bluuebunny/crossref_metadata_2025 huggingface dataset:
Global Trends in Childhood Sexual Abuse and Bullying Victimization in 204 Countries: A Comprehensive Analysis From 1990 to 2019
Authors: Borumandnia Nasrin , Alvani Mohammadamin Sabbagh , Fattahi Payam , Gohari Mahmood Reza , Kheirolahkhani Yashar , Alavimajd Hamid
Published: August 2024

Objectives: No comprehensive analysis has yet been published regarding global trends in childhood sexual abuse (CSA) and bullying victimization (BV). The present study offers a longitudinal perspective on their prevalence worldwide.Methods: CSA and BV rates were extracted from the Global Burden of Disease study, spanning the years 1990 to 2019 across 204 countries. Trends by gender, region, and human development index (HDI) were examined.Results: For both boys and girls, and in both high-HDI and low-HDI countries, CSA rates did not significantly change from 1990 to 2019 (p>0.05). However, BV rates increased significantly in high-HDI and low-HDI countries for both genders (p<0.001). Subsequently, we analyzed trends separately by gender across all countries, without considering development level. In this analysis, CSA rates among girls decreased from 1990 to 2000, followed by an increasing tendency after 2000; overall, an upward trend was evident between 1990 and 2019 (p=0.029). In contrast, no significant pattern was observed for boys. Notably, BV demonstrated an increasing trend across all regions when HDI was not considered (p<0.05), with African populations experiencing the most pronounced rise (p<0.001). Globally, boys consistently exhibited higher BV rates than girls.Conclusions: Our research indicates that, on a global scale, rates of CSA among girls have been rising. Additionally, BV rates have increased in all regions for both boys and girls. Notably, this trend in BV rates is occurring irrespective of HDI. These findings underscore the necessity for targeted interventions in areas with high rates of CSA and BV.
Importance of Manually Vetting Acoustic Bat Call Files: A Case Study for Northern Long-Eared Bats
Authors: Roby Piper L. , Jordan Gary W.
Published: August 2024

Definitively identifying bats based on their acoustic calls is difficult and sometimes impossible. This is particularly true for Myotis species that can make similar calls, which could lead to false positive detections. This is problematic for conducting species presence or probable absence surveys using acoustic detection. Manual vetting of calls to reduce identification error by the automated programs is an option but not a requirement to survey for species listed as threatened or endangered pursuant to the Endangered Species Act. We conducted simultaneous mist net and acoustic surveys for bats in areas of Edgecombe and Johnston counties in eastern North Carolina where there are capture records of a common Myotis species, the southeastern myotis Myotis austroriparius, but not for the federally endangered northern long-eared bat Myotis septentrionalis. We caught southeastern myotis at six of the 12 sites surveyed. Although automated acoustics software produced a Maximum Likelihood Estimation value for probable presence of northern long-eared bats at three of the 12 sites surveyed, we did not catch any individuals or confirm the species acoustically through manual vetting. If we had used automated software alone without manual vetting, we would have incorrectly presumed presence of an endangered species at 25% of our sites. Therefore, manual vetting is highly recommended for northern long-eared bat acoustic surveys where southeastern myotis co-occur.
Design of a Wearable Antenna Using Metamaterials
Authors: Mujawar Mehaboob , Pramono Subuh
Published: August 2024

This study focused on developing and testing a flexible dual-band (2.4 GHz, 5.2 GHz) wearable dipole antenna, examining its return loss, gain pattern, and specific absorption rate (SAR) under different bending scenarios (E-plane, H-plane) across various human body regions such as the arms and legs. The antenna utilized felt, a clothing material, as a dielectric, and Zelt as a conducting patch to ensure flexibility and conformity. By maintaining resonant frequencies as required, the design prevented detuning during wearable use. Furthermore, compared to traditional designs, the antenna exhibited an increased gain of up to 4.45 decibels (dBi). Incorporating metamaterials into the design led to a significant reduction in SAR, addressing a common issue with omnidirectional wearable dipoles. The use of an electromagnetic bandgap (EBG) ground plane resulted in an 83.3% and 92.8% reduction in SAR for 2.4 GHz and 5.2 GHz respectively, meeting acceptable levels defined as less than 2.0 W/Kg over 10 g of tissue. Consequently, the dual-band dipole based on metamaterials proved to be compact, low-profile, flexible, and outperformed conventional counterparts in wearable technology applications.
CPW FED Circular Shaped MIMO Antenna for 5G Applications
Authors: Subashini V. , Rajalakshmi B. , Chitra S.
Published: August 2024

In the ever-evolving landscape of wireless communication systems the demand for compact and efficient antennas for Wi-Fi and wireless local area network applications has surged. This chapter presents a novel design for circular monopole, a two-port multiple input multiple output antenna tailored to meet the requirements of modern communication standards. The circular monopole antenna with FR4 substrate is designed to cover the 2.4 GHz, 5,4GHz frequency bands, which are the primary frequency ranges used in WiFi and WLAN communication. Its compact form factor and circular polarization characteristics make it suitable for indoor and outdoor wireless communication scenarios. The antenna is fed using a coplanar waveguide (CPW) feed structure, known for its wide bandwidth and impedance matching capabilities. Simulation results demonstrate that the proposed antenna exhibits excellent performance in terms of impedance bandwidth, radiation patterns, and envelope correlation coefficient (ECC) for MIMO operation. The achieved impedance bandwidth covers the entire 2.4 GHz band, ensuring compatibility with current and future Wi-Fi and WLAN standards. Moreover, the circular polarization of the antenna helps mitigate multipath interference, making it well-suited for MIMO applications.
Dual Band and Wideband Wearable Antenna Designs for ISM and 5G Remote Health Monitoring
Authors: Kommuri Usha Kiran , Giftsy A. L. Sharon
Published: August 2024

