bluuebunny/crossref_metadata_2025 huggingface dataset:
Isolated humeral metastasis in cervical cancer
Authors: Gioè Alessandro , Arciuolo Damiano , Carbone Vittoria , Zannoni Gianfranco , Gambacorta Maria Antonietta , Maccauro Giulio , Scambia Giovanni , Corrado Giacomo
Published: January 2023

There are a few reported cases of isolated localized metastasis to bone arising from cancer of uterine cervix in the literature. This is a case of uterine cervix cancer with isolated metastasis to the humerus. A 57-year-old female with a diagnosis of FIGO Stage IIB invasive squamous cell carcinoma of uterine cervix underwent neoadjuvant chemoradiation therapy (CRT) and radical surgery with complete pathological response. Nine months after the surgery, a total body positron emission tomography/computed tomography (PET/CT) scan documented a lesion localized in the proximal part of the right humerus, whereas no evidence of skeletal metastasis found elsewhere. The biopsy from the bone lesion showed a metastatic squamous cell carcinoma of the uterine cervix. A surgical excision of the humeral lesion plus chemotherapy and zoledronic acid was performed. After 9 months, the patient experienced liver metastases and died 2 months later. Bone metastasis is not so infrequent in patients with locally advanced cervical cancer. Total body PET/CT scan should be included in staging work up, and an appropriate treatment should have the primary objective of quality of life preservation.
Prevalence of Osteoporosis and Associated Risk Factors among Postmenopausal Women
Authors: Imran Mohammad , Singh Abhishek , Bhardwaj Anu , Agrawal Deepika
Published: January 2023

Context:

Prevalence statistics of postmenopausal osteoporosis and knowledge regarding its independent predictors are lacking, especially in India, where every third woman and every eighth man is suffering from it.

Aim:

This study aims to investigate the prevalence of osteoporosis and associated risk factors among postmenopausal women.

Study Settings and Design:

This was a hospital-based prospective cross-sectional study.

Methods:

This study was carried out among postmenopausal women, who attended orthopaedics outpatient department from August 2020 to July 2021 and 587 women ranging in age between 50 and 80 years who had confirmed menopause were enrolled for the study. Finally, 539 women were recommended for bone mineral density testing, using dual energy X-ray absorptiometry.

Statistical Analysis:

To analyze the differences between the groups, a Chi-square and Student’s t-test were used for the categorical and continuous variables, respectively. P < 0.05 was considered to show significant associations.

Results:

In our study, 54.7% of subjects belonged to <60 years of age group. Half of the subjects (51.9%) were illiterate. 37.7% of subjects were having 6 or more children. 14.5% of subjects were currently smoking or chewing tobacco. Age of menopause among 38.0% of subjects was after 50 years of age and duration of menopause at the time of enrolment in the study was more than 10 years in 48.8% of subjects. The prevalence of osteoporosis increased with the increase in the parity and increased number of abortions. Subjects with family history of symptoms related to osteoporosis, and fragility fracture; and self-history of fragility fracture had higher prevalence of osteoporosis (P < 0.05).

Conclusion:

In our study, the overall prevalence of osteoporotic fractures among postmenopausal females was 82.2% (osteoporosis: 37.5% and osteopenia: 44.7%). The findings of current study and previous studies clearly indicate the urgent need of collective efforts towards the growing problem of osteoporosis in postmenopausal women.
Leydig Cell Hyperplasia of Ovary – An Unusual Finding in Postneoadjuvant Chemotherapy Case of Primary Fallopian Tube Carcinoma
Authors: Chaturvedi Kriti , Rao Meenakshi , Saha Souvik , Vishnoi Jeewan Ram , Nalwa Aasma
Published: January 2023

A large number of high-grade serous ovarian carcinomas originate in the fallopian tubes. Neoadjuvant chemotherapy followed by surgery may lead to a number of chemotherapy-induced changes in the ovary, which may lead to an erroneous diagnosis. We present a rare case of a 55-year-old postmenopausal woman who was clinically diagnosed with carcinoma of the right ovary; on histopathologic evaluation after neoadjuvant chemotherapy, the primary site was found to be the right fallopian tube. The right ovary showed chemotherapy-related changes along with extensive Leydig cell hyperplasia. As the presence of Leydig cell hyperplasia in this setting is an unusual finding, it may pose a diagnostic dilemma for the pathologist; so an awareness of this entity is important to avoid misdiagnosis.
Epithelioid Leiomyosarcoma of the Uterus and the Diagnostic Challenge in Diagnosing it on Small Biopsy
Authors: Aden Durre , Zaheer Sufian , Singh Shruti , Ranga Sunil
Published: January 2023

Epithelioid leiomyosarcoma of the uterus is a rare soft-tissue tumor of the pelvis with <1% cases. It can be asymptomatic or can reach an enormous size, resulting in chronic pelvic pain, postmenopausal bleeding, or may cause bowel and bladder dysfunction. The diagnostic dilemma arises especially when they have epithelioid morphology. This case is being presented because of its rare incidence along with the diagnostic dilemma it presented due to epithelioid morphology which is a very rare presentation, especially challenging on small biopsies. This case also highlights the usefulness of immunohistochemical markers, such as WT1, p53, and p16, which has important diagnostic as well as prognostic values in rare variants of usual tumors. Leiomyosarcoma per se is a highly aggressive tumor, therefore, timely diagnosis and management are advised.
Evaluating Clinical Features in Intracavitary Uterine Pathologies among Vietnamese Women Presenting with Peri-and Postmenopausal Bleeding
Authors: Nguyen Phuc Nhon , Nguyen Van Tuan
Published: January 2023

Background:

Intracavitary uterine pathologies (IUPs) may be resulting in vaginal bleeding in perimenopausal and postmenopausal women. Especially, malignant disease needed to be investigated due to its adverse impact on the quality of mid-life women as well as the burden of health-care costs in low- and middle-income countries such as Vietnam.

