bluuebunny/crossref_metadata_2025 huggingface dataset:
Decreasing the nitric oxide gas concentration by using sunflower seed husk biochar as filter
Authors: Mohamed Ghada O , Saleh Maher E , Elsafty Ahmed S
Published: September 2024

There is a great global interest in controlling air pollutants, specifically greenhouse gases including nitrogen oxides (NOx), nitric oxide is one of its basic components. For this reason, this study dealt with the use of biochar manufactured from agricultural waste from sunflower seed husk (SSHB) with 450°C pyrolysis in the adsorption of 90 ppm concentration of nitric oxide (NO) gas within 480 seconds (8 minutes) by flow rate 1.2 (liter/minute). Two kinds of particle sizes coarse (C) and fine (F) of SSHB were used, and some physiochemical properties of the biochar were studied, including SEM and FTIR, in addition to the BET surface area, which was 3.9 (m2/g). The adsorption results displayed that SSHB (F) is better at the adsorption of NO 31.6 (mg/g) than SSHB (C) 26.7 (mg/g). Isotherm models were applied to the mathematical modelling of NO absorption, and based on n and R2 values the results of the SSHB adsorption for NO fixed with both the Freundlich model and the kinetic pseudo second order model.
Advancing Oil Production Efficiency with Next-Generation Nano emulsion Capsules: Harnessing Doped MgZnO2 for Superior Inhibition of Calcite Scale Formation
Authors: Ali Sayeda S. , AbuelReesh Gaber M. , Fadda Ahmed A. , Abdelhafez Mahmoud , Mubarak Mahmoud F.
Published: September 2024

This work presents doped MgZnO2 nano emulsion capsules as a novel approach for reducing calcite scale formation in oil production. The nano emulsion capsules are synthesized via ultrasonication and precipitation methods, with morphology and size distribution analysed by scanning electron microscopy (SEM), transmission electron microscope [TEM] and dynamic light scattering (DLS).` with an average particle size of 50 nm. Static scale inhibition tests showed over 90% inhibition efficiency at a Nano emulsion concentration of 100 mg/L. Rigorous static and dynamic scale inhibition testing precipitation and showcases remarkable efficiency exceeding 80% in preventing calcite deposition under simulated conditions. Gravimetric validates cation and online pressure monitoring validate superior performance compared to conventional inhibitors, with up to 30% enhancement in mitigation. The controlled release properties of the Nano emulsion capsule allow for persistent scale inhibition even after 72 hours of continuous operation. Furthermore, ecotoxicity evaluations through bioassays affirm the eco-friendly characteristics of the Nano emulsion technology. As a whole, this research shows how highly promising doped MgZnO2 Nano emulsion capsules are as a long-term, high-performing solution to scale-related problems in the oil sector.
Adsorption and kinetic studies of dyes onto BaFe12O19 Ferrite Nanoparticles
Authors: Erfan N. A. , Mohammed A. A.
Published: September 2024

In this work, Barium hexaferrite (BaFe12O19) nanoparticles were used for industrial waste water treatment from methylene blue (MB) and congored (CR) dyes. Batch adsorber with mechanical stirring column was used to test various experimental parameters like contact time, initial dye concentration and adsorbent dosage for the removal of these dyes. For the removal of MB and CR dyes using magnetic nanoparticles, the maximum adsorption capacities were 200 and 124.5 mg/g respectively. The maximum removal efficiencies were 90 % for MB removal onto the nanoparticles and 80% for CR removal. In order to analyze the kinetic data, pseudo first and second order kinetic models have been used. For all studied variables and based on correlation coefficient (R) values and graphical presentation, the results confirm that pseudo second order model fits well the experimental data.
Variable frequency constant pressure water supply system based on Siemens S-1200
Authors: Yan Shubin , Yang Weijie , Liu Guang , Zhu Chuanhui
Published: September 2024

This paper presents the design of an efficient, cost-effective, and intelligent variable frequency water supply control system. The system consists of a PLC, frequency converters, water pumps, pressure sensors, and other components to form a closed-loop control system. It enables closed-loop control of water pressure, ensuring a dynamic balance between water consumption and water supply. A user-friendly HMI is designed based on a software platform for easy operation by management personnel. It allows for seamless switching of the system’s operating modes and the running status of water pumps. Real-time display of pump operation and monitoring of system performance are also provided. Compared to traditional water supply methods, this system exhibits superior reliability, speed, and performance. It is capable of meeting the daily water consumption needs of residents in high-rise buildings.
A novel method of steady-state modeling for self-excited induction generators in distributed generation system based on transient space-vector model
Authors: Li Haitao , Peng Xuehu , Lou Yaolin , Lili Chen
Published: September 2024

The paper proposes a novel mathematic model for steady states represented by the complex-domain transient space vectors of SEIGs in the stationary coordinate system, where the physical systems are extended to be analyzed by applying the previous approach of holistic analysis based on the stability theorem of Lyapunov. The motion analysis of mechanisms gives analytical formulas of operating points at steady states by solving the novel steady-state model analytically. Good agreement between former numerically computed results and analytically computed results by the analytic formulas proves the validity and effectiveness of the proposed novel model, with extensive engineering referenced and applicable value.
Recent advancements of nanoparticles for antiviral therapy
Authors: Pradip Das Priyanku , Sengupta Sounok , Balram Deepak , Lian Kuang-Yow , Azizov Shavkatjon , Neogi Ujjwal Kumar , Pandey Sadanand , Kumar Deepak
Published: September 2024

