bluuebunny/crossref_metadata_2025 huggingface dataset:
Prospects of Direct Evapotranspiration Measurements for the Immediate Societal benefits
Authors: Griessbaum Frank , Fratini Gerardo , Gerot Katie , McCoy Johnathan , Miller Bill , Walbridge Ryan , Frodyma Alex , Fuhrman Isaac , Parr Andrew , Trutna Derek , Burba George
Published: February 2023

Over the last 30 years, dozens of networks of eddy covariance flux stations have been introduced in different countries and continents around the world. Many of them, such as the ICOS network in Europe or the AmeriFlux network in the US, have a specific focus on greenhouse gas measurement focus, mainly CO2, but in all cases, the latent heat flux is concurrently measured as a required variable, thus actual evapotranspiration can be derived.This important hydrologic parameter is needed both in rainfed and irrigated areas to monitor drought conditions, and soil water balance as well as to determine irrigation water amounts to be applied to crops and the timing of optimal fertilizer applications. Quasi-real-time measurements of actual evapotranspiration can be used by water managers, crop consultants, and producers in both rainfed and irrigated agriculture, reducing water and energy use and associated expenses, ultimately helping increase the efficiency of global food production while reducing its costs. So, the importance of providing freely available, scientific-grade data is imperative.The cutting-edge technologies to assess water use on leaf-level to ecosystem-level scales has been actively developed in academia for past 40 years. One example of such technologies is a next-generation fully-automated evapotranspiration station network, to effectively and efficiently handle the “big data” on water use coming from a grid of measurement stations providing high spatial and temporal coverage of water usage on multiple scales, ranging from a single watershed to a region, state, or a continent.This presentation aims to provide multiple examples, and validations against existing standards, of the latest technology, hardware, and scientific method behind the eddy covariance approach to direct, field-scale, unattended, and automated measurements of evapotranspiration.
Clustering aggregation model for statistical forecasting of multiphase flow problems
Authors: Liao Qinzhuo
Published: February 2023

Reservoir simulations often require statistical predictions to quantify production uncertainty or assess potential risks. Most existing uncertainty quantification procedures aim to decompose the input random field into independent random variables if the correlation scale is small compared to the domain size. In this work, we develop a K-means-based aggregation model, for efficiently estimating multiphase flow performance in multiple geological realizations. This approach performs a number of single-phase flow simulations and uses K-means clustering to select only a few representatives on which multiphase flow simulations are performed. In addition, an empirical model is then employed to describe the relationship between the single-phase solution and the multiphase solution using these representatives. Finally, the multiphase solution in all realizations can be easily predicted using empirical models. The method is applicable to both 2D and 3D synthetic models and has been shown to perform well in the trusted interval of productivity, and probability distribution as indicated by the cumulative density function. It is able to capture a large number of ensemble statistical realizations of Monte Carlo simulation results with significantly reduced computational cost.
New analysis of diurnal and seasonal variations in fair-weather atmospheric potential gradient and cloud condensation nuclei measured in S. Kalinowski Geophysical Observatory in Świder, Poland
Authors: Pawlak Izabela , Kępski Daniel , Tacza Jose , Odzimek Anna
Published: February 2023

The ground-level atmospheric potential gradient (PG) has been measured with a radioactive collector method in Stanislaw Kalinowski Geophysical Observatory in Świder, Poland, for several decades. The observations have been previously analysed by Kubicki et al. (ICAE 2003, ICAE 2007) revealing rather typical behaviour in the diurnal and seasonal variations of the PG of a land station controlled by pollution. Electric field measurements at such station usually show a maximum at local winter months which are mostly affected by anthropogenic pollution. The whole series has been newly analysed to describe the Świder PG variations in greater detail, also in connection with an analysis of simultaneous measurements of cloud condensation nuclei. Fair-weather potential gradient course is calculated in different time scales (annual, seasonal and diurnal) with taking into account local meteorological and air pollution conditions. An attempt is made to calculate the diurnal and seasonal variations at very low cloud condensation nuclei counts. The work is supported by Poland National Science Centre grant no 2021/41/B/ST10/04448.
Dust fertilization: Measurements of CO2 sequestration by coral reefs in the Gulf of Eilat, Israel after atmospheric dust loading.
Authors: McGowan Hamish , Lensky Nadav , Abir Shai , Shaked Yonathan , Wurgaft Eyal
Published: February 2023

Coral reefs are complex biophysical, geochemical and hydrodynamic marine environments impacted by meteorological processes. In continental coastal and oceanic locations bordering or downwind of dust source areas, coral reefs are affected by the deposition of dust. Dust may supply nanomolar amounts of nitrate and essential bio-elements including iron, manganese, zinc and copper from natural, industrial and agricultural processes to coral reefs; in turn these are absorbed by the coral algae symbionts, thereby enhancing chlorophyll concentrations. This fertilization of coral reefs by dust increases photosynthesis which lowers the aqueous CO2 partial pressure relative to the overlying air. If this causes a reversal of the coral reef water to air CO2 gradient, then a coral reef will switch from a source to sink of CO2.Here we present the first direct measurements of air-sea CO2 exchange measured by an eddy covariance tower exclusively over the fringing coral reefs in the Gulf of Eilat, Israel. These show a strong relationship to atmospheric dust load entrained from the surrounding hyper-arid deserts in Israel, Saudi Arabia and North Africa. The coral reefs became CO2 sinks most notably during episodes of moderate to high atmospheric dust load. We conclude that the coral reefs in the Gulf of Eilat are net sinks of atmospheric CO2 due to the deposition of dust and suggest that direct measurements of air – sea CO2 exchange are required over coral reefs in other locations impacted by dust to increase accuracy of marine and global carbon budgets.          
Asymmetry of valley systems of the northern and southern slopes of the Flysch Carpathians in the light of geomorphometric analyses
Authors: Derii Anastasiia
Published: February 2023

