bluuebunny/crossref_metadata_2025 huggingface dataset:
Tobacco prevalence among adults in the urban slums of Delhi: results from a cross-sectional survey
Authors: Saroj Shyam Kanhaiya , Bhardwaj Tushti , Kaushik Archana
Published: February 2025

Slum areas exhibited a marked prevalence of elevated tobacco consumption rates, prompting the investigation to assess the extent and perspectives of tobacco usage among the residents in these regions. The present study aimed to evaluate the prevalence and attitudes toward tobacco use within five distinct slum localities in close proximity to the tobacco cessation center. During a house-to-house visit, a cross-sectional survey was conducted in five different slum areas, coded as Zone 1 to Zone 5. To ensure a representative sample, 20% of households were randomly selected from each slum. The survey utilized a pre-designed, pretested, and semi-structured questionnaire to collect relevant data. A total of 274 households provided consent to participate in the survey. The variations in tobacco prevalence were observed across all five slums, ranging adult tobacco prevalence from 16.3% to 36.7%. Tobacco use prevalence differed significantly by gender, with 86.1% males and 13.9% females. Smokeless tobacco was the most preferred method of tobacco use. Notably, 43.8% of adult tobacco users expressed their willingness to quit tobacco usage, out of which 22.3% were female. A large proportion (70.4%) of total adult women tobacco users showed their willingness to quit, while the corresponding percentage for men was only 39.5%. This study highlights the high prevalence of tobacco use and the limited awareness of cessation services among users in nearby slums despite the proximity to cessation centers and mandatory tobacco cessation helpline numbers on tobacco packets. However, during the awareness session, individuals exhibited interest in quitting tobacco consumption.
Cyclone Idai Disaster in Zimbabwe: A New Testament ethical analysis of Matthew 24:37–39
Authors: Chabata Lovejoy
Published: February 2025

The ravaging effects of Tropical Cyclone Idai on Zimbabwe’s Eastern border with Mozambique in March 2019 posed a rude awakening for the country to develop strategic disaster management policies. The loss of 340 lives, with many others declared missing, displacement and distress more than 200 and 70 000 people, annihilation of agricultural, educational, health and residential infrastructure, all combined to endorse the need for sustainable disaster risk management strategies in Zimbabwe. Matthew 24:37–39 cast the story of Noah who adopted a disaster response framework in the form of an ark, which was going to float above the floods to prevent loss of fauna and human lives. Through the lens of New Testament Ethical Analysis (NTEA), this article discusses how deployment of ethics of love, selfless service, charity, social responsibility, justice, sharing, care ministry, good neighbourliness, good relationships with self, others, God, environment and climate constitute an effective way of controlling, managing and reducing disaster risks. The article discusses moral exhortations embedded in Matthew 24:37–39 in relation to disaster response frameworks in Zimbabwe.Contribution: The article contributes to the ongoing debate on how biblical ethics can be deployed to the catalogue of disaster management and risk reduction strategies in Zimbabwe and beyond.
Effectiveness of Oral Health Rehabilitation Under General Anaesthesia on Oral Health-Related Quality of Life in Children with Intellectual and Developmental Disabilities – A Prospective Study
Authors: Patnana Arun K. , Chaudhry Kirti , Dhawan Archit , Duraisamy Arun K. , Rathore Kanupriya , Kumar Pravin
Published: February 2025

Context/Background:

Children with intellectual and developmental disabilities may have compromised oral health and require oral health rehabilitation under general anaesthesia.

Aim:

The present study aimed to evaluate the changes observed in the Child Oral Health Impact Profile (COHIP-14) and Family Impact scores (FIS-12) of children with severe behavioural disabilities and medically compromised conditions after oral health rehabilitation (OHR) under general anaesthesia (GA).

Materials and Methods:

Children with severe behavioural disabilities and medically compromised conditions were recruited, and OHR was done under GA. Teeth with fair prognosis were functionally restored, and teeth with poor prognosis were extracted after parents’/caregivers’ informed consent. Pre-operative and post-operative COHIP-14 and FIS-12 questionnaires were filled out by the parents/caregivers. The pre-operative and post-operative values were compared with those of the Student t-test.

Results:

All responses for the COHIP-14 and FIS -14 had shown significant (P ≤ 0.001) change after OHR under GA.

Conclusion:

The oral and functional health of children with severe behavioural disabilities was improved after OHR under general anaesthesia. The family impact score was also improved in terms of activity and emotions; further financial concerns of the family were also reduced after OHR under GA.
Rhomboid Intercostal and Subserratus Plane Block in Multiple Rib Fractures and Thoracoabdominal Tumor – One for All: A Case Series
Authors: Bansal Priyanka , Sultania Nidhi , Bansal Kunal , Chhikara Monica
Published: February 2025

The rhomboid intercostal block and the rhomboid intercostal subserratus block are novel blocks. These provide effective postoperative analgesia for a myriad of indications. It surpasses previous blocks by being away from the surgical site which soothes any fear of the surgeon – a possibility of infection at the site and also difficulty of postoperative catheter maintenance. The landmarks of this block are very lucid and understood easily. It is relatively a very safe block with rib acting as a safe barrier as well as a landmark. The catheter of the site does not interfere with patients’ routine activity, thus increasing overall patient satisfaction. The authors discuss five cases in which RISS proved immensely effective in relieving pain from rib fractures and postoperative. Furthermore, details of the block including anatomical site, dermatomal coverage, and USG images are discussed. It has proved to be a boon for all patients offering an excellent analgesia. Rhomboid intercostal subserratus plane block is an excellent option for providing adequate postoperative analgesia for thoracoabdominal surgeries as well as patients with multiple rib fractures. More reporting of cases and randomized trials are needed to confirm the same.
Neurolytic Erector Spinae Plane Block in Advanced Abdominal Carcinoma: A Case Report on Pain Management
Authors: Hithish MJ , Dey Samarjit , Reddy Koldinne Jagadeeswara , Tangirala Nageswara Rao
Published: February 2025