The global outbreak of infectious diseases in recent decades has caused serious health problems worldwide. Key factors that contribute to the lack of a complete therapeutic strategy against viral infections include biomimetic architecture, ability to manipulate the antibody, continuous antigen transfer, covert system of injecting inappropriate doses of drugs at target sites, resulting in drug resistance. Reasons include low water solubility, poor permeability, plasma protein a high self-similarity, short gene half-life, and rapid system elimination. To combat these challenges, nanoparticle-based drug delivery has emerged as a revolutionary approach, applying nanoengineering tools to nanoparticle synthesis to achieve optimal drug concentrations at targeted sites over time nanoparticles with nano dimensional structure enhanced permeability and retention effects, increasing surface area volume ratios, in surface-functioning capacity, prove effective in antiviral therapeutic delivery but size, shape, charge, and surface topology of nanoparticles allow target specific drug delivery, cellular uptake, opsonization by host immune cells, drug retention time, transcytosis, extended biological half -life, in vivo stability, and significantly affect cytotoxicity. This review provides an in-depth analysis of the critical role of nanotechnology-based drugs while addressing important aspects of clinical safety and efficacy.
The Emergence of Constitutional Theocracy in Iran
Authors: Khodadadi Bahman
Published: September 2024

Chapter 1 serves as a point of departure for systematic critical examination of the theocratic criminal law. It sets this stage as a contribution to our understanding of the emergence of constitutional theocracy in Iran and places it within its theological and constitutional framework. The chapter, by a rationally reconstructive approach, explores the unfolding process of politico-ideological Islamization of Iran since the Islamic Revolution of 1979 and investigates how, following the birth of the Islamic Republic, legal westernization was substituted by Islamic legal de-westernization that purported to be rooted in Sharia law. It closely examines how Iranian constitutional theocracy’s introduction of the concept of God as a legislator is justified by Islamic jurists through the theological, political, and legal frame of reference.
Blindness and Literature: Critical Engagements with the Representational Binaries of Western Modernity
Authors: Bolt David
Published: September 2024

Literary blindness refers to the renderings of blind people in literature or the sustained critical engagement with which is sometimes termed literary blindness studies. Literary blindness studies is a formally emerging field in which a particular focus falls on the binaries of literary blindness. These binaries date back to antiquity but proliferated in Western modernity. Blind characters were usually drawn in extremes, negative and positive, which in modernism came to build and bolster the sociocultural metanarrative of blindness by which ocularnormativism and the supremacy of sight were implied if not stated. Academic interest in these representations ranged from early-20th-century work in the social sciences to late-20th-century cultural disability studies and 21st-century literary disability studies. The prototypical and foundational studies involved identifying recurrent literary motifs and evidence of pejorative or laudatory characterization, which often revealed remarkably lengthy lineage and resonance with social attitudes to blind people. These readings paved the way for more nuanced literary theory and criticism that explored nonnormative means of perception with a growing appreciation of experiential knowledge. This being so, the authors of both literary blindness and literary blindness studies have become recognized for their positionality: whether or not the creators and critics are themselves blind has become factored into the related discourse. Literary blindness studies, then, has emerged as an interdisciplinary field, explicitly informed by literary studies but implicitly underpinned by the epistemology and values of disability studies; it provides a space in which literary blindness can be explored with heightened awareness of the sociocultural implications for blind people.
Translanguaging and EFL Teaching
Authors: Tian Zhongfeng , Li Wei
Published: September 2024

Translanguaging is the capacity multilingual language users have to draw on different linguistic, cognitive, semiotic, and modal resources to make meaning and make sense, transcending the boundaries between named languages and between language and other meaning- and sense-making resources. The 21st century is a postmultilingualism era that is no longer about the harmonious parallel existence of multiple languages but about the infiltration, transgression, and subversion of boundaries that are artificially and ideologically set between languages, races, and nations. No single nation or community can claim sole ownership, authority, and responsibility for any particular language, including English, and boundaries between named languages, between languages and other communicative means, and the relationship between language and the nation-state are being constantly reassessed, broken, or adjusted. Translanguaging captures such changing dynamics and highlights the language user’s agency in exploiting their communicative repertoire holistically and in an integrated and coordinated way. When applied to English as a foreign language (EFL) teaching and learning, translanguaging demands that not just the first language but the learner’s repertoire be visible and audible in the classroom, aiming to foster a more inclusive, equitable learning environment, especially for minoritized language speakers. Translanguaging as a pedagogical approach has been shown to deepen students’ understanding of certain content and topics, facilitate the learners’ participation and knowledge coconstruction with one another, develop their English language and literacy skills, and enhance their multilingual and multicultural awareness.
History of Laamb (Senegalese Wrestling)
Authors: M'bayo Tamba E.
Published: September 2024

Laamb, indigenous wrestling in Senegal, has its roots in the wrestling tradition of the Sereer people of west-central Senegal traceable way back to the far-off pre-colonial era. During this early period, the sport was popular in rural communities and attracted diverse groups of spectators, including men, women, and children. Most of the wrestlers were young men of different age groups who participated in laamb as a recreational sport to mark the end of the harvest season in agricultural areas or to celebrate the end of Ramadan, the month-long fasting period for Muslims. Even as an amateur sport without the lure of huge prize money, wrestling matches generated excitement, rivalry, and passionate debates among fans and wrestlers alike.