Wireless health monitors increase the efficiency of continuous and fast monitoring of patient health condition. High data communication in 5G bands is suitable in transmission of the huge data from body sensers. The 5G communication is in 3.5 GHz and 5.7-5.8 GHz. The present chapter discusses the design topologies of wideband wearable textile antennas for remote health monitoring in 5G and ISM band. Here three prototype design antennas are proposed: i) Dual band wearable textile antenna for ISM band 2.4 GHz and 5.8 GHz; ii) Wideband Rectangular; and iii) Wideband elliptical textile antenna for ISM, Wifi and 5G communication, wideband antennas bandwidth is from 1.6 GHz to 6.5 GHz. The antenna characteristics like return loss, gain and radiation patterns are discussed. The wide band antenna has less effect on shift in the resonant frequency during the conformal bending of the wearable antenna on patient body. Further antennas with lower SAR are preferred and hence SAR reduction using frequency selective techniques (FSS) from the literature is extensively discussed.
Microstrip Circular Sensor for Determination of Moisture Content
Authors: Jain Sweety , Mishra Pankaj Kumar , Thakare Vandana Vikas , Mishra Jyoti
Published: August 2024

A microstrip moisture sensor (MMS) was designed, printed on FR4 material sheet size 18×18 mm2. The objective behind designing the sensor was to calculate moisture content (MC) in basmati rice. It is simulated on CST software on three frequencies: 3.6 GHz, 5.6 GHz, and 8.5 GHz. Actual moisture content (AMC) was varied from 10.71% to 21.87% for five samples at different water content; PMC was calculated for five samples with the help of calibration equations in which R.C. was achieved from VNA Model No. N9925A. For each frequency and sample, three moisture contents at each frequency were obtained, whose mean was taken to obtain final PMC. For other samples the same procedure was followed. Therefore, PMC varied from 10.70% to 21.82%. As MRE value determined with the help of AMC and PMC. Hence, the lowest MRE was 0.12%. Its significance is that when the grains (basmati rice) are fully saturated (100%) then MC measured from sensor will be reduced by 0.12%, i.e., obtained MC from sensor will be 99.88%.
AI Applications for Clean Energy and Sustainability
Authors: Hemanth Babitha , Prabhu Preethi , Shetti Kartik Maruti , Shetty Deeksha D. , T. M. Zhenkar
Published: August 2024

The marine ecosystem, one of Earth's most vital and diverse environments, spans from sunlit surface waters to deep ocean trenches. It supports a vast array of life forms, from microscopic phytoplankton to colossal whales, and plays a crucial role in maintaining ecological balance and providing essential services for human well-being. Understanding and managing this complex system is critical, especially with increasing human impacts and environmental changes. Artificial intelligence (AI) has emerged as a transformative tool in environmental monitoring, revolutionizing the collection, processing, and interpretation of vast data related to natural systems. Environmental monitoring covers biodiversity, land use, air and water quality, and climate change indicators. Traditional methods, reliant on manual data collection and analysis, are costly, time-consuming, and limited in scope. AI enhances the efficiency, accuracy, and scope of these efforts, supporting more effective ecosystem management and conservation strategies.
Applying Data Into Action
Authors: Satpathy Ipseeta , Nayak Ankita , Jain Vishal , Padmadas Sabu S.
Published: August 2024

AI has the potential to accelerate climate action through applications like solar power generation, heating and cooling systems, and deforestation detection. It has also been used to impede the fight against climate change. AI can analyze large amounts of data, aiding policymakers in understanding complex relationships between the environment and human behavior. AI-driven predictive analytics can predict extreme weather events, improve agricultural productivity, and enhance resource management. Integrating AI technologies into climate policies requires governance and policy frameworks.
Green Data Centers and Renewable Energy
Authors: Channi Harpreet Kaur , Kumar Pulkit
Published: August 2024

Green data centers and renewable energy integration are essential for IT sustainability. Traditional centers consume more energy and emit carbon as digital demand rises. Green data centers prioritize resource efficiency, using energy-efficient technologies and renewable energy sources like sun, wind, and hydropower. This minimizes environmental impact and operational costs while promoting sustainability. Innovative hardware and cooling systems further reduce energy usage, setting a standard for responsible computing. These centers can generate or purchase green power through solar panels and wind turbines, aligning with global climate efforts. Collaboration between green data centers and renewable energy is crucial for sustainable data management, demonstrating a balanced approach between technical advancements and environmental responsibility, setting an example for companies worldwide.
The Role of Logistics in Responsible Consumption and Production
Authors: Erdal Ekin , İpçioğlu Nermin Dilara
Published: August 2024