The asymmetry of slope of the opposing inclinations of the Eastern Carpathians is a regularity that was recognised over 100 years ago (after Jahn 1992). It is particularly well visible in the Bieszczady Mountains, where the southern slope is steeper than the northern slope and the erosion base of the southern slope is 100 m lower than the erosion base of the northern slope. Previous studies have not exhausted the possibilities of characterising this asymmetry, and contemporary analyses make it possible to refine and verify the theses put forward by previous researchers.  The research is supported by the availability of relatively new sources of data from laser scanning of the Earth's surface, with much greater accuracy than ever before. These data are available for both the N-Polish and S-Slovakian slopes. Their analysis is enabled by modern tools and methods of Geographical Information Systems (GIS). The execution of all measurements and calculations will be automated and much more accurate compared to previous measurements on topographic maps.The paper will present selected morphometric parameters to determine differences in relief under the influence of asymmetry in the erosion base. The selection of surface units for the analysis of asymmetry will be addressed. Preliminary results of morphometric analysis for mesoregions will be shown: Beskid Niski, Nízke Beskydy, Bieszczady, Poloniny.
An approach to refining the ground meteorological observation stations for improving PM2.5 forecasts in Beijing-Tianjin-Hebei region
Authors: Yang Lichao , Duan Wansuo , Wang Zifa
Published: February 2023

Abstract. The paper investigates how to refine the ground meteorological observation network for greatly improving the PM2.5 concentration forecasts by identifying the sensitive areas for targeted observations associated with a total of 48 forecasts in eight heavy haze events during the years of 2016–2018 over the Beijing-Tianjin-Hebei (BTH) region. The conditional non-linear optimal perturbation (CNOP) method is adopted to determine the sensitive area of the surface meteorological fields for each forecast and a total of 48 CNOP-type errors are obtained including wind, temperature, and water vapor mixing ratio components. It is found that, although all the sensitive areas tend to locate within and/or surrounding the BTH region, their specific distributions are dependent on the events and the start times of the forecasts. Based on these sensitive areas, the current ground meteorological stations within and surrounding the BTH region are refined to form a cost-effective observation network, which makes the relevant PM2.5 forecasts starting from different initial times for varying events assimilate fewer observations but overall achieve the forecasting skill comparable to, even higher than that obtained by assimilating all ground station observations. This network sheds light on that some of the current ground stations within and surrounding the BTH region are very useless for improving the PM2.5 forecasts in the BTH region and can be greatly scattered to avoid the thankless work.
Seismic amplitude response to internal heterogeneity of mass-transport deposits
Authors: Ford Jonathan , Camerlenghi Angelo , Zolezzi Francesca , Calarco Marilena
Published: February 2023

Abstract. Compared to unfailed sediments, mass-transport deposits are often characterised by a low-amplitude response in single-channel seismic reflection images.
This “acoustic transparency” amplitude signature is widely used to delineate mass-transport deposits and is conventionally interpreted as a lack of coherent internal reflectivity due to a loss of preserved internal structure caused by mass-transport processes.
In this study we examine the variation in the single-channel seismic response with changing heterogeneity using synthetic 2-D elastic seismic modelling.
We model the internal structure of mass-transport deposits as a two-component random medium, using the lateral correlation length (ax) as a proxy for the degree of internal deformation.
The average internal reflectivity is held approximately constant with increasing deformation by fixing the two component sediment lithologies to have realistic P-wave velocity and density based on sediment core measurements from the study area.
For a controlled single-source synthetic model a reduction in observed amplitude with reduced ax is consistently observed across a range of vertical correlation lengths (az).
For typical autonomous underwater vehicle (AUV) sub-bottom profiler acquisition parameters, in a simulated mass-transport deposit with realistic geostatistical properties, we find that when ax≈1 m, recorded seismic amplitudes are, on average, reduced by ∼25 % relative to unfailed sediments (ax≫103 m).
We also observe that deformation significantly larger than core scale (ax>0.1 m) can generate a significant amplitude decrease.
These synthetic modelling results should discourage interpretation of the internal structure of mass-transport deposits based on seismic amplitudes alone, as acoustically transparent mass-transport deposits may still preserve coherent, metre-scale internal structure.
In addition, the minimum scale of heterogeneity required to produce a significant reduction in seismic amplitudes is likely much larger than the typical diameter of sediment cores, meaning that acoustically transparent mass-transport deposits may still appear well stratified and undeformed at core scale.
De Consideratione ad Eugenium Papam: un programa de re-espiritualización del pontificado
Authors: García-Lomas Gago Luis Javier
Published: February 2023

