bluuebunny/crossref_metadata_2025 huggingface dataset:
Bilateral dense coin-like lenticular opacities in an infant
Authors: Rathod Aishwarya , Rani Deeksha , Gupta Tavish , Khokhar Sudarshan
Published: October 2023

A 6-month-old child with impaired vision was taken to a tertiary care hospital. Ocular examination revealed no abnormalities, but under anesthesia, ultrasonic biomicroscopy (UBM) found small, white, and dense lenticular opacities, which were further confirmed on the intraoperative clinical examination. The morphology of these coin-like opacities was distinct from previously described pediatric cataracts, being larger than those in cataract pulverulenta and thinner than “ant-eggs.” The child underwent lens aspiration, anterior vitrectomy, and intraocular lens (IOL) insertion. Understanding the unique morphology of this cataract may contribute to improved management of similar cases and deepen our knowledge of lens embryology and etiopathogenesis of cataract.
A case of Listeria keratitis postkeratoplasty and review of literature
Authors: Lahane Sumeet T , Chipre Sanjana R , Bade Jyoti , Vaishya Aman , Parekh Ragini , Lahane Tatyarao P
Published: October 2023

Infectious keratitis post keratoplasty is a rare, dreaded, and vision-threatening complication. In the case of therapeutic keratoplasty (TKP), post-graft infection defeats the purpose of surgery. We report a case of a 17-year-old female patient who developed keratitis post 12 months of primary TKP for proven fungal keratitis. Gram-positive bacilli were reported on Gram staining that did not respond to a course of vancomycin and fluoroquinolones. Culture proved it to be Listeria monocytogenes, which was treated successfully with a combination of gentamycin and piperacillin–tazobactam. Graft scarring developed post-healed keratitis, and the need for repeat TKP was deferred.
A case of postoperative sclerotomy site infection secondary to hordeolum externum
Authors: Sreenivasan Janani , Agarwal Mamta , Bhende Muna
Published: October 2023

Postoperative infective scleritis is a rare entity, often reported following pterygium surgery involving anti-metabolites. Infective scleritis following hordeolum has not been reported before. We report a case of hordeolum externum that developed 3 days post uneventful vitreoretinal surgery that led to sclerotomy site infection. The condition was managed successfully with topical and systemic antimicrobials based on microbiology. This case also highlights the importance of proper examination of the lid, adnexa, and sclerotomy sites in the postoperative period.
Acute dacryocystitis in aplastic anemia – A case report
Authors: Gupta Twinkle , Sethi Neha K. , Singh Navchint , Kaur Karamjeet
Published: October 2023

Immunosuppression in Aplastic anemia often leads to bacterial sepsis and pneumonias. We report a case of a 33-year female with aplastic anemia, with acute fulminant dacryocystitis. She also had anemic retinopathy in both eyes with subhyaloid hemorrhage in the left eye. The clinical presentation was as with typical acute dacryocystitis with characteristic erythema and edema inferior to medial canthus. However, there was a rapid progression to systemic sepsis. She was treated with blood and blood component transfusion and hematopoietic growth factors in addition to high-dose broad-spectrum lytic antibiotics. The patient responded initially, but clinical course subsequently deteriorated due to systemic involvement. This may have happened due to infected lacrimal sac acting as a persistent focus of infection. This is the first documented case of treatment of acute dacryocystitis in aplastic anemia.
A rare case of spontaneous anterior dislocation of cataractous lens in coloboma
Authors: Hema VK , Narendran Kalpana , Arjun V
Published: October 2023

We present a case of a young patient who developed leukocoria as a result of spontaneous anterior dislocation of lens in conjunction with an iridolenticular coloboma. Patient presented to us owing to sudden onset accentuation of leukocoria since she had no perception of light due to a long-standing retinal detachment. The catarctous lens was extracted by manual small incision surgery, preventing further complications from arising and improving cosmetics.
Amputated ICL haptic
Authors: Mukherji Payal , Konar Ipsita , Biswas Preeyam , Biswas Partha
Published: October 2023

23 yrs/F, high myope wanted to get rid of glasses. Ophthalmic examination revealed Best Corrected Visual Acuity (BCVA) of 6/12 (P), N6 with −15.50 DS/−2.50DC × 180° in right eye (RE), and 6/18(P), N6 with −18 DS/−1.50DC × 180° in left eye. Due to high refractive error, she was planned for BE toric Implantable Collamer Lens (ICL) implantation. Necessary investigations were done, and she underwent RE ICL implantation first. During ICL implantation, the foam tip applicator entrapped one trailing haptic in the injector nozzle resulting in an amputation of a part of the right trailing haptic. The ICL with three intact haptics was implanted in the sulcus. Next day, VA in RE was 6/18, N6. Slit-lamp examination and anterior segment OCT showed ICL in place with normal vaulting and no tilt.
A case of Hemi CRAO in a young post-COVID patient
Authors: Sarwate Renuka N , Karambelkar Vijay H , Singh Avanish K , Achwal Gargi M
Published: October 2023

SARS-CoV-2 infection has frequently been linked to thromboembolic consequences and coagulation abnormalities. A relatively uncommon condition known as hemiretinal artery occlusion (HRAO) is a variation of central retinal artery occlusion (CRAO) in which hypercoagulability is regarded to be a risk factor, particularly in younger patients. The goal of bringing up this case is to increase awareness of the possibility that a hemicentral retinal artery occlusion in a young; otherwise, healthy patient could be a sign of the thromboinflammatory state brought on by SARS-CoV-2 infection.
NUT carcinoma presenting as retrobulbar optic neuropathy: A lethal masquerade!
Authors: Neena R , Dominic Mathew , Abraham Ranjima
Published: October 2023