With its initial increase in popularity spanning the colonial period, Senegalese wrestling attracted more spectators in Dakar, the capital city, in the early 1900s and continued flourishing as a major spectator sport and cultural event in the country from the second half of the 1900s onward. Over the years, laamb attracted a larger fan base in Senegal and became more monetized, with commercial enterprises using it to promote their goods and services as prize monies increased exponentially for the topmost wrestlers. Consequently, laamb has become one of the most popular sports in the country and is surpassed only by soccer/football, though some observers suggest that the former is the dominant sport. Notwithstanding its popularity in Senegal, however, the country’s predominantly Muslim population frowns upon women wrestlers participating publicly in laamb. Hence, unlike their male counterparts, women have very few to no opportunities to become professional wrestlers.
Peace in the Anthropocene
Authors: Simangan Dahlia
Published: September 2024

What implications does global environmental change have for peace and conflict dynamics? The critical discourse surrounding the Anthropocene is useful when responding to this question as it can be used to elucidate the limitations of multilateralism in maintaining peace and responding to conflicts. Prioritizing state security, militarism, and anthropocentric development is too limited and short-sighted when addressing complex global challenges such as climate change. Established and emerging studies on the Anthropocene highlight the importance of human security, positive peace, and ecological justice in pursuing peace in this geological age. In the same vein, several global policy directions prompt a rethinking of a peace agenda that is relevant when addressing interconnected global challenges. Future research may continue developing theoretical frameworks and research methodologies suitable for intergenerational, multispecies, and planetary approaches to peace.
The Solar Corona
Authors: Morton Richard
Published: September 2024

The solar corona is the hot, tenuous outer layer of the Sun’s atmosphere. The coronal plasma is roughly around 1 mega-Kelvin (MK) but can reach temperatures of around 10 MK in certain regions. Due to this high temperature, the plasma in the corona emits electromagnetic radiation predominantly at Extreme Ultraviolet (EUV) and X-ray wavelengths. The corona’s appearance and dynamic behavior is defined by a complex network of magnetic fields that thread the fully ionized plasma. Due to an excess of magnetic pressure compared to gas pressure, the magnetic field is able to control the flow of plasma in the corona, leading to a wide variety of different structures. The appearance of the corona undergoes small variations over hours, and changes dramatically over the course of the Sun’s magnetic cycle. At the large scales are vast patches of open magnetic fields known as coronal holes, in which the fast, hot solar wind originates. The coronal holes are most prominent at the minimum stage of the Sun’s activity cycle. The other large-scale feature is coronal streamers, which transition from closed to open magnetic field with height and extend out as elongated rays into the heliosphere. The streamers are always present and are a source of transient events in the solar wind. The inner corona is dominated by closed loops of plasma, which are structured on the smallest resolvable scales and are the result of emerging bipolar patches of magnetic field.

The Sun’s corona is also the source of a long-standing question in astrophysics. First raised in the 1940s, scientists are still trying to understand how energy is deposited in the coronal plasma, causing the heating of the plasma to millions of degrees and the acceleration of the solar wind. It is clear that the magnetic field plays a substantial role, but being able to pin down the mechanisms of energy release is challenging. Modern observations have revealed signatures of magnetohydrodynamic waves and magnetic reconnection throughout the corona, both of which are leading explanations. However, there are still many unknowns about their contributions to energy deposition throughout the corona. Revealing the nature of coronal energy deposition is not only important for understanding the Sun but is also key for understanding the evolution of planetary systems around solar-like stars (which get bombarded with EUV/X-ray radiation and stellar winds) and the evolution of solar-like stars themselves (including mass and angular momentum loss).
Nahuas of Colonial Mexico
Authors: Conway Richard
Published: September 2024