This chapter aims to emphasize the crucial role of logistics in promoting responsible consumption and production practices, a core objective of Sustainable Development Goal 12 (SDG 12). It explores the significant contributions of green manufacturing, green procurement, and reverse logistics to sustainability initiatives by reducing environmental impacts and optimizing resource use. Green manufacturing (GM) practices focus on efficient raw material management and waste reduction, significantly lowering carbon footprints. Green procurement (GP) encourages consumers to choose environmentally conscious products, fostering sustainable supply chain development. Reverse logistics (RL) enhances sustainable consumption and production by managing recycling activities and redistributing products to secondary markets, thus emphasizing the importance of logistics in these processes.
The Headaches of Developing a Concussion App for Youth
Authors: DeMatteo Carol , Jakubowski Josephine , Stazyk Kathy , Randall Sarah , Perrotta Samantha , Zhang Richard
Published: August 2024

This descriptive manuscript describes challenges, solutions, and recommendations to provide a supportive framework for clinician researchers striving to develop a clinical app. The Back2Play app aims to support youth in concussion recovery through mobile health monitoring. Developed in Phase 1 of a randomized control trial, the app intends to prevent re-injury and improve recovery by integrating evidence-based return-to-school and activity guidelines with biological monitoring. Methods outline the stages of successful app development. Identified challenges include defining app requirements, database hosting, development, and legal procedures. Results of usability testing show that the Back2Play app was highly acceptable to 66% of youth and none found it unacceptable. Successful clinical app development hinges on understanding the scope of the app, data management and exportation. Adequate funds should also be allocated for potential delays. These recommendations provide a framework for clinical researchers hoping to develop a clinical app that achieves their envisioned outcome.
Facial Expression Recognition Using a Semantic-Based Bottleneck Attention Module
Authors: Zhang Shengfu , Xiao Zhongjie
Published: August 2024

Facial expression recognition (FER) is of great value in affective computing. Currently, many FER models have difficulty distinguishing between primary and secondary features. To this end, we propose a FER model based on the semantic bottleneck attention module (BAM). The improvement is that the input image is processed through two branches. BAM uses spatial attention to construct feature maps that can highlight important feature areas and suppress secondary features. The moving flipped bottleneck convolution (MBConv) module introduces random depth, reducing training time and improving model performance. Random depth enables the model to reduce the risk of overfitting during training by randomly skipping some layers. Global average pooling replaces the fully connected layer and compresses the entire feature map (FM) into numerical values to obtain high-purity image features. Through experiments on Extended Cohn-Kanade, Static Facial Expressions in the Wild, and Real-world Affective Faces Database CK+, SFEW, and RAFDB databases, the accuracy of our model reaches 98.33%, 61.14%, and 89.43% respectively, which is better than the other three advanced comparison methods.
Optimizing Sustainable Performance Green Talent Management Strategies Focused on Core Competencies
Authors: Shao Jianbing , Ahmad Hassan , Butt Asad Hassan , Shao Hui , Liu Yulong David , Alam Faizan
Published: August 2024

This study aims to examine the relationship among green innovation performance (GIP), sustainable performance (SP), and green talent management (GTM) through the lens of natural resource. It investigates the moderating impact of organizational corporate social responsibility (CSR) commitment and the mediation influence of green core competencies (GCC). GTM is deemed crucial in the development of sustainability programs. Subsequently, it gathered employee data from 362 Pakistani small- and medium-sized enterprises based on judgmental sampling. Finally, by employing SmartPLS 4 software, the research conclusion finds the following: GTM advances GCC, expands a company's pledge to CSR, and boosts the link between GTM and environmental outcomes. The research underlines the importance of organizational commitment to CSR and green core competencies to understand the dynamics between GTM and sustainable performance and green innovation. Lastly, the value of a comprehensive personnel management strategy to promote eco-friendly behavior is demonstrated.
Risk factors for colorectal carcinoma; a hospital-based study
Authors: De Zoysa Ishan Malith , Ekanayake Narmada Vinyani , Senarath Upul , Seneviratne Suranjith Luke
Published: August 2024

Background: Colorectal carcinoma (CRC) accounts for substantial cancer morbidity and mortality worldwide. Our study was designed to assess the contributions of dietary and lifestyle factors on the risk of developing CRC.Methods: A case-control study was conducted over a five-year period at the National Hospital of Sri Lanka. Data was collected via an interviewer administered, structured, pre-tested questionnaire on 200 histologically confirmed CRC cases and 200 age and gender-matched controls. Multivariate analyses were done to identify associations.Results: The median age was 58 years in the CRC group and 54 years in the control group, while the male:female ratio was 1.50 and 1.49 respectively. On multivariate analysis the consumption of six or more cups of brown tea per day [Odds Ratio (OR) = 2.98 (95% CI 1.47-6.05), p=0.003] was independently associated with CRC. Beef consumption also showed significant association with risk of CRC [OR = 1.76 (95% CI 1.12-2.78), p=0.015]. Green tea was not found to be associated with CRC. There were no associations with body weight, work-sleep pattern, smoking or the consumption of alcohol, mutton, pork, fruits or coffee.Conclusions: The consumption of six or more cups of brown tea per day or beef was associated with an increased risk of developing CRC.
Correlates of burnout among military personnel of Sri Lanka Army: a nested case-control study
Authors: Jothipala Darshitha , Semage Saveen , Balasuriya Aindralal
Published: August 2024