A case of a 15-year-old girl with sudden vision loss left eye, left relative afferent pupillary defect, and normal fundus both eyes. Magnetic resonance imaging (MRI) brain and orbits showed a heterogeneous enhancing mass lesion in the left posterior ethmoid sinus with bony invasion and crowding of the optic canal. She underwent left optic nerve decompression with removal of the lesion and was started on systemic steroids. Biopsy was suggestive of NUT carcinoma (NC) and immunohistochemistry (IHC) confirmed the same. Despite chemotherapy, the tumor progressed rapidly in six months invading the left orbit, extending to right side of the midline and left anterior cranial fossa, with subsequent complete loss of vision of right eye also. She eventually underwent a globe sparing orbital exenteration with anterior cranial base resection along with postoperative radiotherapy. A month later, patient developed extensive skeletal and hepatic metastasis and succumbed to the disease; 11 months after the initial diagnosis.
Treatment of tuberous sclerosis complex-associated retinal astrocytic hamartoma complicated with vitreous hemorrhage
Authors: Hang Song , Kai-Feng Xu , Chen-Xi Zhang , Xiao Zhang , Zhi-Qiao Zhang
Published: October 2023

Three cases of tuberous sclerosis complex (TSC)-associated retinal astrocytic hamartomas (RAH) complicated with vitreous hemorrhage were presented in this report. The first patient received sirolimus monotherapy. The lipid exudation was absorbed gradually, but there remained some stable exudative masses around the macula covered by epiretinal membranes. The second case was treated with vitrectomy, followed by sirolimus and intravitreal anti-vascular endothelial growth factor (VEGF) treatment. The exudates were absorbed, and the tumor remained stable afterward. The third patient was initially treated with vitrectomy combined with anti-VEGF treatment, but vitreous hemorrhage re-occurred soon after the surgery. He was then treated with sirolimus, and the tumor remained stable afterwards without further recurrence. From experience of treating these three patients, we suggested that for TSC-RAH complicated with vitreous hemorrhage, vitrectomy in combination with sirolimus is suggested to be the better choice. Intravitreal anti-VEGF injection is a supplementary treatment.
Small incision lenticule extraction (SMILE) surgery as an effective strategy to treat Megalocornea: A case report
Authors: Mehta Cyres , Mehta Keiki
Published: October 2023

Megalocornea is a developmental defect in which the entire anterior segment is enlarged bilaterally. Megalocornea is associated with Marfan syndrome and other ocular and systemic congenital defects. One may suppose that in situations of megalocornea, there may be abnormal collagen production, abnormal collagen tissue/cross-linking, a risk of corneal ectasia, and the presence of secondary glaucoma or cataracts, which may serve as the factors for not considering refractory surgeries. We report a case of megalocornea that was successfully treated with small incision lenticule extraction surgery. The patient noticed considerable improvement and no further complications were observed during the follow-up.
Juveline ocular factitious disease and its psychological implications
Authors: Rehman Alphia , Nivean Pratheeba Devi , Nivean M
Published: October 2023

Factitious disorder (FD) is a diagnostic entity in which patients intentionally manipulate clinicians by creating false physical or mental symptoms. Although the disorder is rare, having an early diagnosis is critical because it causes unnecessary health expenditures and tends to become chronic. In this article, we discuss two case reports of ophthalmic manifestations of FD. Although the management of FD is challenging, early detection and referral to a psychologist improves the outcome.
Endoilluminator-assisted management of acute hydrops in pellucid marginal corneal degeneration (PMCD) with compression sutures and intracameral perfluropropane (C3F8)
Authors: Shetty Prerana A , Bhalerao Sushank A , Vuyyuru Sowjanya , Thigale Uma Y , Mallipudi Rajavardhan
Published: October 2023

In this case, a male in his 30s presented to the clinic with blurring of vision, sudden whiteness, and pain in the left eye for 10 days. All preliminary examinations were recorded. He was a known case of Pellucid marginal corneal degeneration (PMCD). Clinical examination revealed corneal edema due to acute hydrops. Anterior segment optical coherence tomography (OCT) showed increased corneal thickness and a large descemets detachment. Endoilluminator-assisted compression sutures were placed along with intracameral C3F8 gas. As the tear was large, a 10-0 prolene suture was used instead of the conventional 10-0 nylon. This is the first case in literature in which acute hydrops in PMCD was managed with compression sutures (10-0 prolene) along with the injection of intracameral perfluropropane (C3F8) with the help of intraoperative use of endoilluminator.
Cerebral venous sinus thrombosis in a young patient with idiopathic thrombocytopenic purpura: A case report
Authors: Zhang Xin , Zhang Kai , Li Feifei
Published: October 2023

Cerebral venous sinus thrombosis (CVST) is a rare form of stroke associated with an increased mortality rate. While anticoagulant therapy is used to treat this form of stroke, treatment risks increase when patients have concurrent thrombocytopenia. In this paper, we report the case of a 19-year-old Asian woman with idiopathic thrombocytopenic purpura complicated by CVST treated with platelet-raising drugs and anticoagulants.
Unilateral isolated macular coloboma with full-thickness macular hole—Case report
Authors: Patnaik Gazal , Das Debmalya , Ramanadhane Raghulnadhan , Geol Nikita
Published: October 2023