Pain management in patients with advanced abdominal carcinoma remains a significant challenge, particularly in settings where opioid availability is limited. This case report describes the use of a neurolytic erector spinae plane block (ESPB) in a 60-year-old female patient with recurrent periampullary carcinoma, who presented with severe, intractable abdominal pain that was inadequately controlled with a regimen of opioids and adjuvant analgesics. Despite receiving morphine, paracetamol, and pregabalin, the patient continued to experience significant pain and suffered from opioid-induced constipation. Given the complexity of her condition, a neurolytic ESPB was performed at the T12 level under ultrasound guidance. The procedure provided rapid and sustained pain relief, reducing her Numerical Rating Scale pain score from 8/10 to 1/10 within an hour postprocedure. Over the following months, the patient’s pain remained well controlled with minimal medication, allowing her to resume daily activities. This case highlights the potential of neurolytic ESPB as a valuable addition to the multimodal pain management strategies for cancer patients, offering effective pain relief with a favorable safety profile.
Use of Trans-nasal Humidified Rapid Insufflation Ventilatory Exchange and Jet Ventilation in Laser Surgery for Supraglottic Stenosis
Authors: Raju Dinesh , Ravi Meghana , Shenoy Samyukta , Kudpaje Akshay
Published: February 2025

A 67-year-old male patient with carcinoma hypopharynx, treated with chemotherapy and radiation, presented with supraglottic stenosis. He was posted for a transoral laser-assisted release of stenosis. The anaesthetic management of laser airway surgeries is fraught with difficulties, including a difficult airway, provision of adequate surgical access, the use of laser and its implications. In this case report, trans-nasal humidified rapid insufflation ventilatory exchange with jet ventilation was used in the anaesthetic management with good clinical outcomes and patient satisfaction.
A Prospective Observational Study to Compare Stroke Volume Variation with Pleth Variability Index in Predicting Fluid Responsiveness in Mechanically Ventilated Adult Patients Undergoing Major Abdominal Oncosurgery
Authors: Salam Suha Abdul , Thomas Mary , Prabhu Deepthi J.
Published: February 2025

Background and Aims:

Determining intravascular volume status is crucial to planning fluid therapy in major surgery. Stroke volume variation (SVV) and pleth variability index (PVI) are dynamic indicators of fluid responsiveness. The study’s primary objective is to determine whether the SVV and PVI measurements correlate and whether the non-invasive PVI measurement may replace the invasive SVV measurement as a gauge of fluid requirement during major abdominal oncosurgery.

Methods:

In this prospective observational study, 54 adult patients undergoing major open abdominal oncosurgery were recruited. They were continually monitored using the FloTrac® system to measure SVV and the Masimo pulse oximeter to assess PVI. Readings were taken at baseline and every 10 min until the procedure was completed, and concordance was checked between the two measurements. Karl Pearson’s correlation coefficients were used to compare the correlation between SVV and PVI measurements. A Bland–Altman plot was made to compare the two measurements in the study.

Results:

Out of the 54 patients studied, 15 underwent pancreatic surgery. A total of 1745 pairs of measurements were obtained. All patients displayed a similar pattern of SVV and PVI variation. Compared to SVV, the mean PVI value was higher. There was a moderately positive correlation (r = 0.622) between the individual readings of PVI and SVV when they were plotted against each other (P < 0.001).

Conclusion:

Although PVI overestimates fluid responsiveness, it is still a valid measure like SVV. PVI can be replaced for SVV in patients undergoing major open abdominal oncosurgery.
Endotracheal Tube Migration in Trendelenburg Position in Robotic and Laparoscopic Oncology Surgeries
Authors: Chatterjee Aparna Sanjay , Deshpande Gargi Amol , Lahiri Debashree Pradipta
Published: February 2025

Background and Aims:

In robotic and laparoscopic oncological surgeries, a combination of pneumoperitoneum and Trendelenburg position causes a cephalad displacement of the diaphragm, increasing the chances of endobronchial migration of the endotracheal tube. The study aimed to identify the endotracheal tube displacement in Trendelenburg position in robotic and laparoscopic oncological surgeries and identify the factors responsible for it.

Methods:

After Institutional Ethics Committee approval, a prospective, observational study was conducted from June 2019 to March 2020. Fifty patients undergoing robotic and laparoscopic oncological surgeries requiring Trendelenburg position were recruited. A flexible fibre-optic bronchoscope was used to measure the distance between the tracheal tube tip and the carina at the following time points –10 min after induction, 10 min after insufflation, 10 min after Trendelenburg and 30 min after Trendelenburg position. Tube fixation at the lips, degree of Trendelenburg tilt, intra-abdominal pressure, positive end-expiratory pressure (PEEP) and desaturation episode were recorded. The mean endotracheal tube tip-to-carina distances at the four time points were compared using the paired t-test. P < 0.05 was considered to be statistically significant.