Objective:

Thereby, through this study, we aimed to assess the major clinical features of IUPs in women with perimenopausal and postmenopausal bleeding women.

Materials and Methods:

This was a cross-sectional observational study at Hue University Hospital and Hue Central Hospital from June 2016 to June 2019. The study enrolled 150 women above 40 years old involving with intrauterine bleeding.

Results:

The mean age of the study population was 51.51 ± 7.65. The most common symptom in perimenopausal women was menorrhagia, up to 62.2% of cases. In addition to intrauterine bleeding, there were 54.7% of cases had at least one other functional symptom, they were pale skin (35.9%), and lower abdominal pain (31.3). Endometrial hyperplasia (EH) was the most common pathology in both groups with perimenopausal and postmenopausal bleeding (PMB), respectively, 66.7% and 51.7%. In PMB group, endometrial cancer (EC) occupied approximately 38.3% following EH. Our study revealed age, menstrual characteristics, and diabetes in relation to malignant disease. Other factors seemed to be less associated with EC.

Conclusions:

Menorrhagia was the most common type of abnormal uterine bleeding in perimenopausal women. Besides vaginal bleeding, others symptoms such as pale skin, pelvic pain, and fatigue were also common. Length day and blood loss before hospitalization in perimenopausal women were greater significantly than that in postmenopausal women. Age, menstrual characteristics, and diabetes increased the risk of EC in women with PMB.
Depression among Peri- and Post-Menopausal Women during COVID-19 Pandemic in Chandigarh, North India
Authors: Khatak Sukriti , Gupta Madhu , Grover Sandeep , Aggarwal Neelam
Published: January 2023

Background:

Peri- and post-menopausal women are vulnerable to suffer from mental health problems including depression, anxiety, and stress, which might have increased during the COVID-19 pandemic.

Objective:

To estimate the prevalence of depression and associated factors among peri- and post-menopausal women during the COVID-19 pandemic in Chandigarh.

Materials and Methods:

A community-based cross-sectional study was conducted among 200 urban peri- and post-menopausal women of age 40–60 years in Chandigarh, from May to June 2021. Patient Health Questionnaire-9, Generalized Anxiety Disorder 7, and EuroQol-5D validated tools were used to screen depression, anxiety, and quality of life (QOL). Fear of COVID-19 scale was developed as part of this study was used to assess the fear related to COVID-19 infection. Data analysis was done using the Statistical Package for the Social Sciences (SPSS) software version 26.0. Binary multivariate logistic regression model was used to identify the predictors.

Results:

The prevalence of depression was 39% and anxiety 29.5% among peri-and post-menopausal women. The fear of COVID-19 infection (adjusted odds ratio [aOR] 8.43, confidence interval [CI]: 1.99–35.64; aOR 10.54, CI: 2.76–40.24) and sleeplessness (aOR 13.29, CI: 3.22–54.82) were the significant (P < 0.005) predictors of depression and anxiety, respectively. Fearful peri- and post-menopausal women (aOR 5.94, CI: 2.68–13.13) and widow status (aOR 7.08, CI: 1.10–45.28) were the significant (P < 0.005) predictors of poor QOL.

Conclusions:

The prevalence of depression was high among peri- and post-menopausal women during the COVID-19 pandemic. Fear of getting COVID-19 infection was significantly associated with depression, anxiety, and poor QOL.
Comparison of Radiofrequency Ablation and Conventional Surgery in the Treatment of Varicose Veins
Authors: Leons Jibin , Jose Jomine , John Binni
Published: January 2023

Background:

This retrospective study was aimed to compare the outcomes between radiofrequency ablation (RFA) and conventional surgery which included the Trendelenburg procedure, multiple perforator ligation, hook phlebectomy and stripping for the treatment of varicose veins using Clinical, Etiological, Anatomical, and Pathophysiological classification (CEAP) and Venous Clinical Severity Score (VCSS) in a tertiary care centre.

Materials and Methods:

The pre-operative and post-operative CEAP classification and VCSS were calculated. The satisfaction from the surgery was assessed using a structured questionnaire and data analysed using IBM SPSS software.

Results:

The majority of the patients in the study belonged to the age group of 41–50 years. Females comprised 58% and housewives comprised 35% of the total patients. Patients with a body mass index of 18.5–24.9 constituted almost 44%. Twenty-four individuals had a family history of varicose veins. Doppler studies showed that at 83%, the most common pathology was sapheno-femoral junction (SFJ) and perforator incompetence. Five per cent of individuals had perforator incompetence alone. Thirty-four per cent of the individuals underwent RFA. The improvement in CEAP was 3.03 ± 1.513 in RFA group and 2.91 ± 1.279 in conventional surgery group; statistical analysis did not show any significant difference between the groups. The post-operative VCSS improved from 7.94 ± 1.718 in conventional surgery group and 7.38 ± 1.706 in RFA group to 1.52 ± 1.070 and 1.03 ± 0.577, respectively. The most common problem after surgery was saphenous neuralgia (8%). The severity of pain in the 1st week after the intervention was 'very mild' for most of the patients who underwent RFA (47.1%), and moderate for those in conventional surgery group (37.9%). The average days to return to normal activity were 10.26 ± 3.96 and 3.44 ± 1.637 in conventional surgery and RFA groups, respectively, whereas the average days to return to work were 17.41 ± 5.418 and 9.50 ± 1.846 days, respectively.

