bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of an Integrated Observation Data and Global Numerical Weather Prediction System-Based Rainfall-Runoff Forecasting Model as PJT-I’s Effort in Water Resources Disaster Mitigation
Authors: Muttaqin R M A , Nugrahany A
Published: May 2024

Given the vital role of water resources and their vulnerability to climate-driven disasters, especially floods and droughts, the need for effective disaster mitigation strategies in water resource management is evident. PJT-I, a key player in the industry, grapples with this challenge. To address it, PJT-I has embraced the Smart Water Management System (SWMS) platform and innovative enhancements in rainfall-runoff modeling, showcasing their dedication to bolstering real-time monitoring and predictive capabilities. These advances hold the promise of strengthening operational water resource management, spanning allocation and infrastructure operations, and are particularly relevant in the face of escalating extreme weather events. The study’s focus on the Sengguruh reservoir catchment area serves as an illustration, highlighting the creation of two hydrometric-based models: the AWLR Gadang model and the Sengguruh reservoir model. Their effectiveness is validated through data calibration and integration of GFS forecast data, enabling 120-hour forecasting. Rigorous assessment involving correlation, efficiency, determination, and error metrics provides insights into the models’ predictive capacities and limitations amid the dynamic interplay of rainfall-runoff dynamics.
Design of the Jlantah Reservoir Mini-Hydro Power Plant, Karanganyar Regency, Central Java Province
Authors: Soekarno I , Harahap A C
Published: May 2024

An increase in the number of electricity users in Jatiyoso District, Central Java, has occurred in the last few years. In 2020 there were 12,773 families using electricity in Jatiyoso District, where there has been an increase of 79 families using electricity compared to 2019. This increase in electricity demand should be balanced with an increase in sources of electrical energy for the community. Therefore, Jlantah Mini-hydro Power Plant is expected to become a source of electrical energy for the local community. The normal water level of the reservoir is planned at an elevation of +691.00 MASL and the elevation of the intake structure at +661.00 MASL. The total dead storage of the reservoir is 1.66 million and the total effective storage is 9.16 million. The powerhouse elevation planning is carried out by analyzing the 100-year return period of flood in the river around the powerhouse. The powerhouse is planned at an elevation of +624.00 MASL. The turbines used in the powerhouse are 2 turbines. Turbine 1 with HLA550-WJ-55 series and turbine 2 with HLA678-WJ-50 series. The average power generated in a normal year (2013) is 516.44 kW with a total energy of 4.47 GWh. The construction cost of the Jlantah PLTM is estimated at IDR 18,795,716,076.00 with normal annual income (2013) of IDR 4,060,935,522. With this income, the NPV value is IDR 4,461,454,224, IRR is 12.96%, BCR is 1.24, and PBP is 12.78 years, so this project is said to be economically feasible.
Wonorejo dam operation and storage analysis against climate change
Authors: Nurdianyoto I , Cahyo H , Djajasinga V
Published: May 2024

Climate change affecting rain intensity within catchment and increase the potential hydrometeorology disasters. Wonorejo Reservoir as a multipurpose dam requires an operational plan and water allocation to fulfill downstream needs, such as irrigation, hydropower, microhydropower, domestic industry uses and flood control. Wonorejo Dam is a backfill type dam with High Water Level (HWL) elevation is +183.00 mSHVP and Low Water Level (LWL) elevation is +141.00 mSHVP, Total storage capacity Wonorejo Reservoir is 109.118 million m3 (2021) or 89.4% from initial total storage capacity (2000), in 2050 predicted sediment volume increase to 17.73 million m3 or 17.6% reservoir capacity and 2050 capacity volume is 100,585 million m3 or 82.4% from initial total storage capacity. Annual Reservoir Operation Plan and Annual Water Allocation Plan for Wonorejo Reservoir in 2022/2023 as water services December 2022 to November 2023 periode, Wonorejo Reservoir elevation at the end of May 2023 reaches HWL and lowest water elevation is +162.64 mSHVP in the first week of November 2023.
Lahar flow characteristic of Semeru Volcano based on Flow-R Model and its countermeasure
Authors: Munir M D , Santoso F I , Eka N A , Amanda A E
Published: May 2024

Lahar flows represent a consequential outcome of volcanic eruptions, posing a natural hazard with the potential to profoundly impact both society and infrastructure. These fast-moving streams of volcanic lahar surge from elevated terrains to lower altitudes, commonly referred to as lahar flows. The Rejali Watershed, nestled in Lumajang Regency, East Java, Indonesia, serves as one of the key watersheds sourced from the elevated slopes of the Semeru Volcano, eventually merging into the Indian Ocean as its outlet. The primary objective of the study is to uncover the distinct characteristics of Semeru Volcano’s lahar flows and suggest feasible countermeasures aimed at averting potential future disasters. A thorough comprehension of the potential dangers associated with lahar flows is imperative in identifying the requisite countermeasures and regulations to be implemented for the purpose of disaster risk reduction. The findings highlight the utility of the model in effectively mapping the impact of the Semeru volcanic eruption. This is achieved through the utilization of back analysis to acquire insights into the characteristics of these lahar-related disasters. While the model exhibits a good correlation with reality, as evidenced by the Sentinel 2 image, it falls short of adequately representing certain specific areas.
Adaptive water management in response to tidal inundation and sea level rise on tidal agricultural lowlands of Katingan, Central Kalimantan
Authors: Kamil I , Jayadi R , Rahardjo A P
Published: May 2024