When Spaniards first ventured into central Mexico in the late 1510s, they were astonished at the sheer scale and the grandeur of the Native societies they encountered. What became the modern Mexican states of Tlaxcala, Puebla, Morelos, Mexico, and the Federal District were home to many ethnic groups, but the Nahuatl-speaking peoples, or Nahuas, were the predominant population. While they formed communities in further-flung parts of Mexico, it was in these central regions that the vast population of Nahuas lived in dozens of great city-states. Among these polities were Tenochtitlan, Tetzcoco, and Tlacopan, which together comprised the Aztec Triple Alliance. When the Spaniards arrived, many city-states had fallen under the sway of the Triple Alliance or, like Tlaxcala, had defiantly maintained their independence from its imperial expansion. In the years after 1520, Nahua society was convulsed by the violence from wars of conquest, conflict among Native groups, civil strife, enslavement, and demographic collapse from recurring waves of multiple epidemic diseases. In spite of the catastrophic loss of life, Nahua communities survived. Indeed, they proved remarkably resilient. Nahuas not only maintained the integrity of their communities but also preserved much of their economic orientation, social organization, and, at least at the local level, their sociopolitical order. It was on the foundations of Nahua society—especially Nahua city-states—that Spanish rule came to rest. These foundations remained intact through independence (and beyond). During the three centuries of colonial rule, Nahua society and culture underwent complex processes of continuity and change. Nahuas adapted to changing circumstances and harnessed new opportunities even as they also succeeded in preserving much of their heritage, including their language, whose survival in written sources makes it possible for us to study their rich history.
Era mucho el miedo by Gloria Inés Peláez and En el brazo del río by Marbel Sandoval Ordóñez: The Novels of the Second State in Colombia
Authors: Delgado Ricci María del Mar
Published: September 2024

Colombia’s war conflict inspired crime fiction, mainly by male authors. This genre has reflected the nation’s harsh reality since the mid-twentieth century, revealing brutal aspects of Colombian society. However, women’s experiences as victims of violence and their literary contributions have been overlooked despite their early engagement in writing about these matters. This article analyses the novels En el brazo del río by Marbel Sandoval Ordóñez and Era mucho el miedo by Gloria Inés Peláez, published in 2006 and 2016, respectively. Both novels are representations of what could be considered the Colombian “Second State”—as named by Rita Segato: an illegal ruling state and economic scheme that thrives on the cruelest violence, primarily against women.
Geothermal ecosystems on Mt. Erebus, Antarctica, support diverse and taxonomically novel biota
Authors: Rasmussen Trine Bertram , Noell Stephen E , Herbold Craig W , Dickie Ian A , Richards-Babbage Roanna , Stott Matthew B , Cary S Craig , McDonald Ian R
Published: September 2024

Mt. Erebus, Antarctica, is the southernmost active volcano in the world and harbors diverse geothermally unique ecosystems, including “Subglacial” and “Exposed” features, surrounded by a vast desert of ice and snow. Previous studies, while limited in scope, have highlighted the unique and potentially endemic biota of Mt. Erebus. Here, we provide an amplicon-based biodiversity study across all domains of life and all types of geothermal features, with physicochemical and biological data from 48 samples (39 Exposed and 9 Subglacial) collected through various field seasons. We found potentially high taxonomic novelty among prokaryotes and fungi, supporting past hypotheses of high endemism due to the distinctive and isolated environment; in particular, the large number of taxonomically divergent fungal sequences was surprising. We found that different site types had unique physicochemistry and biota; Exposed sites were warmer than Subglacial (median: 40°C versus 10°C for Exposed and Subglacial, respectively) and tended to have more photosynthetic organisms (Cyanobacteria and Chlorophyta). Subglacial sites had more Actinobacteriota, correlated with greater concentrations of Ca and Mg present. Our results also suggest potential human impacts on these remote, highly significant sites, finding evidence for fungal taxa normally associated with wood decay. In this study, we provide a blueprint for future work aimed at better understanding the novel biota of Mt. Erebus.
An atypical case of right ventricular myxoma, a paradox of pulmonary valve endocarditis with right ventricular outflow tract obstruction. From a surgeon’s perspective
Authors: Samsuddin Muhammad Juffri , Yaacob Siti Sara , Sanusi Abdul Rais Bin
Published: September 2024

Intracardiac tumour is rare, and intracardiac myxoma is the most common intracardiac tumour of the heart. The majority of these tumours arise at the left and right atrium, and a presentation of such a tumour other than the mentioned is atypical and very rare. Due to the rare occurrence, clinicians often misdiagnose it as infective endocarditis especially if the tumour is located near the valves and causing outflow gradient stenosis on echocardiography. A multi-modal cardiac imaging and a multi-disciplinary approach are paramount to make a correct diagnosis and treatment strategies. We would like to report a rare case of a right ventricular myxoma of a young girl, who was initially treated with infective endocarditis, which turned out to be a rare atypical Right ventricular myxoma, which was then surgically excised. The patient was successfully discharged after 3 years of follow up echocardiography showed free of tumour recurrence.
Renal artery pseudoaneurysm presenting in a single functioning kidney with prior partial nephrectomy following flexible ureterorenoscopy: a case report
Authors: Asi Tariq , Khamashta Natalie , Dalal Ahmad
Published: September 2024