Background: Burnout is well known mental health problem that can be found in many occupational settings. Due to the potential for concentrating known antecedents, the military context is particularly susceptible to burnout. Sri Lanka Army is the main focal asset in national security, resilience in disaster or any other national threat as the defender of the nation. Due to recent reforms, there is an increased risk that the Sri Lanka Army to experience known correlates of burnout. For the development of policies to enhance the mental health of the army community, it is essential to determine the influential power of those elements.Method: A nested case-control study was carried out. Cases and controls were selected from a cohort of 1692 army soldiers that had been previously chosen to investigate the prevalence of burnout. The validated MBI-GS (Sinhala version), the brief COPE, and the structured questionnaire on correlates of burnout were all included in the self-administered questionnaire for data collection.  Cases and controls were defined using the findings of the criteria validity evaluation of MBI-GS (Sinhala version); 386 cases and 766 controls were selected as per the desired case-control ratio of 1:2. After doing a bivariate analysis for dichotomous variables and an independent t test for continuous variables, a binary logistic regression was carried out to determine the antecedents.Results: Altogether 29 factors were identified as significant correlates of burnout through bivariate analysis and t tests, out of those only 14 factors were confirmed through logistic regression. Age of 30 years or below, no additional income, no saved money, have bed ridden dependent, having transport difficulties, past history of psychiatric treatment, family history of psychiatry, frustration about life, being a daily smoker, and practicing dysfunctional coping strategies were identified as risk factors. Whereas satisfied on children support, received special training relevant to current tasks, able to get leave timely and practicing problem focused coping strategies were identified as protective factors.Conclusion: Identified antecedents should consider at policy making of the organization. Early attention and proper action is strongly recommended.
“What’s in a name?” – The implications of change in nomenclature for fatty liver disease from NAFLD to MAFLD to MASLD.
Authors: Niriella Madunil Anuk
Published: August 2024

No abstract available
Identification of Candida species isolated from cancer patients by Polymerase Chain Reaction – Restriction Fragment Length Polymorphism in Apeksha Hospital, Maharagama, Sri Lanka
Authors: Ganguli Sammarappulige Chathma , Wijendra Somalatha , Dasanayaka Nilanthie , Ratnasingham Ramesh , Kaushalya Gaya , Gunasekera Samanmalee Priyantha
Published: August 2024

Candida infections pose a significant challenge in managing cancer patients. A rapid and effective method for Candida species identification is crucial to address this issue. This study at Apeksha Hospital, Maharagama, aimed to identify Candida species using Polymerase Chain Reaction – Restriction Fragment Length Polymorphism. ITS1-5.8S-ITS2 rDNA regions of 52 clinical Candida isolates and standard strains were amplified using ITS1 and ITS4 primers and digested with MspI enzyme. Candida tropicalis (38%), Candida parapsilosis (31%), Candida albicans (13%), Candida glabrata (8%), Candida krusei (4%), Candida haemulonii (4%), and Candida intermedia (2%) were identified. PCRRFLP proves to be a rapid, and reliable method for identifying medically important Candida species in cancer patients.
Late-life Attenuation of Cytomegalovirus-mediated CD8 T Cell Memory Inflation: Shrinking of the Cytomegalovirus Latency Niche
Authors: Coplen Christopher P , Sonar Sandip Ashok , Nikolich Janko Ž
Published: August 2024

CMV drives the accumulation of virus-specific, highly differentiated CD8 memory T cells (memory inflation [MI]). In mice, MI was shown to directly correlate with the CMV infection dose, yet the CMV-associated CD8 MI plateaus over time. It is unclear how MI is regulated with aging. We infected young mice with 102, 104, and 106 PFU of murine CMV and confirmed that MI magnitude was directly proportional to the infectious dose, reaching a setpoint by midlife. By old age, MI subsided, most prominently in mice infected with 106 PFU, and reached statistical parity between groups in 26-mo-old mice. This corresponded to an age-related loss in lymphatic endothelial cells in lymph nodes, recently shown to be sufficient to drive MI in mice. We propose that MI size and persistence over the lifespan is controlled by the size of the lymphatic endothelial cell niche, whose shrinking leads to reduced MI with aging.
Factors associated with the rabies vaccination status of dogs in households in Beni City, D.R. Congo
Authors: Kimpanga Prince D. , Taghembwa Emery K. , Mubenga Gauthier M. , Makwera Jean-Marie T. , Muhongya Norbert M. , Chabikuli Odrade B. , Masumu Justin M.
Published: August 2024

Human rabies transmitted by dogs still kills thousands of people each year worldwide. Dog bites are common in the city of Beni (Democratic Republic of Congo), which shows low rabies vaccination coverage. This study aimed to determine the factors associated with the rabies vaccination status of dogs. A cross-sectional analytical study was conducted in the town of Beni among dog owners, during a household survey selected using a multistage sampling. The information sought concerned the knowledge and characteristics of the dog owners as well as the vaccination status of these dogs. Logistic regression was used to investigate associations between the vaccination status of the dogs and the main independent factors. Rabies vaccination coverage in Beni was 26% (95% confidence interval [CI]: 22% – 30%). The main factors associated with the rabies vaccination status of the dog were primary education level of household head (adjusted odds ratio [aOR]:4.8; 95% CI: 1.2– 19.8); university education level of household head (aOR: 5.9; 95% CI: 1.6–22); perceived rabies severity (aOR: 44. 4; 95% CI: 10.4–188), having more than one dog in the household (aOR: 2.6; 95% CI: 1.6–4.3); age range 7–12 months (aOR: 0.2; 95% CI: 0.1–0.6) and confined dog breeding (aOR: 3.9; 95% CI: 1.1–14.9). The low vaccination coverage in Beni requires mass vaccination campaigns against canine rabies targeting the dog owners with low education levels, those raising more than one dog, with stray dogs or dogs less than 12 months old.
Diagnostic Value of Serum Procalcitonin, CSF Neutrophil-to-lymphocyte ratio, and CSF Lactate in Pediatric Bacterial Meningoencephalitis
Authors: Nugrahanto Andika Priamas , Triono Agung , Damroni Rais Aliffandy , Herini Elisabeth Siti
Published: August 2024