Decreased water management systems and sea level rise cause inundation in the Katingan tidal agricultural lowland. Excessive and prolonged inundation can decrease rice production or even loss of rice land. A study was conducted to provide adaptive water management for controlling water levels in canals and rice crop fields inundation. For this purpose, a combined one- and two-dimensional unsteady flow method was used in HEC-RAS. The scenario of water level control uses sluice and flap gates in secondary canals. Under spring tide conditions, water level control with gates decreases the inundation area by 95.62%. Likewise, in the 25 and 50-year sea level rise scenarios, inundation decreased by 88.51% and 82.25%. In the spring tide condition, the duration of inundation is decreased from 3.5 to 0.9 days. Under 25 and 50-year sea level rise scenarios, the duration of inundation was decreased from 3.7 to 3 days and from 4.3 to 4.1 days. The use of gates significantly decreases inundation in the spring tide condition, but under sea level rise in 25 and 50-year, the depth and duration of inundation are still dangerous for rice crops; therefore, it is necessary to advance water management control for the sustainability of rice fields.
Coastal conditions and long-term topographic changes of Tanjung Benoa Beach on Bali Island, Indonesia
Authors: Onaka S , Uda T , San-Nami T , Miyagawa K , Mori T
Published: May 2024

Tanjung Benoa Beach on Bali Island, a globally recognized coastal resort with well-developed coral reefs, is experiencing beach erosion. This study aimed to formulate measures against the beach erosion, with a quantitative analysis of the coastal mechanisms through field observations, aerial photographs, satellite images and bathymetric data. The results indicate that the beach erosion on Tanjung Benoa Beach has occurred over time due to the longshore sediment transport, although the rate reduced by a construction of a groin. Additionally, the eroded area can be considered as a closure system of sediment transport between two groins at both ends, where accumulation and erosion of sand occur simultaneously. Based on these results, sand back pass was proposed, and its implementation plan was examined through numerical calculations for three-dimensional beach topographic changes. The numerical calculation compared a case of beach nourishment alone to adding four groins, suggesting that beach nourishment without groins is more effective for achieving the target beach width, maintenance plan efficiency and the high demand for beach uses on Tanjung Benoa Beach. This plan represents one of the few instances of sand back pass in Indonesia and promotes sustainable solutions to beach erosion, balancing beach utilization and conservation.
Sustainable use of magnesite mine waste in self-compacting concrete and its study on strength, microstructure, cost and CO2 emission
Authors: Shunmuga Vembu Pitchiah Raman , Ammasi Arun Kumar
Published: May 2024

Managing waste materials from mining is of universal interest owing to its massive volume, ecological impacts, health hazards, and disposal challenges despite high operational costs. Advancements advocate for recycling mine waste to sustainably support construction. As the construction sector heavily consumes resources, utilizing mine waste from magnesite mines (MMW) in concrete has gained attention. This experimental study assesses the viability of substituting MMW for natural fine and coarse aggregates in self-compacting concrete (SCC) at intervals of 10% up to 50% by weight. Evaluations were done on fresh (slump flow, T50 slump, V-funnel, J-ring, L-box) and hardened (compressive, splitting tensile, and flexural strength) properties, along with microstructural features, cost, and CO2 emissions. The findings unveil that nearly all mixtures exhibit commendable performance, where mine waste is replaced for fine and coarse aggregates showcasing superior fresh and hardened properties, respectively. Fresh property results reveal the SF1 flow category with VF1 and VF2 viscosity types for the SCC mixtures. Moreover, these SCC mixtures observed substantial strength enhancements of approximately 10% to 15% in compressive, splitting tensile and flexural test results at 28 and 90 days. Microstructural analysis corroborates the observed strength outcomes, indicating a denser concrete matrix. Significant environmental and economic benefits were observed, including a notable 20% reduction in CO2 emissions and 17% cost savings. These findings underscore the potential of integrating MMW into SCC mixtures as a sustainable approach towards construction materials, offering both performance and environmental advantages.
Comparisons of microstructure and mechanical properties of MAG joints welded under 2G and 3G conditions
Authors: Peng Xingna , Zhang Hao , Qiao Yaxia , Sun Shaoheng , Tu Dejun
Published: May 2024

MAG welding of 07MnMoVR steel was performed at the 2G and 3G positions, and weld formation, microstructure, residual stress, and tensile properties were compared. In this study, welds without defects were obtained at the 2G and 3G positions. The results showed that a larger distortion of the weld at the 3G position was present because of the higher heat input and that the perlage morphology was related to the introduction of the arc weaving process. In addition, the grain size of the filling pass was coarser than that of the cap pass because of the repeated heating process, and the grain sizes of the filling and cap passes increased by approximately 33% for the weld at the 3G position compared with that at the 2G position. In this case, the weld at the 3G position showed a larger residual stress and lower yield and tensile strengths, and the elongation rates and microhardness of the weld at the 3G position were lower than were those of the weld at the 2G position, regardless of the root pass, filling pass, or cap pass.
Prediction of cervix cancer stage and grade from diffusion weighted imaging using EfficientNet
Authors: Aouadi Souha , Torfeh Tarraf , Bouhali Othmane , Yoganathan SA , Paloor Satheesh , Chandramouli Suparna , Hammoud Rabih , Al-Hammadi Noora
Published: May 2024