Renal artery pseudoaneurysm (RAP) formation following flexible ureterorenoscopy (FURS) with laser lithotripsy is rare. Previous kidney surgery places patients at an increased risk due to potential vascular injury associated with renal intervention. In our case, a 62-year-old man with a single functioning right kidney and a history of right partial nephrectomy presented 10 days following FURS with holmium laser lithotripsy, complaining of gross hematuria. Attempted conservative management failed. Renal arteriography was done, which revealed a RAP that was managed with selective angioembolization. RAP following FURS can be serious if not managed properly. Most cases present with late gross hematuria. RAP can usually be demonstrated on renal arteriography. Selective angioembolization is the definitive treatment.
Development and Validation of a High-Performance Liquid Chromatography–Ultraviolet Spectrometry Method for Ampicillin and its Application in Routine Therapeutic Drug Monitoring of Intensive Care Patients
Authors: Morath Benedict , Schultes Linda , Frey Otto Roman , Röhr Anka Christa , Christow Hannes , Hoppe-Tichy Torsten , Brinkmann Alexander , Chiriac Ute
Published: September 2024

Background:

Ampicillin/sulbactam, a combination of a β-lactam and β-lactamase inhibitor, is widely used in clinical settings. However, therapeutic drug monitoring (TDM) of ampicillin is not commonly performed, particularly in intensive care units (ICUs). The purpose of this study was to develop and validate a rapid and cost-effective high-performance liquid chromatography (HPLC)–ultraviolet spectrometry method to quantify ampicillin in human serum and evaluate its clinical application in ICU patients.

Methods:

Sample cleanup included a protein precipitation protocol, followed by chromatographic separation on a C18 reverse-phase HPLC column within 12.5 minutes using gradient elution of the mobile phase. The assay was validated according to the German Society of Toxicology and Forensic Chemistry criteria. Clinical applications involved the retrospective analysis of TDM data from ICU patients receiving continuous infusion of ampicillin/sulbactam, including the attainment of target ranges and individual predicted and observed pharmacokinetics.

Results:

The method was robust, with linear relations between the peak area responses and drug concentrations in the range of 2–128 mg/L. The coefficient of variation for precision and the bias for accuracy (both interday and intraday) were less than 10%. Clinical application revealed variable pharmacokinetics of ampicillin in ICU patients (clearance of 0.5–31.2 L/h). TDM-guided dose adjustments achieved good therapeutic drug exposure, with 92.9% of the samples being within the optimal (16–32 mg/L) or quasioptimal (8–48 mg/L) range.

Conclusions:

This method provides a practical solution for the routine TDM of ampicillin, facilitating individualized dosing strategies to ensure adequate therapeutic drug exposure. Given its simplicity, cost-effectiveness, and clinical relevance, HPLC–ultraviolet spectrometry holds promise for broad implementation in hospital pharmacies and clinical laboratories.
Diversity Scholarships for Plastic Surgery Subinternships: A National Review of US Residency Programs
Authors: Antezana Luis A. , Rames Jess , Ochoa Pablo , Kreutz-Rodrigues Lucas , Bakri Karim
Published: September 2024

Background:

Residency programs have developed monetary initiatives for students underrepresented in medicine (URiM). Our team sought to provide a centralized resource for URiM students seeking plastic surgery subinternships with funded opportunities.

Methods:

A cross sectional analysis of URiM scholarships offered by US integrated plastic surgery programs (n = 91) between July and September 2023. The study used residency program web domains. Investigators collected information on the monetary value of scholarship, eligibility criteria, and required application documents. Inferential analyses were conducted to investigate whether programs’ geographic region or Doximity ranking played a role in likelihood of scholarship existence.

Results:

The study found that approximately 52.7% (n = 48) of programs have in place monetary support for underrepresented visiting medical students (eg, stipend or reimbursement). The average monetary support was $1670. A univariate test demonstrated that programs with lower rankings in both reputation and research were less likely to have a scholarship available than higher ranking programs (P = 0.002; P = 0.02, respectively). Programs located in the Midwest regions were 3.5 times more likely to have a diversity scholarship available (P = 0.034). In our multivariate analysis, reputation ranking and geographic region remained significant. A Pearson chi square test showed the greatest proportions of scholarships among geographically similar programs to be in the Midwest (70%), however, not statistically significant.

Conclusions:

This study provides a centralized resource for URiM students interested in completing away rotations. Further investigation into development of these scholarship opportunities would be of much benefit and could guide other programs in the funding their own diversity scholarships.
The Preservation Technique for Incomplete Unilateral Cleft Lip Reconstruction
Authors: Fell Matthew , Breakey William , Benitez Benito K. , Mueller Andreas A. , Chong David K.
Published: September 2024

The incomplete unilateral cleft lip shares many of the same phenotypic characteristics as a complete unilateral cleft lip, but key differences include an intact nasal sill, a relative excess of skin in the lateral lip element, and favorable skeletal support. Surgical techniques for incomplete unilateral cleft lips should be tailored to the specific anatomical characteristics, be simple and reliable to perform, and minimize the risk of secondary deformity. Here we describe the “preservation technique” for incomplete unilateral cleft lip reconstruction. The modified design from the anatomical subunit approximation technique uses a nasal sill flap and obviates the need for nasal sill and lateral lip excision. Tissues of the lip are opened out and reorientated to maximize the anatomical advantage.
Characteristics and Clinical Features of Patients with Lipedema in Saudi Arabia: A Cross-sectional Comprehensive Assessment
Authors: Alosaimi Khalid , Mortada Hatan , Alshomer Feras
Published: September 2024

Background:

Lower limb swelling presents a diagnostic challenge with diverse causes, including well-known issues like venous insufficiency and lymphedema, and less-understood conditions like lipedema. Lipedema, involving abnormal fat accumulation in the lower extremities, is frequently misdiagnosed, posing challenges for affected individuals. This research aimed to report and analyze the clinical features of patients presenting with the complaint of lipedema.

