bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of the Role of Premarital Guidance in Building Adolescents' Marriage Readiness: Study in Liunggunung Village, Purwakarta Regency, Indonesia
Authors: Widyastuti Dwi
Published: January 2024

Marriage is one of the important events in human life. Therefore, marriage readiness is an important thing to pay attention to, especially for teenagers. Premarital guidance is one effort to increase teenagers' marriage readiness. This research aims to analyze the role of premarital guidance in building adolescent marriage readiness in Liunggunung Village, Purwakarta Regency, Indonesia. This research uses a qualitative approach with a case study method. The research subjects were 10 teenagers who had attended premarital guidance in Liunggunung Village. Data was collected through in-depth interviews and observations. The research results show that premarital guidance plays an important role in building teenagers' marriage readiness. Premarital guidance provides the knowledge and skills that teenagers need to get married, such as understanding marriage, husband-wife relationships, communication, and financial management. Premarital guidance also helps teenagers to prepare themselves physically and mentally for marriage.
Hair Transplant Follicular Unit Extraction Technique as a Current Treatment Option for Androgenetic Alopecia
Authors: Gardenia Akhyar  , Nagara Adianto Jaya
Published: January 2024

The therapy for androgenetic alopecia currently varies, and there is no generally efficacious form of treatment. Despite receiving therapy, a portion of individuals with alopecia still do not achieve the anticipated hair regrowth outcomes. The absence of efficacious medical intervention typically necessitates the exploration of alternative therapy modalities. A significant number of patients who do not get satisfactory results from medical treatment explore other therapeutic approaches, such as hair transplantation. Advancements in hair transplantation procedures have seen substantial progress since the 1960s. Men frequently seek hair transplantation, making it a popular cosmetic treatment. Over 11,000 operations took place in the United States in 2014. Commonly practiced contemporary hair transplant procedures include follicular unit transplantation (FUT) and follicular unit extraction (FUE). The FUE technique is gaining popularity due to its non-invasive nature, quicker recovery time, reduced post-operative discomfort, and fewer surgical scars, in contrast to the FUT approach.
Comparative Analysis of the Inhibitory Efficacy of 50% and 80% Concentrations of Rambutan Seed Extract (Nephelium lappaceum L.) on the Growth of Candida albicans
Authors: Wijaya Cindy Denhara , Daryono  , Rasyika Adani
Published: January 2024

Introduction. Denture stomatitis is a prevalent issue among those who wear dentures, and it is caused by Candida albicans. Ketoconazole, an azole antifungal medication, is commonly employed to treat denture stomatitis. However, it is important to note that the usage of this agent might lead to hepatotoxicity and the development of resistance. The objective of the study was to assess the inhibitory efficacy of rambutan seed extract (Nephelium lappaecum L.) at concentrations of 50% and 80% on the proliferation of Candida albicans.

Methods. This research employs a laboratory experiment using a design that includes a post-test only control group. The specimen is an uncontaminated culture isolation of Candida albicans. This study had four distinct groups: rambutan seed extract concentrations of 50% and 80%, a positive control group, and a negative control group. Each group was reproduced six times. Using digital calipers to measure the diameter of resistance. Upon completion of data collection, the acquired data was subsequently subjected to analysis utilizing one-way ANOVA and post hoc LSD statistical testing.

Results. The research findings indicate that the average ± standard deviation inhibitory diameter of rambutan seed extract was 50%, 80%, and the positive control for the growth of Candida albicans was 8.68 ± 0.585; 12.38±0.505; 22.43 ± 0.809 mm, respectively. In contrast, the negative control (DMSO) did not exhibit any inhibitory effects. The one-way ANOVA test revealed a statistically significant difference in the mean inhibitory diameter of rambutan seed extract at concentrations of 50% and 80% on the growth of Candida albicans (p=0.000; p?0.05). The findings of the LSD post hoc test indicated a significant difference in inhibitory power between the 50% and 80% concentrations of rambutan seed extract, as well as between these concentrations and both the positive and negative controls. Additionally, there was a significant difference in the growth of Candida albicans between the 50% and 80% concentrations of rambutan seed extract (p?0.05).

Conclusion. The research findings indicate that the extract derived from rambutan seeds effectively inhibits the development of Candida albicans. An 80% concentration is the optimal concentration for maximum effectiveness.
Effect 0f Deficit Budget Financing Sources on Inflation Rate in Nigeria
Authors: Agu Patrick Chinonso , Oshim Judethadeus Chukwuebuka
Published: January 2024

The study examined the effect of deficit budget financing sources on inflation rate in Nigeria. External debt, Ways and Means Advances, and Treasury Bills were the independent variables of the study, while inflation rate was the dependent variable. The study adopted an ex-post-facto research design, covering the period between 2011 and 2020. Secondary data were extracted from the Central Bank of Nigeria Statistical Bulletin. Ordinary Least Square multiple regression technique was used for the data analysis. In line with the specific objectives of the study which is to ascertain the effect of external debt, ways and means advances, and treasury bills on inflation rate in Nigeria, it was revealed that external debt and treasury bills have a significant effect on inflation rate in Nigeria. Ways and means advances have a positive and significant effect on inflation rate in Nigeria. This implies that among the explanatory variables, ways and means advances is the major determinant of inflation rate in Nigeria. The study recommended therefore that government policies on inflation rate should factor in external debts because of their negative effect on inflation rate. external borrowing should be prudently used in productive activities that can raise investments, reduced inflation and improve the country's exchange rate. The Government should drastically reduce the rate they borrow from CBN. Any of such borrowing should be targeted towards developing the economy and they should always maintain the credit limit set by the CBN. The government should reduce the number of treasury bills issued to the general populace. Other sources of deficit budget funding, such as privatization of obsolete government institutions, should be considered by the government.
Personality Traits and Academic Performance of Students in Akwa Ibom State University, Nigeria
Authors: Toby Ubong Godfrey , Uwa Kingsley Lazarus , Akpan Aaron
Published: January 2024