El presente texto pretende mostrar, como contraposición a la figura del papa como Typus Moysi, el retrato del pontífice ideal que presenta Bernardo de Claraval en su escrito De Consideratione ad Eugenium Papam, escrito para Eugenio III. En él, Bernardo dibuja un retrato del papado más preocupado por el autoconocimiento y la práctica de la virtud (en línea con la tradición platónico-agustiniana) que por afirmar su autoridad sobre los poderes seculares. La virtud de la consideración es propuesta por Bernardo como un camino hacia un ejercicio de la autoridad en clave de servicio. Un análisis del texto bernardiano muestra que, aunque participa de la tesis medieval de las dos espadas, la ubica en un contexto donde el aspecto espiritual prima frente a lo político y lo organizativo. La tesis de las dos espadas, buen reflejo de los desplazamientos del agustinismo político durante la Edad Media, encuentra así un marco interpretativo más adecuado que proporciona una alternativa a las pretensiones mostradas por Eugenio IV en su bula de 1439.
Resenha: SAPIRO, Gisèle. É possível dissociar a obra do autor? Tradução de Juçara Valentino. Belo Horizonte: Moinhos, 2022. 184p.
Authors: Campagnoli Karina Regalio , Floriano Jaine dos Santos
Published: February 2023

Resenha (Book review) do livro "É possível dissociar a obra do autor?", de Gisèle Sapiro.
Relationship Between Knowledge With The Implementation Of Reproductive Organs Care
Authors: Roslianti Elis , Srinayanti Yanti , Susilawati Susi , Fitriani Ade
Published: February 2023

According to WHO, reproductive health is a state of complete physical, mental and social well-being, not only free from disease or disability in all aspects related to the reproductive system, its functions and processes. Reproductive health is related to the cleanliness of the organs. Reproductive organs are very important to maintain cleanliness, it is also necessary to pay attention to how to maintain and care for them properly and correctly, especially in women. Women have reproductive systems that are sensitive to disease. Objective of This study aims to analyze the relationship between knowledge and the implementation of reproductive organ care in STIKes Muhammadiyah Ciamis S1 Nursing Study Program students. This type of research is an analytical survey with a Cross Sectional approach. The population in this study were second and third level students of the S1 Nursing Study Program at STIKes Muhammadiyah Ciamis. Samples were taken as many as 55 respondents using purposive sampling technique. The data collected consisted of primary data obtained through questionnaire sheets and direct observation and statistical analysis using Chi - Square.The results of the study: There is a relationship between knowledge and the implementation of reproductive organ care. With the Chi Square test, it can be concluded that the P Value of 0.007 <0.05, it can be concluded that Ho is rejected, which means that there is a significant relationship between knowledge and the implementation of reproductive organ care for undergraduate students of STIKes Muhammadiyah Ciamis.
The Relationship of Stimulation By People To The Development Of Toddlers: Literature Review
Authors: Nurherliyany Metty , Rahayu Yuyun , Yogari Agiv
Published: February 2023

Background: Development (development) is a change that is quantitative and qualitative. Development is the increase (skill) structure and function of the body that is more complex, in a regular and predictable pattern. Stimulation of development is very important in child development and is the forerunner of the learning process of children in the form of educating and training. Children who get targeted and regular stimulation will develop faster than children who are less stimulated. the act of providing stimulation to the child is to help the child achieve the optimal level of development or as expected.

Objective: To determine the effect of elderly exercise on pain scale in patients with rheumatoid arthritis at the Ciamis Public Health Center

Method: The method used in this literature review is a search sourced from an electronic data base including DOAJ and Google Scholar from 2015-2020 using 15 journals related to parent stimulation, toddler development, the relationship of parent stimula to the development of a toddler. The results of the literature review indicate that there is a relationship between parent stimula on the development of a toddler.

Result: The results of the literature review indicate that there is a relationship between parent stimula on the development of a toddler. Based on 15 analyzed journals obtained by researchers, stated that growth stimulation is a factor influencing toddler development. The interaction between the environment and stimuli can help the brain develop neurological structures.

Conclusion: Based on studies from all journals, it states that there is a relationship of stimulation provided by parents to toddlers on their development
Relationship between the use of ATS and the level of satisfaction of the family of patients in the emergency room at the Banjar City Hospital
Authors: Aprilia Rohman Asri , Ginanjar Yoga
Published: February 2023