Background:

Bacterial meningoencephalitis presents significant diagnostic and therapeutic challenges with high morbidity and mortality in pediatric populations worldwide. The early and precise identification of the etiology of these infections is essential for effective treatment and better patient results. Traditional diagnostic methods, while effective, can be time-consuming. This manuscript aims to evaluate the accuracy of serum procalcitonin (PCT), cerebrospinal fluid (CSF) neutrophil-to-lymphocyte ratio (NLR), and CSF lactate as biomarkers in pediatric bacterial meningoencephalitis.

Methods:

From March 2021 to November 2023, a cross-sectional study was conducted at Dr. Sardjito General Hospital, a tertiary referral hospital in Yogyakarta, Indonesia. One hundred ninety-seven patients underwent complete clinical and laboratory examinations before being divided into bacterial and non-bacterial groups based on CSF culture results and cytochemical profiles. The diagnostic accuracy was evaluated by the receiver operating characteristic curve using Statistical Package for the Social Sciences.

Results:

Serum PCT, CSF NLR, and CSF lactate levels showed a notable increase in the bacterial meningoencephalitis group (mean = 4.63 ± 5.52 ng/ml, 4.39 ± 6.68, and 3.59 ± 2.38 mmol/l, respectively) compared to the viral/aseptic group (mean = 0.51 ± 0.88 ng/ml, 0.33 ± 0.95, and 2.25 ± 2.33 mmol/l, respectively) (P < 0.001). Serum PCT and CSF NLR combined measurement had high sensitivity (86.4%) and specificity (88.6%), with an area under the curve of 0.929 (95% confidence interval, 0.873–0.985), surpassing other tested biomarkers.

Conclusion:

The findings suggest that combining serum PCT and CSF NLR could be beneficial for early diagnosis, potentially allowing timely, targeted treatment and differentiating between bacterial and non-bacterial infections, ultimately improving patient outcomes.
Asleep surgery for deep brain stimulation of the globus pallidus internus in pediatric dystonia associated with KMT2B mutation
Authors: Nurimanov Chingiz , Menlibayeva Karashash , Aidarov Seitzhan , Mammadinova Iroda , Nurakay Nurtay
Published: August 2024

Pediatric dystonia refers to the onset of dystonia before the age of 21 years. Accurate diagnosis through genetic testing and precise electrode placement may significantly improve motor symptoms and quality of life of patients with gene-associated dystonia. This report presents a rare KMT2B-related dystonia case managed with bilateral pallidal deep brain stimulation (DBS) in an 8-year-old girl. The patient presented with muscle contractions on the distal parts of the lower limbs, speech impairment, and myoclonic jerking movements. Genomic sequencing identified a heterozygous mutation in the KMT2B gene (617284 on chromosome 19p13). In this case, DBS of the globus pallidus internus was performed under general anesthesia. Six months post-surgery, the Burke–Fahn–Marsden scale scores indicated a 46% improvement, and the scores for the Unified Dystonia Rating Scale and Global Dystonia Severity Rating Scale showed 50% and 28% improvements, respectively. Accurate diagnosis of KMT2B-related dystonia holds significant value in terms of guiding appropriate treatment as the disease is responsive to DBS surgery targeting the globus pallidus internus. This case illustrates the benefits of DBS in pediatric patients and its role in advancing surgical interventions for dystonia.
Onconeural antibody-associated cerebellar ataxia: An analysis
Authors: Mahale Rohan , M Sandeep , Mahadevan Anitha , Kamble Nitish , Holla Vikram , Pal Pramod K. , Yadav Ravi
Published: August 2024

BACKGROUND:

Cohort-based studies on onconeural antibody-associated cerebellar ataxia (CA) investigating the immunological and radiological spectrum as well as functional outcomes are limited.

OBJECTIVE:

To study the clinical, radiological, and immunological spectrum, as well as the treatment profile and outcomes, of onconeural antibody-associated CA.

METHODS:

A retrospective descriptive analysis was performed for a cohort of patients who presented with CA and had positive onconeural antibodies in serum. The clinical, radiological, and immunological spectrum and the treatment profile and outcomes of the patients were analyzed.

RESULTS:

Thirty-two patients were diagnosed with onconeural antibody-associated CA and were selected for our analysis. Eighteen patients (56%) had anti-Yo, seven (22%) had anti-Zic4, four (12.5%) had anti-CV2/CRMP5, two (6.25%) had anti-Hu, and one had anti-PCA-2 antibodies. The median duration of illness was 4 months (interquartile range (IQR): 3–6 months). Twenty-eight patients had pancerebellar syndrome. The mean score of the Scale for the Assessment and Rating of Ataxia (SARA) was 23.9 ± 5.2 (range: 16–34; median: 26). Bilateral cerebellar atrophy was observed in 24 patients (75%). Four patients with anti-Yo antibodies had breast lesions on screening at the time of admission. Two patients with anti-Yo antibodies had carcinoma ovary at 1-year follow-up. The median modified Rankin scale (mRS) score at admission was 4. Twelve patients underwent a 6-month follow-up (37%) and eight had a 1-year follow-up. Favorable outcomes (mRS scores ≤ 2) were observed in five patients (42%), whereas poor outcomes were observed in seven patients (58%).