The broad objective of the study was to examine the relationship between personality traits and academic performance of students in Akwa Ibom State University, Ikot Akpaden/Obio Akpa Campus. The research hypotheses were formulated in line with the research questions and objectives. The descriptive survey research design was adopted for the study and a sample size of three hundred and fifty-three (379) respondents was drawn from a population of seven thousand five hundred and sixty (7560) students using Taro Yamani formula. The major instrument for data collection was a structured questionnaire administered to the respondents using stratified sampling technique and the interval data collected were analyzed using simple percentage and Pearson Moment Correlation Analysis. The result of the findings revealed that, that there is a significant relationship between conscientiousness, (RX1 = 547) agreeableness (RX2 =770) and academic performance (p= 0.000) of students in Akwa Ibom State University, Ikot Akpaden/Obio Akpa Campus. Consequently, it is recommended that Students who exhibit higher levels of conscientiousness tend to achieve better academic outcomes. Here's how conscientiousness can influence academic performance and some tips for leveraging this trait to excel in academics: Time Management, task completion, attentions to detail and organizations.
PRAKTIK DAN IMPLEMENTASI PENERAPAN MEDIA BELAJAR INTERAKTIF BAGI SISWA SEKOLAH DASAR
Authors: Benu Asti Yunita , Rafael Agnes M.D. , Fallo Diana. Y
Published: January 2024

AbstrakKegiatan Pengabdian Kepada Masyarkat ini dilakukan selama 3 minggu. Tujuan pelaksanaan kegiatan PKM untuk merancang dan menerapkan pembelajaran menggunakan media pembelajaran. Proses pembelajaran mengajarkan materi-materi Sekolah Dasar. Materi dasar tersebut terbagi pada kelompok kelas Rendah dan kelompok Kelas Tinggi. Kegiatan ini melibatkan beberapa SD yaitu SD Negeri Sikumana 2, SD Negeri 2 Baumata Timur, SD Inpres Oepura 2, SD GMIT Kolhua, SD GMIT Baumata dan SD GMIT Kuanino 2. Hasil yang diperoleh dari kegiatan ini yaitu anak lebih aktif, interaktif dan antusias belajar berkelompok maupun secara mandiri. Guru dan pihak sekolah dengan antusias menerima semua media pembelajaran yang dirancang dan pada akhir kegiatan diserahkan pada pihak sekolah. Media interaktif yang digunakan oleh pelaksana awalnya dianalisis sesuai kebutuhan, dirancang dan diterapkan sehingga menghasilkan hasil sesuai dengan harapan.
Kata Kunci : media pembelajaran
PELATIHAN PEMBUATAN E-LKPD BERBASIS GOOGLE FROM MODEL PROJECT BASED LEARNING BAGI MAHASISWA PGSD
Authors: Risandy Lolita Anna , Sholikhah Septiana , Ferryka Putri Zudhah , Firnanda Anggi
Published: January 2024

AbstrakPelatihan Pembuatan E-Lembar Kerja Peserta Didik (E-LKPD) dengan Model Project Based Learning (PBL) berbasis Google Form bagi Mahasiswa Pendidikan Guru Sekolah Dasar (PGSD) merupakan upaya untuk meningkatkan keterampilan mahasiswa dalam menciptakan materi pembelajaran interaktif. Penelitian ini fokus pada penggunaan Google Form dan pendekatan PBL untuk menciptakan E-LKPD yang relevan dengan kurikulum. Metode pelatihan mencakup pemaparan konsep, demonstrasi penggunaan Google Form, dan proyek kolaboratif dalam menerapkan PBL. Evaluasi dilakukan terhadap kualitas E-LKPD yang dihasilkan dan kemampuan mahasiswa dalam menerapkan PBL. Hasilnya menunjukkan peningkatan kualitas E-LKPD dan pemahaman yang lebih baik mengenai PBL.Kata Kunci : (E-LKPD), Google Form, Project Based Learning (PBL)
AbtsractTraining on Creating Student E-Worksheets (E-LKPD) using the Google Form-based Project Based Learning (PBL) Model for Elementary School Teacher Education (PGSD) Students is an effort to improve students' skills in creating interactive learning materials. This research focuses on the use of Google Forms and the PBL approach to create E-LKPD that is relevant to the curriculum. Training methods include concept exposure, demonstration of the use of Google Forms, and collaborative projects in implementing PBL. Evaluation is carried out on the quality of the E-LKPD produced and students' ability to apply PBL. The results show an increase in the quality of E-LKPD and a better understanding of PBL.
Keywords: (E-LKPD), Google Form, Project Based Learning (PBL).
Podcast como Recurso en la Enseñanza de Matemáticas en Educación Secundaria
Authors: Quintuña Padilla Sandro Xavier , Herrera Caldas Verónica Alexandra
Published: January 2024