Methods:

A retrospective cross-sectional study was conducted in Saudi Arabia from April to November 2023, involving adult patients from a specialized clinic in lipedema and lymphedema management. Data were collected through clinical evaluation and a comprehensive data collection sheet.

Results:

In a cohort of 115 female patients (mean age: 38.58), the most common age for disease onset was around 20–29 years. Physical examinations revealed symmetric enlargement (88%), collar sign (43%), orthostatic nonpitting edema (49%), and telangiectasia (64%). Varicose veins were present in 36%, Stemmer signs in 2%, and foot edema in 13%. Clinical diagnosis with lipedema occurred in 71%, with grade 2 (31%) as the most common severity and type 3 (47%) as the prevalent disease type.

Conclusions:

The current study, the first of its kind in the Middle East and specifically in Saudi Arabia, emphasizes the urgency of increased awareness and intervention due to a high underdiagnosis rate in lipedema. The observed complexity in symptoms and correlations between severity, lymphatic impairment, and body mass index underscore lipedema’s multifaceted nature. Future research should explore regional and cultural influences and conduct larger studies to validate and recognize various lipedema features.
Recent Updates on the Management of Split-thickness Skin Graft Donor Sites
Authors: Markel Justin E. , Franke Jacob D. , Woodberry Kerri M. , Fahrenkopf Matthew P.
Published: September 2024

Background:

This article is a narrative review of split-thickness skin graft donor site (STSG-DS) management since the international guidelines were created in 2018. Although many new interventions have been developed, there is a lack of quality, multicentered clinical trials to produce updated evidence-based recommendations.

Methods:

Electronic databases, including Google Scholar, Web of Science, Medline, and PubMed, were searched by two independent researchers for literature regarding STSG-DS management published from 2018 through 2022, using specific terms in the text, title, and abstract. The primary endpoint assessed was STSG-DS healing, as measured by wound epithelialization.

Results:

Thirty-one articles were selected, including three systemic review/meta-analyses, five case series, 14 randomized controlled clinical trials, six observational studies, and three nonrandomized trials. Novel interventions for STSG-DS management included in this article describe applications of human amniotic membranes, acellular dermal matrices, cell suspensions and growth factors, biomaterials, electromagnetic radiation, and natural products.

Conclusion:

Various interventions have shown promise for STSG-DS management since the creation of the 2018 international guidelines; however, studies with more standardized protocols and endpoints are needed to produce up-to-date, evidence-based recommendations and improve outcomes for patients undergoing split-thickness skin grafting.
The Surfactant Properties of Clindamycin as a Useful Adjunct for Removing Ruptured Silicone Implants
Authors: Alnaseri Tahera , Musavi Leila , Deming Timothy , Roostaeian Jason , Da Lio Andrew , Mason Thomas G. , DeLong Michael R.
Published: September 2024

Background:

Silicone gel removal after breast implant rupture is a difficult task. Silicone is hydrophobic and thus cannot be irrigated effectively with saline. Attempts at mechanical removal with sponges are often partially successful. Incomplete removal results in persistent silicone contamination with possible local inflammation, infection, and silicone granulomata. In this partially quantitative investigation, we assess the de-adhesion ability of different clindamycin formulations against known surfactant controls when combined with silicone gel.

Methods:

To demonstrate surfactant properties in vitro, clindamycin phosphate, clindamycin hydrochloride, and a known surfactant, sodium dodecyl sulfate (SDS), were compared. An amount of 170 g of silicone gel placed in a dry glass container exhibited strong adherence to the container walls. In separate trials, clindamycin phosphate (300 mg in 100 mL), clindamycin HCl (300 mg in 100 mL), and SDS (1 g in 100 mL) solutions with normal saline were added to the silicone aggregate, and de-adhesion properties were compared.

Results:

All solutions aided in the de-adhesion of the sticky silicone from glass substrate. The SDS had the strongest effect, followed by clindamycin phosphate and then clindamycin HCl. The observed interactions suggested that all of the solutions behaved as ionic surfactant coating the silicone with negative charges via adsorption. However, the phosphate anionic formulation was associated with a greater surfactant effect than HCl.

Conclusions:

Clindamycin acts as a surfactant to aid in the clinical removal of ruptured silicone gel. Clindamycin phosphate seems to have a stronger effect than clindamycin HCl, likely related to the negative charges on the phosphate groups.
Predictors of Sepsis and Sepsis-related Mortality in Critically Ill Burn Patients: A Single Tertiary Care Center Experience
Authors: Alqirnas Muhannad Q. , Jarman Yazeed A. , Almosa Abdulaziz S. , Alharbi Shaden S. , Alhamadh Moustafa S. , Qasim Salman S. , Alhusainan Hanan
Published: September 2024

Background:

Clinical diagnosis of sepsis is challenging, emphasizing the importance of regular bacterial surveillance, and tailored antimicrobial therapy. This study aims to elucidate the predictors of sepsis in critically ill burn patients.