CONCLUSION:

CA was most commonly caused by anti-Yo antibodies, followed by anti-Zic4 antibodies. Patients with anti-Zic4 antibodies had the lowest mean SARA score and the most favorable functional outcome. Patients with anti-Yo had poor functional outcomes with immunotherapy.
Burden of non-motor symptoms in Parkinson’s disease and atypical parkinsonism syndromes: A single-center cross-sectional comparison study
Authors: Barad Narendra , Asole Dnyaneshwar , Thakre Mahendra , Sankhla Charulata
Published: August 2024

BACKGROUND:

Non motor symptoms (NMS) in idiopathic Parkinson’s disease (IPD) and atypical Parkinsonism (APD), are common. There are very few Indian studies addressing the frequency and burden in APD. Hence, this study aimed to investigate the frequency and burden of NMS in Indian patients with APD, compared with IPD and controls.

OBJECTIVES:

1) To examine the clinical characteristics and burden of NMS in patients with APD, 2) To compare the frequency, and burden of NMS between typical and atypical Parkinsonism.

METHODS:

The study had total 114 participants, with 42 APD, 44 IPD patients meeting the standard diagnostic criteria and 28 age and sex matched healthy controls. The Non-Motor Symptoms scale (NMSS) was used to assess the frequency and burden of non-motor symptoms associated with parkinsonian disorders.

RESULTS:

The frequency and burden of NMS, across all domains, are highest (p < 0.05) in patients with atypical Parkinsonism compared to those with IPD and the control group. In the APD group, the most common NMS reported was sexual dysfunction (85%), followed by urinary urgency (72.5%), fatigue, lack of motivation, and nocturia (67.5%). The most common NMS reported in IPD patients were sexual dysfunction (81%), fatigue (70.45%), and constipation (68.18%). Restless legs symptoms were significantly more prevalent in the IPD group (p ≤ 0.05). The mean total NMS score was also significantly higher in APD patients (p ≤ 0.05).

CONCLUSION:

The frequency and burden of NMS, across all domains, are higher in patients with APD group.
Efficacy and safety of ciprofol versus propofol for induction of general anaesthesia or sedation: A systematic review and meta-analysis of randomised controlled trials
Authors: Saeed Abdallah , Elewidi Mariam , Nawlo Ahmad , Elzahaby Amr , Khaled Asmaa , Othman Abdalla , Abuelazm Mohamed , Abdelazeem Basel
Published: August 2024

Background and Aims:

Propofol has been used in medical practice as an anaesthetic drug for producing and sustaining general anaesthesia due to its advantages. However, it also has drawbacks, including injection-related discomfort. Recently, ciprofol has emerged as a promising anaesthetic drug that may overcome many drawbacks associated with propofol. In this systematic review and meta-analysis, we assess the efficacy and safety of ciprofol compared to propofol in different anaesthesia procedures.

Methods:

The study protocol was registered in the International Prospective Register of Systematic Reviews (ID: CRD42023458170). Central, PubMed, EMBASE, Scopus and WOS were searched for English literature until 26 February 2024. Meta-analysis was performed using RevMan. The risk of bias was assessed using the RoB 2.0 tool. Results were reported as risk ratios (RRs), mean differences (MDs) and 95% confidence intervals (CIs).

Results:

Nineteen randomised controlled trials were included in our analysis, with 2841 participants. There was no difference between ciprofol and propofol in the success rate of endoscopy (RR: 1.01, 95% CI: 0.99, 1.02; P = 0.44), while ciprofol showed a significant increase in the success rate of general anaesthesia/sedation (RR: 1.01, 95% CI: 1.00, 1.02; P = 0.04). Ciprofol showed significantly lower pain on injection (RR: 0.14, 95% CI: 0.09, 0.22; P < 0.001), lower adverse events (RR: 0.80, 95% CI: 0.69, 0.92; P = 0.002) and higher patient satisfaction (standardised mean difference (SMD): 0.36, 95% CI: 0.24, 0.48; P < 0.001).

Conclusion:

Ciprofol exhibited a comparable efficacy to propofol in inducing general anaesthesia and sedation with fewer adverse events, less pain on injection and higher patient satisfaction. These collective findings may suggest that ciprofol can be used as an alternative drug to ensure effective general anaesthesia/sedation induction in the future.
Comparison of aprepitant versus ondansetron for prevention of postoperative nausea and vomiting: A systematic review and meta-analysis with trial sequential analysis
Authors: Singh Madhusudan P. , Gurunthalingam Meenalotchini P. , Gupta Ayushee , Singh Juhi
Published: August 2024

Background and Aims:

Postoperative nausea and vomiting (PONV) is a common complication after surgery. Preventing PONV in high-risk patients often requires a multimodal approach combining antiemetic drugs with diverse mechanisms. While aprepitant, a neurokinin-1 receptor antagonist, is recognised as highly effective for PONV prevention, uncertainties remain regarding its effectiveness.