Purpose. This study aims to introduce an innovative noninvasive method that leverages a single image for both grading and staging prediction. The grade and the stage of cervix cancer (CC) are determined from diffusion-weighted imaging (DWI) in particular apparent diffusion coefficient (ADC) maps using deep convolutional neural networks (DCNN). Methods. datasets composed of 85 patients having annotated tumor stage (I, II, III, and IV), out of this, 66 were with grade (II and III) and the remaining patients with no reported grade were retrospectively collected. The study was IRB approved. For each patient, sagittal and axial slices containing the gross tumor volume (GTV) were extracted from ADC maps. These were computed using the mono exponential model from diffusion weighted images (b-values = 0, 100, 1000) that were acquired prior to radiotherapy treatment. Balanced training sets were created using the Synthetic Minority Oversampling Technique (SMOTE) and fed to the DCNN. EfficientNetB0 and EfficientNetB3 were transferred from the ImageNet application to binary and four-class classification tasks. Five-fold stratified cross validation was performed for the assessment of the networks. Multiple evaluation metrics were computed including the area under the receiver operating characteristic curve (AUC). Comparisons with Resnet50, Xception, and radiomic analysis were performed. Results. for grade prediction, EfficientNetB3 gave the best performance with AUC = 0.924. For stage prediction, EfficientNetB0 was the best with AUC = 0.931. The difference between both models was, however, small and not statistically significant EfficientNetB0-B3 outperformed ResNet50 (AUC = 0.71) and Xception (AUC = 0.89) in stage prediction, and demonstrated comparable results in grade classification, where AUCs of 0.89 and 0.90 were achieved by ResNet50 and Xception, respectively. DCNN outperformed radiomic analysis that gave AUC = 0.67 (grade) and AUC = 0.66 (stage). Conclusion. the prediction of CC grade and stage from ADC maps is feasible by adapting EfficientNet approaches to the medical context.
Clinical Implications of Fat Grafting in the Posterior Calf: A Dynamic Cadaver-based Study
Authors: Glener Adam D , Del Vecchio Daniel , Halani Sameer H , Cárdenas-Camarena Lázaro , Hoyos Alfredo E , Kenkel Jeffrey M
Published: May 2024

Background

Intramuscular fat grafting in extremity muscles, especially the gastrocnemius, has become increasingly popular. However, while safety in truncal muscle fat grafting has been well-studied, research on extremity muscles is lacking.

Objectives

In this study, we aimed to explore the anatomy of the gastrocnemius muscle and adjacent structures as intramuscular and subcutaneous recipient sites. Additionally, we sought to analyze pressure-volume relationships and fat migration patterns during posterior calf grafting.

Methods

Eight cadaveric lower extremities were examined. A prosection was performed to better understand the vascular complex around the gastrocnemius. Ultrasound-guided fat injections were then performed into both the subcutaneous and intramuscular layers; dynamic pressures were measured with a manometer. Last, dyed-injectant was injected subcutaneously to better elucidate subcutaneous anatomy.

Results

Anatomic prosection demonstrated the proximity of the gastrocnemius muscle to the popliteal venous system that arborized (>1 mm) intramuscularly. In the 3 specimens that underwent intramuscular fat grafting, the peak intramuscular pressures plateaued at 21 mmHg (19.5–23 mmHg); there was no observed extrafascial migration of the injectant. With subcutaneous injectant in 1 specimen, pressures in the subcutaneous space increased (125 mmHg) with additional injectant (240 mL) while pressures in the intramuscular space remained relatively constant (4 mmHg).

Conclusions

Intramuscular gastrocnemius fat grafting should be done with caution: its proximity to critical veins and sustained increased intramuscular pressures following grafting increases risks of embolus and thrombosis, respectively. Subcutaneous injection may be safer in that increased pressures are not communicated to deep structures. Last, we present a novel description of posterior calf subcutaneous compartments that may better allow surgeons to direct and predict subcutaneous injectant.
And the award goes to… white men
Authors: Sandhu Jasmine K
Published: May 2024

Jasmine K Sandhu digs into some glaring (and some rather less glaring) issues with diversity and inclusion in scientific awards
A bigger broader Autumn MIST
Authors: Sanchez-Cano Beatriz , Woodfield Emma , Rennie Sam , Pombo Diego Moral
Published: May 2024

Beatriz Sanchez-Cano, Emma Woodfield, Sam Rennie and Diego Moral Pombo report on a big meeting reflecting a thriving community
Extracellular cold-inducible RNA-binding protein mediated neuroinflammation and neuronal apoptosis after traumatic brain injury
Authors: Liu Yu-xiao , Zhao Ming , Yu Yang , Liu Jing-peng , Liu Wen-jia , Yao Ren-qi , Wang Jing , Yang Rong-li , Wu Yao , Dong Ning , Cao Yang , Li Shou-chun , Zhang Qin-hong , Yan Run-min , Yao Yong-ming
Published: May 2024

Background

Extracellular cold-inducible RNA-binding protein (eCIRP) plays a vital role in the inflammatory response during cerebral ischaemia. However, the potential role and regulatory mechanism of eCIRP in traumatic brain injury (TBI) remain unclear. Here, we explored the effect of eCIRP on the development of TBI using a neural-specific CIRP knockout (KO) mouse model to determine the contribution of eCIRP to TBI-induced neuronal injury and to discover novel therapeutic targets for TBI.