Conclusion:

The results indicate that both RFA and conventional surgeries in the form of the Trendelenburg procedure, stripping, phlebectomy and perforator ligation provide comparable relief of symptoms and clinical improvement when applied for the treatment of varicose veins. However, RFA may offer a significant advantage over conventional surgery in terms of faster recovery and early return to normal life and work.
Primary Hyperparathyroidism and Metastatic Papillary Carcinoma of the Thyroid Complicating a Twin Pregnancy
Authors: Safwan A. Mohamad , Vijayan KN , Chandru Rakesh , Aakash S
Published: January 2023

Primary hyperparathyroidism (PHPT) is the unregulated overproduction of parathyroid hormone due to abnormal parathyroid gland which results in abnormal calcium homeostasis. PHPT in pregnancy is a rare and often unrecognised condition which possesses a threat to both the mother and the foetus. Papillary carcinoma of the thyroid is the most common thyroid malignancy and its management is quite challenging when it is diagnosed during pregnancy. Herewith, we report the case of a 28-year-old pregnant woman who presented with severe hyperemesis and hypercalcaemia due to PHPT along with incidentally detected metastatic papillary carcinoma thyroid complicating the pregnancy.
Diagnostic Test Evaluation of Raja Isteri Pengiran Anak Saleha Appendicitis Score in Patients with Acute Appendicitis
Authors: Gowshika S. , Kumar S. Santhosh
Published: January 2023

Introduction:

The diagnosis of acute appendicitis is still heavy reliant on clinical judgement as the availability and quality of imaging studies are quite variable. The Alvarado score and newer scores have been proposed in recent times, one of which is the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score. It has been developed for a better diagnosis of acute appendicitis; the score includes 14 clinical parameters, which have higher sensitivity, specificity and diagnostic accuracy than Alvarado scoring, especially in the Asian population.

Methodology:

The objective was to evaluate the diagnostic accuracy of the RIPASA score with respect to histopathologically proven appendicitis. A diagnostic test evaluation was conducted in the surgical wards of a tertiary care centre for 1 year on patients undergoing emergency appendicectomy for acute appendicitis. Consecutive sampling was done on 132 participants. After administering the RIPASA score questionnaire to the patients, the histopathological reports were collected and the scoring system was compared to obtain sensitivity, specificity, predictive values, likelihood ratios and area under curve (AUC).

Results:

Of the 132 patients, 50.8% were male and 49.2% were female, with the majority of patients <40 years. Among components of the RIPASA score other than age, sex, anorexia, duration of symptoms and Rovsing's sign, all other components had an independent statistically significant association to histologically proven appendicitis. The receiver operating characteristic curve analysis of the RIPASA score showed an AUC of 0.915 (P < 0.0001). The negative appendicectomy rate was about 19.6%.

Conclusion:

The RIPASA score is a simple scoring system with high sensitivity and specificity for the diagnosis of acute appendicitis. The 14 clinical parameters are easily obtained from a good clinical history and examination and can be easily and quickly applied. Therefore, a decision on the management can be made early and complications can be prevented.
Predictive Value of Serum C-Reactive Protein and Serum Lactate in Intestinal Obstruction with Suspected Strangulation
Authors: Safwan A Mohamad , Muhammed Irfan K. P. C. , Chellapan Rajeev , Firoz Khan M. H. , Vijayan K. N
Published: January 2023

Background:

Intestinal obstruction is one of the common clinical problems encountered in surgical practice, and the dreadful complication of intestinal obstruction is strangulation, which requires an emergency surgery for management. The main objective of our study was to evaluate patients with clinical suspicious intestinal obstruction and to find out the significant levels of serum C-reactive protein (CRP) and serum lactate in the early detections of strangulation preoperatively.

Materials and Methods:

A total of 30 patients who aged between 15 and 80 years were included in the study after excluding the patients of comorbid medical illness and patients with findings other than obstruction or strangulation. The serum values of CRP and lactate were measured pre-operatively and compared between obstruction with strangulation and obstruction without strangulation. Receiver operating characteristic (ROC) curve was drawn, and cut-off values for the diagnosis of strangulation were calculated along the calculation of sensitivity, specificity, positive predictive values (PPVs) and negative predictive values (NPVs).

Results:

Fifteen patients of strangulated bowel obstruction had significantly higher values of serum CRP and lactate when compared with 15 patients of simple bowel obstruction (99 vs. 38.3 mg/L and 35 vs. 9.9 mg/dl, respectively, P < 0.05). Using ROC analysis, the area under the curve of serum CRP and lactate was found to be 0.809 and 0.947, respectively for bowel strangulation. The serum CRP test has the sensitivity of 80.0%, specificity of 66.7%, PPV of 70.6% and NPV of 76.9% to detect the obstruction with strangulation when using a cut-off value of 49 mg/L. The serum lactate test has the sensitivity of 86.7%, specificity of 73.3%, PPV of 76.5% and NPV of 84.6% to detect the obstruction with strangulation when using a cut-off value of 19 mg/dl.