Este estudio se centra en la aplicación del podcast como recurso educativo en la enseñanza de matemáticas en la educación secundaria. Se utiliza el modelo ADDIE (Análisis, Diseño, Desarrollo, Implementación y Evaluación) para planificar y ejecutar la experiencia de aprendizaje. El modelo ADDIE se utilizó como una metodología efectiva para la integración exitosa de podcasts en la enseñanza de matemáticas. Se recopilaron datos a través de una encuesta realizada a 79 estudiantes de diferentes niveles de secundaria. Los resultados muestran una alta satisfacción de los estudiantes con el uso de podcasts, destacando mejoras en la comprensión de las matemáticas y aumento de la motivación por aprender. Las herramientas tecnológicas utilizadas fueron Anchor.fm y Spotify, las cuales también tuvieron una valoración positiva por parte de los estudiantes.
La Educación Temprana como Herramienta para Naturalizar el Conocimiento del Sistema Inmunológico
Authors: Rojas de Hidalgo Yeimy Marlene , Sillagana- Verdezoto Cristian
Published: January 2024

La educación para la salud en Latinoamérica proporciona herramientas para fomentar el bienestar físico y promover mejoras sanitarias, centrándose en la alimentación y la integridad física. Sin embargo, se presta poca atención al conocimiento del sistema inmunológico y su papel en la respuesta del cuerpo humano a los desafíos que afectan la homeostasis, lo cual marca la diferencia entre la salud y la enfermedad. Este estudio propone integrar el conocimiento del sistema inmunológico desde las etapas iniciales de la educación con el objetivo de introducir conceptos de salud desde temprana edad. A través de este enfoque educativo, se busca enseñar a niños y adolescentes cómo el cuerpo desarrolla defensas contra diversos patógenos a lo largo de la historia humana. Además, al combinar el conocimiento del sistema inmunológico y el sistema educativo, se contribuye a dos objetivos de desarrollo sostenible: calidad educativa y salud y bienestar. Este currículo diseñado permitirá a los individuos comprender la influencia de la nutrición, las medidas de higiene y las vacunas en la mejora de la salud personal y comunitaria.
Enteropatía Biliar y su Tratamiento Quirúrgico, Íleobiliar Caso Inusual de Obstrucción Intestinal, Reporte de Caso
Authors: Pons Taracena José Enrique , Valverde Leyva Eduardo Isabel
Published: January 2024

El íleo biliar es una complicación infrecuente, caracterizada por datos clínicos de oclusión intestinal, siendo el 4% de las causas de obstrucción intestinal en la población en general. El diagnóstico es clínico e imagenologico(tríada de rigler). El manejo al principio será conservador, sin embargo, al no tener adecuada evolución se requiere de intervención quirúrgica, siendo la enterotomía con extracción de cálculos la piedra angular. El objetivo de este reporte es presentar un caso de oclusión intestinal causado íleo biliar tratado mediante  laparotomía + enterotomía, extracción de lito y cierre primario. Se presenta el caso de una mujer de 69 años, mediante radiografía abdominal, colangioresonancia y tomografía abdominopelvica simple, se detectó enterocolito en íleon distal con datos de oclusión intestinal sin mejoría de tratamiento conservador. Se concluye que este diagnóstico es raro, pero de suma importancia en su diagnóstico para un abordaje terapéutico efectivo. Gallstone ileus is a rare complication, characterized by clinical data of intestinal occlusion, accounting for 4% of the causes of intestinal obstruction in the general population. Diagnosis is clinical and imaging (Rigler's triad. Management will be conservative at first, however, due to not having an adequate evolution, surgical intervention is required, with enterotomy with stone extraction being the cornerstone. The objective of this report is to present a case of gallstone ileus treated by laparotomy + enterotomy, stone extraction and primary closure. The case of a 69-year-old woman is presented, by abdominal radiography, magnetic resonance cholangiography and simple abdominopelvic tomography, enterocolith was detected in the distal ileum with data of intestinal occlusion without improvement of conservative treatment. It is concluded that this diagnosis is rare, but of great importance in its diagnosis for an effective therapeutic approach.
Relación del Nivel de Actividad Física y el Estado Nutricional Infantil en la Umf No.9
Authors: Adame Solano Jemimah , Ocampo Rentería Teresa , Cruz Garcia Alma Delia , Sosa Martínez María de Jesús
Published: January 2024

En la población infantil, un nivel de actividad física baja favorece el desarrollo de sobrepeso y obesidad, aumentando el riesgo de desarrollar enfermedades crónicas. Adoptar un nivel de actividad física mayor, contribuirían favorablemente. Con el objetivo de determinar la relación del nivel de actividad física y el estado nutricional infantil en niñas y niños de 6 a 12 años de la Unidad de Medicina Familiar No.9 del IMSS en Acapulco Guerrero, México. Se desarrolla un estudio transversal, prospectivo, descriptivo y analítico, aplicando el “PAQ-C”, (Physical Activity Questionnaire for Children), en 327 infantes de 6 a 12 años de edad adscritos a la UMF No. 9, del 1 de julio al 31 de agosto de 2023, utilizando el programa SPSS versión 22, estadística descriptiva e inferencial, la prueba de Chi cuadrada, OR, IC al 95%. Los resultados permitieron observar mayor incidencia del sexo masculino 53% (173 /327), predominó la edad de 9 años 31% (102/327). El nivel de actividad física baja fue de 55% (62/154) en mujeres, y actividad física regular 59% (69/173) en hombres. En el nivel de actividad física baja predominó la obesidad 39.3%(44/112), regular e intensa con peso normal 37.6% (44/117) y 35.7%(35/98) respectivamente. El nivel de actividad física baja y regular tienen 1.1 más riesgo de padecer sobrepeso y obesidad (OR = 1.108, IC 95%: 0.685-1.793, p = 0.55). Como conclusión no se encontró confianza estadística entre el nivel de actividad física y el estado nutricional, pero si asociación protectora.
Efektifitas Komunikasi di Era Digital dengan ChatGPT sebagai Media Pembelajaran
Authors: Supradaka  , Sri Ekowati P  , Velantin Valiant
Published: January 2024