Methods:

This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The analysis assessed the effectiveness of aprepitant (A), aprepitant plus ondansetron (AO) and aprepitant plus dexamethasone and ondansetron (ADO) in preventing PONV compared to ondansetron alone (O) or in combination with dexamethasone (DO).

Results:

In the analysis of 12 studies involving 2729 patients, aprepitant demonstrated significant efficacy in preventing PONV compared to ondansetron alone (A versus [vs.] O: PONV incidence 12.5% vs. 28.5%, relative risk [RR] = 0.45, P < 0.001; complete response rate 55.97% vs. 50.35%, RR = 1.13, P = 0.010). The combination of aprepitant with ondansetron (AO) also showed a significantly lower incidence of PONV compared to ondansetron alone (11.3% vs. 26.8%, RR = 0.43, P < 0.001) and a higher complete response rate (38.1% vs. 26.84%, RR = 1.41, P = 0.020). In addition, ADO significantly reduced PONV incidence compared to DO (ADO vs. DO: 13.63% vs. 35.38%, RR = 0.38, P = 0.006).

Conclusion:

Aprepitant, whether used alone or in combination with ondansetron or both ondansetron and dexamethasone, consistently outperforms ondansetron in achieving a complete response as it lowers vomiting rates and reduces the need for rescue therapy during the crucial 24–48-h postoperative period.
A randomised controlled trial to compare the occurrence of postoperative nausea and vomiting in early versus conventional feeding in children undergoing daycare surgery under general anaesthesia
Authors: Singh Ranju , Huligeri H Santoshkumar , Singh Pooja
Published: August 2024

Background and Aims:

The time paediatric patients should resume oral intake after surgery is still ill-defined. No specific evidence suggests that the usual practice of postoperative fasting of 4–6 h to reduce postoperative nausea and vomiting (PONV) is beneficial. The primary objective of this study was to assess the occurrence of PONV with early oral feeding compared to conventional feeding in children undergoing daycare surgery under general anaesthesia.

Methods:

A randomised controlled trial was conducted in 300 children undergoing daycare surgery under general anaesthesia. Children were randomised into the early feeding group (Group EF, n = 150) or the conventional feeding group (Group CF, n = 150). Group EF received carbohydrate-containing oral fluids when the child demanded feed in the postoperative period. Group CF received oral fluids 4 h post-anaesthesia. All patients were monitored for occurrence of PONV, postoperative pain, duration of hospital stay and parental satisfaction. The incidence of PONV was compared using the Chi-squared test, while other continuous variables were compared using the Student’s t-test.

Results:

Both groups were comparable regarding PONV (12% in Group EF vs. 18.7% in Group CF, P = 0.109). The Face, Legs, Activity, Cry, Consolability scores were significantly lower in Group EF at 0 min (P = 0.011), 30 min (P = 0.001) and 1 h (P < 0.001). Patients in Group EF had a significantly shorter duration of hospital stay, that is, 6.31 [standard deviation (SD): 3.52] [95% confidence interval (CI): 1.45–12.24] h in EF versus 10.13 (SD: 2.99) (95% CI: 5.12–16.33) h in CF (P < 0.001). Parents of the children in Group EF had significantly better parental satisfaction scores (P < 0.001).

Conclusion:

Early postoperative feeding in children undergoing lower abdominal, non-gastrointestinal surgery under general anaesthesia does not increase the incidence of PONV.
Comparison of two techniques of administering the Valsalva manoeuvre in patients under general anaesthesia: A randomised controlled study
Authors: Shah Shagun B. , Chaudhary Vineet , Chawla Rajiv , Hariharan Uma , Ghiloria Neha , Dubey Jitendra Kumar
Published: August 2024

Background and Aims:

Surgeons often request a Valsalva manoeuvre (VM) at the end of surgery (head–neck surgery, craniotomy) to check haemostasis and to unmask covert venous bleeders. We aimed to compare an anaesthesia machine-generated objective technique for delivering VM under pressure-control (PC) mode with the traditional subjective technique of delivering VM in manual mode.

Methods:

This randomised controlled study included 60 adult patients randomised to manual (Group M) and controlled ventilation (Group C) groups. Our primary outcome measure was internal jugular vein (IJV) diameter at pre-determined time points (T0 = baseline, T1 = VM initiation, T2 = 20 s after VM initiation, T3 = immediately after VM release, and T4 = 1 min, T5 = 2 min and T6 = 5 min post-VM release). Secondary outcome measures included mean arterial pressure (MAP), heart rate, time to desired plateau airway pressure, number of patients with bleeders unmasked and surgeon satisfaction. Independent/paired sample t-tests were applied. Results are expressed as mean (standard deviation), mean difference (95% confidence interval), dotted box–whisker plots and trendlines. P <0.05 is considered statistically significant.

Results:

Mean differences in diameter changes in IJV (in centimetres) in the mediolateral and anteroposterior directions between Group C and Group M were -0.136 (-0.227, -0.044) and -0.073 (-0.143, -0.002), respectively. VM in the PC mode produced more significant IJV dilatation (P = 0.004, P = 0.044). MAP at T0 and T1 was comparable. At T2 and T3, there was a more significant fall in MAP in Group C versus Group M (P = 0.018 and P = 0.021, respectively). At T4, T5 and T6, MAP was comparable.