Conclusion:

The serum CRP and lactate are useful and reasonable diagnostic markers for predicting strangulation in cases of acute intestinal obstruction in an emergency setting.
Serum Bilirubin as a Predictor of Complications of Acute Appendicitis in Adults
Authors: Muhammed Irfan K P C , Rajeev C , Safwan A Mohamad , Khan Shafy Ali , Vijayan K N , Varghese Liju
Published: January 2023

Introduction:

Acute appendicitis is a very common cause of acute abdomen and the diagnosis is essentially clinical. A decision to operate based on clinical suspicion alone can result in removal of a normal appendix; whereas, if left untreated, appendicitis can result in necrosis and perforation. Therefore, improving the diagnostic accuracy of appendicitis is a need of the hour. This study was conducted to evaluate hyperbilirubinaemia in acute appendicitis to find out its predictive value in complications like perforation.

Materials and Methods:

This prospective study for diagnostic test evaluation was conducted amongst the inpatients in the Department of General Surgery, KIMSHEALTH Trivandrum, during the period from August 2019 to August 2020. A total number of 100 patients who were admitted with the clinical diagnosis of acute appendicitis were studied, and serum bilirubin and liver function tests were carried out in all of them.

Results:

Total bilirubin levels when compared with histopathological diagnosis by unpaired samples t-test, the t-value = 0.763, P = 0.447 > 0.05 which shows no statistically significant difference between total bilirubin levels in uncomplicated and complicated acute appendicitis based on histopathological diagnosis. Sensitivity is 81.8%; specificity is 29.2%; positive predictive value (PPV) is 12.5%; negative predictive value (NPV) is 92.9%.

Conclusion:

Elevated total serum bilirubin levels have a fairly high sensitivity and NPV in predicting complications of acute appendicitis, but the specificity and PPV are quite low, and hence, hyperbilirubinaemia could be used as an aid in diagnosing complicated acute appendicitis along with the clinical findings and ultrasonography findings, but it is not reliable as a standalone diagnostic test. If the total serum bilirubin levels are low, an alternate diagnosis could be suspected, and the chances of complicated appendicitis are quite low, but elevated serum bilirubin values alone cannot confirm the presence of complications. Therefore, our study could not find any correlation between the absolute levels of elevation of total bilirubin values and the presence or absence of complications in acute appendicitis.
Therapeutic Outcome of Lateral Internal Sphincterotomy in the Treatment of Chronic Anal Fissures
Authors: Varghese Melvin , Shaju S. , Saran N. , Firoz Khan M. H. , Ali Khan S. L. Shafy
Published: January 2023

Introduction:

Chronic anal fissure (CAF) is one of the most common proctologic conditions seen in surgery and is the most common cause of perianal pain. The surgical procedure of choice is lateral internal sphincterotomy (LIS) which usually provides a permanent cure for CAF. The fear of causing incontinence restricts many surgeons from performing LIS for managing CAF. The objective of our study is to evaluate the outcome of LIS in treating CAF in terms of fissure healing and reduction in resting anal pressure (RAP), as well as the incidence of anal incontinence following the procedure.

Materials and Methods:

A prospective study was conducted among 43 patients with CAF who underwent LIS. Anal manometry of the patients was done and results were noted preoperatively as well as at 6 weeks postoperatively. Patients were followed up and symptom relief, healing of fissure and incontinence to flatus or stool if present were noted on post-operative day, 1 week after surgery and 6 weeks after surgery.

Results:

Fissure healed in all 43 patients who underwent LIS in our institute. Hence, we observed a 100% healing rate following the procedure. RAP was found to be raised in all patients with CAF who required surgical treatment with a mean pre-operative RAP of 86.6 mmHg (normal 40–60 mmHg.). There was a significant reduction in RAP after the LIS surgery with a P < 0.001. The mean post-operative RAP was 53.16 mmHg which is in the normal range. Only one patient (2.3%) developed post-operative anal incontinence in our study. He was also managed conservatively with no permanent incontinence.

Conclusions:

We conclude that LIS is the surgical treatment of choice for CAFs, as it gave a 100% healing rate with a very low incidence of post-operative anal incontinence and other complications.
Hypocalcaemia Following Thyroid Surgery in a Tertiary Care Centre
Authors: Vadivelu Anusha , Vijayan K. N. , Varghese Liju
Published: January 2023

Introduction:

Hypocalcaemia may occur secondarily to surgical trauma, devascularisation, unintentional removal of parathyroid glands and ligation of both inferior thyroid arteries. The objective of the study was to evaluate the calcium level after thyroid surgery and to evaluate the clinical symptoms and signs of hypocalcaemia after thyroid surgery.

Materials and Methods:

Eighty-one patients were evaluated; post-operatively, the calcium levels were monitored and early hypocalcaemia was detected by looking for the symptoms and signs of hypocalcaemia. The calcium levels were recorded from post-operative day 1, 2, 3 and 7. By this method, low serum calcium levels are corrected by calcium supplements and can prevent the need of parental calcium.

Results:

The most common age group affected by thyroid disorders was 41–50 years and less common age group affected was above 60 years. Females (71.6%) were commonly affected by thyroid disorders compared to males (28.4%). Majority of the patients were diagnosed with multinodular goitre (42%), followed by papillary carcinoma (39.5%). Most of our study population underwent total thyroidectomy (around 90%). The number of patients who encountered carpodeal spasm was 1.2% Chovstek sign, trousseau sign, electrocardiogram changes were seen in 2.5% population Patients who received treatment for symptomatic hypocalcaemia was 2.5%.