Methods

TBI animal models were generated in mice using the fluid percussion injury method. Microglia or neuron lines were subjected to different drug interventions. Histological and functional changes were observed by immunofluorescence and neurobehavioural testing. Apoptosis was examined by a TdT-mediated dUTP nick end labelling assay in vivo or by an annexin-V assay in vitro. Ultrastructural alterations in the cells were examined via electron microscopy. Tissue acetylation alterations were identified by non-labelled quantitative acetylation via proteomics. Protein or mRNA expression in cells and tissues was determined by western blot analysis or real-time quantitative polymerase chain reaction. The levels of inflammatory cytokines and mediators in the serum and supernatants were measured via enzyme-linked immunoassay.

Results

There were closely positive correlations between eCIRP and inflammatory mediators, and between eCIRP and TBI markers in human and mouse serum. Neural-specific eCIRP KO decreased hemispheric volume loss and neuronal apoptosis and alleviated glial cell activation and neurological function damage after TBI. In contrast, eCIRP treatment resulted in endoplasmic reticulum disruption and ER stress (ERS)-related death of neurons and enhanced inflammatory mediators by glial cells. Mechanistically, we noted that eCIRP-induced neural apoptosis was associated with the activation of the protein kinase RNA-like ER kinase-activating transcription factor 4 (ATF4)-C/EBP homologous protein signalling pathway, and that eCIRP-induced microglial inflammation was associated with histone H3 acetylation and the α7 nicotinic acetylcholine receptor.

Conclusions

These results suggest that TBI obviously enhances the secretion of eCIRP, thereby resulting in neural damage and inflammation in TBI. eCIRP may be a biomarker of TBI that can mediate the apoptosis of neuronal cells through the ERS apoptotic pathway and regulate the inflammatory response of microglia via histone modification.
Sevoflurane inhibits lung cancer development by promoting FUS1 transcription via downregulating IRF6
Authors: Zhou Pei , Yang Lei , Ma Xinyu , Li Qiuguo
Published: May 2024

Lung cancer is a major contributor to cancer deaths worldwide and is on the rise. Although surgical resection has been widely used as a standard therapy for lung cancer patients, the relapse rate after surgery is high. It is still unclear whether there is a potential drug that can reduce the probability of postsurgical recurrence in lung cancer patients. We used 5 typical lung cancer cell lines as well as 41 lung cancer tissue samples and paracancer tissue samples to investigate the expression levels of interferon regulatory factor 6 (IRF6) and tumor suppressor candidate 2 (TUSC2, also known as FUS1). We also treated lung cancer cells (H322 and A549) with different concentrations of sevoflurane to study its influence on lung cancer cell tumorigenesis. Lentivirus-mediated gain-of-function studies of IRF6 and FUS1 were applied to validate the role of IRF6 and FUS1 in lung cancer. Next, we used short hairpin RNA-mediated loss of function of IRF6 and luciferase, chromatin immunoprecipitation assays to validate the regulatory role of IRF6 on FUS1. Our findings reported that IRF6 was upregulated in lung cancer tissues, while FUS1 was downregulated. Functional assays revealed that sevoflurane inhibits lung cancer development by downregulating IRF6 expression. Luciferase and chromatin immunoprecipitation-quantitative real-time PCR assays uncovered that IRF6 represses FUS1 transcriptional expression in lung cancer cells. We have shown that sevoflurane prevents lung cancer development by downregulating IRF6 to stimulate FUS1 transcription, indicating that sevoflurane can be used as the potential anesthetic drug in surgical resection to reduce postoperative tumor relapse in lung cancer patients.
Synthesis and properties of 1,3-dithiole[6]dendralene analogs with two thiophene spacers inserted
Authors: Misaki Tomoya , Nishiwaki Masataka , Ito Toshiki , Ueda Masafumi , Fujisaki Masahiro , Yoshimura Aya , Shirahata Takashi , Hayashi Minoru , Misaki Yohji
Published: May 2024

Derivatives of a 1,3-dithiole[6]dendralene analog with two thiophene spacers inserted (2) have been successfully synthesized. Cyclic voltammetry and spectroelectrochemistry revealed that their redox behavior, based on the distribution of the positive charges, differed depending on the position and the electronic effect of substituents on the 1,3-dithiole rings.
The Collected Writings of Richard Ferdinand Kahn
Authors: Howson Susan
Published: May 2024

Richard Kahn published three books in his lifetime, the second one his Selected Essays on Employment and Growth (Cambridge University Press 1972). Now Maria Cristina Marcuzzo and Paolo Paesani have edited Richard F. Kahn: Collected Economic Essays (Palgrave Macmillan 2023) intended to complement Kahn’s own collection. As well as comparing the two volumes and some of Kahn’s writings not included in either collection, this review article considers how far the two volumes together reflect Kahn’s achievements in his life and academic career.
How Best to Be Egyptian? The “Honorable Citizen” and the Making of the Counter-revolutionary Subject
Authors: Abdelhamid Amira
Published: May 2024