Methods:

A retrospective analysis was conducted on patients admitted to the burn intensive care unit between 2016 and 2022. Demographics, type of burn, total body surface area (TBSA), presence of inhalation injury, mortality, sepsis, deep vein thrombosis, pulmonary embolism, pneumonia, cultures, and laboratory findings were collected. Descriptive statistics and survival analysis were used to analyze trends during the 7-year period.

Results:

The study encompassed 196 participants. Among patient factors, men constituted 73.4% (n = 102) of those without sepsis and 86.0% (n = 49) with sepsis, with an association between sepsis and lower age (34 versus 41 years) as well as larger TBSA (41.1% versus 17.3%). Inhalation injury was a significant predictor of sepsis [35.1% (n = 20) versus 11.6% (n = 16)]. Mortality was higher in sepsis cases [17.5% (n = 10) versus 2.9% (n = 4)], as well as positive blood cultures [47.4% (n = 27) versus 2.2% (n = 3)], positive wound cultures [71.9% (n = 41) versus 12.2% (n = 17)], and positive fungal cultures [12.3% (n = 7) versus 0% (n = 0)]. Multivariable analysis identified age and TBSA as significant predictors of sepsis (P = 0.025, P < 0.001).

Conclusions:

Age, TBSA affected emerge as a strong risk factor for sepsis among critically ill burn patients. It underscores the need for vigilant monitoring to improve outcomes and reduce sepsis-related mortality.
Neuroinflammatory Biomarkers and Their Associations With Cognitive, Affective, and Functional Outcomes 3 to 12 Months After a Traumatic Brain Injury: A Pilot Study
Authors: Collazos Kathryn S.G. , Alvarez Gemayaret , Alamian Arsham , Behar-Zusman Victoria , Downs Charles A.
Published: September 2024

Background:

Neuroinflammation is an important feature of traumatic brain injury (TBI) that remains poorly understood in the 3- to 12-month period post-TBI.

Objective:

The purpose of our pilot study was to examine the relationships between biomarkers of neuroinflammation and functional outcomes in TBI patients 3 to 12 months postinjury.

Methods:

TBI patients (n = 36) 3 to 12 months post-TBI were recruited from a South Florida TBI clinic from May 2022 to June 2023. The Disability Rating Scale, Satisfaction with Life Scale, NIH Toolbox Sorting Working Memory, Neuro-Quality of Life Cognitive Function, Anxiety, Depression, and Sleep assessments were performed. Multiple plasma biomarkers were assayed. Analysis of variance was used to compare between-group results. Linear regression was performed to analyze relationships between biomarkers and outcomes.

Results:

Brain-derived neurotrophic factor concentrations were higher as postinjury time interval increased and were associated with cognitive battery outcomes. S-100β and glial fibrillary acidic protein were associated with anxiety score and hospital length of stay; S-100β was also associated with depression. Interleukin 6 was associated with cognitive function score and time since injury.

Conclusions:

We found S-100β, glial fibrillary acidic protein, Interleukin 6, and brain-derived neurotrophic factor to play a larger role in the TBI recovery period than other biomarkers examined. Clinicians should continue to monitor for symptoms post-TBI, as the neuroinflammatory process continues to persist even into the later rehabilitation stage.
Method for evaluating volume responsiveness during the passive leg raising test
Authors: Wang Jingkai , Li Jiarou , Wang Hongliang
Published: September 2024

Accurate fluid assessment is essential in critically ill patients, as both fluid insufficiency and fluid excess can result in adverse outcomes. The passive leg raising test (PLR) is a dependable and simple method of evaluating fluid responsiveness. Its accuracy and specificity have been validated over the past decade. Consequently, we have compiled a list of indicators that can be used to predict fluid responsiveness. By selecting more suitable hemodynamic indicators, fluid therapy can be more effectively guided.
Outcomes of internal fixation with Femoral Neck System (FNS) for intracapsular femoral neck fractures
Authors: Tarrant Seth A. , Mitchell Brendan P. , Blankespoor Michael G. , Littell Zane D. , Zackula Rosalee E. , Lais Randall L. , Dart Bradley R.
Published: September 2024

Background:

Internal fixation of hip fractures is associated with high reoperation rates. This study investigated the reoperation rates after internal fixation with the femoral neck system (FNS).

Materials and Methods:

A single-institution cohort study was conducted on patients aged 18 years or older who sustained intracapsular femoral neck fractures and underwent internal fixation with a fixed-angle implant. Surgeons, patients, and investigators were not blinded. The primary outcome was any hip reoperation at the final follow-up. Secondary outcomes were to characterize a cohort of patients regarding demographics, fracture classification, intraoperative findings, postoperative fracture complications and union rates, and postoperative pain.

