bluuebunny/crossref_metadata_2025 huggingface dataset:
Modeling transmission dynamics of measles in Nepal and its control with monitored vaccination program
Authors: Pokharel Anjana , Adhikari Khagendra , Gautam Ramesh , Uprety Kedar Nath , Vaidya Naveen K.
Published: June 2022

Measles is one of the highly contagious human viral diseases. Despite the availability of vaccines, measles outbreak frequently occurs in many places, including Nepal, partly due to the lack of compliance with vaccination. In this study, we develop a novel transmission dynamics model to evaluate the effects of monitored vaccination programs to control and eliminate measles. We use our model, parameterized with the data from the measles outbreak in Nepal, to calculate the vaccinated reproduction number, $ R_v $, of measles in Nepal. We perform model analyses to establish the global asymptotic stability of the disease-free equilibrium point for $ R_v < 1 $ and the uniform persistence of the disease for $ R_v > 1 $. Moreover, we perform model simulations to identify monitored vaccination strategies for the successful control of measles in Nepal. Our model predicts that the monitored vaccination programs can help control the potential resurgence of the disease.
Self-Care and Self-Advocacy for Improved Educator Engagement and Satisfaction
Authors: Davis Brennan , Chick Whitney
Published: June 2022

Teachers are leaving the profession at high rates for myriad reasons, including heavy workloads, too little time to complete tasks, lack of administrative support, inadequate professional development, and insufficient collaborative support. Well-being, a relatively new research area in relation to teachers, is at the heart of the issue of teacher retention. This chapter provides background information on teacher retention, an overview of self-care and self-advocacy for teachers, and strategies for teachers and administrators to implement for teachers' overall well-being. Teachers who work in supportive environments that allow for innovation, authentic collaboration, and leadership opportunities often have higher job satisfaction and perceptions of self-efficacy. Additionally, teachers whose well-being is cared for are better teachers, and student outcomes are positively correlated to increased teacher satisfaction, self-efficacy, and empowerment.
Coping With Compassion Fatigue Through Self-Care
Authors: Wolfe Trudi Pinnick
Published: June 2022

This chapter focuses on how the stress of teaching can lead to compassion fatigue. It will examine the general stressors of teaching which have led to the current teacher shortage with a special focus on the unique stress of teaching students who have experienced trauma. In addition, it will offer a snapshot of how trauma presents itself in the classroom and some of the challenges that educators experience. This chapter will share one school's experience with helping their teachers cope with compassion fatigue through a professional development series covering these topics: defining compassion fatigue and its impact, coping strategies, and the importance of self-care. Data will be presented to show the effectiveness of this intervention at this author's school.
Occupational Health and Well-Being in Higher Education Institutions in Mexico
Authors: Montaudon- Tomas Cynthia Maria , Pinto-López Ingrid N. , Amsler Anna
Published: June 2022

This chapter presents an overview of occupational health in remote work from the self-care perspective. A literature review regarding remote working conditions and their effects on health and well-being is included, along with an analysis of the most relevant self-care and practices that have been developed for working at the distance. The study focuses on faculty, specifically at a private university in Puebla, Mexico, and the effects of the pandemic-induced remote work schemes on their well-being, along with the most common ailments that emerged from remote working conditions and self-care practices that can be adopted to prevent or reduce them. A survey was conducted among faculty members to understand the health implications of remote work and what people have been doing to deal with them. The concept of health circles is introduced to help explain specific actions taken to promote self-care and group care.
A Critical Interrogation of the Same Sex Marriage Prohibition Act 2013 Against the Backdrop of the Human Rights Provisions of the Nigerian Constitution
Authors: Akogwu Agada
Published: June 2022