Conclusion:

Females were more prone to hypocalcaemia compared to males. Hypocalcaemia was found to be more prevalent in those patients who underwent total thyroidectomy compared to other surgeries. This can be prevented by meticulous dissection, identification of parathyroid and serial monitoring of calcium levels. Our study also serves as a cost-effective tool for the general population and immediate intervention can be given to the patients who are at risk to become symptomatic and improve their quality of life.
Validation of a scoring system to predict difficult laparoscopic cholecystectomy
Authors: Saran N. , Khan Shafy Ali , Najeeb A. A. , Jithu T. G. , Safwan A. Mohamad , Varghese Melvin , Shaju S. , Vijayan K. N.
Published: January 2023

Background:

Acute calculous cholecystitis is one of the common conditions. The initial radiological investigation of choice is ultrasonography of the abdomen. Cholecystectomy is the definitive treatment for acute cholecystitis. Laparoscopic cholecystectomy is the procedure of choice for acute cholecystitis. Sometimes there is a need for conversion to open cholecystectomy due to intra-abdominal adhesions which make laparoscopic cholecystectomy difficult. Hence, pre-operative prediction of the risk of conversion or difficulty of operation is an important aspect of planning laparoscopic surgery. In our study, we aimed to analyse the various risk factors and to predict the difficulty and degree of difficulty pre-operative lay by the use of a scoring system.

Materials and Methods:

All 100 patients were evaluated and their clinical and ultrasound parameters were recorded. They received symptomatic treatment with antibiotics and analgesics preoperatively. Following that, they were subjected to laparoscopic cholecystectomy, time taken, bile spillage, stone spillage, injury to duct, artery and conversion to open cholecystectomy were noted. All patients were operated by similarly experienced surgeons. Postoperatively, cases were followed up for any complications and they were discharged on recovery.

Results:

Receiver operating characteristic curve analysis of pre-operative with an intraoperative score in our study with area = 0.846, P = 0.0005 <0.01 is highly statistically significant at P < 0.01 level. The sensitivity and specificity of the scoring system at score 0–5 for the prediction of easy laparoscopic cholecystectomy are 89.2% and 80.0%, respectively, and the sensitivity and specificity of the scoring system at score 6–10 for the prediction of difficult laparoscopic cholecystectomy are 80.0% and 89.2%, respectively.

Conclusion:

Our study concludes that the scoring system evaluated is robust, reliable and useful to predict difficult laparoscopic cholecystectomy.
Clinical assessment and risk stratification for prehospital use of methoxyflurane versus standard analgesia in adult patients with trauma pain
Authors: Zaki Hany , Türkmen Süha , Azad Aftab , Bashir Khalid , Elmoheen Amr , Shaban Eman , Iftikhar Haris , Shallik Nabil
Published: January 2023

Oligoanalgesia, the undertreatment of trauma-related pain using standard analgesics in prehospital and emergency departments, has been extensively documented as one of the major challenges affecting the effective treatment of trauma-related pain. When administered in low doses, methoxyflurane has been highlighted by numerous medical works of literature to provide an effective, nonopioid, nonnarcotic treatment alternative to standard analgesics for prehospital and emergency department use. Low-dose methoxyflurane has been associated with fast-pain relief in adult patients manifesting moderate-to-severe pain symptoms. This systematic review and meta-analysis aimed to assess the clinical implication of low-dose methoxyflurane use in prehospital and emergency departments in adult patients with moderate-to-severe trauma-related pain. Moreover, the review aimed at assessing the risk stratification associated with using low-dose methoxyflurane in prehospital and emergency departments. The systematic review and meta-analysis performed a comprehensive search for pertinent literature assessing the implications and risks of using low-dose methoxyflurane in adult patients exhibiting moderate-to-severe trauma-related pain in prehospital settings. A comparison between the use of low-dose methoxyflurane and standard-of-care analgesics, placebo, in prehospital settings was reported in four clinically conducted randomized controlled trials (RCTs). These RCTs included the STOP! trial, InMEDIATE, MEDIATA, and the PenASAP trials. A meta-analysis comparing the time taken to achieve first pain relief on initial treatment of patients with moderate-to-severe trauma-related pain favored the use of low-dose methoxyflurane to the standard-of-care analgesics (mean difference = −6.63, 95% confidence interval = −7.37, −5.09) on time taken to establish effective pain relief. Low-dose methoxyflurane has been associated with superior and faster pain relief in prehospital and emergency departments in adult patients exhibiting moderate-to-severe trauma-related pain compared to other standard analgesics.
Cocycle superrigidity for profinite actions of irreducible lattices
Authors: Drimbe Daniel , Ioana Adrian , Peterson Jesse
Published: January 2023

Let

\Gamma

be an irreducible lattice in a product of two locally compact groups and assume that

\Gamma

is densely embedded in a profinite group

K

. We give necessary conditions which imply that the left translation action

\Gamma \curvearrowright K

is “virtually” cocycle superrigid: any cocycle

{w\colon \Gamma\times K\rightarrow\Delta}

with values in a countable group

\Delta

is cohomologous to a cocycle which factors through the map

\Gamma\times K\rightarrow\Gamma\times K_0

for some finite quotient group

K_0

of

K

. As a corollary, we deduce that any ergodic profinite action of

\Gamma=\mathrm{SL}_2(\mathbb Z[S^{-1}])

is virtually cocycle superrigid and virtually W

^*

-superrigid for any finite nonempty set of primes

S

.
A new monotonicity formula for the spatially homogeneous Landau equation with Coulomb potential and its applications
Authors: Desvillettes Laurent , He Ling-Bing , Jiang Jin-Cheng
Published: January 2023