Results:

We found a significant reduction in the distance between the tracheal tube tip and the carina post-insufflation and Trendelenburg position (P < 0.05) with a tilt >25°.

Conclusion:

Endobronchial migration of the endotracheal tube is more likely when the tracheal tube tip to the carinal distance is <3 cm. Hence, confirming that the tracheal tube tip is positioned more than 3 cm above the carina with a flexible fibre-optic bronchoscopy would be wise for patients undergoing robotic and laparoscopic oncological surgeries.
A Case Report on Feasibility of Performing Robotic Thymectomy without Nondepolarising Muscle Relaxants in Myasthenia Gravis
Authors: Ramkrishnan Aishwarya , Srinivasaraghavan Nivedhyaa
Published: February 2025

Robotic surgeries are popular for their enhanced perioperative outcomes and are performed under balanced anaesthesia with muscle relaxants to ensure minimal patient movement. However, in patients with myasthenia gravis, the use of muscle relaxants during surgery can exacerbate muscle weakness and respiratory issues. Thus, performing a thymectomy without muscle relaxants may be a safer option in such cases, albeit more technically challenging. A case of a 70-year-old male with myasthenia gravis undergoing robotic thymectomy without the use of non-depolarising muscle relaxants. The anaesthesia management involved multimodal analgesia with ketamine, lignocaine, epidural local anaesthetic infusions and meticulous monitoring to ensure patient safety and optimal surgical conditions. This case serves to demonstrate the feasibility of conducting a robotic thymectomy procedure without the use of muscle relaxants, thereby paving the way for its potential application in patients with severe myasthenia gravis.
Ultrasound-guided Bilevel Erector Spinae Plane Block for Oncoplastic Breast Reconstruction Involving Latissimus Dorsi Myocutaneous Flap
Authors: Kumar Koilada Shiv , Ramkiran Seshadri , Dalai Kailashini , Jayant Aveek
Published: February 2025

The incidence of chronic post-operative pain following breast surgery has been estimated to be ranging between 25% and 60%. The principal cause has been due to higher post-operative pain following breast surgery, which could be prevented by inclusive regional anaesthesia techniques. Erector spinae plane (ESP) block across various studies has demonstrated reduced post-operative pain and reduction in opioid consumption. We present a case series of 10 patients who underwent oncoplastic breast reconstructive surgeries involving latissimus dorsi myocutaneous flap. All patients received bi-level ESP block at T2 and T6 levels before induction of anaesthesia. Patients were followed up for 24 h post-surgery during which pain scores were elicited by Numeric Rating Scale (NRS) and total rescue analgesic dose noted. All patients had an NRS of <3 at rest immediate and after 2 h following surgery in post-anaesthesia care unit. Further, patients had NRS <3 both at rest and on movement induced by physiotherapy-assisted shoulder exercise up to 24 h post-surgery. None of them received any rescue analgesic and no side effects were noted.
Three-dimensional CT a Valuable Tool in Airway Assessment – How Manoeuvres and Positioning Result in False Measurements!
Authors: Ganjoo Shivangi , Dhamija Ekta
Published: February 2025

Three-dimensional computerised tomography (3D CT) reconstruction is an emerging technique of advanced airway imaging useful for pre-operative airway assessment. Several parameters on CT have been studied and mentioned in the literature as the predictors of difficult airway. Head-and-neck CT scans done by surgeons preoperatively to know the extent of tumour can be useful for airway assessment. Herein, we describe two cases where manoeuvres and patient positioning while undergoing CT scan affected measurements of certain parameters.
Ultrasound-guided quadratus lumborum block versus unilateral intrathecal block for the patient undergoing inguinal hernia repair
Authors: Galal Eldin Asmaa M. , Hamada Hala R.
Published: February 2025

Purpose

Inguinal hernia is a common condition that requires surgery. “Inguinal hernia repair” is a procedure that comes with a considerable risk of long-term postoperative pain as well as significant postoperative pain. The common use of ultrasound in anesthesiology departments has led to the advanced use of new regional block techniques.

Patients and methods

Fifty patients undergoing open inguinal hernia surgery were randomly assigned to either unilateral intrathecal block or ultrasound-guided anterior quadratus lumborum block (QLB). The primary outcome was the total dose of rescue analgesia between the two techniques. The secondary outcomes were the duration of the sensory block, changes in intraoperative hemodynamics, the first time of rescue analgesia, and the incidence of complications.

Results

In the current study, the total dose of required analgesia was statistically significantly higher in the intrathecal block group, and the duration of block performance and the onset of sensory block was statistically significantly longer in the QLB (P<0.001). There was no statistically significant difference regarding the hemodynamic change (heart rate, mean arterial pressure) between the two groups during the duration of follow-up. The duration of the first analgesic recall was statistically significantly longer in the QLB compared to the intrathecal block group (P<0.001).

Conclusion

QLB technique improves analgesic control by prolonging first analgesic recall, decreasing postoperative pain score, and reducing postoperative analgesic consumption. Moreover, QLB improves vital signs by increasing mean arterial pressure and decreasing heart rate.
Ultrasound-guided erector spinae block versus serratus anterior block for perioperative analgesia in patients undergoing modified radical mastectomy surgery
Authors: Yousif Sara H. , Zanfaly Hala I. , Galal Eldin Asmaa M.
Published: February 2025

Background

Breast cancer is the most prevalent cancer among women. There are several approaches to postmastectomy pain management such as opioids, nonsteroid anti-inflammatory which have many side effects. on the other hand, uses of regional block more effective and less side effect, prior research has demonstrated that erector spinae block (ESB) effectively reduces postoperative pain.