Coloboma is a very rare developmental anomaly. The most common form is retinochoroidal coloboma. Macular coloboma is a very rare occurrence. We describe a rare case of unilateral isolated macular coloboma with full-thickness macular hole.
Isolated foveal hypoplasia – A case report
Authors: Phusate Rinkle P , Bawankule Prashant
Published: October 2023

Foveal hypoplasia is associated with albinism, nystagmus, achromatopsia. Isolated foveal hypoplasia is rare condition usually needs high index of suspicion and OCT for diagnosis.
Perceptions and factors associated with COVID Appropriate Behavior (CAB) obedience among general public in India: A mixed methods research
Authors: Shukla Kasturi , Phalke Vivek , Gupta Puneet Kumar , Bandawane Ketki , Dixit Aparna , Chandra Hem
Published: October 2023

BACKGROUND:

The purpose of the study was to analyze the public perception toward COVID Appropriate Behavior (CAB) obedience and to identify the factors associated with declining CAB.

MATERIALS AND METHODS:

It is a mixed methods study conducted from November 2021 to September 2022 in Pune city, India. A set of 15-CAB guidelines published by the Ministry of Health and Family Welfare, Government of India (GoI), were used as a base document to design the instruments of qualitative and quantitative study. Using a one-sample Kolmogorov–Smirnov test, CAB scores were tested for normality and distribution. Comparisons of various parameters were done using z test for proportion and paired t-test (statistical significance level was 0.05). Thematic content analysis was conducted for qualitative data analysis and verbatims are reported where applicable.

RESULTS:

The main motivation for people to get vaccinated was family and personal safety and a higher proportion of people felt safer post-vaccination which was linked to a reduced likelihood of CAB obedience. Qualitative results showed that people's lack of empathy and concern for others leads to undesirable personal behaviors such as spitting in public places, not wearing masks, etc., The need for socialization is high but discomfort with the use of masks/face shields and habituation with the disease were prominent causes of CAB disobedience.

CONCLUSION:

We conclude that reduced fear and gradual habituation have led to reduced CAB obedience. There is a need to reinforce empathy and concern for others to improve adherence to CAB like maintaining social distancing and wearing masks in public places for personal and social safety from the disease.
Women's motivation towards Pap smear screening based on sexual and screening status: A cross-sectional study using protection motivation theory
Authors: Romli Rodziah , Abd Rahman Rahana , Mohd Hashim Syahnaz , Chew Kah Teik , Mohamad Emma Mirza Wati , Mohammed Nawi Azmawati
Published: October 2023

INTRODUCTION:

Cervical cancer remains a reproductive health burden. Pap smear (PS) screening can detect cervical cancer early but is underused despite being subsidized. Motivational factors play a role in promoting PS screening. This study aimed to determine the women's motivation toward PS screening based on Protection Motivation Theory (PMT), which mainly focused on sexual and screening status.

MATERIALS AND METHODS:

The study was conducted electronically throughout Malaysia from January to February 2022 by disseminating Google Form (https://forms.gle/cD7fkUKYR4Cq6kZC8) via multiple WhatsApp groups to reach 526 women aged 21–65 years. The questionnaire consists of 24 items based on seven PMT constructs [perceived vulnerability, perceived severity, self-efficacy, response efficacy, fear (threat appraisal), response costs (coping appraisal), and protection motivation]. The descriptive statistics and independent t-test was used to analyze data using IBM SPSS Statistics software, version 25.

RESULTS:

Most respondents were sexually active [80.6% (n = 424)] and have heard of PS screening [95.8% (n = 504)]. More than half of respondents did not have PS screening in the last three years [59.3% (n = 312)]. Sexually active women have heard and have undergone PS screening feel less threatened with low coping appraisals. Undergoing PS screening made women perceived more response efficacy (P = .011), more self-efficacy (P < .001), and higher protection motivation (P < .001) toward PS screening.

CONCLUSIONS:

Women's motivation related to PS screening needs to be highlighted. Future development of health education strategy should include motivation focused in emphasizing the threat and coping appraisal into educational plan to ensure women come forward for screening.
Interprofessional education in problem-based learning: A frontier form of PBL in medical education
Authors: Chu Ming , Xu Lan , Liu Yuan , Ye Huihui , Zhang Yan , Xue Yintong , Li Yan , Gao Xiang , Hao Jie , Wang Lijun , Guo Qi , Wang Yuedan
Published: October 2023

BACKGROUND:

Interprofessional education (IPE) aims to educate healthcare students to improve collaboration and the quality of care. The delivery of IPE through a problem-based learning (PBL) setting appears to hold good validity. However, there are few studies that show the value of combining these two teaching modes.

MATERIALS AND METHODS:

The research was a longitudinal intervention study. A total of 360 students were randomly divided into three interprofessional PBL (IPBL) groups that mixed nursing, pharmacy, and clinical medical students and three uniprofessional PBL (UPBL) groups that consisted of a single profession. An improved Attitude and Learning Ability Questionnaire (ALAQ) was used to measure the improvement in attitudes toward interprofessional cooperation and learning outcomes. The tutorial session and final examination grades were compared between IPBL and UPBL by Chi-square tests and Cochran–Mantel–Haenszel tests. Cronbach's α analysis was calculated to assess the validity and reliability. Cronbach's alpha coefficient of the questionnaire was 0.887, demonstrating high levels of reliability (95% confidence interval [CI]: 0.842 0.916).