The Australasian Triage Scale (ATS) method is one of several triage systems used in Indonesia for the assessment of clinical emergencies. Emergency Department (IGD) as the leading service provider also takes part in the realization of hospital customer satisfaction. Siboro (2014) says that customer satisfaction is determined by the whole series of services, including patient registration/admission, doctors, nurses, food, medicines, facilities and equipment, hospital physical facilities and administrative services (Siboro, 2014). Based on information compiled by Warta Priangan on March 15, 2019, a Banjar resident complained about the service at the Emergency Room at Banjar City Hospital. One of the patient's families admitted that they were disappointed with the government hospital services due to the lack of response from nurses and doctors in dealing with their sick child. These complaints indicate that patients are not satisfied with nursing services and can affect the quality of hospital services. The purpose of this study was to determine the relationship between the use of ATS triage and the level of patient satisfaction in the ER at the Banjar City Hospital. The type of research used is a descriptive correlation design with a cross-sectional design which aims to determine the relationship between the variables studied. The total population is 19,661 people. The sampling technique of Non-Probability Sampling is accidental sampling with a sample size of 99 people. The instrument in this study used a questionnaire. The results of hypothesis testing using the chi-square obtained p-value of 0.000, smaller than 0.05, which means Ho is rejected and Ha is accepted so the decision is that there is a relationship between the use of ATS and the level of satisfaction of the patient's family in the Emergency Room of the Banjar City Hospital
Overview Of Family Emotional And Instrumental Support Of Schhizophrenic Patients With Social Isolation
Authors: Nurherliyany Metty , Rahmana Septian Try , Rosmiati Rosmiati
Published: February 2023

Background: Schizophrenia is a persistent psychotic disorder that includes disturbances in behavior, emotions, and perceptions. Symptoms of schizophrenia are social isolation. Social isolation is the state of an individual experiencing a decline or even being completely unable to interact with other people around him. The physical impact of patients with social isolation if not addressed will cause more serious problems including; self-care deficits, and hallucinations which can eventually lead to violent behavior and suicidal actions. Family support or the role of the family in educating family members greatly influences the occurrence or absence of mental disorders. Objective: This study aims to describe the family's emotional and instrumental support for schizophrenic patients with social isolation in the work area of the Ciamis Health Center in 2020. Method: The research method used is descriptive. The population in this study were families of schizophrenic patients with social isolation disorders in the Work Area of the Ciamis Health Center as many as 15 people. Samples were taken using the total sampling technique. Result: The results showed that most of the emotional support in schizophrenic patients with social isolation was categorized as unsupportive by as many as 9 people (60%) and instrumental support in schizophrenic patients with social isolation was mostly categorized as unsupportive by as many as 8 people (53.3%).
Conclusion: description of emotional support and instrumental support in schizophrenic patients with social isolation in the Work Area of the Ciamis Health Center, most of which are categorized as not supportive.
Relationship Of Personal Hygiene by Nurses With Patient Satisfaction In Intensive Care Unit at Ciamis Hospital
Authors: Roslianti Elis , Apipudin Aap , Hendriyana Yuda , Fitriani Ade , Hidayat Nur
Published: February 2023

The impact of patients who do not receive personal hygiene is that patients are susceptible to skin diseases, infectious diseases, and gastrointestinal diseases and there is a possibility that patients are exposed to nosocomial infections. As a result, patients are not satisfied and have a bad view of the quality of hospital services. Fulfillment of patient personal hygiene by nurses can lead to patient satisfaction which has an impact on good stigma in services. Patient dissatisfaction with hospital services can be caused by not getting basic services such as personal hygiene by nurses and only be charged to the family. As a result, the stigma of hospital services will be bad. Quantitative analytical research method using a cross-sectional approach. The number of samples was as many as 20 people with a sampling technique using an accidental sampling technique taken from ICU patients at Ciamis Hospital. The results of the research on the relationship of personal hygiene by nurses with patient satisfaction in the ICU room at Ciamis Hospital, the results of the Correlations statistical test showed a significant value of p-value = 0.000. personal hygiene by nurses in the ICU RSUD Ciamis obtained the highest frequency, namely the good category as many as 19 respondents (95%), and the lowest frequency, namely the unfavorable category, with as many as 1 respondent (5%). ICU patient satisfaction at RSUD Ciamis obtained the highest frequency, namely the satisfied category of 19 respondents (95%), and the lowest frequency was the dissatisfied category of 1 respondent (5%). Conclusion Based on the results of the Correlations statistical test, it showed a significant value of p-value = 0.000. So it can be concluded that there is a relationship between the personal hygiene of nurses on patient satisfaction.
Effect Of Prenatal Yoga On Third Trimester Pregnant Women’s to Reduce Anxiety
Authors: Taviyanda Dian , Richard Selvia David , Filipus Agnes Martha
Published: February 2023

Objective : Forms of anxiety experienced by third trimester mothers include doubts about being able to give birth normally, smooth delivery, fear of not being able to withstand the pain experienced during childbirth, condition of the baby being born, delivery not as desired, condition of the mother after giving birth, indirectly met her baby after giving birth, and received less attention from those around her. Prenatal Yoga is a non-pharmacological therapy in reducing anxiety in pregnant women. The purpose of the study was to determine the effectiveness of prenatal yoga in reducing anxiety in third trimester pregnant women in Bangsal RW 2 Kediri.

Method : The method used in this study was experimental. The study population was third trimester pregnant women. The number of samples in the study was 35 respondents. This research uses purposive sampling. The variables used were prenatal yoga and anxiety. Researchers used a measuring instrument in the form of an Anxiety Scale for Pregnant (ASP) questionnaire.