Aim

Assess and compare between ultrasound-guided ESB and Serratus anterior Block (SAB) for peri operative analgesia in patients undergoing Modified Radical Mastectomy (MRM) under general anesthesia.

Patients and methods

A total of 75 female patients scheduled for MRM were randomized to three equal groups: (group C) patient received no block, (group E) patient received ESB and (group S) patient received serratus anterior block before induction of anesthesia. The primary outcome was the time of the first rescue analgesic, The secondary outcomes were total consumption of opioid perioperative, visual analogue scale (VAS) in static and dynamic state, onset and duration of sensory block and complication.

Results

In the current study, there was a significant delay in the first time of rescue analgesia and a lower total dose of rescue analgesia in erectors when compared with the other two groups (P<0.001). Furthermore, there was a significant delay of the first time of rescue analgesia and a lower total dose of rescue analgesia in the serratus group when compared with control group (P<0.001).

Conclusion

Ultrasound-guided ESB and SPB are simple and safe techniques for the management of postoperative pain in patients underwent MRM. ESB technique provided significant superior analgesia and longer time for the first required analgesic than SPB technique.
Fentanyl versus magnesium sulphate as adjuvants to low-dose bupivacaine in spinal anesthesia in transurethral resection of prostate surgery
Authors: Elhoshy Hassan S. , Siam Ezzat M. , Alia Doaa M.A. , Khalil Hossam E.R.
Published: February 2025

Background

Recent progress in the use of intrathecal (IT) adjuvants has led to faster recovery and improved pain management following transurethral resection of the prostate (TURP). Promising outcomes have been achieved with the use of IT magnesium. This study investigated the consequences of adding fentanyl or magnesium sulphate (MgSO4) to low-dose IT bupivacaine in patients undergoing TURP using subarachnoid block.

Patients and methods

Seventy adult males with American Society of Anesthesiologists physical status classification I or II, scheduled for TURP under spinal anesthesia, were enrolled in this prospective randomized, double-blind study. They were randomly allocated into two groups: group F: received 25 µg (0.5 ml) of fentanyl diluted in 1 ml of normal saline added to 1.5 ml of hyperbaric bupivacaine 0.5% to form a total volume of 3.0 ml. Group M: received 100 mg (1 ml) of MgSO4 diluted in 0.5 ml of normal saline and added to 1.5 ml of hyperbaric bupivacaine 0.5% to form a total volume of 3.0 ml. Hemodynamic parameters, sensory and motor block levels, and pain scores were recorded and compared across the two studied groups.

Results

A total of 70 patients were included in this study, with 35 patients per group. There was no statistically significant difference in terms of heart rate, oxygen saturation, mean blood pressure, duration of surgery, and postoperative complications (P>0.05). The two groups showed no significant differences in terms of onset and duration of either sensory or motor blocks after spinal anesthesia (P>0.05). Additionally, no significant difference was noted in pain scores, time to first analgesic requirements, or total analgesic consumption among the two studied groups (P>0.05).

Conclusion

MgSO4 might be as effective as fentanyl when added to low-dose IT bupivacaine in patients undergoing TURP.
The relation between interleukin 10 and acute coronary syndrome
Authors: El-Badawy Tarek H. , Megahed Mohamed M.A. , Ayad Mona W. , Mehana Ahmed A.
Published: February 2025

Background

Atherosclerosis is the one of leading causes of death in the advanced world. It is a disease of large and medium-sized muscular arteries that carries a significant health burden worldwide, Atherogenesis is not a fully understood process and many theories may participate in the etiology of atheromatous plaque formation such as inflammatory theory which states that atherosclerosis is a chronic inflammatory disease characterized by migration of monocytes and T lymphocytes to the area of arterial wall injury. Early investigators also noted that the lipid-rich atherosclerotic plaque may develop secondary to a primary inflammatory process. Although the inflammation is believed to be primarily defensive or protective, its principal aims are to neutralize and remove the initiating agent and to initiate the process of tissue repair and healing. However, the inflammatory mediators or cytokines associated with inflammatory cells are also potentially harmful because they may damage tissue and aggravate injury.

Aim

Was to explain the clinical and pathophysiologic meaning of Interleukin 10 (IL-10) elevation in acute coronary syndrome (ACS) by clarifying whether IL-10 release is a factor initiating the inflammatory process in Myocardial Infarction or is predominantly a response to that clinical condition. The other point is to assess the correlation between the level of IL-10 and other cardiac biomarkers for risk prediction in ACS.

Methods

Sixty patients were recruited to the study with a diagnosis of ACS as designed by American Heart Association (AHA) recommendations, all of them were admitted to the Intensive Care Units, Critical Care Medicine Department, Faculty of Medicine, University of Alexandria. Those patients were categorized into four groups: group I: Unstable Angina, group II: ST-segment elevation myocardial infarction with successful thrombolytic therapy, group III: STEMI with failed thrombolytic therapy, and a control group of matched age and sex (10 control persons). Full history and comprehensive clinical assessment, 12-lead ECG and biochemical analysis of CK-MB, troponin, c-reactive protein (CRP) and IL-10 were performed in all the patients and control groups. Blood samples were taken for all groups and control for cardiac biomarkers (by dimension RXL), CRP (Nephelometry Dade Behring), and IL-10 (ELISA). All the samples were stored for the study and processed in one setting by a clinical pathologist.