That Nigeria ranks among the most homophobic countries globally is not in doubt. Africa's most populous nation took its ‘enviable' position in the comity of homophobic nations of the world with the passage of the Same-Sex Marriage (Prohibition) Act in the year 2013. With the passage of the SSMPA, sexual minorities in Nigeria not only find themselves in a complex situation, but also on an apparent collision course with the 1999 Constitution of the Federal Republic of Nigeria (CFRN). The complex dilemma being confronted by sexual minorities in Nigeria is therefore the choice between exercising their right to fully express themselves in line with their right to sexual orientation and becoming vulnerable to criminal prosecution in accordance with the provision of Nigeria's plethora of homophobic laws or obeying the dictates of homophobic laws. The Nigerian Constitution is regarded as the paramount law of the land, the grundorm, from which all other laws derive their legality and legitimacy.
Soil-Water Management With AI-Enabled Irrigation Methods
Authors: Singh Ved Prakash , Khedikar Shirish , Mathew Jimson , Kulshrestha Lucky
Published: June 2022

In India, farming assumes many conventional and modern processes, having large impact on GDP. Modernizing the old methods diminishes the manual practices at fields. Irrigation is one of these processes, which involves several activities like soil parameters estimations, arrangement of watering instruments with substantial itemized and labour costs. It directly affects soil quality, water availability for the plants, and ultimately, affects the growth and yield of the crops. If irrigation is well managed with accurate soil-water availability estimation, minimizing water requirement, and intelligent techniques of applying the water in sites of interest, then significant reduction in overall farming cost can be achieved with retaining soil nutrients and reusable irrigation facilities in the fields.
Flood Assessment Using Hydrodynamic HEC-RAS Modelling
Authors: Rana Vaishali I. , Pathan Azazkhan I. , Patel Dhruvesh P. , Agnihotri Prasit G. , Patel Samir B.
Published: June 2022

River flooding causes several human and financial casualties, and hence, it is necessary to perform research studies and implement subsequent actions consistent with the nature of the river. To minimize flood damage, floodplain zoning is a prominent non-structural measure in planning the areas surrounding the river. The present study uses HEC-RAS Version 5 to develop a flood model for the Chandan River, situated in the southern part of Balaghat district. The Digital Elevation Model (DEM) used for this analysis is 30m open source CartoDEM V-3 R1. The peak floods of 1990, 2002, and 2006 are taken into consideration. The river reach is divided into 48 cross sections, and a one-dimensional steady flow analysis is performed on HEC-RAS to assess the flood. The depths observed in the floods of 1990, 2005, and 2006 are 5.99 m, 3.2 m, and 3.49 m, respectively. The coefficient of correlation (R2) is obtained as 0.954 which shows the consistency and accuracy of the model. This study can help governing bodies to plan the city and attenuate the losses caused by floods in the Chandan River.
A Novel Approach to Enhance the Employability Skills of Higher Education Students Through Teaching Learning Techniques and Tools
Authors: Patra J. P. , Verma Gurudatta , Rathore Yogesh Kumar , Jain Alok Kumar , Samal Sumitra
Published: June 2022

The aim of higher education is to make the youth employable, but in the last few years, we are not getting to see its result. Employability skills are extremely important for any institution. In today's higher education and placements scenario, the lack of employability skills is one of the main reasons why students are not getting jobs in the field of technical education, especially engineering. Through this chapter, the authors give information to upsurge the employability skill of higher education students through teaching-learning techniques, soft skills, technical skills, and project-based learning.
The Experiences of Preparatory School Students With Online Language Classes and Tools
Authors: Aysu Semahat , Çankaya Pınar , Karaduman Güray
Published: June 2022

As language learning is based on communication and interaction, this study will mainly focus on how synchronous and asynchronous online language learning processes affect language learners, what students think about online language classes and tools, and what they suggest in order to improve the language teaching. Therefore, in an attempt to reveal the way online language learning process has affected the learners, the researchers designed a qualitative study in which the following three domains are highlighted: 1) self-reported effects of synchronous online language learning on students' interactional ability, 2) the attitudes of the participants toward synchronous and asynchronous online language learning and tools, 3) the challenges the participants have faced. By doing so, the researchers aimed to reach a better understanding of learners' reactions to online language instruction in order to make suggestions for improving online language teaching practices through practical and suitable teaching tools and further enhance the lifelong learning process.
A New Model of Tourism Destination Planning and Management
Authors: Pimentel de Oliveira Danielle
Published: June 2022