Despite growing interest in studying counter-revolution in Egypt, scholars have neglected the ways in which the regulation of normativity governs conduct and discourages resistance. This article argues that discourses of normativity in Egypt have produced counter-revolutionary subjectivities, without whom the counter-revolution could not have succeeded. These subjectivities are constructed through the mobilization of normal/deviant binary logics, which are encapsulated in the normative figure of the honorable citizen. I suggest that the honorable citizen—which informs how best to be Egyptian—is a contradictory figure that is made possible by the ongoing interaction between (post)colonial and neoliberal governing rationalities. By employing Foucault’s work on governmentality, and Cynthia Weber’s queer analysis of figuration, I conceptualize normal/deviant logics through what I call counter-revolutionary governmentality (CRG). CRG reduces the originality of Egyptian resistance by associating it with the desire to be Westernized and constructs revolutionary aspirations as a threat to sovereignty. I argue that figurations of normative “Egyptianness” fortify Egypt’s “backwardness” in contemporary international orderings of progressive versus backward states and maintain international hierarchies that privilege Western modes of socio-economic and political organization. Such maintenance is not only the work of the global North but is also reproduced in the South.
Using large language models for safety-related table summarization in clinical study reports
Authors: Landman Rogier , Healey Sean P , Loprinzo Vittorio , Kochendoerfer Ulrike , Winnier Angela Russell , Henstock Peter V , Lin Wenyi , Chen Aqiu , Rajendran Arthi , Penshanwar Sushant , Khan Sheraz , Madhavan Subha
Published: May 2024

Objectives

The generation of structured documents for clinical trials is a promising application of large language models (LLMs). We share opportunities, insights, and challenges from a competitive challenge that used LLMs for automating clinical trial documentation.

Materials and Methods

As part of a challenge initiated by Pfizer (organizer), several teams (participant) created a pilot for generating summaries of safety tables for clinical study reports (CSRs). Our evaluation framework used automated metrics and expert reviews to assess the quality of AI-generated documents.

Results

The comparative analysis revealed differences in performance across solutions, particularly in factual accuracy and lean writing. Most participants employed prompt engineering with generative pre-trained transformer (GPT) models.

Discussion

We discuss areas for improvement, including better ingestion of tables, addition of context and fine-tuning.

Conclusion

The challenge results demonstrate the potential of LLMs in automating table summarization in CSRs while also revealing the importance of human involvement and continued research to optimize this technology.
Debiased inference for a covariate-adjusted regression function
Authors: Takatsu Kenta , Westling Ted
Published: May 2024

In this article, we study nonparametric inference for a covariate-adjusted regression function. This parameter captures the average association between a continuous exposure and an outcome after adjusting for other covariates. Under certain causal conditions, it also corresponds to the average outcome had all units been assigned to a specific exposure level, known as the causal dose–response curve. We propose a debiased local linear estimator of the covariate-adjusted regression function and demonstrate that our estimator converges pointwise to a mean-zero normal limit distribution. We use this result to construct asymptotically valid confidence intervals for function values and differences thereof. In addition, we use approximation results for the distribution of the supremum of an empirical process to construct asymptotically valid uniform confidence bands. Our methods do not require undersmoothing, permit the use of data-adaptive estimators of nuisance functions, and our estimator attains the optimal rate of convergence for a twice differentiable regression function. We illustrate the practical performance of our estimator using numerical studies and an analysis of the effect of air pollution exposure on cardiovascular mortality.
Atypical presentation of an epiphrenic esophageal diverticulum 20 years post fundoplication: a case report and review
Authors: Tasabehji Dana , Jarrah Mohammad , Mokadem Mohamad
Published: May 2024

Esophageal diverticulum is a rare condition characterized by the herniation of the esophageal mucosa outside the esophageal wall. Here, we explore the prevalence of ED and its associated esophageal dysmotility. We also shed light on the potential impact of previous surgical interventions, such as Nissen’s fundoplication, on the development of ED. This manuscript presents the case of a 72-year-old woman with a history of Nissen’s fundoplication surgery who experienced worsening symptoms of dysphagia, heartburn and postprandial cough. Despite exhibiting a normal motility pattern, upper endoscopy revealed a large epiphrenic esophageal diverticulum. The patient underwent successful surgical resection with myotomy, resulting in the resolution of symptoms with no complications. This case highlights the rarity of symptomatic ED and the need to recognize it while choosing the optimal treatment modality.
Voluminous cervical polyp delivered: a case report
Authors: Marrakchi Salma , Bouanane Rania , Ez-zaky Sara , Taibi Ouiam , Aouadi Salma , Sassi Samia , Lakhdar Khaoula , El Hassouni Fatima , Allali Nazik , Chat Latifa , El Haddad Sihame
Published: May 2024

Cervical polyps are common gynecological findings, typically small and benign. However, larger polyps can mimic malignant neoplasms and pose diagnostic challenges. We present a case of a 40-year-old woman with a large cervical polyp, highlighting the critical role of radiological imaging in diagnosis and management. The lesion was successfully resected, with histological examination confirming a benign nature. This case underscores the necessity for careful evaluation of large cervical polyps to ensure accurate diagnosis and treatment.
Simultaneous surgery for coexisting heart disease and non-cardiac malignancy: assessment of feasibility in case series
Authors: Abdikarimov Anuar , Bekenova Aigerim , Nurmakhan Nazerke , Shayakhmetov Yerzhan , Tuganbekov Turlybek
Published: May 2024