Results

IL-10 level showed a significant difference between all groups as IL-10 concentrations were significantly increased in ACS in comparison with the control group. We found a statistically significant inverse correlation between IL-10 and CRP in all patient groups. A full explanation of the results will be mentioned separately.
Comparative clinical study between dexmedetomidine and fentanyl as adjuvants to bupivacaine in ultrasound-guided supraclavicular brachial plexus block for upper limb surgeries: a randomized study
Authors: Elenain Mohamed M.A. , Zaher Mostafa M.A. , Ahmed Osama H. , Gadallah Mahmoud F.
Published: February 2025

Background

The use of regional nerve block techniques is shown to successfully minimize the response to stress in patients. In addition, the administration of small amounts of anesthetic medicines is consistently advantageous for individuals with diverse comorbidities. The objective of this work was to evaluate the motor and sensory properties of ultrasound (US)-guided supraclavicular brachial plexus block (SCBPB) utilizing bupivacaine 0.5% alone or in combination with dexmedetomidine or fentanyl among individuals having elective upper limb surgery.

Patients and methods

This prospective, randomized, double-blinded study was performed on 150 individuals with the American Society of Anesthesiologists class I and II, who underwent elective upper limb surgeries utilizing US-guided SCBPB. Participants were divided into three equal groups at random; group D (dexmedetomidine group) was administered 30 ml of bupivacaine 0.5% plus 100 μg of dexmedetomidine (2 ml); group F (fentanyl group) was administered 30 ml of bupivacaine 0.5% plus 100 μg of fentanyl (2 ml); and group C (control group) was administered 30 ml of bupivacaine 0.5% plus 2 ml normal saline 0.9%. All patients received US-guided SCBPB with 32 ml of the local anesthetic mixture.

Results

The length of motor and sensory blockade was substantially longer in group D compared with group F and group C, with significantly faster onset and prolonged duration in group F compared with group C. The visual analog scale at 4 h was substantially greater in group C compared with groups D and F, but at 6, 8, and 24 h it was substantially higher in both groups F and C compared with group D. Modified Ramsay score 15, 30, and 60 min after injection was substantially greater in group D and group F contrasted to group C. Time for first postoperative call for analgesia was substantially longer in group D contrasted to group F and group C and was substantially longer in group F contrasted to group C. Total analgesic consumption was substantially decreased in group D compared with groups F and C.

Conclusions

The addition of 100 μg of dexmedetomidine in SCBPB was more efficient in achieving faster onset and prolongation of motor and sensory duration in addition to ensuring sufficient intraoperative analgesic provision.
Is nasal closure an effective treatment for severe refractory epistaxis in HHT? A scoping review and narrative synthesis
Authors: Bickerton R , Gera R , Ross T , Rennie C
Published: February 2025

Introduction: Hereditary haemorrhagic telangiectasia (HHT) is an uncommon genetic disorder characterised by recurrent, severe
epistaxis which poses significant management challenges. Nasal closure has emerged as a treatment for refractory cases, however
there is limited research on its outcomes. We aim to consolidate existing evidence to assess its efficacy and safety.
Methods: We conducted a systematic search of the Cochrane library, EMBASE, PubMed and non-indexed publications from the
past 30 years. Two independent reviewers extracted data and assessed bias from included studies. Findings were summarised via
narrative synthesis due to heterogeneity of included studies.
Results: 192 patients from ten studies underwent nasal closure. Frequently used outcome measures were validated epistaxis
severity scores, Glasgow Benefit Inventory and haemoglobin trends. Surgery improved quality of life and reduced epistaxis severity
post-operatively. Partial dehiscence is a frequently reported complication which is usually successfully treated with revision
surgery.
Conclusions: Nasal closure reduces epistaxis severity, improving quality of life in patients with severe, refractory HHT-related
epistaxis, providing a valuable treatment option for the most challenging cases. The strength of our conclusions is limited by the
heterogeneity of outcome measures. To our knowledge, this is the largest pooled database of patients who have undergone nasal
closure.
Greenhouse Gas Emissions from Fuel Cell Heavy-Duty Vehicles in China:
A Cradle-to-Gate Analysis
Authors: Mu Zhexuan , Deng YunFeng , Bai Fanlong , Zhao Fuquan , Liu Zongwei , Hao Han , Liu Ming
Published: February 2025

Considered as one of the most promising technology pathways for the transport
sector to realize the target of “carbon neutral,” fuel cell vehicles have been
seriously discussed in terms of its potential for alleviating environmental
burden. Focused on cradle-to-gate (CtG) stage, this article evaluates the
environmental impacts of fuel cell heavy-duty vehicles of three size classes and
three driving ranges to find the critical components and manufacturing processes
in the energy context of China. The findings show that the greenhouse gas (GHG)
emissions of the investigated fuel cell heavy-duty vehicle range from 47 ton
CO2-eq to 162 ton CO2-eq, with the fuel cell system
and hydrogen storage system collectively contributing to 37%–56% of the total.
Notably, as the driving range increases, the proportion of GHG emissions
stemming from fuel cell-related components also rises. Within the fuel cell
system, the catalyst layer and bipolar plate are identified as the components
with the most significant impacts, accounting for 62.9% and 32.7%, respectively,
of the total GHG emissions from a fuel cell stack. The fundamental materials
constituting these components namely, platinum, titanium, and carbon black are
thus of considerable significance in the emission profile of the fuel cell
stack. For the hydrogen storage system, carbon fiber-reinforced polymer (CFRP)
layer stands out as the most important component, constituting 98% of the total
GHG emissions. It is suggested that GHG emissions from fuel cell systems and
hydrogen storage systems can be effectively curtailed by implementing strategies
such as grid decarbonization, reducing Pt loading in catalysts, and enhancing
fuel cell power density. Additionally, the potential for GHG emissions reduction
in fuel cell heavy-duty vehicles can be reinforced through the adoption of
lightweight materials and the integration of low-carbon alternatives into the
glider components.
Recycling data for Marine Spatial Planning: A review of maritime plans in Europe
Authors: Davret Juliette , Trouillet Brice
Published: February 2025