Result  : The results of the research on anxiety in third trimester pregnant women before being given heavy prenatal yoga were 25 respondents (71.4%), after being given prenatal yoga anxiety in third trimester mild pregnant women were 32 respondents (91.4%) with Wilcoxon test results p = 0.000.

Conclusion : The conclusion of this study is that prenatal yoga is very effective in reducing anxiety in third trimester pregnant women.
Relationship Of Mother's Knowledge Level With Basic Immunization Completeness In Children At Posyandu Bungatanjung Ciamis
Authors: Suhanda Suhanda , Rahayu Yuyun , Permatasari Elisa , El Haque Iif Taufiq , Gunawan Asep
Published: February 2023

Immunization is a program that is much needed in the prevention of various infectious diseases and avoiding disabilities and child mortality. One of the efforts carried out by the government is by providing counseling to mothers to bring their children to get immunizations, especially carrying out 5 Complete Basic Immunizations, namely Hepatitis B, BCG, Polio, DPT, Measles and also striving to ensure access to services in areas reached by work the same as across other sectors. This is to determine the relationship between the mother's level of knowledge and the completeness of basic immunization for children at the Bungatanjung Posyandu, Cigembor Village, the working area of the Ciamis Health Center. The research method in this study is to use quantitative research methods with a cross-sectional research design, a population of 47 mothers, and sampling using a total sampling method. The results of the study showed that there were 30 people (78.9%) in good category knowledge, 8 people in poor category knowledge (21.1%), 33 people (86.8%) who completed basic immunization in the complete category, and 5 incomplete categories. (13.2%) with a statistical p-value of 0.022. The conclusion of this study is that there is a significant relationship between the level of maternal knowledge and the completeness of basic immunizations for children at the Bungatanjung Posyandu, Cigembor Village, the working area of the Ciamis Health Center.
GEOGRAFIA: DIÁLOGOS SOBRE O COTIDIANO, ECONOMIA E A CIDADE
Authors:   Carlos Alexandre de Botolo,   Paulo Fernando Jurado da Silva
Published: February 2023

Este livro analisa, em especial, questões urbanas relativas aos espaços públicos da cidade de Montes Claros, em Minas Gerais, bem como as inerentes a alguns residenciais fechados da capital do Mato Grosso do Sul, Campo Grande. Para além disso, em uma escala mais ampla, têm-se diálogos no âmbito de Dourados-MS e Araxá-MG, atravessando contextos nos espaços brasileiros e dos países periféricos. Assim, os textos elaborados com base em pesquisas científicas refletem problemáticas acerca do cotidiano, da economia e de espaços urbanos. Neste sentido, apresenta-se a importância de reproduzir tais investigações e seus produtos.
Penyuluhan Manfaat Netiket pada Siswa-Siswi SMK Putra Mandiri Bangsa
Authors: Wandy Wandy , Catur Bhakti Muhammad Agni , Ayu Media Anugerah , Mantoro Teddy , Fikri Muhamad Rausyan
Published: February 2023

Populasi Indonesia yang besar menjadi pasar pengguna Telepon Seluler yang besar pula, di mana sebagian besarnya terkoneksi dengan Internet. Tipe perangkat yang terkoneksi dengan Internet kian beragam dengan harga yang juga kian terjangkau. Koneksi Internet yang cepat juga semakin terjangkau oleh pengguna. Ragam aplikasi untuk dapat berkomunikasi, bersosialisasi, dan berinteraksi semakin membentuk masyarakat pengguna yang semakin bergantung dengan teknologi ini. Diperlukan cukup edukasi kepada masyarakat untuk menggunakan teknologi ini dengan bijaksana, khususnya pada area beretika di Internet, mengingat konten yang tersebar dan terserap melalui Internet juga semakin cepat.Kata Kunci: Netiket, Internet, Media Sosial, Pesan Instan, Pengabdian kepada Masyarakat
Prevalence of Biomass Use and its Effect on the Respiratory Health of Women Residing in Eastern Terai Region of Nepal
Authors: Adhikar Puspanjali , Buddhacharya Matina , Jha Nilambar , Yadav Deepak Kumar
Published: February 2023

NA
Cardiovascular Fitness Assessment of Medical Students at Patan Academy of Health Sciences, Lalitpur, Nepal
Authors: Shakya Binnam , Byanju Jayandra , Maharjan Sanjay , Bhaila Archana
Published: February 2023

N/A
Synovial Chondromatosis of the Hip Joint: A Case Report
Authors: Duwal Shrestha Sailendra Kumar , Shrestha Mahendra Raj , Nepal Prabin , Maharjan Rajendra , Lamichhane Suman , Shrestha Kumar
Published: February 2023

N/A
Ethics, Moral Relativism and Moral Cognition
Authors: Acharya Jenash
Published: February 2023

N/A
Locoregional Anesthesia for Major Abdominal Surgeries during COVID-19 Outbreak: An Experience in a Tertiary Care Hospital of Kathmandu, Nepal
Authors: Basukala Sunil , Mishra Raveesh , Raj Gautam Alok , Basukala Bikram , Karki Saurav
Published: February 2023

Introduction: Locoregional Anesthesia (LA) has many benefits over general anaesthesia in major abdominal surgeries with high risks including avoidance of endotracheal intubation thus avoiding aerosol contamination during coronavirus disease 2019 (COVID-19).