We present case series of simultaneous surgery for coexisting cardiac and non-cardiac pathologies to evaluate the feasibility of the treatment. The retrospective analysis included 27 patients aged between 28 and 74 years. The most often heart diseases were coronary arterial disease and valve defects, and the most often heart surgery was coronary artery bypass grafting. The non-cardiac diseases included neoplasms in the abdominal cavity, urinary system, and chest organs. The average duration of surgery was 277 ± 87 minutes, blood loss 285 ± 182 ml. The in-hospital mortality was 0%, with median stay of 2 and 12 days in the intensive care unit (ICU) and emergency room, respectively. The 1 and 5-year survival rates were 85.7% and 76.2%, respectively. Simultaneous surgeries can be a treatment of choice for patients with cardiac pathology and concomitant neoplasm in abdominal, thoracic, or urinary system. This is the first such study conducted in the Central-Asian region and, in particular, in Kazakhstan.
The significance of a ‘T shaped’ incision for resection of giant mediastinal tumors: a case report
Authors: Pannu Manjinder Kaur , Ehrsam Jonas Peter , Schöb Othmar Markus , Inci Ilhan
Published: May 2024

A 37-year-old male, with a 5-year history of liposarcoma of the right thigh, was incidentally diagnosed with two huge thoracic metastases following a fall. One of these masses, measuring 22 cm, was located in the right chest apex, adjacent to a second 20 cm mass situated in the anterior mediastinum, partially invading the left chest. The patient underwent surgical intervention for mass resection that commenced with a hemi-clamshell incision, but was then extended by completing the lower median sternotomy in order to create a T shaped incision. This type of incision provides ample access for large mediastinal tumors that extensively extend into one side of the thoracic cavity, encompass the anterior mediastinum, and partially reach into the opposite cavity. It enhances visualization, facilitates access to vital organs, allows for precise surgical maneuvers, minimizes the risk of inadvertent tissue damage, and enables thorough oncological resection.
Localized conjunctival amyloidosis clinically presenting as pyogenic granuloma
Authors: Amir Amaar , Amir Baraa , Rabah Rola , Sheikh Salwa
Published: May 2024

Primary amyloidosis of the conjunctiva and eyelid is a rare and often misdiagnosed condition. It is characterized by the deposition of insoluble amyloid fibrils, which are misfolded proteins, in the body. Amyloidosis can be systemic or localized with different types of amyloid fibril proteins identified using mass spectrometry. Ocular involvement in amyloidosis can lead to corneal dystrophies, glaucoma, vitreous opacities, and other symptoms. Diagnosis involves clinical examination and histopathological assessment. Treatment options depend on the extent of involvement and may include surgical excision, glaucoma management, vitrectomy, or liver transplantation in rare cases. We present a rare case of localized conjunctival amyloidosis initially misdiagnosed as pyogenic granuloma, with clinical symptoms of ptosis, periorbital swelling, and conjunctival lesions. The patient underwent excision of the lesions, and subsequent evaluation did not reveal systemic amyloidosis. Ocular amyloidosis requires careful diagnosis and consideration of systemic involvement for appropriate management.
Nonunion after medial malleolar osteotomy in total ankle arthroplasties for severe varus deformity: a report of 3 cases
Authors: Okamura Gensuke , Hirao Makoto , Noguchi Takaaki , Etani Yuki , Ebina Kosuke , Miura Taihei , Tsuboi Hideki , Goshima Atsushi , Okada Seiji , Hashimoto Jun
Published: May 2024

Of the three ankles after total ankle arthroplasty (TAA) with medial malleolar osteotomy for severe varus deformity (talar varus tilt >10°), two failed in varus migration of the tibial component. In these two cases, tibial osteotomy was performed with varus alignment of 5°and 2°, and with medially shifted placement of tibial component, while one ankle showed no migratoin of prostheses after 5 years, even with nonunion. In this case, tibial osteotomy was performed with a valgus alignment of 4°. Internal fixation after medial malleolar osteotomy should be done for severe varus cases. Medially shifted placement of tibial component should be avoided. Fortunately, the failure did not occur in a case of valgus of the distal tibia. Valgus tibial osteotomy might help to reduce the collision of the talus against the medial malleolus.
Granulocyte colony-stimulating factor-producing lung cancer complicated with antiphospholipid antibody syndrome: a case report
Authors: Yoshino Ryusei , Nakatsubo Masaki , Ujiie Nanami , Yuzawa Sayaka , Ishida Kensuke , Kitada Masahiro
Published: May 2024

No reports on granulocyte colony-stimulating factor-producing lung cancer associated with antiphospholipid antibody syndrome. A 73-year-old man was referred to our department to undergo surgery for lung cancer in the right upper lobe. His examination results suggested that his condition was caused by an elevated white blood cell count and an increased inflammatory response due to granulocyte colony-stimulating factor production. The presence of antiphospholipid antibody syndrome was suspected, and the decrease in coagulation factors was considered to be inhibited by the lupus anticoagulant. Perioperatively, the patient was treated with heparin and steroids, and a thoracoscopically assisted right upper lobectomy was performed. Postoperatively, histopathological examination revealed pleomorphic carcinoma, and the patient tested negative for anticardiolipin IgG antibodies. In lung cancer patients with elevated white blood cell counts, fever, and an inflammatory response, granulocyte colony-stimulating factor-producing lung cancer is an important differential diagnosis. Additionally, when coagulation abnormalities are observed preoperatively, a thorough examination is necessary to prepare for perioperative management.
Phlegmasia cerulea dolens after endovenous cyanoacrylate closure of incompetent small saphenous vein
Authors: Kawatani Yohei , Saitoh Hirofumi , Hori Takaki
Published: May 2024

