:

Primary CNS presentation of hematological malignancies requires a high index of suspicion clinically and radiologically, and diagnosis requires IHC for proper classification.
Hippocampus sparing
Authors: Gupta Meenu , Nautiyal Vipul , Bansal Saurabh , Saini Manju , Kumar Viney , Badola Amit , Ahmad Mushtaq
Published: April 2022

Patients with brain metastasis survival has been improved due to better diagnostic and treatment approaches. Quality of life is a major concern for these subset of patients. Seahorse of brain “Hippocampus” is the structure which plays a major role in cognitive functions which can be further alter the quality of life of these patients. Hippocampus sparing whole brain external beam radiotherapy in brain secondaries with simultaneously respecting the doses to the target volumes can be considered a novel approach for acceptable quality of life in these patients.
Giant cell tumor of the clivus
Authors: Masodkar Renuka , Bhadauria Mano , Prasad Rajendra
Published: April 2022

Giant cell tumors arising from the skull base are rare. We present a case of a giant cell tumor arising from clivus, which was managed by surgery, radiotherapy, and denosumab therapy.
Gaussianity and typicality in matrix distributional semantics
Authors: Ramgoolam Sanjaye , Sadrzadeh Mehrnoosh , Sword Lewis
Published: April 2022

Constructions in type-driven compositional distributional semantics associate large collections of matrices of size

D

to linguistic corpora. We develop the proposal of analysing the statistical characteristics of this data in the framework of permutation invariant matrix models. The observables in this framework are permutation invariant polynomial functions of the matrix entries, which correspond to directed graphs. Using the general 13-parameter permutation invariant Gaussian matrix models recently solved, we find, using a dataset of matrices constructed via standard techniques in distributional semantics, that the expectation values of a large class of cubic and quartic observables show high Gaussianity at levels between 90 to 99 percent. Beyond expectation values, which are averages over words, the dataset allows the computation of standard deviations for each observable, which can be viewed as a measure of typicality for each observable. There is a wide range of magnitudes in the measures of typicality. The permutation invariant matrix models, considered as functions of random couplings, give a very good prediction of the magnitude of the typicality for different observables. We find evidence that observables with similar matrix model characteristics of Gaussianity and typicality also have high degrees of correlation between the ranked lists of words associated to these observables.
Nested Catalan tables and a recurrence relation in noncommutative quantum field theory
Authors: de Jong Jins , Hock Alexander , Wulkenhaar Raimar
Published: April 2022

Correlation functions in a dynamic quartic matrix model are obtained from the twopoint function through a recurrence relation. This paper gives the explicit solution of the recurrence by mapping it bijectively to a two-fold nested combinatorial structure each counted by Catalan numbers. These “nested Catalan tables” have a description as diagrams of non-crossing chords and threads.
Combinatorial expression of the fundamental second kind differential on an algebraic curve
Authors: Eynard Bertrand
Published: April 2022

The zero locus of a bivariate polynomial

P(x,y)=0

defines a compact Riemann surface

\Sigma

. The fundamental second kind differential is a symmetric

1\otimes 1

-form on

\Sigma\times\Sigma

that has a double pole at coinciding points and no other pole. As its name indicates, this is one of the most important geometric objects on a Riemann surface. Here we give a rational expression in terms of combinatorics of the Newton's polygon of

P

, involving only integer combinations of products of coefficients of

P

. Since the expression uses only combinatorics, the coefficients are in the same field as the coefficients of

P

.
Notes on tensor models and tensor field theories
Authors: Gurau Razvan G.
Published: April 2022

Tensor models and tensor field theories admit a

1/N

expansion and a melonic large

N

limit which is simpler than the planar limit of random matrices and richer than the large

N

limit of vector models. They provide examples of analytically tractable but non-trivial strongly coupled quantum field theories and lead to a new class of conformal field theories. We present a compact introduction to the topic, covering both some of the classical results in the field, like the details of the

1/N

expansion, as well as recent developments. These notes are loosely bases on four lectures given at the Journées de physique mathématique Lyon 2019: Random tensors and SYK models.