Vaccines have opened up a new horizon for tourism worldwide. Municipalities with significant dependence on the sector in their economies will have to adjust to the new needs and expectations of their visitors. Following COVID-19, the key to the development of balanced and sustainable tourism will be the rapid power of adaptation, which, in addition to the 17 SDGs, will have to rely on the involvement of the destination's stakeholders and on the “re”-knowledge of their own reality. The study reflects on the necessary adaptation of tourist municipalities to the reality of the current tourist environment, through the effective use of accessible tools and the recognition of the needs of the new visitor. The idea of destination emotional intelligence is proposed on the basis of a comparative adaptation between the theory of intelligence and the new criteria to be met by post-COVID-19 tourist destinations.
Toward Achievement of the UN Ocean Decade: Does “CANAL STUDY” in Central Tokyo Bay Area Enhance Ocean Literacy?
Authors: Tsuyoshi Sasaki
Published: June 2022

Abstract “CANAL STUDY” at a junior high school in Minato Ward in the Central Tokyo Bay Area has been involved with the Tokyo University of Marine Science and Technology Aquatic Marine Environmental Education efforts to promote Aquatic Marine Environmental Literacy
(AMEL). AMEL is the ability to understand the interaction between humans and the aquatic environment, and to utilize the knowledge in decision making. AMEL is almost synonymous with Ocean Literacy, but regional characteristics such as traditional knowledge and conventional knowledge have been
added. In this article, the research results of CANAL STUDY will be introduced and the significance of CANAL STUDY will be discussed from the viewpoint of self-determination theory and relational values, suggesting the direction of UNESCO Ocean literacy education planned for the UN Decade
of Ocean Science for Sustainable Development. The CANAL STUDY, based on the learning cycle theory, has fostered AMEL, scientific inquiry skill development, attachment to the community, a sense of competence, and motivation for each learner to take the initiative for solving problems, such
as improving the water quality of Tokyo Bay. Currently, Ocean Literacy Education is being tackled all over the world, but CANAL STUDY is an effective example that shows concrete methods and directions for the effective promotion of Ocean literacy education. In addition, it was shown that enhancing
Ocean literacy fosters relational values.
Implementing SDG 14 Under Principles, Ethical Values, and Environmental and Economic Justice for Small-Scale Artisanal Fishermen in Costa Rica
Authors: Borrás Marvin Fonseca , Rivera Vivienne Solís
Published: June 2022

Abstract In Costa Rica, as in other countries, vulnerability and marginalization experienced by small-scale artisanal fishermen, fisherwomen, and mollusk collectors are the result of the absence of a human rights‐based approach to marine conservation and development
in the coastal areas. Usually non-formality, absence of tenure and access rights, bad health services, and low education compared to other productive sectors are part of what fisherfolks experience. This commentary shares how working in a long-term and integral way with these communities and
incorporating a human rights‐based approach strengthens the contributions that the sector provides toward the sustainable use of the fishing resource of their marine territories with dignity, equity, and justice, especially in the context of SDG 14, the Ocean Decade, and 2022 as the
International Year of Artisanal Fisheries and Aquaculture. Born during the COVID pandemic, the initiative of a fair and equitable Sea Market for the fishing products of these small-scale communities supported by CoopeSoliDar RL 1 and the Marine Responsible Fishing areas and marine
territories of life network in Costa Rica is today a concrete example of how a fair and just market can contribute positively to the objectives of sustainable development and the fundamental elements contained in the Convention on Biological Diversity, preservation of the natural environment,
sustainable use, and fair and equitable distribution of benefits.
Empowering Women for the United Nations Decade of Ocean Science for Sustainable Development
Authors: Sun Zhen , Kitada Momoko , Buckingham Susan , Chavez-Rodriguez Mariamalia , Jarnsäter Jill , Johannesen Ellen , Long Ronan , Neat Francis , Ojwala Renis Auma , Schofield Clive
Published: June 2022