A previously healthy 70-year-old woman underwent cyanoacrylate closure of an incompetent left small saphenous vein. Six days later, grade 2 treatment-induced thrombosis occurred at the sapheno-popliteal junction. Three days later, the patient presented with pale, cold pain in the left lower extremity. Diffuse thrombosis of the left lower extremity involved the small and great saphenous and deep veins. The patient was admitted and immediately administered heparin with anticoagulant factors, with symptoms began resolving 1 d later. The superficial vein thrombi were resolved. Although a deep venous thrombus remained, symptoms disappeared, and the patient was discharged.
Fixation of a chondral lateral femoral condyle fracture in a 13-year-old boy following patella dislocation using a new suture technique
Authors: Delniotis Ioannis , Leidinger Benedikt
Published: May 2024

Osteochondral or, even more rarely, purely chondral fractures of the lateral femoral condyle following patella dislocation in adolescents are relatively infrequent. Various fixation methods are described in the literature, ranging from traditional screws to bioabsorbable constructs or the use of anchors. Each method possesses its own advantages and limitations. Here, we present a case involving a 13-year-old boy with a large purely chondral fracture of the lateral femoral condyle after patella dislocation, initially overlooked. We introduce a cost-effective suture-bridge technique for the fixation of this fracture, which eliminates the need for a second operation and has yielded favorable outcomes. It is important to know that fractures of this type can be easily overlooked, necessitating a high index of suspicion and the utilization of advanced imaging techniques to prevent potential long-term catastrophic outcomes for the knee joint.
Chest
Authors: Suero Felipe F. , Mundi Gurpreet
Published: May 2024

This chapter discusses the anatomy of the lung, cardiac landmarks, and vascular anatomy of the chest. Murmurs indicate abnormal blood flow through the heart valves and can be detected by auscultation at specific precordial locations. Understanding the vascular anatomy of the chest is important for the anesthetic management of specific thoracic procedures.
Dermatome Anatomy
Authors: Shirey Derek , Matusic Bryan
Published: May 2024

Dermatomes, areas of skin in which a single spinal nerve root provides distinct sensory information, are critical anatomical regions which serve as a foundational aspect for anesthetic procedures. Detailed mapping of dermatomal anatomy allows for focused therapy involved in neuraxial anesthesia, interventional pain procedures, and regional nerve blocks. Additionally, a full understanding of dermatomal anatomy provides with the anesthesiologist a road map of the specific spinal nerve levels associated with anatomical landmarks throughout the body when delivering regional anesthesia to reduce pain in the operative and outpatient setting. Spinal nerve levels also define specific motor functions which are termed myotomes. Observation of specific muscle actions allows for identification of the spinal nerve level responsible for the production of the movement.
Brain and Skull
Authors: Liu Nathan , Malik Tariq M.
Published: May 2024

The chapter includes a brief overview of bones, vasculature, and general neuroanatomy. Anesthetic considerations of variability in skull or brain are included where appropriate. The term skull includes the cranium and mandible. The top of the cranium is called the cranial cavity, and the floor is the base of the skull. The facial skeleton includes the front of the skull with the mandible. The skull is composed of many flat bones connected by fibrous joints, which have many foramens for the entry and exit of vessels or nerves and many ridges which are from attachments from different muscles or ligamentous structures. The skull contains the brain along with an extensive network of vessels around it. The medulla becomes spinal cord once it leaves the foramen magnum. The cerebrospinal fluid (CSF) fills the space around the brain, and is mainly produced by the ventricles. The driving force for the circulation of the CSF is the pulsation of arteries within and around the brain. The CSF movement is more oscillatory in nature, rather than free-flowing.
Flow Velocity
Authors: Lennertz Richard
Published: May 2024

This chapter reviews basic concepts in fluid dynamics that are useful to the practice of anesthesiology. Laminar flow occurs when fluids flow in an orderly fashion without mixing. Turbulent flow involves mixing within the fluid and creates additional resistance to flow. The Reynolds number equation describes factors that promote turbulent versus laminar flow. Pouiselle’s Law describes factors that contribute to resistance regardless of the type of flow. Path diameter is the most important determinant of resistance. Increasing path diameter reduces resistance and increases flow. Increasing path length or fluid viscosity increases resistance and reduces flow. These concepts are particularly relevant in managing fluid resuscitation and partial airway obstruction.
Flowmeters
Authors: Mahboobi Sohail K. , Germani Mark L.
Published: May 2024

A traditional flowmeter is a glass tube, also called a Thorpe tube, with variable orifice and a flow measurement scale (graduations) marked on it. Inside there is a floating device, a ball or bobbin, to indicate the flow of gases. The function of the flowmeter is based primarily on physical principles. The annular space around the bobbin is tubular at low flow rates with laminar flow, and viscosity determining the gas flow, as described by Poiseuille’s law. At high flow rates, the annular space simulates an orifice, creating turbulent gas flow. This turbulent flow depends primarily on the density of the gas, as described by Graham’s law. Flow across the annular space results in a constant pressure drop which equilibrates with gravitational force, allowing quantification of the flow, since increasing flows cause the pressure drop to occur over increasing cross-sectional areas. Safety systems include color and touch coding and a hypoxic guard system, which prevents administration of hypoxic mixtures either electronically, mechanically, or pneumatically. Limitations include faulty connections and pipeline crossovers.
Uptake and Elimination Curves
Authors: Levin Lora B.
Published: May 2024