Sekolah Menengah Kejuruan (SMK) merupakan pendidikan yang menyiapkan lulusan Siswa yang siap memasuki dunia kerja. Program studi yang dipelajari pada Sekolah Menengah Kejuruan umumnya ilmu terapan, antara lain bidang studi Bisnis dan Perkantoran serta program studi pemasaran. SMK PGRI 4 Jakarta merupakan salah satu SMK Swasta yang berada di Jakarta pusat di bawah naungan yayasan PGRI yang memiliki misi yang cukup bagus yaitu: Mempersiapkan Tenaga Kerja Yang Berjiwa Wiraswasta, Mandiri Serta Mampu Memenuhi Tuntutan Dunia Kerja, Hal ini telah menarik perhatian dosen-dosen Fakultas Komunikasi Universitas Persada Indonesia YAI untuk melakukan penyuluhan dengan tema Efektifitas Komunikasi di Era Digital dengan ChatGPT sebagai Media Pembelajaran. Dengan tujuan mendukung harapan SMK PGRI 4 Jakarta untuk menciptakan lulusan yang siap kerja. Hasil dari kegiatan pengabdian masyarakat ini menunjukkan peningkatan pengetahuan dan pemahaman siswa tentang ChatGPT, serta berhasil membuat logo dengan menggunakan aplikasi ChatGPT dan aplikasi Kittl. Saran dari hasil kegiatan ini adalah dapat dilakukan kegiatan yang sama pada siswa sekolah SMA dan SMK negeri maupun swasta
Fractional $ 3/8 $-Simpson type inequalities for differentiable convex functions
Authors: Nasri Nassima , Meftah Badreddine , Moumen Abdelkader , Saber Hicham
Published: January 2024

The main objective of this study is to establish error estimates of the new parameterized quadrature rule similar to and covering the second Simpson formula. To do this, we start by introducing a new parameterized identity involving the right and left Riemann-Liouville integral operators. On the basis of this identity, we establish some fractional Simpson-type inequalities for functions whose absolute value of the first derivatives are s-convex in the second sense. Also, we examine the special cases $ m = 1/2 $ and $ m = 3/8 $, as well as the two cases $ s = 1 $ and $ \alpha = 1 $, which respectively represent the classical convexity and the classical integration. By applying the definition of convexity, we derive larger estimates that only used the extreme points. Finally, we provide applications to quadrature formulas, special means, and random variables.
A GraphSAGE-based model with fingerprints only to predict drug-drug interactions
Authors: Zhou Bo , Ran Bing , Chen Lei
Published: January 2024

Drugs are an effective way to treat various diseases. Some diseases are so complicated that the effect of a single drug for such diseases is limited, which has led to the emergence of combination drug therapy. The use multiple drugs to treat these diseases can improve the drug efficacy, but it can also bring adverse effects. Thus, it is essential to determine drug-drug interactions (DDIs). Recently, deep learning algorithms have become popular to design DDI prediction models. However, most deep learning-based models need several types of drug properties, inducing the application problems for drugs without these properties. In this study, a new deep learning-based model was designed to predict DDIs. For wide applications, drugs were first represented by commonly used properties, referred to as fingerprint features. Then, these features were perfectly fused with the drug interaction network by a type of graph convolutional network method, GraphSAGE, yielding high-level drug features. The inner product was adopted to score the strength of drug pairs. The model was evaluated by 10-fold cross-validation, resulting in an AUROC of 0.9704 and AUPR of 0.9727. Such performance was better than the previous model which directly used drug fingerprint features and was competitive compared with some other previous models that used more drug properties. Furthermore, the ablation tests indicated the importance of the main parts of the model, and we analyzed the strengths and limitations of a model for drugs with different degrees in the network. This model identified some novel DDIs that may bring expected benefits, such as the combination of PEA and cannabinol that may produce better effects. DDIs that may cause unexpected side effects have also been discovered, such as the combined use of WIN 55,212-2 and cannabinol. These DDIs can provide novel insights for treating complex diseases or avoiding adverse drug events.
Online capacity building for the health workforce: the case of the Integrated Disease Surveillance and Response for the African region
Authors: Bonkoungou Boukare , Utunen Heini , Talisuna Ambrose O. , O’Connell Gillian , Koua Etien , Chamla Dick D. , Arabi Elham , Tokar Anna , Gueye Abdou S.
Published: January 2024

Background: The World Health Organisation (WHO) Regional Office for Africa (AFRO) has developed a comprehensive capacity development programme to support the successful implementation of the Integrated Disease Surveillance and Response 3rd edition Technical Guidelines (IDSR). As part of the learning program, a series of asynchronous online courses are offered on OpenWHO in English, French and Portuguese. This paper describes the use of five IDSR online courses and reports on feedback received from learners on Course 1 in the English series. Methods: An online learner survey was developed, and a descriptive analysis was conducted. This paper also reports on use related empirical metadata from the OpenWHO platform. Results: Overall, learners (97%-n/N) of Course 1 IDSR English series indicated a positive perception toward their online learning experience because of the quality of course content, its organization, ease of use and relevance to their workplace needs. In addition, 88% (n/N) of learners reported that they had used their acquired knowledge at least sometimes and 54.4% (n/N) had shared their learning with others. Lastly, the quiz analyses showed an average of right answers of 78.97% for quiz 1 and 69.94% for quiz 2. Conclusion: Online learning is an essential component of a blended capacity development programme and provides cost effective, equitable and impactful learning. Learners who have a learning goal and find their needs met in courses tend to show more satisfaction and motivation to share their learning.
Effectiveness of tibio-talo-calcaneal arthrodesis for Charcot ankle arthropathy: Unraveling the impact of glycated hemoglobin on postoperative recovery and complications
Authors: Toreih Ahmed A , Abdelbadie Ahmed , El-Adawy Moawed F
Published: January 2024

Background

Charcot arthropathy of the ankle is a severe complication of diabetes that can lead to deformity, ulcers, and amputation. Tibio-talo-calcaneal arthrodesis is a surgical technique to stabilize the ankle, but optimal management remains unclear.