RESULTS:

According to Chi-square tests and Cochran–Mantel–Haenszel tests, we observed the student's positive attitudes toward interprofessional collaboration and the student's role awareness in the IPBL students was increased compared with UPBL students. In addition, a great majority of IPBL students felt that they had improved their self-learning ability and maintained a high enthusiasm for learning during the course.

CONCLUSION:

Our study found that the IPBL teaching model was more effective than the UPBL teaching model in healthcare student's positive attitudes toward interprofessional collaboration and learning outcomes.
The net atrioventricular compliance in mild to moderate hypertensive patients during the early left ventricle filling: A case series
Authors: Mohammed Nadiya Y. , Ali Mohammed Dalya A. , Al-Qadhi Ramaq G. , Al-Ganmi Ali Hussein Alek
Published: October 2023

BACKGROUND:

The compliance is considered one of the most important parameters which is defined as the change in volume with given change in pressure (dv/dp). It is varying inversely with both diastolic filling and modulus of chamber stiffness.

AIMS:

This study aimed to deduce the net atrioventricular compliance which is affected the trans mitral blood flow.

MATERIALS AND METHODS:

This study focuses on study group of 25 patients (15 males and ten females) with mild to moderate hypertension and mean age (49 ± 5.9) who were investigated for atrioventricular compliance and compared with 18 normal individuals (ten males and eight females) with a mean age of (44.9 ± 14.9) years old. The measurement of mitral valve area and the deceleration flow rate during ventricular early filling were taken from peak E wave to the minimum of the descending E wave. The atrioventricular (net) compliance was calculated according to the theoretical calculation Formula.

RESULTS:

When the atrioventricular compliance is measured during the early filling, a decrease in the net compliance of 50.27% in normal individuals was observed. The isovolumetric relaxation time was lower by 32.9% in normal individuals than in patients with mild to moderate hypertension.

CONCLUSION:

The increase in the atrioventricular net compliance for hypertensive patients is thought to be attributed to the compensatory mechanism of cardiac muscle before fibrosis can take place leading to a consequent increase in compliance measured during the early diastolic filling stage of the cardiac cycle.
Comparative evaluation of the effectiveness of three commercially available desensitizing mouthwash on dentinal tubule occlusion: An in vitro scanning electron microscopic study
Authors: Khot Tanvi , Lele Priya , Dodwad Vidya , Bhosale Nishita , Yewale Manasi , Mariam Sarah
Published: October 2023

Abstract

Aim:

To compare and evaluate the effectiveness of three commercially available desensitizing mouthwashes on dentinal tubule occlusion in vitro using a scanning electron microscope (SEM).

Materials and Methods:

Twenty-seven premolar maxillary teeth were collected and cleaned to remove debris and tissue using an ultrasonic scaler. Enamel was removed with the help of a high-speed plain cut tungsten carbide fissure bur under continuous water spray. Dentinal discs measuring 5 mm × 5 mm × 3 mm were prepared from the coronal region of the extracted teeth using a double-sided carborundum disc and straight micromotor handpiece. Using carborundum paper, the discs were polished and washed with distilled water. The discs were etched using 37% phosphoric acid to remove any smear layer that was caused by the grinding process and to simulate dentinal hypersensitivity by opening the dentinal tubules. The specimens were again washed and stored in distilled water until use. Samples were then randomly allocated into Group A: calcium sodium phosphosilicate mouthwash, Group B: potassium nitrate mouthwash, and Group C: dipotassium oxalate monohydrate mouthwash. The specimens were immersed in a test tube filled with the respective mouthwash and vigorously shaken for 60 s for simulating the natural mouth rinsing action. This procedure was repeated for 7 days, twice daily. To compare and assess the proportion of dentinal tubule occlusion, all the samples were processed and examined under an SEM.

Results:

The efficacy of the mouthwash on the obliteration of dentinal tubules was compared using the Kruskal–Walis analysis of variance test followed by the post hoc Mann–Whitney U test for pairwise comparison. Group A showed completely occluded tubules in 5 (55.6) and mostly occluded tubules in 4 (44.4). Group B showed mostly occluded in 4 samples (44.4) and partially occluded in 5 samples (55.6) and Group C showed completely occluded tubules in 3 samples (33.3) and mostly occluded tubules in 6 samples (66.7). A P value of 0.05 or less is regarded as statistically significant. *P ≤ 0.05 is statistically significant. Between Group A and Group B as well as between Group B and Group C, there was a statistically significant difference. However, a statistically significant difference between Group A and Group C does not exist.

Conclusion:

The calcium sodium phosphosilicate group was shown to have the most occlusion of the dentinal tubule, followed by dipotassium oxalate monohydrate and potassium nitrate group.
A Study of Psychiatric Comorbidities in Patients of Bipolar Disorder with and without Attention Deficit Hyperactivity Disorder during Euthymic Phase
Authors: Mishra Vikash Chandra , Solanki Gunjan , Singh Dharmdeep , Goyal Manish Kumar
Published: October 2023

Introduction:

Bipolar disorders (BDs) are comorbid with other psychiatric disorders including attention deficit hyperactivity disorder (ADHD). ADHD is often associated with a number of psychiatric comorbidities. Many symptoms related to ADHD are frequently misdiagnosed as being caused by other psychiatric disorders, leading to incomplete treatment. Hence, this study was planned to assess psychiatric comorbidities in BD with and without ADHD.