Volatile anesthetic uptake and elimination curves graphically demonstrate the speed of induction and emergence from anesthesia. Changes in the alveolar concentration of volatile anesthetics as compared to the inspired concentration (FA/FI) plotted against time demonstrate relative anesthestic uptake. Changes in alveolar concentration of anesthetics as compated to the inspired concentration when gases are discontinued (FA/FA0) plotted against time demonstrate the elimination of anesthetic gases. Changes in the uptake and elimination curves demonstrate how different volatile anesthetic factors, as well as physical and physiologic factors, can speed up or slow down induction and emergence.
Nitrous Oxides and Closed Spaces
Authors: Ahmed Muhammad Fayyaz , Chuba Emuejevoke
Published: May 2024

Nitrous oxide is a colorless, sweet-smelling, tasteless gas used as an adjunct to other volatile or intravenous anesthetic for balanced general anesthesia. It has a very high MAC of 104% and hence it cannot be used as a sole anesthetic. It is commonly used as a supplement for analgesia. Nitrous oxide is 30 times more soluble than nitrogen in blood, and it can diffuse to closed spaces and can lead to detrimental effects. It is vital to understand the properties of nitrous oxide and the potential effect on certain surgeries to ensure safe application.
Neuromuscular Function
Authors: Shah Nimit K. , Gwam Chike
Published: May 2024

Postoperative residual neuromuscular blockade remains a frequent occurrence after administration of neuromuscular blocking agent (NMBA), even after a single dose of intermediate-acting NMBA. There is increasing evidence that these can lead to postoperative pulmonary complications and increased postoperative morbidity and mortality. Several anesthesia societies now recommend quantitative neuromuscular function monitoring during anesthesia when NMBA is used to decrease the incidence of postop residual neuromuscular blockade. Neuromuscular function is monitored in 3 ways: (1) clinical evaluation for performing tests such as 5 s head lift, ability to cough, good grip strength, etc. (2) qualitative monitoring in which the strength of a muscle contraction following a nerve stimulus given by a peripheral nerve stimulator is subjectively evaluated visually or tactilely, and (3) quantitative neuromuscular monitoring in which neuromuscular function is objectively assessed by monitors which give a numerical value of the evoked response following a nerve stimulation. Several studies have shown that the clinical evaluation and qualitative monitoring are both unreliable in excluding residual neuromuscular block (NMB) completely. A TOFR >0.9 should be obtained by quantitative monitoring before tracheal extubation, as this is the only way of assuring adequate recovery of neuromuscular function. A peripheral nerve stimulator uses single twitch, TOF, tetanic stimulation, PTC, and DBS patterns of stimulation. A quantitative monitor employs electromyography, acceleromyography, and other techniques and most commonly gives TOFR as a measure of residual blockade.
Statistics and Simple Math in Anesthesia Practice
Authors: Scott Stayner R. , Ferguson Kris
Published: May 2024

Statistical methods are used to help validate the conclusions drawn by authors who report on studies published in medical and scientific journals. An understanding of basic statistical methods is necessary to independently assess the quality of research data and conclusions presented at conferences, in journal articles, and in independent research. Basic understanding of the types of data that can be analyzed, the types of statistical tests that can be used for data analysis, how to determine the quality of the data, and conclusions that can be made based on the data collected are necessary to effectively incorporate new medical and scientific findings into medical practice.
Termination of Drug Action
Authors: Parker Nicholas M.
Published: May 2024

Termination of a drug’s action usually depends on the drug being pulled from the site of action down a concentration gradient into the blood. Drug clearance from the blood may then occur via biotransformation (enzymatic chemical change to the drug molecule), active efflux, passive elimination, or any combination of the three. Lipophilic drugs can accumulate significantly in peripheral tissues, creating a reservoir that can shorten or lengthen the duration of action depending on the context. A multitude of factors in the operating room may affect the duration of drug action, including hypotension, drug interactions, fluid shifts, and the length of surgery.
Impact of Hepatic Disease
Authors: Zubair Muhammad Haseeb , Ranieri Aladino De
Published: May 2024

The liver is the predominant site of metabolism for nearly all drugs absorbed from the gastrointestinal tract, and the role of hepatic system is not limited to glucose metabolism, protein synthesis, and functioning as a blood reservoir, but also functions to metabolically transform various drugs into either active and inactive forms. The hepatic system is connected to the heart via the hepatic arteries, which draws two-third of the blood from the spleen, pancreas, and stomach. Phase I and phase II reactions govern most drug metabolism. The substrates of the cytochrome enzyme system, along with their inducers and inhibitors, can aid in anesthetic management of patients with liver disease. Thus an understanding of hepatic physiology and pathology is critical to the anesthetic management of the patient.
Drug-Drug Binding
Authors: Ozinga John , Knezevic Nebojsa Nick
Published: May 2024

This chapter discusses the main concept of drug-drug binding, defining the key elements of drug-drug interaction such as affinity, potency, different types of dose-response curves, etc. Knowledge of whether the drug is a full or partial agonist, and whether antagonism is competitive or noncompetitive is requisite prior to drug administration. Furthermore, the pharmacodynamic profile of a drug is an important variable when evaluating concentration-dependent effects of that drug. Being aware of pharmacodynamic drug-drug interactions, based on drug-drug binding and different types of synergism and antagonism, is an essential part of anesthesia practice.