The ecosystem-based approach to marine spatial planning (MSP) is attracting increasing attention due to the requirements of Directive 2014/89/EU. To date, research on the ecosystem-based approach has focused mainly on the methods used to set up studies to assess the impact of human marine activities on ecosystems. This article presents a review of European marine plans, focusing in particular on the data and maps used to translate MSP. This study should contribute to our understanding of the notion of entanglement in planning. We draw on critical data studies, and in particular on the theory of intra-action and the concept of information in-formation, to understand the biases of data and maps. We used a method based on a content analysis to study maritime plans in Europe with regard to four main indicators enabling us to evaluate data and map uses in MSPs in relation to the ecosystem-based approach. Overall, our results suggest that the ecosystem approach is poorly transcribed on maps due to a lack of suitable data sets, geotechnological constraints, or political decisions. In particular, we observe a recycling of data for planning purposes. Our research has highlighted the importance of studying the entire data lifecycle, from production to display, in order to have a holistic vision of MSP.

Le domaine des études en Planification Spatiale Marine (PSM) basée sur les approches écosystémiques suscite une attention croissante en raison des exigences de la directive 2014/89/UE. À ce jour, la recherche sur les approches écosystémiques s’est principalement concentrée sur les méthodes utilisées pour mettre en place des études visant à évaluer l'impact des activités marines humaines sur les écosystèmes. Ce document présente un examen des plans marins européens, en se concentrant en particulier sur les données et les cartes utilisées pour traduire la PSM. Cette étude devrait contribuer à notre compréhension de la notion d'enchevêtrement dans la planification. Nous nous appuyons sur des études de données critiques, et en particulier sur la théorie de l'intra-action et le concept d'information en-information, pour comprendre les biais des données et des cartes. Nous avons déployé une analyse de contenu portant sur les plans maritimes en Europe au regard de 4 indicateurs principaux permettant d'évaluer les usages des données et des cartes dans les PSM au regard de l’approche écosystémique. Globalement, nos résultats suggèrent que l'approche écosystémique est peu retranscrite dans les cartes en raison d'un manque de jeux de données adaptés, de contraintes géotechnologiques ou de décisions politiques. En particulier, nous observons un recyclage des données à des fins de planification. Notre recherche a mis en évidence l'importance d'étudier l'ensemble du cycle de vie des données : de la production à l'affichage, afin d'avoir une vision holistique des PSM.
Tetiaroa diachronic geomorphology 1955 -2023 Monitoring the shoreline and vegetation cover of tropical atoll in the climate change context
Authors: Stoll Benoît , Fischer Tobias , Daniellot-Dejoux Julie , Hopuare Marania , Murphy Frank
Published: February 2025

The Tetiaroa atoll is virtually free of anthropogenic pressure, making it a textbook case for observing the impact of climate change on the pristine coral atolls of French Polynesia. A geospatial databasedating back to 1955 was used to map and analyze erosion and accretion phenomena on the atoll's motu (Tahitian name for islets). Its diachronic analysis documents two types of motu: those with a coralline base, which experience minimal movement over time, and the sandy motu which, on the contrary, exhibit significant dynamics linked to strong swells and storms. While we cannot yet link the observed dynamics to climate change and rising sea levels, these results will help us better understand the future impacts of extreme climatic events on Polynesian atolls.
Cyberstalking en parejas juveniles
Authors: Cerezo Domínguez Ana Isabel , García Cornejo Remedios
Published: February 2025

El trabajo que se presenta consiste en una investigación sobre el fenómeno del cyberstalking, centrado concretamente en las relaciones de pareja juveniles. Más allá del conocimiento de la prevalencia de este fenómeno, el objetivo principal que se persigue es conocer aquellas características más novedosas y/o llamativas sobre el cyberstalking. Para ello, se han recogido datos procedentes del Sistema VioGén sobre denuncias de cyberstalking de menores de 25 años y se ha llevado a cabo una revisión y análisis cuantitativo y cualitativo de dichos datos. Los principales resultados nos llevaron a concluir que en prácticamente todos los casos analizados tiene lugar ambos tipos de conductas, es decir, tanto online como offline (94,8%), habiéndose hallado conductas online de forma exclusiva tan sólo en el 5,2% de los casos, siendo las más frecuentes las amenazas a través de mensajes (SMS o WhatsApp). La aparición o aumento de estas conductas se produjeron tras la ruptura de la relación de las parejas, teniendo estas parejas más características en común con las parejas adultas que con las jóvenes.
Low dose deltamethrin exposure affects gene expression in rat frontal cortex
Authors: Wu Junze , Shah Ariv , Ridi Rami , Rashid Zacharia , Ali Sajid Imami , Saferin Nilanjana , Burkett James Patrick
Published: February 2025