Materials and Methods:

A total of 110 euthymic BD patients were recruited. They were screened for childhood ADHD (cADHD) symptoms and adult ADHD (aADHD) symptoms by the Wender Utah Rating Scale for the ADHD and aADHD Self-Report Screening Scale for the Diagnostic and Statistical Manual of Mental Disorders-5. These were divided into three groups: Group 1 included BD patients without ADHD, Group 2 included bipolar patients with comorbid BD-aADHD, and Group 3 included bipolar patients who had a diagnosis of BD-cADHD.

Results:

The BD-aADHD group showed significantly higher associated comorbidity than the BD-cADHD and BD-only groups. The presence of generalized anxiety disorder, panic disorder, and alcohol use disorder is significantly higher in the BD-aADHD and BD-cADHD groups than the BD-only group.

Conclusion:

The presence of lifetime ADHD comorbidity is associated with a greater frequency of other comorbid conditions associated with a worse course of BD and a greater burden of other psychiatric comorbid conditions.
Cardiovascular Risk Factors and Venous Thromboembolism in Kingdom of Saudi Arabia: A Meta-Analysis and Systemic Review
Authors: Alsulami SS , El-Ghammaz A
Published: October 2023

ABSTRACT

Over the years, the literature dealt with venous thromboembolism (VTE) and atherosclerosis as two distinct pathologic processes but recently this theory has been challenged. This research aims to determine the relationship between cardiovascular risk factors and VTE. This meta-analysis and systemic review included case–control and non-case–control studies. We searched Google Scholar, Web of Science, MEDLINE, and EMBASE for studies conducted in Saudi Arabia, addressing the relationship between VTE and cardiovascular risk factors, and published during the period from January 2001 to December 2021. Quality assessment was done for included studies and pooled odds and prevalence ratios were reported. Evidence of bias was assessed using funnel plots and the Egger regression test. A total of 3291 patients with VTE and 3393 controls from 24 studies were enrolled. The pooled odds ratios were 1.33 (95% confidence interval (95% CI) = 1.01–1.77), 1.2 (95% CI = 0.88–1.64), 0.881 (95% CI = 0.55–1.41), 0.676 (95% CI = 0.04–11.25), 1.15 (95% CI = 0.75–1.75), 0.925 (95% CI = 0.55–1.56), 1.45 (95% CI = 0.89–2.35), and 1.49 (95% CI = 0.24–5.23) for age >60 years, female gender, hypertension, dyslipidemia, diabetes, cardiovascular disease, obesity, and smoking, respectively. The pooled prevalence ratios were 42.6%, 55.7%, 51.6%, 48%, 44%, 32.8%, 30.9%, and 46.6%, respectively, for the same factors. Few studies reported dyslipidemia and smoking. In conclusion, old Old age, female gender, diabetes, obesity, and smoking are associated with increased risk of VTE with the highest risks seen with obesity and smoking. Additionally, female gender was the most prevalent risk factor among VTE patients.
Assessment of Antioxidant System Status before and after Operation in Neonates with Congenital Heart Disease
Authors: Özlü F , Demiray GA , Güneş D , Yıldızdaş HY , Yıldız ŞM
Published: October 2023

ABSTRACT

Background/Aim:

Oxidative stress is considered to have a significant role in the development of cardiovascular diseases (CVDs) as well as many other diseases. Therefore, the purpose of the study is to evaluate the antioxidant system status at pre- and post-operative period in newborns with congenital heart disease (CHD) requiring operation.

Materials and Methods:

Fifty CHD patients participated in this research. Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and thiobarbituric acid reactive substances (TBARS) levels were studied in blood samples. RACHS-1 score, blood lactate levels, and hypoxic events were also recorded. Comparisons of antioxidant system parameters were conducted at pre- and post-operative periods and also between exitus and discharged groups.

Results:

GPx activity and TBARS levels were significantly higher in the pre-operative period than post-operative period though the other antioxidant enzymes were not altered. In pre-operative period, GPx activity was low in addition to rarer hypoxic events in the discharged group. Also, a negative correlation was found between SOD and GPx activities in pre-operative period.

Conclusion:

The results provide fundamental data showing the lowered GPx activity and TBARS levels considered as sensitive oxidative biomarkers after the operation. It was assumed that antioxidant system parameters might show changes after the operation, and GPx is prominent for resistance to hypoxic conditions. Post-operative reduction of GPx and TBARS levels is significant for evaluating the antioxidant system alterations after the operation. However, further investigations follow long-term duration for post-operative monitoring to estimate how antioxidant system status changes to improve the treatment of the health condition.
Short-Term Outcomes of Double Omentopexy in One Anastomosis Gastric Bypass Surgery: A Controlled Clinical Trial
Authors: Abdelsamee KS
Published: October 2023

ABSTRACT

Purpose:

This study aims to assess the efficacy of implementing a novel technique of reinforcement of gastric pouch and remnant stomach staple line with Double Omentopexy (DO) in patients undergoing One-Anastomosis Gastric Bypass (OAGB) surgery and evaluate its impact in reducing the early postoperative complications.