Methods: A retrospective analysis was performed among patients undergone major abdominal surgery under loco regional anesthesia during April 2019 and March 2020 in 750 bedded tertiary care hospital during COVID- 19 pandemic. In all cases, locoregional anesthesia (spinal, epidural, or combined spinal-epidural anesthesia) was performed. Intraoperative and postoperative complications were monitored and was analyzed.

Results: A total of twenty-four cases were included during the study period. Among the cases, majority of cases belonged to Gastrointestinal, n=17(70.83%). The mean operative time was 94 minutes (minimum 55 minutes; maximum 168 minutes). None of the cases required conversion to general anesthesia. Postoperative pain was always well controlled. None of them required postoperative intensive care support. No perioperative major complications (Clavien–Dindo ≥3) occurred. Three cases were found to be infected with COVID -19 infection postoperatively.

Conclusion: Our study showed that major abdominal surgeries under loco regional anesthesia resulted feasible, safe, painless, and, in specific cases, was the only viable option. In such a pandemic, it could become a vital strategy to avoid contamination among Health care workers (HCWs) and could limit viral transmission inside theatres.
Economic Burden Associated with Neurocysticercosis at a Tertiary Care Neurological Center in Nepal
Authors: Acharya Samir , Rajbhandari Pravesh , Shrestha Resha , Dhakal Sudan , Shrestha Pranaya , Hari Gajuryal Sharad , Pant Basant
Published: February 2023

Introduction: Neurocysticercosis (NCC) is the most common parasitic disease of the central nervous system and is a major cause of epilepsy and neurological morbidity in humans in endemic areas of the world. This study was conducted to estimate economic burden of the paients due to Neurocysticercosis arriving at Tertiary Neurological center of Kathmandu,Nepal.

Methods: A cross sectional prospective study was conducted for 2 years among the patients with NCC at Tertiary Neurological Center in Kathmandu. Patients treatment plan and followup date were recorded and patient were categorized into four different groups depending on the frequency of followup and completion of treatment. Direct and indirect cost centers were catagorised and calculated accordingly. The cost was estimated in US dollar as of 2020.

Results: Out of 52 patients who were followed up completely for treatment, majority of patient were from age group 21-30 years . The total cost incurred for group 1, group 2, group 3 and group 4 were $468, $714, $ 1054 and $1986 respectively.The average cost per day for a patient with NCC was calculated to be $1.5.

Conclusion: This study suggests that Neurocysticercosis results in considerable monetary losses to patient in developing country like Nepal. The average loss of each individual accounted for around one half of per day capita income of Nepal. Various programs and poolicies shall be implemented to reduce the burden of NCC so as to reduce the economic burden associated to it.
Correlation between Serum Calcium and In-Patient Mortality among Patients with Hemorrhagic and Non-Hemorrhagic Cerebrovascular Disease
Authors: Gautam Rakshya , Mesina-Nepomuceno Belinda Lioba L. , Paudel Pratik
Published: February 2023

Introduction: Cerebrovascular disease is the second most frequent cause of death worldwide. This study was designed to access the correlation between ionized calcium and clinical outcomes of Cerebrovascular events.
Methods: The study included 225 cases diagnosed with cerebrovascular disease and undergone a CT scan. Calcium (ionized calcium) was measured within 1-2 hrs. Of sample collection. The time frame of the study was from December 2016 till December 2017.
Result: There were a total of 52 patients admitted as DVT, among which 26(50%) were male and 26(50%) were female. Twenty patients (38.5%) were COVID-19 positive and 32 (61.5%) were COVID-19 negative. Mean age for among those patients was 50.50±4.8 years, average hospital stay was 6.4±0.6 days, after anticoagulation therapy target INR was reached in 3.8±0.17 days and CVI was present in 14(70%) for COVID positive with DVT. Similarly, mean age was 46.80±3.3 years, average hospital stay was 4.6±0.3 days, after anticoagulation therapy target INR was reached in 3.3±0.21 days and CVI was present in 18(56.65%) with COVID negative with DVT.
Conclusion: Serum calcium was found to be associated with clinical outcome among stroke patients found to have infarction. High incidence of favourable clinical outcome among those who have normal level of serum calcium compared to those who have low serum calcium level was found.
An Audacious Voyage during COVID-19 Pandemic in Management of Patients with Aneurysmal Subarachnoid Hemorrhage at Annapurna Neurological Institute and Allied Sciences
Authors: Rajbhandari Pravesh , Kumar Yadav Jayant , Giri Shilpa , Shrestha Bishal , Kayastha Jessica , Shrestha Janam , Nepal Gopi , Gurung Pritam , Rajbhandari Reema , Shrestha Jitesh , Palikhe Anusha , Bahadur Karki Shambhu , Acharya Samir , Shrestha Resha , Dhakal Sudan , Hari Gajuryal Sharad , Shrestha Pranaya , Pant Basant
Published: February 2023

Introduction: Aneurysmal Subarachnoid Hemorrhage(SAH) is a neurosurgical emergency for which testing for COVID PCR was not an option and was unlikely to change the management of the case. Hence, all surgeries were performed without COVID PCR and Rapid Diagnostic Test (RDT) at our center for the welfare of the patient despite risks involved for the surgeons and supporting staff.