Objective

This study aimed to evaluate the functional and radiological effectiveness of tibio-talo-calcaneal arthrodesis using retrograde intramedullary nailing without bone graft for Charcot ankle and achieve stable aligned ankle construct.

Patients and methods

In this prospective study, 31 diabetic patients Eichenholtz stages 2–3 (coalescence or reconstruction phases) Charcot ankle underwent tibio-talo-calcaneal arthrodesis with retrograde nail. The American Orthopedic Foot & Ankle Society ankle-hindfoot score measured outcomes at baseline, 6 months, and 12 months postoperatively. Complications were recorded. Regression analysis identified outcome predictors.

Results

American Orthopedic Foot & Ankle Society scores improved significantly from 17.4 ± 2.37 preoperatively to 73.4 ± 10.5 at 6 months and 81.9 ± 11.5 at 12 months (P<0.001). Twelve (38.7%) patients experienced complications including deep vein thrombosis and sepsis. Elevated glycated hemoglobin predicted complications (odds ratio=3.25, P=0.010) and longer recovery (B=1.353, P=0.008). An glycated hemoglobin cutoff of 8.0% predicted complications with 75.0% sensitivity and 78.9% specificity (area under the curve=0.816).

Conclusion

Tibio-talo-calcaneal arthrodesis effectively improved ankle function in Charcot arthropathy but complications were common, emphasizing the importance of perioperative glycemic control.
A systematic review of endoprosthetic replacement versus cement spacer in reconstruction of proximal humerus following proximal humerus metastasis
Authors: Helmy Abdel R M A , Zaki Mina S , El Masry Ayman M
Published: January 2024

Background

The choice between cement spacer and endprosthesis in the treatment of metastatic lesions to the proximal humerus is increasingly controversial. However, it may be easier to categorize the patients, and their socioeconomic and perioperative parameters into two groups.

Aim

This work aims to review the available literature on the topic of endoprosthetic replacement versus cement spacer in the reconstruction of the proximal humerus following metastatic lesions to the proximal humerus regarding the surgical technique, its indications, its advantages, and limitations.

Patients and methods

We followed the preferred reporting items for systematic review and Meta-analysis (PRISMA) statement guidelines during this systematic review and performed all steps according to the Cochrane Handbook of Systematic Reviews of Intervention.

Results

Four studies were included in this systematic review, and a total of 100 patients were included (22 of which had cement spacer and 78 had endprosthesis). Several parameters were compared in the reviewed studies including the MSTS score of the patients; the primary tumor; postoperative complications; the patients’ age; follow-up periods; and the presenting symptoms of the patients.

Conclusion

This systematic review suggests that the cement spacer technique is not inferior to endoprosthetic replacement of the proximal humerus in cases of metastases. Therefore, we suggest that determining whether to use an end prosthesis or a cement spacer depends on categorizing the patients into two groups. Endoprosthetic replacement will be an appropriate choice for patients with preserved deltoid and axillary nerve function following resection, solitary and nonaggressive metastatic lesion, and long-life expectancy with minimal co-morbidities. We believe that cement spacer is a more appropriate choice in patients with nonfunctioning deltoid or axillary nerve following resection; multiple and aggressive metastatic lesions; short life expectancy with many co-morbidities, and poor socioeconomic status.
Expert tibial nail (ETN) versus minimally invasive plate osteosynthesis techniques in the treatment of distal tibia fractures in young adults: A randomized controlled trial
Authors: Zawam Sherif H , Bedair Mohammed A , Eldin Alaa E M , Nagy Mohamed
Published: January 2024

Purpose

To compare anatomical locked plates inserted in a minimally invasive pattern (MIPO) versus expert tibial nailing (ETN) for fixation of extra-articular fractures of the distal tibia in young adults.

Patients and methods

The study included 120 patients, 84 males and 36 females. The mean follow-up time was 13.5 months, with at least 12 months of follow-up. Cases were equally divided and randomized by the closed-envelope technique into two groups, group A: fixed by anatomical locked plate through a minimally invasive approach, and group B: fixed by ETN.

Results

The average operative time was significantly higher in the MIPO group (94 min) compared with the ETN group (81.67 mins). Also, the radiological exposure time was also higher (87.6 secs) in group A versus 78.4 in group B. Although there was an incidence of deformity in few cases of the ETN group (eight patients), that was not significant enough to warrant correction by revision surgery. There were no significant differences in the union time (P value: 0.09) and American Orthopedic Foot and Ankle Society (AOFAS) scores (P value: 0.78) between the two groups. Furthermore, the infection and the need for further surgeries did not show significant differences among both groups.

Conclusion

Both MIPO and ETN are valid treatment options for distal tibia fractures, AO type 43 A. Both methods resulted in acceptable union time, and American Orthopedic Foot and Ankle Society scores, with no reported cases of nonunion.