Materials and Methods:

The 123 patients were allocated into two groups: 61 in the standard OAGB group and 62 in OAGB with DO group. The primary outcomes are postoperative complications (including early postoperative bleeding, leakage, gastric twist, reflux, etc.) and hospital stay. The secondary outcome is excess body weight loss. Follow-up visits were planned after discharge: at two weeks, two months, and three months postoperatively.

Results:

Postoperative complications were significantly lower, 3 (4.84%) in OAGB with DO compared with 10 (16.39%) in standard OAGB (P =0.037). There was no statistically significant difference in the incidence of early postoperative bleeding, deep vein thrombosis, biliary reflux, and gall bladder stone (P >.05). No patient had leakage in either group. The mean operative time was significantly longer (68.66 ± 6.68 min) in OAGB with the DO group when compared with the standard OAGB group (62.16 ± 7.54 min) (P <.001).

Conclusion:

Applying the DO technique may be a good measure to be added during OAGB to decrease the incidence of potential postoperative complications, especially the rate and severity of bleeding.
Diagnostic Value of Digital Breast Tomosynthesis and Synthetic Images in Patients with Breast Cancer
Authors: Bahadır H
Published: October 2023

ABSTRACT

Background:

Different imaging techniques are used in the diagnosis of breast cancer. The low sensitivity of mammography to detect cancer in the dense breast parenchyma and the lack of standard application of digital breast tomosynthesis (DBT) are some of the problems. Therefore, breast cancer imaging techniques should be compared in terms of conspicuity and characterization of lesions.

Aim:

Full-field digital mammography (DM) and synthetic mammography (SM) which are obtained from the slices of digital breast tomosynthesis (DBT) give similar results in terms of conspicuity and characterization of the lesions in detecting breast cancer.

Patients and Methods:

In this retrospective study, 47 women diagnosed with breast cancer were included in the study. DM, SM, and DBT images were evaluated by scoring the conspicuity of the index lesion in the parenchyma and its characterization in terms of contour and shape with a 4-point scale. In addition, the conspicuity of the lesions in relation to lesion size and breast density was examined with these three techniques.

Results:

There is no significant difference between DM and SM techniques for index lesion conspicuity and characterization; however, the imaging score of DBT is significantly higher than other techniques for the conspicuity and characterization of the lesions. In terms of the conspicuity of the lesions in relation to lesion size, DM and SM techniques show significant difference according to the size of the lesion, whereas the DBT technique did not show significant difference. While mammography type is a determinant of lesion conspicuity in only DM and SM techniques, conspicuity findings do not differ significantly in the DBT technique.

Conclusion:

In conclusion, it was shown that standard images and SM images obtained from DBT did not differ significantly in terms of conspicuity and characterization of lesions. Thus, DBT is significantly superior to the DM and SM images. While the DM and SM images are more successful in showing large lesions and lesion detection in nondense breasts, DBT images were not affected by lesion size and breast density.
Video Shot Boundary Detection and Sports Video Classification Algorithm Based on Particle Filter
Authors: Chen Dongsheng , Ni Zhen
Published: October 2023

INTRODUCTION: Sports video is a very important information resource. The classification of sports video with high accuracy can effectively improve the browsing and query effect of users. This project intends to study a motion video classification algorithm based on deep learning particle filter to solve the problems of strong subjectivity and low accuracy of existing motion video classification algorithms. A key box extraction method based on similarity is proposed. The moving video classification algorithm based on deep learning coding model is studied. Examples of various types of sports videos are analyzed. The overall performance of the motion video classification algorithm proposed in this paper is much better than other existing motion video classification algorithms. This algorithm can greatly improve the classification performance of motion video.
Methanol (M85) Port Fuel-Injected Spark Ignition Motorcycle Engine
Development—Part 1: Combustion Optimization for Efficiency Improvement and
Emission Reduction
Authors: Agarwal Avinash , Yadav Omkar , Valera Hardikk
Published: October 2023

Limited fossil fuel resources and carbonaceous greenhouse gas emissions are two
major problems the world faces today. Alternative fuels can effectively power
internal combustion engines to address these issues. Methanol can be an
alternative to conventional fuels, particularly to displace gasoline in spark
ignition engines. The physicochemical properties of methanol are significantly
different than baseline gasoline and fuel mixture-aim lambda; hence
methanol-fueled engines require modifications in the fuel injection parameters.
This study optimized the fuel injection quantity, spark timing, and air–fuel
ratio for M85 (85% v/v methanol + 15% v/v gasoline) fueling of a port
fuel-injected single-cylinder 500 cc motorcycle test engine. Comparative engine
performance, combustion, and emissions analyses were performed for M85 and
baseline gasoline. M85-fueled engine exhibited improved combustion
characteristics such as higher peak in-cylinder pressure, heat release rate, and
cumulative heat release due to higher flame speed and the effect of fuel oxygen.
The brake thermal efficiency increased by up to 23% at lower loads and 8% at
higher loads for M85 fueling. Carbon monoxide was reduced by 11.4–94% and
46.1–94.4% for M85 w.r.t. baseline gasoline at 2500 and 3500 rpm, respectively,
at varying engine loads. Hydrocarbon emissions showed mixed trends for M85
w.r.t. baseline gasoline. Nitric oxide emissions were 4–90.2% higher for M85
w.r.t. baseline gasoline at 2500 rpm, at varying engine loads; however, mixed
trends were observed at 1500 and 3500 rpm. Carbon monoxide, hydrocarbons, and
nitric oxide emissions were 4.6, 38.9, and 84.3% lower for M85 than baseline
gasoline during idling. Overall the M85-fueled motorcycle engine emitted fewer
harmful pollutants, indicating its superior environmental sustainability, except
for slightly higher NO emission.
Analysis of Real-World Preignition Data Using Neural Networks
Authors: Kaul Brian , Maldonado Bryan , Michlberger Alexander , Halley Scott
Published: October 2023