Methods: Data were collected retrospectively of all cerebral aneurysm patients who received treatment at Annapurna Neurological Institute and Allied Sciences during the covid pandemic between February 2020 to May 2021. Their demographic profile, clinical and imaging characteristics, treatment decision, postoperative complication, postoperative functional status in terms of Modified Rankin Scale were taken into consideration and analyzed.

Result: 63 patients were enrolled in study with patient age ranging from 9 years to 81 years. Male to female ratio was 1:3. Amongst them, 28% had hypertension. 82% underwent microsurgical clipping while three patients underwent coiling. Basilar Top aneurysm, Para clinoid aneurysm, PICA aneurysm underwent simple coiling. Wrapping, bypass and trapping were performed in 1,1, and 3 cases respectively. At the time of discharge, most of the patients (77%) achieved good functional recovery (mRS ≤ 2) while mortality was reported in 8% of patients. Based on our experience and limited dataset, posterior location of aneurysm, increasing HuntHess Grade and modified fisher grade had poor prognosis, related with degree of cerebral vasospasm, and delayed cerebral ischemia.

Conclusion: Results from our study showed outcomes in surgical patients with aneurysmal SAH at par with international standards. COVID pandemic although posed initial difficulties, with proper guidelines and protocols in place, we were able to perform the emergency surgeries without compromising our standards.
Correlation between White Blood Cell Count and Myocardial Infarction Mortality in Patients admitted at Tertiary Care Center of Philippines
Authors: Paudel Pratik , B. Lopez Mariano , Gautam Rakshya
Published: February 2023

Introduction: Coronary artery disease (CAD) continues to be a major cause of morbidity and mortality in developed as well as developing countries. This study aims to find out the correlation between elevated WBC and AMI mortality and also to enhance as an independent marker for higher risk for in-hospital patients which would finally help for risk stratification and better care for such presentation.

Methods: This is a retrospective research evaluating all adult patients with AMI who were admitted to Rizal Medical Center from January 1, 2016 to December 31, 2017. Clinical data were retrieved from the Medical Records Section and Department of Laboratory Medicine. Detailed history, physical examination and relevant investigations such as complete blood count and electrocardiographic results were reviewed. All data was managed by Microsoft Excel for windows and after collecting a sample size of 225 cases. Analysis was executed using SAS Software Version 9.3.

Results: Relationship existed between clinical outcome and white blood cell count. The patients with elevated WBC on comparison to patients with normal WBC had 3 times more risk of dying (discharged(5.8%)/died(18.7%), p value 0.028. The mean WBC for favourable clinical outcome was 11.87±4.85 S.D which is lower as compared to the poor clinical outcome averaged 13.87±6.20 S.D. (p .028 < .05).

Conclusion: The results indicate that patients with elevated white blood cell count would be more likely to have poor clinical outcome compared to patients who have normal white blood cell count. White blood cell count within 24 h of admission for an AMI is a strong and independent predictor of in-hospital mortality.
A Comparative Study of Cross Finger Flap with Thenar Flap for Finger Tip Reconstruction
Authors: Kumar Pradhan Suresh , Man Rai Shankar , Dahal Peeyush
Published: February 2023

Introduction: Fingertip injuries are common hand injuries ranging from simple laceration to larger defects with amputations. Different methods are used to reconstruct the affected finger. Cross finger flaps and thenar flaps are commonly used but it is difficult to select among these two flaps to reconstruct the finger in our settings.

Method: This is a time-bound prospective comparative study conducted in 14 months duration. The aesthetic (sensibility, appearance and function as subjective assessment) and functional outcomes (2 point discrimination and range of motion) were measured. Data were analyzed using SPSS version 21. Overall significance level was maintained at ‘p’ value < 0.05.

Results: There was female predisposition with average age of 34.66 years. The common mode of injury was crush injury with right hand most commonly involved hand and middle finger being commonly injured digit. On subjective assessment, the difference on rating scale on sensibility, function and appearance was not statistically significant among two groups. There were statistical significant differences in mean of static and moving 2 point discrimination among thenar flap and cross finger flap. . The mean active range of motion at three types of joint (MP, PIP, DIP) of finger were 97.660, 82.660 and 38.660 in thenar group and 88.330, 78.660 and 33.660 in cross finger group respectively which were not statistically significant.