We describe a time-dependent functional involving the relative entropy and the

\dot{H}^1

seminorm, which decreases along solutions to the spatially homogeneous Landau equation with Coulomb potential. The study of this monotone functional sheds light on the competition between dissipation and nonlinearity for this equation. It enables us to obtain new results concerning regularity/blowup issues for the Landau equation with Coulomb potential.
Construction of $L^2$ log-log blowup solutions for the mass critical nonlinear Schrödinger equation
Authors: Fan Chenjie , Mendelson Dana
Published: January 2023

In this article, we study the log-log blowup dynamics for the mass critical nonlinear Schrödinger equation on

\mathbb{R}^2

under rough but structured random perturbations at

L^{2}(\mathbb{R}^2)

regularity. In particular, by employing probabilistic methods, we provide a construction of a family of

L^{2}(\mathbb{R}^2)

regularity solutions which do not lie in

H^{s}(\mathbb{R}^2)

for any

s>0

, and which blowup according to the log-log dynamics.
Algebraic independence and linear difference equations
Authors: Adamczewski Boris , Dreyfus Thomas , Hardouin Charlotte , Wibmer Michael
Published: January 2023

We consider pairs of automorphisms

(\phi,\sigma)

acting on fields of Laurent or Puiseux series: pairs of shift operators

(\phi\colon x\mapsto x+h_1, \sigma\colon x\mapsto x+h_2)

, of

q

-difference operators

(\phi\colon x\mapsto q_1x

,

\sigma\colon x\mapsto q_2x)

, and of Mahler operators

(\phi\colon x\mapsto x^{p_1},\ \sigma\colon x\mapsto x^{p_2})

. Given a solution

f

to a linear

\phi

-equation and a solution

g

to an algebraic

\sigma

-equation, both transcendental, we show that

f

and

g

are algebraically independent over the field of rational functions, assuming that the corresponding parameters are sufficiently independent. As a consequence, we settle a conjecture about Mahler functions put forward by Loxton and van der Poorten in 1987. We also give an application to the algebraic independence of

q

-hypergeometric functions. Our approach provides a general strategy to study this kind of question and is based on a suitable Galois theory: the

\sigma

-Galois theory of linear

\phi

-equations.
Multivariate mean estimation with direction-dependent accuracy
Authors: Lugosi Gábor , Mendelson Shahar
Published: January 2023

We consider the problem of estimating the mean of a random vector based on

N

independent, identically distributed observations.We prove the existence of an estimator that has a nearoptimal error in all directions in which the variance of the one-dimensional marginal of the random vector is not too small: with probability

1-\delta

, the procedure returns

\widehat{\mu}_N

which satisfies, for every direction

u \in S^{d-1}

,

\langle {\widehat{\mu}_N - \mu, u}\rangle \leq \frac{C}{\sqrt{N}} (\sigma(u)\sqrt{\log(1/\delta)} + (\mathbb{E}\,\|X-\mathbb{E} X \|^2)^{1/2}),

where

\sigma^2(u) = \operatorname{Var}(\langle{X,u}\rangle)

and

C

is a constant. To achieve this, we require only slightly more than the existence of the covariance matrix, in the form of a certain moment-equivalence assumption.
Об объемах гиперболических прямоугольных многогранников
Authors: Alexandrov Stepan Andreevich , Bogachev Nikolay Vladimirovich , Vesnin Andrei Yurievich , Egorov Andrei Aleksandrovich
Published: January 2023

Получены новые верхние оценки объемов прямоугольных многогранников в пространстве Лобачевского $\mathbb{H}^3$ в следующих трех случаях: для идеальных многогранников, все вершины которых лежат на абсолюте, для компактных многогранников, все вершины которых конечны, и для многогранников конечного объема с вершинами обоих типов.
Библиография: 23 названия.
О единственности рядов Франклина со сходящейся подпоследовательностью частичных сумм
Authors: Gevorkyan Gegham Grigor'evich
Published: January 2023

В работе доказано, что если частичные суммы $S_{n_i}(x)=\sum_{k=0}^{n_i}a_kf_k(x)$ ряда Франклина $\sum_{k=0}^{\infty}a_kf_k(x)$ сходятся по мере к ограниченной функции $f$ и $\sup_i|S_{n_i}(x)|<\infty$, когда $x\notin B$, где $B$ - некоторое счетное множество, и $\sup_i{n_i}/(n_{i-1})<\infty$, то этот ряд является рядом Фурье-Франклина функции $f$.
Библиография: 24 названия.
Классификация слоений Лиувилля интегрируемых топологических биллиардов в магнитном поле
Authors: Vedyushkina Viktoriya Viktorovna , Pustovoitov Sergey Evgen'evich
Published: January 2023

В работе изучена топология слоений Лиувилля интегрируемых магнитных топологических биллиардов - систем движения шара по кусочно гладким двумерным поверхностям в постоянном магнитном поле. Вычислены инварианты Фоменко-Цишанга лиувиллевой эквивалентности возникающих гамильтоновых систем, а также изучена топология трехмерных инвариантных многообразий - изоинтегральных и изоэнергетических. Также обнаружена лиувиллева эквивалентность таких биллиардов с уже известными гамильтоновыми системами, такими как геодезические потоки на двумерных поверхностях и системы динамики твердого тела. В частности, обнаружены интересные седловые особенности с разным направлением особых окружностей, которые также встречались ранее в механических системах с магнитным полем на поверхностях вращения, гомеоморфных двумерной сфере.
Библиография: 13 названий.
Evaluation of Collaboration of Automotive Researchers in Indian
Automotive Industry: A Trend Analysis of SIAT Conferences Held from 2001 to
2017
Authors: Joshi Ashutosh Gopalrao , Santhoshkumar S. , Priyan E. , Kumbhar Rajendra Madhavrao , Venugopal M. Shankar
Published: January 2023