Level of evidence.

Therapeutic study, level I
Role of intra-articular tranexamic acid in reducing blood loss in total knee arthroplasty
Authors: Bayomy El-Sayed Mahmoud , Abd Elgawad Samy Mohamed Khairy , El-Begawy Hossam Abd El-Naby
Published: January 2024

Background

Total knee arthroplasty (TKA) is associated with postoperative blood loss. Tranexamic acid (TXA) administration is an effective strategy used to reduce the blood loss.

This study aimed to evaluate the effect of intra-articular injection of TXA on blood loss and transfusion rate after an elective TKA.

Patients and methods

This was a randomized controlled clinical trial adopted to fulfill the purpose of this study. The study was conducted at Benha Health Insurance Hospital and Benha University Hospitals. It was conducted on 42 adult patients who underwent an elective primary unilateral total knee arthroplasty (TKA) through midline incision with medial parapatellar approach after tourniquet application. Patients were categorized into two groups: control group (without TXA), and intra-articular (IA) group who received 1.5 gm of TXA in 10 ml of normal saline injected into the joint after packing, lavage, hemostasis and closure of the muscle layer just before the deflation of the tourniquet to guarantee maintenance of the injected fluid inside the joint. Demographic data and age, sex, comorbidities, and preoperative hemoglobin levels were collected. The maximum hemoglobin decline was the primary outcome, while the drain’s blood amount (cc/day), the rate of blood transfusion, and the duration of hospital stay were secondary outcomes.

Results

Patients who received Intra-articular TXA had statistically significant lower drop in hemoglobin level (0.99 + 0.45 mg/dl) compared to their control group (2.14 + 1.07 mg/dl) (P<0.001).

Conclusion

TXA is a safe and efficient way to reduce overall blood loss in TKA patients, according to data from this study and the literature. Administration intraarticular seems to be significantly effective in reducing postoperative blood loss without increasing the risk of thrombotic events.
Hip abductor dysfunction following total hip arthroplasty by modified direct lateral approach: Assessment by quantitative electromyography
Authors: Khalifa Yaser E , Hamed Mohamed , Abdelhameed Mohammed Anter , El-Hamed Mohamed A A , Bakr Hatem , Rageh Tarek , Abdelnasser Mohammad Kamal
Published: January 2024

Background

The use of the direct lateral approach and its modifications for total hip arthroplasty (THA) may lead to postoperative abductor weakness. Assessment of abductor muscle function by the use of quantitative electromyography (EMG) aims to investigate the nature of abductor muscle dysfunction.

Methods

We conducted a study on 40 patients who had hip replacement through the modified direct lateral approach. EMG was performed before surgery on the affected and normal sides and repeated on the operated side after surgery by 6 and 12 weeks. Analysis of EMG of the three abductor muscles was done in all patients.

Results

EMG evidence of acute denervation of hip abductors was present in 15 hips (37.5%) after 6 weeks. Improvement of EMG findings occurred in 8 out of 15 patients. Quantitative electromyography (QEMG) showed early significant increase in amplitude in all muscles and decrease in duration in gluteus medius (G. Med) with a pattern of acute nerve injury. At 12 weeks, the values of duration, amplitude, and phase were insignificantly different from the preoperative values signifying the return of near normal muscle activity.

Conclusion

The use of modified direct lateral approach can cause denervation of hip abductors. It is common in the early postoperative weeks. However, it tends to improve and the residual weakness in some patients is not marked. Quantitative electromyography showed that partial denervation is related to superior gluteal nerve stretching and not to direct injury of the terminal branches of the nerve through the incision.
Investigation into the clinical performance of rectus sheath block in reducing postoperative pain following surgical intervention: A systematic review and meta-analysis of randomised controlled trials
Authors: Jeffries Sean D. , Harutyunyan Robert , Morse Joshua , Hemmerling Thomas M.
Published: January 2024

Background and Aims:

Rectus sheath block (RSB) is an effective postoperative pain control technique in abdominal surgical procedures. This systematic review evaluated the efficacy and outcome data of patients undergoing RSB compared to the standard of care in both laparoscopic and open surgical procedures.

Methods:

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO ID: CRD42022372596). The search was restricted to randomised controlled trials (RCTs) comparing RSB effectiveness on postoperative pain to any standard general anaesthesia technique (control). We systematically explored PubMed, Medline, Central, Scopus and Web of Science for RCTs from inception to September 2023. The primary outcome was the evaluation of pain scores at rest 0-2, 10-12 and 12-24 h postoperatively. The secondary outcome was the analysis of postoperative intravenous (IV) morphine equivalent consumption at 24-h. A risk-of-bias tool for randomised trials (ROB 2.0, Cochrane, Copenhagen, Denmark) assessment and Grades of Recommendation, Assessment, Development and Evaluation (GRADE, Cochrane, Copenhagen, Denmark) analysis was conducted to evaluate the quality of the RCTs.

Results:

Twenty RCTs involving 708 participants who received RSB intervention and 713 who received alternative analgesic care were included. RSB pain scores were significantly lower than control at 0-2 h (P < 0.001) and 10-12 h (P < 0.001) postoperatively. No significant effect was observed at 24 h (P = 0.11). RSB performance compared to control in 24-h IV morphine equivalency in milligrams was significantly lower (P < 0.001).