Conclusion:

Performing VM in PC mode is a better technique based on IJV diameter, haemodynamics, bleeder unmasking and surgeon satisfaction.
Comparison of efficacy of ultrasound-guided erector spinae plane block versus thoracolumbar interfascial plane block in patients undergoing lumbar spine surgeries: A systematic review and trial sequential meta-analysis
Authors: Majage Siddhavivek , Ravikumar Rajathadri Hosur , Prasanna Mrudula , Chandramouli M , Datta Priyankar Kumar , Baidya Dalim Kumar
Published: August 2024

Background and Aims:

Existing literature does not establish the superiority of the erector spinae plane (ESP) block or the thoracolumbar interfascial plane (TLIP) block in pain relief and reducing opioid consumption in lumbar spine surgeries. This systematic review and meta-analysis was aimed to discern their relative efficacy and safety.

Methods:

This meta-analysis included randomised controlled trials (RCTs) comparing ESP and TLIP blocks in lumbar spine surgeries. The primary outcome was 24-h opioid consumption, and secondary outcomes were visual analogue scale (VAS) scores at 1 h and 24 h and various complications. PubMed, Central Register of Controlled Trials, SCOPUS, EMBASE databases and cross-references were electronically searched. Two authors extracted data independently, cross-checked, and analysed them using RevMan 5.4. Binary outcomes were reported as odds ratios (OR), while continuous outcomes were presented as standardised mean differences (SMDs) accompanied by 95% confidence intervals (95% CIs).

Results:

Among 1107 articles, six RCTs (492 patients) were finally included. The ESP block demonstrated lower 24-h opioid consumption compared to TLIP [SMD -0.32 (95% CI: -0.50, -0.14); P < 0.001, I
2 = 83%]. At 1 and 24 h, ESPB yielded significantly lower VAS scores compared to TLIP [1 h: SMD -0.38 (95% CI: -0.57, -0.18); P < 0.001, I
2 = 83%; 24 h: SMD -0.57 (95% CI: -0.76, -0.37); P < 0.001, I
2 = 73%]. No significant difference was noted in adverse events.

Conclusion:

In comparison to the TLIP block, the ESP block has significantly lower 24-h opioid consumption and VAS scores at 1 and 24 h in patients undergoing lumbar spine surgery.
Enhancing postoperative analgesia in carotid endarterectomy patients: The potential of ultrasound-guided carotid sheath block combined with superficial cervical plexus block: A randomised trial
Authors: Kruc Anamarija , Lijovic Lada , Skrtic Matteo , Pazur Iva , Perisa Nikola , Radocaj Tomislav
Published: August 2024

Background and Aims:

Carotid endarterectomy (CEA) is a common procedure conducted under regional anaesthesia, providing real-time cerebral function monitoring. Many different combinations of regional cervical blocks exist, and most offer adequate analgesia in intraoperative and postoperative recovery. This research compares a superficial cervical plexus block (SCB) alone and combined with an ultrasound (US)-guided carotid sheath block (CSB). The primary objective was to explore the length of the sensory block after combining SCB and CSB.

Methods:

Patients scheduled for nonemergency CEA surgery were randomised into two cohorts. The Subject group (28 participants) received US-guided CSB and SCB. The Control group (31 participants) received only an SCB. Both groups received 0.5% levobupivacaine (2 mg/kg) along with 2% lidocaine (2 mg/kg). The sensory block time and its initiation, analgesia and neutrophil-to-lymphocyte ratio (NLR) were recorded before and after the block. The numeric pain rating scale (NPRS) was used to evaluate analgesia every 2 h for 12 h post block. Analysis of variance, Mann–Whitney U or log-rank test was used to analyse the distinction of selected variables.

Results:

The demographic characteristics were comparable across the cohorts. The Subject group demonstrated a significantly accelerated onset of sensory block (P = 0.029) and an extended time to first analgesia (P = 0.003). The sensory block was also substantially extended in the Subject group (P = 0.040). Postoperative pain (NPRS ≥1) within the first 12 h was more recurrent in the Control group (P = 0.048). NLR showed minimal disparity between the groups (P = 0.125).

Conclusion:

Combining SCB and US-guided CSB effectively and safely extends postoperative analgesia for CEA surgery.
School-Based Anti-Bullying Program on Reducing Violence among High School Students in Indonesia: A Quasi-Experimental study
Authors: Talib Susi Tentrem Roestyati , Senan Dato’ C. Prathapa , Said Faridah Mohd , Pamungkas Rian Adi , Matualage Amestina , Susantie Niluh Gede
Published: August 2024

Background and Objectives

Bullying is a form of aggression that has detrimental effects on the physical, emotional, and psychological well-being of youths. The study sought to investigate the impact of school-based anti-bullying initiatives on mitigating violence among high school students in Indonesia.

Patient and Methods

This study employed a quasi-experimental design, including a pretest and post-test, with a non-equivalent control group. This study included a total of 160 high school students.

Results

The findings indicated that school-based anti-bullying interventions had a substantial impact on the attitudes and behaviors of the experimental group, who received the program, in comparison to the control group, who received the standard care provided by the school. Nevertheless, there was no notable disparity in students’ understanding of anti-bullying between the experimental group and the control group both before and during the implementation of the school-based anti-bullying program.

Conclusion

Ultimately, school-based anti-bullying initiatives have proven to be efficacious and have the potential to be widely deployed as a means of curbing violence within educational environments. Additional research is required to carry out randomized control trials in order to ascertain the efficacy of the program in different educational institutions.