1Increasing adoption of downsized, boosted, spark-ignition engines has improved vehicle fuel economy, and continued improvement is desirable to reduce carbon emissions in the near-term. However, this strategy is limited by damaging preignition events which can cause hardware failure. Research to date has shed light on various contributing factors related to fuel and lubricant properties as well as calibration strategies, but the causal factors behind an individual preignition cycle remain elusive. If actionable precursors could be identified, mitigation through active control strategies would be possible. This paper uses artificial neural networks to search for identifiable precursors in the cylinder pressure data from a large real-world data set containing many preignition cycles. It is found that while follow-up preignition cycles in clusters can be readily predicted, the initial preignition cycle is not predictable based on features of the cylinder pressure. This indicates that the alternating pattern of preignition cycles within clusters is influenced by the thermodynamic state as reflected in the pressure, but that the trigger for the initial preignition cycle is not thermodynamic in nature, but more likely tied to a critical threshold in the chemistry of the fuel/lubricant mixture in the upper crevice or other factors related to the presence of an ignition source.
Experimental Study of Combustion Characteristics and Emissions of Pre-Chamber Induced HCCI Combustion
Authors: Ugrinić Sara , Krajnovic Josip , Sjeric Momir , Kozarac Darko
Published: October 2023

It is a well-known fact that HCCI combustion offers the possibility of achieving high efficiency with low emissions, but with the challenges in combustion control and ability to adjust to changing environmental conditions. To resolve the aforementioned challenges, a pre-chamber induced homogeneous charge compression ignition (PC-HCCI) combustion mode was experimentally tested with aim of providing initial operating boundaries in terms of combustion stability and obtaining initial performance results. The single cylinder engine equipped with active pre-chamber and compression ratio (CR) of 17.5 was fueled by gasoline. The initial experiments were performed at the engine speed of 1600 rpm with intake air temperatures varied from 33°C to 100°C to verify the possibility of achieving the PC-HCCI combustion mode and to compare the achieved engine performance and emission results with both PCSI and pure HCCI combustion modes used as reference cases. The results showed that PC-HCCI combustion mode ensures stable operation at low loads, extending the lean limit while maintaining higher efficiency compared to PCSI combustion mode. When compared to the pure HCCI combustion mode, lower efficiency is obtained, possibly only due to non-optimized operating parameters. The results however confirm that a significant reduction and narrowing of the required intake temperature range is feasible along with the direct control of ignition timing and thus much improved resilience to the changing of boundary conditions. The analysis further showed that pre-chamber fuel mass has a major impact not only on ignition and combustion stability but is also directly corelated with total emissions of NOX, confirming that at such diluted mixtures most of the engine-out emissions come from the pre-chamber.
Emissions of Aerospace Fuels F-24 and Jet-A in a Jet Engine and Correlation with Combustion Characteristics from a Constant Volume Combustion Chamber
Authors: Soloiu Valentin , Rowell Aidan , Weaver Amanda , Mcafee John , Willis James , O'Brien Brandon
Published: October 2023

An investigation into emissions differences and their correlations with differing combustion characteristics between F24 and Jet-A was conducted. Raw emissions data was taken from a single stage jet engine by a FTIR gas analyzer. Measurements of H2O, CO2, CO, NOx, and total hydrocarbon emissions (THC) were taken at 60K, 65K, and 70K RPM. At 70K RPM Jet-A and F-24 the emissions were similar at approx.: 4% H2O, 3% CO2, 970 PPM CO, 28 PPM NOx. Jet-A THC emissions were approx.: 1200 PPM THC, F24 THC emissions were lower by over 60%. The significantly lower amount of THC emissions for F24 suggests more complete combustion compared to Jet-A.
Reinforcement Learning Based Fast Charging of Electric Vehicle Battery Packs
Authors: Abbasi Mohammad Hossein , Arjmandzadeh PhD Ziba , Zhang Jiangfeng , Xu Bin , Krovi Venkat N
Published: October 2023

Range anxiety and lack of adequate access to fast charging are proving to be important impediments to electric vehicle (EV) adoption. While many techniques to fast charging EV batteries (model-based & model-free) have been developed, they have focused on a single Lithium-ion cell. Extensions to battery packs are scarce, often considering simplified architectures (e.g., series-connected) for ease of modeling. Computational considerations have also restricted fast-charging simulations to small battery packs, e.g., four cells (for both series and parallel connected cells). Hence, in this paper, we pursue a model-free approach based on reinforcement learning (RL) to fast charge a large battery pack (comprising 444 cells). Each cell is characterized by an equivalent circuit model coupled with a second-order lumped thermal model to simulate the battery behavior. After training the underlying RL, the developed model will be straightforward to implement with low computational complexity. In detail, we utilize a Proximal Policy Optimization (PPO) deep RL as the training algorithm. The RL is trained in such a way that the capacity loss due to fast charging is minimized. The pack’s highest cell surface temperature is considered an RL state, along with the pack’s state of charge. Finally, in a detailed case study, the results are compared with the constant current-constant voltage (CC-CV) approach, and the outperformance of the RL-based approach is demonstrated. Our proposed PPO model charges the battery as fast as a CC-CV with a 5C constant stage while maintaining the temperature as low as a CC-CV with a 4C constant stage.
Experimental Study on Diesel Spray Combustion and Wall Heat Transfer with Multiple Fuel Injection Strategies - Results of Rapid Compression and Expansion Machine Experiment
Authors: HADI Herry Sufyan , FAN Chengyuan , Takayama Atsushi , Nishida Keiya , Ogata Youichi , Mahmud Rizal
Published: October 2023