Pyrethroids are a class of commonly used synthetic insecticides, widely used in agricultural and residential settings due to their efficacy and relatively low environmental impact. Nonetheless, epidemiological studies have found that exposure to pyrethroids during developmental stages is linked to risk for neurodevelopmental disorders. However, the molecular mechanisms behind these neurotoxic effects remain unclear. Our study investigates the impact of oral exposure to deltamethrin, a widely used Type II pyrethroid pesticide, on gene expression in the frontal cortex of rats. We used differential gene expression data from frontal cortex dissections from male Long-Evans rats exposed to a 3 mg/kg oral dose of deltamethrin (or vehicle) to perform a 3Pod analysis in R Studio, which included GSEA, Enrichr, and iLINCS analyses. We found that rats who were exposed to deltamethrin had significant changes in gene expression in cortex in pathways related to inflammation, apoptosis, cellular energy metabolism, and synapses. Our study provides important insight on the effects of pesticide exposure on the brain and possible treatments and preventions. This study also emphasizes the need for further research on pyrethroid pesticides and their relationship to neurodevelopmental disorders.
Borrelia burgdorferi Tolerance-Associated Changes in Gene Expression of Murine Macrophages
Authors: Chen Sophia , Deng Ricki , Hadi Anis , Nandwana Sara , Ryan William , Presloid John B. , Wooten R. Mark
Published: February 2025

Lyme disease, caused by the spirochete Borrelia burgdorferi (Bb), is the most prevalent vector-borne disease in the United States. Macrophages, key cellular players in the innate immune response, exhibit diminished functionality over time during Bb infection, potentially leading to chronic infection. This study explores the transcriptional changes associated with macrophages that develop tolerance to Bb. Using RNA sequencing of murine bone marrow-derived macrophages exposed to Bb, we identified differentially expressed genes and dysregulated pathways between productively stimulated and tolerized macrophages. Key findings revealed significant downregulation of type-I interferon signaling and associated immune responses, suggesting mechanisms of immune tolerance. Additionally, connectivity analysis identified potential drug candidates for repurposing to enhance macrophage activity. Our results underscore the complexity of macrophage responses to Bb and provide a foundation for future research to develop targeted therapies aimed at modulating immune responses and improving treatment outcomes for Lyme disease patients. Ultimately, these findings offer new insights into the pathogenesis and potential treatment strategies for Lyme disease.
A inserção do profissional de Educação Física no Sistema Único de Saúde
Authors: Baumgärtner Lucas Vitor , Nunes Camila da Cunha , Fraga Matheus
Published: February 2025

Este estudo teve como objetivo descrever a atuação de cinco profissionais de Educação Física no Núcleo Ampliado de Saúde da Família e Atenção Básica de Brusque/ Santa Catarina. Foi realizado uma pesquisa qualitativa de caráter exploratório e de campo. Para tal, foram entrevistados e observados cinco profissionais atuantes no Núcleo Ampliado de Saúde da Família e Atenção Básica, sendo um profissional de cada Núcleo Ampliado de Saúde da Família e Atenção Básica do município de Brusque. Todas as entrevistas semiestruturadas e observações não-participantes das intervenções junto aos grupos do Núcleo Ampliado de Saúde da Família e Atenção Básica ocorreram no local de trabalho dos profissionais de Educação Física. Percebeu-se que as funções dos profissionais de Educação Física no Núcleo Ampliado de Saúde da Família e Atenção Básica, apesar de ser muito participativo nos grupos de atividades físicas, vai muito além disso. Mesmo suas funções estando descritas em documento, para usuários, e, para outros integrantes das equipes do Núcleo Ampliado de Saúde da Família e Atenção Básica fica restrita a desenvolver grupos de atividades físicas. Contudo, segundo os relatos, os profissionais de Educação Física participam ativamente dos acolhimentos nas Unidade Básica de Saúde, nos atendimentos compartilhados, na territorialização e das reuniões multidisciplinares nas Unidades, além das reuniões mensais da equipe Núcleo Ampliado de Saúde da Família e Atenção Básica.
Avaliação cardiorrespiratória em nadadores de elite: uma revisão
Authors: Cabral Jonathan Sadrack Amancio da Silva , Costa Adalberto Veronese da , Cardoso Glêbia Alexa
Published: February 2025

Esta pesquisa tem por objetivo analisar a aplicabilidade da avaliação direta do desempenho cardiorrespiratório em nadadores de elite em seu contexto natural. Foi realizada uma revisão integrativa da literatura, com busca em bases de dados específicas. A formulação da pergunta seguiu o modelo PICO (População, Intervenção, Comparação e Desfecho), e os critérios de inclusão/exclusão foram estabelecidos. A pesquisa foi conduzida de maio a julho de 2023, nas bases Medline (PubMed), EMBASE (Elsevier) e Biblioteca Virtual em Saúde (BVS). Foram encontrados 943 artigos após a busca inicial, dos quais 16 foram incluídos na revisão. Os estudos analisados demonstraram heterogeneidade em relação aos sexos dos atletas avaliados, sendo que a maioria incluiu ambos os sexos. A resistência à fadiga e a técnica de nado foram aspectos frequentemente investigados. Os protocolos de avaliação direta também foram discutidos, com destaque para o método Breath-by-Breath utilizando snorkel adaptado. A avaliação do VO2max é crucial para predizer o desempenho de nadadores de elite, porém são necessários mais estudos nesse contexto. A disponibilidade limitada de equipamentos e o alto custo dos mesmos representam desafios para a realização de avaliações diretas em ambiente aquático, o que reforça a importância de pesquisas adicionais nessa área.
Strategies for Working with Students with ADHD in Physical Education. A Literature Review
Authors: Vásquez Pilicita Cristian Marcelo
Published: February 2025