The objective of this paper on the research productivity of the Indian automotive
industry is to present the transformation of the research community of the
Indian automotive industry, with reference to the Symposium on International
Automotive Technology (SIAT) conferences held in the last 17 years. It reveals
the dynamic nature of automotive research in the country. The exhibits research
outcome is dominated by specific fields and specific organizations in a dynamic
way. The study indicates the patterns of research priorities among different
fields and elaborates the extent of concentration and dissemination of their
research output. The output and impact of research under different existing
fields of Indian automotive industry indicates share of international
collaborative research at overall level as well as across various domains. It
also analyzes the strong and weak areas of research. It also elaborates on
countries which impacted and scientists with whom Indian automotive industry
preferred to collaborate.
Pouk na daljavo – nove prakse in izzivi pri poučevanju ter učenju tujega jezika v srednji šoli
Authors: Bobnar Miranda
Published: January 2023

V času epidemije covida-19 je izkušnja pouka na daljavo proces poučevanja in učenja postavila v drugačen, do tedaj še nepreizkušen izobraževalni kontekst, znotraj katerega učenci pod vodstvom učiteljev avtonomno sledijo učnemu procesu. Rabo tehnologije so pred to izkušnjo pogojevali organizacijski in strukturni dejavniki, v okviru katerih so učitelji učni procesu v razredu dopolnjevali s spletno podprtim učenjem. V času t. i. kriznega poučevanja na daljavo med obdobjem epidemije, ko je bila raba tehnologije vsiljena, ni šlo za nadgradnjo že pred tem uveljavljenih praks spletno podprtega pouka, temveč za vpeljavo novih metodologij in pristopov. V prispevku se osredotočamo na pouk tujih jezikov na daljavo v srednji šoli in posebnosti, vezane na razvijanje sporazumevalnih zmožnosti na daljavo. Naslavljamo izzive, s katerimi so se učitelji soočili ob vrnitvi v učilnice in izpostavljamo prednosti, ki učiteljem omogočajo razvijanje novih dimenzij spletno podprtega pouka. Z anketo smo želeli preučiti, kako so dijaki doživljali pouk na daljavo z vidika razvijanja sporazumevalnih zmožnosti in njihove jezikovne podstati (slovnica in besedišče). Zanimalo nas je tudi, kakšne okoliščine so še vplivale na njihovo izkušnjo, kako je tovrstni pouk spodbujal njihovo samostojnost in kakšne spremembe so v učnem procesu zaznali pri sebi ter pri učiteljih. Rezultati kažejo, da je pouk tujega jezika na daljavo pri dijakih omogočal raznovrstno razvijanje sporazumevalnih spretnosti in spodbujal njihovo samostojnost, hkrati pa so se tako pri rabi tehnologije kot pri samouravnavanju učenja soočali s precejšnjimi težavami, ki v luči inovativnih pristopov poučevanja in učenja pred nas postavljajo dodatne izzive za prihodnost.
The reflux phase in monetary circuit theory and stock–flow consistent models
Authors: Cottin-Euziol Edouard , Bougrine Hassan , Rochon Louis-Philippe
Published: January 2023

Stock–flow consistent (SFC) modelling and monetary circuit theory (MCT) have many similarities. However, an important difference concerns the reflux phase, during which the credits issued by banks are repaid. This phase is constitutive of MCT models, but does not generally appear explicitly in SFC models. The authors propose here to develop an SFC model in which the bank loans issued at the beginning of a period are explicitly repaid at the end of it. The repayment of long-term bank loans financing investments will then represent a leakage outside the monetary circuit and affect the level of aggregate demand and the dynamics of the model. The authors show that considering these repayments could have a lasting effect on corporate profits, corporate indebtedness, and growth of production. This result suggests that it could be interesting to focus more on the reflux phase within SFC models, taking inspiration from MCT.
The modern monetary theory literature seems to have escaped Drumetz/Pfister
Authors: Mitchell William F.
Published: January 2023

This paper provides a response to the recently published critique of modern monetary theory (MMT) by Drumetz/Pfister, which is based on a superficial representation of the body of knowledge and follows a familiar script: MMT is about printing money to solve all problems and will cause accelerating inflation, a plethora of unproductive jobs, and a bond-market revolt. The paper demonstrates that if the authors had consulted the published academic literature, they would have realised that many of the assertions they make are simply without foundation.
Some Kaleckian remarks on modern monetary theory in light of a paper by Drumetz/Pfister
Authors: Sawyer Malcolm
Published: January 2023

This paper provides remarks on modern monetary theory (MMT) from a Kaleckian perspective in response to a paper by Drumetz/Pfister. The distinction between initial financing and final financing is drawn up to argue for clear separation of how expenditure is financed and funded, and pointing to the confusions that have arisen. Some issues of crowding in and crowding out are raised. Some aspects of inflation and hyper-inflation are then discussed. The conditions for the establishment of full employment are elaborated. While MMT has focused on financing of government expenditure and aggregate demand, Kaleckians and post-Keynesians have analyses and theories on the operations of the whole economy which differ sharply from those of mainstream economists.
The contribution of MMT to modern macroeconomics
Authors: Watts Martin , Juniper James
Published: January 2023