Conclusion: Our study does not find any precise characteristics for the selection of thenar and cross finger flap based on aesthetic and functional outcomes in reconstruction of fingertip injury.
Engineering and Innovations in Neurosurgery
Authors: Dabadi Sambardhan , Dhungel Raju Raj , Acharya Saugat , Acharya Samir , Shrestha Janam , Dhakal Sudan
Published: February 2023

Introduction: Modern technology engineered and developed with artificial intelligence have significantly improved the nature of diagnosis and treatment of patients. Healthcare facility has changed significantly in the past few decades because of technological developments. Neurosurgery has been able to practise and enjoy a lot of technologically advanced tools in the past few decades. In context of Nepal, technologically sophisticated devices and tools ranging from neuro navigation, high speed cutting drills, intra operative neuro monitoring, deep brain stimulation, to high resolution magnetic resonance imaging are already introduced. In this paper, the literature review on currently available technologies used in neurosurgery, their significance in delivering a better health care and their usage in Nepal has been discussed.
Herbal Remedies in Cosmeceuticals Formulation: A Review on Nepalese Perspectives
Authors: Gyawali Rajendra , Narayan Paudel Prem
Published: February 2023

Introduction: The beauty product preparation from natural ingredients reaches is historical. People of rural area where the practice of modern cosmetic products are not accessible, they mostly use and depend upon the locally available ingredients in their own formulations. The inclusion of extracts in topical formulations can minimize the skin damage of oxidative stress, which has been associated with delaying the aging process. Therapeutic benefits by addition of plant-based active ingredients such as alpha-hydroxy acid, retinoic acid, ferulic acid, ascorbic acid, and coenzyme Q10 are common. Natural preservatives are also in priority but it is equally important to carry research for their efficacy and assurance.

Methods: An independent approach was used to conduct the literature review. Major well-known bibliometric information sources studied are the Web of Science, Scopus, Mendeley and Google Scholar. Several keywords like name of plants, skin whitening, anti-acne, herbal cosmetics, Ayurvedic herbs, skin cancer, moisturizer etc were chosen to obtain a large range of papers to be analyzed. Local news papers, research reports and official websites were also studied.

Results: The results obtained from this review showed that, there are numerous herbs which are effective and safe for cosmetic purpose. Herbal based cosmetic factories are started in Nepal but their research part not much strong and found frequently lead by non-pharmacist or non-chemist human resources. Herbs are rich in vitamins, phenolics and carotenoids which have mainly anti-aging, revitalizing and rejuvenating properties. Herbs have vitamins, saponins and flavanoids which supply various nutrients to hair and help to darkening of hair. Different literatures available prove that the heavy metals are also mixed in large quantity in cosmetics found in Nepalese market. There is an immediate need to execute strong guidelines regarding the quality of cosmetic products in Nepal.

Conclusions: The current review on herbal cosmetics focuses on the natural sources of cosmetics, their medicinal benefits, mechanism of action, key chemical constituents and their advantages along with safety.
Posterior Urethral Valves; Outcome Analysis after Endoscopic Valve Ablation
Authors: Kumar Sah Sanjay , Prasad Chaudhary Ramanandan , Silwal Shirish
Published: February 2023

Introduction: Posterior urethral valves, a major male infra-vesical obstructive uropathy leading to chronic renal failure are most common paediatric urological emergencies with an incidence of 1:5000 -1:8000. Early diagnosis, management and follow up of these patients is challenging in low socio-economic countries like Nepal. This study evaluates the cases with posterior urethral valves and their outcomes after endoscopic valve ablation over a period of five years.

Methods: In this five year retrospective study from January 2016 to December 2020, all the cases with posterior urethral valves undergoing endoscopic valve ablation were reviewed and data were analysed for age, presentation, diagnosis and outcome at follow-up after management.

Results: A total of sixty patients with posterior urethral valves were managed with definitive endoscopic ablation in the five year period. Median age at ablation was 11 months (10 days to 4 years). Commonest presentation was features of bladder outlet obstruction evident by poor stream, straining and dribbling of urine. Only 26.7% cases were managed in neonatal period due to low suspicion of valve in prenatal fetal scan. 83.3% of patients had complete relief from obstruction with normal urinary stream at follow up after ablation of valves with 15% of cases needing re-ablation of the residual valve. Two cases had to undergo anti-reflux surgery two years after valve ablation. Mortality was seen in one case due to cross sepsis. Majority of patients were in regular follow-up which showed its direct relationship to the outcome of the disease after valve ablation.

Conclusion: Early detection, proper relief of obstruction and regular follow-up strategies can avoid life threatening complications of posterior urethral valves. Only treating posterior urethral valves is not the aim of obtaining successful relief of obstruction. Parent’s education, developing prenatal ultrasound skills to detect or suspect prenatal PUVs and early referral to tertiary centers where these patients can be managed promptly are equally important.
From the Field into the Lab: Contribution of Traditional Knowledge to Modern Medicine
Authors: Uprety Yadav , Datta Bhattarai Hari
Published: February 2023

The contribution of traditional knowledge to modern medicine has been recognized as it provides valuable clues to the scientific community for drug discovery. Although western science was reluctant to recognize its contribution until recently, there is growing interest in traditional knowledge in recent years. There are well-established cases of traditional knowledge from around the world that have led to drug discovery. There is also a huge potential to explore this area in Nepal. In this short communication, we discussed some examples of traditional knowledge that are the source of clues for drug discovery, and also discussed the prospects of traditional knowledge and bioprospecting in Nepal. We hope that this brief article is of interest to readers outside the traditional knowledge and biodiversity domain.
Clinical Presentation and Predictors of Acute Coronary Syndrome: A Cross Sectional Study
Authors: Bista Madhab , Nepal Rajesh , Katuwal Sushant , Mehta Ram Kumar
Published: February 2023

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