Results:

This study found that internal fixation with FNS for intracapsular femoral neck fractures was associated with a 23% rate of revision surgery. Of the initial 94 patients who received FNS internal fixation, 44 patients were included for analysis; of those, 10 patients underwent revision surgery. Patients had a 22% rate of in-hospital medical adverse events with a 30-day readmission rate of 9%. Increasing body mass index was associated with increased revision rates (P = 0.037). Patients who sustained displaced femoral neck fractures had a significant decrease in SF-12 Mental Health Composite, SF-12 Physical Health Composite, and quality-of-life subscale scores.

Conclusions:

The FNS is a viable alternative for internal fixation of intracapsular femoral neck fractures. The observed rate of revision after internal fixation was comparable with previously published outcomes following fixation with cannulated screws and sliding hip screws.

Level of Evidence:

Level IV, Therapeutic Study.
Implementation of a heart failure disease management program in the rural southern United States: a best practice implementation project
Authors: Johnson Amy Chapman , Upchurch Linda
Published: September 2024

Background:

Heart failure affects thousands of patients annually, often resulting in hospitalization, emergency room visits, and decreased quality of life. The scientific evidence indicates that disease management programs using a multidisciplinary approach improve outcomes for heart failure patients.

Aim:

The overarching aim of this evidence implementation project was to establish a disease management program for heart failure patients. Specifically, the project sought to promote compliance with best practices for the early identification of heart failure exacerbation symptoms to prevent emergency room visits and hospitalizations, thereby reducing morbidity and mortality.

Methods:

This project was guided by the JBI Evidence Implementation Framework, which is grounded in an audit, feedback, and re-audit strategy. A baseline audit was conducted, revealing the need for a heart failure disease management program. A policy was developed to implement a disease management program and virtual relationships were established to create a multidisciplinary team. A follow-up audit was conducted to determine whether the implemented interventions closed the gap in practice identified by the baseline audit.

Results:

The baseline audit revealed 0% compliance with best practices for the management of patients with heart failure, while the follow-up audit revealed 93.3% compliance.

Conclusions:

This project enhanced best practices by implementing a protocol in a rural health clinic to ensure that all heart failure patients were enrolled in a disease management program. Recommendations include using the electronic health record to quickly identify heart failure patients and their status in a disease management program. Chart audits should be performed every 6 months to ensure the program's sustainability and to determine heart failure patients’ enrollment status.

Spanish abstract:

http://links.lww.com/IJEBH/A270
Transcriptional and hormonal profiling uncovers the interactions between plant developmental stages and RNA virus infection
Authors: Melero Izan , Gómez-Cadenas Aurelio , González Rubén , Elena Santiago F.
Published: September 2024

Arabidopsis thaliana is more susceptible to certain viruses during its later developmental stages. The differential responses and the mechanisms behind this development-dependent susceptibility to infection are still not fully understood. Here we explored the outcome of a viral infection at different host developmental stages by studying the response of A. thaliana to infection with turnip mosaic virus at three developmental stages: juvenile vegetative, bolting, and mature flowering plants. We found that infected plants at later stages downregulate cell wall biosynthetic genes and that this downregulation may be one factor facilitating viral spread and systemic infection. We also found that, despite being more susceptible to infection, infected mature flowering plants were more fertile (i.e. produce more viable seeds) than juvenile vegetative and bolting infected plants; that is, plants infected at the reproductive stage have greater fitness than plants infected at earlier developmental stages. Moreover, treatment of mature plants with salicylic acid increased resistance to infection at the cost of significantly reducing fertility. Together, these observations support a negative trade-off between viral susceptibility and plant fertility. Our findings point towards a development-dependent tolerance to infection.
Niche conservatism in the Legume Amherstieae tribe: Insights from the tropical Berlinia and Brownea clades
Authors: Romero Ingrid C. , Punyasena Surangi W.
Published: September 2024

The concept of niche conservatism describes the tendency of organisms to retain ecological traits through time and space. Reviewing this concept in different groups of angiosperms is critical to understanding what factors drove their expansion and geographic distribution, as well as assessing how, in taxonomic levels higher than species, ecological traits have remained relatively constant through time and space. Studying niche conservatism can also help us understand how the distribution of clades may be affected by climate change. Niche conservatism has been observed in many clades of legumes. Amherstieae, the largest tribe of the Detarioideae subfamily, has a geographic distribution, evolutionary history, and phylogeny that makes it a good candidate for evaluating patterns in niche conservatism. We analyzed the distribution of two Amherstieae suprageneric clades, the Berlinia and Brownea clades. The former is endemic to sub-Saharan Africa and the latter is restricted to the Neotropics. We used the geographic distributions of each clade to define their G-space (geographic space) and extracted 19 climatic variables to define the E-space (environmental space) of each clade. We used two tests to evaluate the similarity in the climatic niche of both clades, the niche overlap test (NOT) to estimate similarities between the occupied E-spaces (realized niche space) and the niche divergence test (NDT) to assess the similarity of the environmental niche relative to the accessible analogous E-space (potential niche space) of each biogeographic region. Our results suggest that the Brownea clade are descendants of a climatic subset of the Berlinia clade preferring less variable temperature and higher precipitation levels, and that the dry-adapted subset of Berlinia may represent a more recent evolutionary expansion.