This paper draws on nearly 25 years of modern monetary theory (MMT) scholarship to provide an assessment of the critique of MMT by Drumetz/Pfister in their 2021 working paper. The present paper commences with a review of methodology. It then pursues a thematic approach, initially exploring the issue of currency sovereignty and the nature of modern monetary systems before addressing the specific criticisms that Drumetz/Pfister have raised about MMT’s approach to monetary and fiscal policy.
Regulatory impact assessments (Ria) As an input in tax law interpretation: Analysis of the administrative courts verdicts
Authors: Gajewski Dominik , Joński Kamil
Published: January 2023

The goal of this paper is to empirically examine the role of Regulatory Impact Assessments (RIAs) accompanying draft laws submitted by the Council of the Ministers as an input in purpose-oriented interpretation of tax law, carried out by Polish Administrative Courts. To this end, full-text database of the universe of Administrative Courts verdicts (CBOIS) had been queried in order to uncover all court decisions issued from Jan 1st 2001 to Dec 31st 2022 and mentioning RIAs in their written motives. All in all 14 decisions of SAC and 39 decisions of FIACs had been located – the result that can be interpreted as an evidence of scant use of RIA as an input for statutory interpretation of the tax law. Qualitative analysis reported in the paper illustrates what sort of information had been recovered by justices from RIA. Results suggest that potential offered by RIA’s coverage of ‘lawmaker’s intent’ is still not fully utilized in the process of tax law interpretation. However, any reliance on this sort of documents have to be accompanied with critical analysis of their quality and role in lawmaking process. Conditional forecasts (what impact is reasonably expected) should not be mistaken with statements of the intent (what impact is desired). Moreover, perfunctory RIA, prepared as part of window-dressing exercise, not genuine analysis underpinning the decision-making process, could turned out misleading.
Investigation of Point Refractivity Gradient and Geoclimatic Factor at 70 m Altitude in Yenagoa, Nigeria
Authors: Lawal Y. B. , Omotoso E. T.
Published: January 2023

The quality of services provided via Inter-Terrestrial radio communication links such as GSM networks, Wide Area Network (WAN), Radio and TV broadcasts is largely influenced by some meteorological parameters such as temperature, pressure and humidity. Proper knowledge of these parameters, specifically at microwave antenna heights (about 70m) is important in order to maintain an effective line-of-sight (LOS) link even during the worst weather conditions. The geoclimatic factor is an important quantity that must be considered in the design of terrestrial links for effective wireless communication. This work utilized satellite data from the European Center for Medium-Range Weather Forecasts (ECMWF) to compute the point refractivity gradient and geoclimatic factor for Yenagoa and its environs. The research was necessitated by the paucity of research on this subject matter for Yenegoa. The results of the research show that point refractivity gradient and geoclimatic factor in the study area vary with season. The average point refractivity gradient and geoclimatic factor at 70 m above the ground level are:136.433 N-unit/Km and 6.638633E-05 respectively. This implies that radiowaves propagating in this region at the said altitude is most likely to be super refractive in both rain and clear air atmospheric conditions. Rain or worst condition refers to the period when atmospheric components such as hydrometeor, lithometeor, aerosol have significant effects on propagated radio signals. Clear-air conditions means when maximum possible signal is received such that the most threatening atmospheric components (rain drops) have negligible effects on propagated signal. The results will be useful for radio engineers in the design and configuration of inter-terrestrial microwave links in Yenagoa and Its environs for optimum quality of service.
Multilevel Model Analysis to Investigate Predictor Variables in Mathematics Achievement PISA Data
Authors: Anggraheni Fani Yunida , Kismiantini Kismiantini , Ediyanto Fajar
Published: January 2023

This study aims to examine the relationship between predictor variables at the student and school levels and the interaction between variables in predicting mathematics achievement in Indonesia. Stratified analysis was implemented in Indonesia’s Programme for International Student Assessment (PISA) 2018 data. The variables of student level encompassed gender, economic, social, and cultural status (ESCS), metacognition, and learning time. This study revealed that the variables of ESCS, metacognition and learning time possessed a significant positive effect on mathematics achievement. The variables of school level are class size, school type, school size, and student-teacher ratio. This study demonstrated that only the data of class size produced a significant effect on mathematics achievement. Furthermore, the interaction between the learning time and class size also significantly affected learning achievement in mathematics. Therefore, variables increasing students’ mathematics achievement are ESCS, metacognition, learning time, class size, and interaction of learning time and class size.
Sarkopenik Obezitede Egzersiz Yaklaşımları
Authors: YURTSEVEN Muhammed
Published: January 2023

Sarkopenik obezite prevalansı, özellikle yaşlanan bireyler arasında
dünya çapında artış göstermektedir. İskelet kası kütlesi ve fonksiyonundaki
azalma (sarkopeni) ve yağ kütlesindeki artış (obezite), kronik
hastalıkların prognozunu kötüleştiren ve fiziksel sınırlamaların gelişimine
önemli ölçüde katkıda bulunan problemlerdir. Sarkopeni ve
obezite olarak adlandırılan bu iki durumun kombinasyonu, olumsuz
sağlık sorunlarının ortaya çıkma ihtimalini daha fazla arttıran önemli
bir risk faktörüdür. Literatürde, sarkopenik obeziteyi önlemenin ve/
veya tedavi etmenin önemi birçok klinik çalışmada vurgulanmaktadır.
Egzersiz, sarkopenik obezitenin tedavisinde kullanılan anahtar bileşenlerden
biridir. Bu nedenlerle bu derlemenin amacı, yaşlı yetişkinlerde
sarkopenik obeziteyi önlemek ve/veya tedavi etmek için kullanılan
çeşitli egzersiz stratejileri ile ilgili güncel araştırmaları bir araya getirmek
ve tartışmaktadır.