Conclusion:

RSB implementation was associated with reduced postoperative pain scores and decreased opioid consumption in IV morphine equivalency up to 24 h following surgical intervention.
Comparison of airway collapsibility following single induction dose ketamine with propofol versus propofol sedation in children undergoing magnetic resonance imaging: A randomised controlled study
Authors: Bhardwaj Pooja , Panneerselvam Sakthirajan , Rudingwa Priya , Govindaraj Kirthiha , Prakash M.V.S. Satya , Badhe Ashok S. , Nagarajan Krishnan
Published: January 2024

Background and Aims:

Adequate sedation is essential for children undergoing magnetic resonance imaging (MRI) console. Propofol is commonly used for sedation, but it has the drawback of upper airway collapse at higher doses, which may be overcome by ketamine. This study was designed to evaluate the beneficial effect of ketamine on propofol in preventing airway collapse.

Methods:

Fifty-eight children undergoing MRI were randomised to Group P (propofol bolus dose followed by infusion or Group KP (bolus dose of ketamine and propofol followed by propofol infusion). The primary aim is to compare the upper airway cross-sectional area (CSA) and diameters (transverse diameter [TD] and anteroposterior diameter [APD]) obtained from MRI during inspiration and expiration.

Results:

Upper airway collapse as measured by delta CSA in mean (SD) [95% confidence interval] was statistically more significant between the two groups [at the soft palate level, 16.9 mm2 (19.8) [9.3–24.4] versus 9.0 mm2 (5.50) [6.9–11.1] (P = 0.043); at the base of the tongue level, 15.4 mm2 (11.03) [11.2–19.6] versus 7.48 mm2 (4.83) [5.64–9.32] (P < 0.001); at the epiglottis level, 23.9 (26.05) [14.0–33.8] versus 10.9 mm2 (9.47) [7.35–14.5] (P = 0.014)]. A significant difference was obtained for TD at all levels and for APD at the soft palate and base of tongue level.

Conclusion:

Adding a single dose of ketamine to propofol reduced the upper airway collapse significantly, as evidenced by the MRI-based measurements of upper airway dimensions, compared to propofol alone.
Incidence, risk factors, and outcomes of acute kidney injury in patients undergoing emergency laparotomy – A prospective observational exploratory study
Authors: Walikar Beeraling Ningappa , Singla Deepak , Tripathi Debendra Kumar , Agrawal Sanjay , Talawar Praveen , Mangla Mishu
Published: January 2024

Background and Aims:

Acute kidney injury (AKI) can occur in post-laparotomy patients, with a variable incidence. This study aimed to determine the incidence of AKI in patients undergoing emergency laparotomy under general anaesthesia, the effect of preoperative variables on the development of AKI, and the association of post-operative AKI with patient outcomes.

Methods:

This prospective exploratory study in patients undergoing emergency laparotomy was followed up for 7 days to determine the incidence of post-operative AKI. We determined the patients developing different severity of AKI based on kidney disease improving global outcome staging. Fisher's exact test or Chi-squared test was used to study the association of demographic variables, and various periopertaive variables on the development of postoperative AKI. The association of AKI with the duration of hospital stay was estimated using the Wilcoxon–Mann–Whitney U Test, and Fisher's exact test was used to study the association between AKI and mortality.

Results:

No patient had AKI in the pre-operative period. On day 3, 18 patients; on day 5, 28 patients; and on day 7, 24 patients developed AKI. Overall, a maximum of 33 patients (out of 100) developed AKI at any time. Our study found that the American Society of Anesthesiologists (ASA) IV and sepsis were independent risk factors for post-operative AKI. Our results also show a moderate-to-high independent association between AKI and duration of hospital stay and mortality (within 30 days).

Conclusion:

Incidence of post-operative AKI following emergency laparotomy was 33%. Higher preoperative ASA physical status and sepsis were significantly associated with postoperative AKI development.
Career opportunities and guidance among early-career anaesthesiologists – A questionnaire-based cross-sectional survey
Authors: Naik Vibhavari Milind , Dongare Pradeep A. , Balavenkatasubramanian J
Published: January 2024

Background and Aims:

The opportunities to work for early-career anaesthesiologists are in various sectors such as teaching institutes, private practice, and corporate hospitals in India or abroad. The primary aim of the survey was to determine whether early-career anaesthesiologists wanted to work in India or abroad. The secondary objectives were to determine the proportion of early-career anaesthesiologists who wished to pursue further studies and what degree they wanted to pursue.

Methods:

A validated questionnaire containing questions related to career preferences was circulated by social media among early-career anaesthesiologists via Google Forms. The survey questionnaire focussed on whether the respondents wanted to work in India or abroad or pursue further studies. The survey results were tabulated in an Excel sheet. Descriptive statistics were used to analyse the data, and the Chi-square test was applied where appropriate. Age-group preferences and gender preferences were also analysed.

Results:

A total of 684 responses were received. The mean (SD) age of the respondents was 31.4 (2.8) years. Among the respondents, 64.1% were female, and 35.9% were male. Of the respondents, 309 (72.5%) were in a job, 50 (11.7%) were pursuing Society-recognised fellowships, and the rest were pursuing super-specialisation degrees or University-recognised fellowships. Two hundred and eighty-six respondents (75.5%) wanted to study outside India. Only 155 (36.6%) had career guidance from immediate contacts or mentors.

Conclusion:

Early-career anaesthesiologists want to pursue further degrees and fellowships after their graduation in anaesthesiology. Career guidance is an important aspect of anaesthesiology training.
Prevention of post-spinal anaesthesia hypotension in caesarean delivery using delayed supine positioning – A randomised controlled trial
Authors: Elsakka Ahmed Ibrahim , Mostafa Gamal , Mohamed Mohamed Raafat Abdelaziz , Mahrous Reham , Abdelnasser Amr
Published: January 2024

Background and Aims:

Maternal hypotension is a common and dangerous consequence after a subarachnoid block for a caesarean section. Combining pharmacological methods such as norepinephrine infusion, ondansetron and non-pharmacological methods in delayed supine positioning better impacts the maternal haemodynamic profile. The present study assessed the benefits and adverse effects of combining pharmacological and non-pharmacological methods in hypotension prophylaxis.