Physical Education (PE) provides an essential platform for students with Attention Deficit Hyperactivity Disorder (ADHD) to develop physical, social, and cognitive skills. However, the unique characteristics of ADHD, such as inattention, hyperactivity, and impulsivity, pose challenges for PE teachers. This study aims to review effective strategies that PE teachers can employ to enhance the learning experience for students with ADHD since it is extremely important to highlight the individual cognitive, motor, and social skills of children and young people. Key strategies include the implementation of structured and predictable routines, which help reduce anxiety and increase focus. Additionally, incorporating short, varied activities can cater to the limited attention spans typical of students with ADHD, keeping them engaged and motivated. Individualized instruction is critical, utilizing clear, concise instructions and frequent positive reinforcement to encourage desired behaviors. Breaks and physical activities interspersed with teaching can help manage hyperactivity and improve concentration. The use of visual aids and hands-on demonstrations can cater to diverse learning styles and enhance understanding. Moreover, collaboration with special education professionals and regular communication with parents can provide insights into each student's needs and progress, allowing for tailored interventions. Creating a supportive and inclusive environment is paramount, fostering peer relationships and minimizing stigmatization. These strategies collectively contribute to an effective PE program that accommodates the needs of students with ADHD, promoting their physical health, social development, and academic success. Through understanding and adaptation, PE teachers can make a significant positive impact on the educational experiences of students with ADHD.
Impactos das atividades físicas ao ar livre sobre a saúde e bem-estar em Santos/Brasil
Authors: Gomes Ricardo José , Miguel Andrea Gamito Santos Aguiar
Published: February 2025

A prática de atividade física (AF) no tempo de lazer tem se mostrado uma ferramenta essencial para a melhoria da qualidade de vida, saúde e bem-estar. O objetivo deste projeto foi investigar o impacto de atividades físicas desenvolvidas no parque e orla do município de Santos/SP sobre a saúde, percepção de qualidade de vida e fatores de adesão (permanência). Foram aplicados questionários com perguntas abertas e fechadas a 76 usuários matriculados e 26 usuários espontâneos, praticantes regulares de AF nos cenários do Parque Roberto Mário Santini e Postos Orla no município de Santos/Brasil. A pesquisa buscou avaliar a percepção dos participantes sobre saúde, qualidade de vida, bem-estar e aspectos relacionados à estrutura dos locais. Os resultados indicaram que a oferta de espaços públicos adequados para a prática de AF é uma relevante estratégia para a promoção e proteção da saúde, destacando a importância da supervisão de profissionais de educação física. Independentemente da modalidade praticada, houve uma melhora significativa no autorrelato de saúde dos usuários após o início das atividades. Esses resultados podem auxiliar na formulação de políticas públicas nas áreas de saúde, esportes e meio ambiente, promovendo a prática de AF ao ar livre como estratégia de saúde comunitária.
Las fosas clandestinas: necroescritura, duelo y subjetividad
Authors: Martínez Martínez Miguel Ángel
Published: February 2025

El objetivo de las presentes consideraciones se despliega en torno a las fosas clandestinas como una inscripción de las violencias extremas en el México contemporáneo. Desde tales coordenadas, se realiza una exploración filosófica, desde las experiencias de sufrimiento social, que subvierta elementos de comprensión en las variaciones de las violencias extremas. En este registro, el nudo entre la ley y exclusión, injusticia y Estado, política y crimen establecen tejidos necroescriturales para situar al pensamiento ante el cuerpo muerto en condiciones de exclusión y marginalidad. Se explora el esfuerzo fallido del pensamiento como punto de partida de un planteamiento que marca una tópica fuera de sí, del espacio clandestino como instancia para una construcción teórica vital anclada en el dolor de la muerte violenta, la memoria y el cadáver agraviado.
Estrés laboral un detonante de desempeño laboral en el Hospital General Alfredo Noboa Montenegro
Authors: Limache Barragán María Alicia , Tello Núñez Cintya Lisbeth
Published: February 2025

Combatir el estrés laboral es uno de los mayores retos en el ámbito hospitalario, que impacta de manera directa en el desempeño del personal de salud. En este contexto, el objetivo general del estudio es analizar cómo el estrés institucional se relaciona con el desempeño laboral de los servidores de salud pública del Hospital General Alfredo Noboa Montenegro. Para ello, se utilizó un muestreo no probabilístico que permitió suministrar 65 encuestas al personal de la casa de salud. Además, se utilizó la prueba de correlación de chi-cuadrado para identificar el grado de relación entre el estrés y el desempeño laboral.  Los resultados obtenidos mostraron que el estrés tiene un impacto significativo en el desempeño laboral (p<0,002). Se concluyó que el estrés institucional afecta de manera considerable en el desempeño laboral. Asimismo, se evidenció que está estrechamente relacionado con el desarrollo de habilidades, la autonomía, y especialmente con el apoyo social recibido por parte de colegas y supervisores, elementos clave para el bienestar y la productividad del personal hospitalario.