The rapid compression expansion machine (RCEM) was used to investigate the temporal variations of the spray flame and wall heat flux in the diesel engine combustion process by using 120 MPa and 180 MPa common rail pressure. A stepped cavity was applied to investigate spray and flame behavior under the pilot, pre and main multiple injection strategy. Wall heat flux sensors were installed in the piston cavity and the cylinder side. The injector has 3 holes with the neighboring angle in the left direction and another 3 holes in the right direction to simulate the spray interaction in the 10-hole injector combustion system in the actual diesel engine. The spray and flame behavior were taken by a high-speed video camera with direct photograph. A two-color analysis was applied to investigate gas temperature and KL factor distribution. The effect of locations and common rail pressure on heat transfer was investigated. The result shows that multiple injections improve better atomization and air fuel mixture formation which reduces combustion duration in the combustion chamber. Pilot injection and pre-injection have no significant effect on the wall heat flux due to the low in-cylinder pressure and ambient temperature before TDC. The wall heat flux in cylinder head is the highest of all locations due to the intense combustion flame occurs in this region. The increasing common rail pressure tends to increase the peak value of the wall heat flux and decrease the combustion duration. To investigate the heat transfer phenomena in more, the correlation between Nusselt and Reynold numbers is presented in this study. The direct flame image, heat flux waveforms, and quasi-steady state are applied to obtain the characteristic velocity. Two-color analysis is used to obtain the gas temperature. The result shows that the heat transfer phenomena can be expressed by the correlation between Nusselt and Reynold numbers.
Analysis of Dynamic Characteristics and Load Sharing Performance of Electric Driven Planetary Gear System Based on Electromechanical Coupling Model
Authors: Guo Fang , Li Chen , Su Jinzhan , Liu Chao
Published: October 2023

Due to the multi-gear configuration and high integration of electric drive systems in electric vehicles, it is necessary to investigate the influence of drive motor torque fluctuation on the dynamic characteristics and load sharing performance of planetary gear transmission systems. Considering both motor torque fluctuation and internal excitations of the transmission system, a dynamic model of the electromechanical coupled system is established by combining the Maxwell motor electromagnetic model with the planetary gear dynamics model. Based on the proposed model, the dynamic characteristics, dynamic load performance and load sharing performance of the system considering motor torque fluctuation are analyzed, and the improvement of system load sharing performance due to sun gear floating is discussed. The results show that motor torque fluctuation leads to more complex dynamic response and causes the vibration displacement amplitude to more than doubled. Furthermore, the system exhibits an increased presence of high-frequency components in its vibration frequency spectrum. Under the conditions of eccentricity error only and both installation error and eccentricity error, motor torque fluctuation increases the load sharing coefficient of the planetary gear system by more than 11.5% and the dynamic load coefficient by more than 76%. The backlash float mechanism can improve the load sharing performance of the system by approximately 3% for both internal and external meshing pairs, but with limited effectiveness. Additionally, when the float amount reaches 5μm, the system’s load sharing performance will no longer show further improvement. This research work provides valuable insights for the optimization design of shock and noise reduction in electric-driven planetary gear systems
Leakage and Diffusion Analysis and Safety Research of Onboard
Hydrogen Systems in Different Space
Authors: Zhang Yongtao , Yu Jiangbin , Yang Zirong , Hao Dong , Zhang Xin
Published: October 2023

This paper presents a simulation study of hydrogen leakage from an onboard
hydrogen supply system in open, closed, and semi-closed spaces. The simulations
investigate the effects of environmental factors and conditions such as
obstacles on the diffusion process of hydrogen leaks. The results show that when
hydrogen gas leaks, the direction of the leak determines the potential risk. If
the leak is directed toward the cab, the gas will accumulate in the gap between
the cab and the hydrogen supply system, posing a significant risk to the driver.
On the other hand, if hydrogen leaks toward the rear, a combustible cloud forms
mainly behind the vehicle at a safe distance of 3.8 meters. The study also
investigated the effects of wind speed, wind direction, and ambient temperature.
It was found that headwinds can cause hydrogen to spread near the vehicle,
increasing the risk of an accident. The paper also investigates the effect of
obstacles that inhibit the horizontal diffusion of hydrogen, causing the gas to
accumulate in front of the obstacles and increasing the risk of explosion in the
vicinity. This paper also investigates the effect of vent area and vent location
on the diffusion of hydrogen leaks in enclosed spaces, and the results show that
the vent location factor has a more significant effect on the magnitude of
hydrogen concentration in enclosed spaces after a hydrogen leak compared to the
vent area. The simulation results can help improve society's understanding of
hydrogen energy, the development of related safety standards and emergency
response measures for accidents, as well as provide insight into the risks
associated with hydrogen systems. The results of this study will be useful for
policymakers, engineers, and researchers who are committed to the widespread use
of hydrogen energy.