Methods:

This randomised controlled trial was conducted at Cairo University Hospital's obstetric theatre from January to October 2020. The study included 85 parturients who were randomised to two groups. Group Sitting was left seated for 2 min after injection, and Group Control was made to lie down in the supine position immediately after the subarachnoid block. Both groups received prophylactic intravenous norepinephrine infusion, in addition to an ondansetron bolus, before surgery. Patients' systolic blood pressure (SBP) from intrathecal injection until delivery of the foetus, was documented.

Results:

The Sitting group's SBP (122 (14) mmHg) till delivery was statistically higher than the Control group's readings (114 (10) mmHg) (P = 0.004). The Sitting group's intraoperative SBP values were often greater than the Control group values. In addition, the Sitting group had a reduced hypotension incidence and a lower rate of ephedrine use than the other group, but bradycardia incidence was comparable between both groups.

Conclusion:

In elective caesarean delivery, combining pharmacological and non-pharmacological methods achieve better results regarding maternal hypotension, vasopressor consumption, nausea and vomiting, and foetal outcomes.
Intrathecal ropivacaine versus bupivacaine in a non-obstetric population- A meta-analysis and trial sequential analysis
Authors: Khalil Rashaad S. , Mehmud Aaliya , Banerjee Rahul , Malhotra Rajiv , Banerjee Arnab
Published: January 2024

Background and Aims:

Intrathecal bupivacaine is used for anaesthesia and analgesia but is associated with hypotension. Ropivacaine is an alternative drug that may have fewer cardiotoxic and neurotoxic events. This meta-analysis investigated whether intrathecal ropivacaine is associated with reduced hypotension as compared to bupivacaine.

Methods:

The meta-analysis is registered in the International Prospective Register of Systematic Reviews (PROSPERO). The databases PubMed, Cinahl Plus, Google Scholar, and Scopus were searched, and papers from January 1980 to January 2023 were deemed eligible and filtered using predetermined inclusion and exclusion criteria. The primary outcome was the incidence of hypotension. Secondary outcomes were the duration of sensory block, duration of motor block, incidence of bradycardia, ephedrine usage, and duration of analgesia. Jadad scores were used to evaluate the quality of the papers. RevMan statistical software® utilised inverse variance and a random effect model to calculate the standardised mean difference with 95% confidence intervals for continuous variables and the Mantel–Haenszel test and the random effect model to calculate the odds ratio for dichotomous variables.

Results:

Thirty-three papers, including 2475 patients in total, were included. The Jadad score was between 1 and 5. The incidence of hypotension was significantly higher with intrathecal bupivacaine than with ropivacaine (P = 0.02). The duration of sensory block (P < 0.001) and motor block (P < 0.001) was prolonged with intrathecal bupivacaine. The duration of analgesia favoured intrathecal bupivacaine (P = 0.003).

Conclusion:

Intrathecal ropivacaine has a reduced incidence of hypotension and a reduced duration of sensory block compared to bupivacaine.
О слабой разрешимости дробных моделей вязкоупругой жидкости высокого порядка
Authors: Zvyagin Viktor Grigorevich , Orlov Vladimir Petrovich
Published: January 2024

В настоящей работе устанавливается существование слабого решения начально-краевой задачи для уравнений движения модели вязкоупругой несжимаемой жидкости с реологическим соотношением, содержащим дробные производные высоких порядков, и с памятью вдоль траекторий поля скоростей. Доказательство проводится с помощью аппроксимации исходной начально-краевой задачи последовательностью регуляризованных задач с последующим предельным переходом на основе соответствующих априорных оценок. Используются методы теории исчисления дробных производных и теории регулярных лагранжевых потоков, обобщения классического решения систем ОДУ.
Библиография: 43 наименования.
Addressing Psychosocial Client Factors in People with Cancer: An Occupational Therapy Guidebook
Authors:   , Marlette Hannah
Published: January 2024

People with cancer experience a variety of physical, cognitive, and psychosocial impacts that affect their quality of life, occupational performance, and occupational engagement. Occupational therapy (OT) practitioners are well-equipped to address these impacts, however, OT is an underused service in the cancer population, resulting in a limited amount of literature addressing OT interventions in cancer care. OT interventions in the literature are focused on addressing an individual’s physical client factors. The focus on physical client factors is causing people with cancer to report that their psychosocial client factors are not being addressed. The literature demonstrates that OT practitioners do not have clear OT guidelines within the literature on how to address psychosocial client factors in their clients with cancer. The purpose of this capstone project was to create an OT guidebook to address psychosocial client factors for people with cancer. An OT guidebook was developed to educate OT practitioners on the role and scope of OT in the cancer population. The guidebook consists of four chapters that provide various assessments/screening tools, the goal setting process, interventions to address the identified psychosocial client factors of spirituality, mood, body-image, self-esteem, and cognition, a case example, and additional resources for OT practitioners and their clients. The capstone project document consists of five chapters that address the background, literature review, methodology for developing the guidebook, results, and the discussion. This capstone project will broaden the role of OT in the cancer population by providing OT practitioners with the guidance to address psychosocial client factors which will enhance the occupational engagement, occupational performance, and quality of life for people with cancer.