Abstract Central to the achievement of the transformational vision and ambitions of the United Nations Decade of Ocean Science for Sustainable Development (Ocean Decade) is human behavioral change. Fundamentally, these changes must embrace equality, diversity, inclusivity,
accountability, and transparency. The Ocean Decade offers an unprecedented opportunity to fast-track gender equality and the empowerment of women in ocean science at all levels, and to achieve it by 2030. This means embedding gender equality as a cross-cutting principle in the planning, implementation,
and application of ocean science. The Programme on Empowering Women for the United Nations Decade of Ocean Science for Sustainable Development directly addresses current gender inequality in both the production and use of ocean science knowledge in the Ocean Decade, with a particular focus
on ocean governance systems that conduct, coordinate, and apply ocean science.The Programme aims to collect baseline data on gender balance, investigate barriers and challenges women face in career progression, and identify good practices to enhance women's participation in ocean science
at all levels. Ultimately the research seeks to provide solutions to overcome such challenges and catalyze actions to achieve gender equality that will drive the Ocean Decade toward its goals.
Scientific Ocean Drilling: A Celebrated Past, An Essential Future
Authors: Cotterill Carol , Brenner Carl
Published: June 2022

Abstract Scientific ocean drilling is an exemplar of international, collaborative research, having provided foundational and transformative knowledge across a wide range of Earth science disciplines. With a legacy of extraordinary discoveries and a visionary new Science Framework
to chart its path forward, ocean drilling will continue to provide critical insights into the interconnectedness of Earth systems and use those insights for the benefit of society.
OneArgo: A New Paradigm for Observing the Global Ocean
Authors: Owens W. Brechner , Zilberman Nathalie , Johnson Ken S. , Claustre Hervé , Scanderbeg Megan , Wijffels Susan , Suga Toshio
Published: June 2022

AbstractOneArgo is a major expansion of the Argo program, which has provided two decades of transformative physical data for the upper 2 km of the global ocean. The present Argo array will be expanded in three ways: (1) Global Core: the existing upper ocean measurements will be extended to high latitudes and marginal seas and with enhanced coverage in the tropics and western boundaries of the major ocean basins; (2) Deep: deep ocean measurements will be obtained for the 50% of the global oceans that are below 2,000-m depth; and (3) Biogeochemical: dissolved oxygen, pH, nitrate, chlorophyll, optical backscatter, and irradiance data will be collected to investigate biogeochemical variability of the upper ocean and the processes by which these cycles respond to a changing climate. The technology and infrastructure necessary for this expansion is now being developed through large-scale regional pilots to further refine the floats and sensors and to demonstrate the utility of these measurements. Further innovation is expected to improve the performance of the floats and sensors and to develop the analyses necessary to provide research-quality data. A fully global OneArgo should be operational within 5‐10 years.
Impact of Internal Corporate Social Responsibility on Employees’ Turnover Intention in the Hotel Sector: The Mediating and Moderating Roles of Job Satisfaction and Work-Life Conflict
Authors: Fernando, A. G. N. K. , Danthanarayana C. P.
Published: June 2022

The study examines the role of employee perceptions of Internal Corporate Social Responsibility (CSR) in employee Turnover Intention (TI) by exploring its mediating and moderating effects through Job Satisfaction (JS) and Work-Life Conflict (WLC) in the hotel industry. Data were collected from 130 employees in the top five hotels in Sri Lanka to explore employees' CSR experience. The hypothesized relationships were tested through the partial least squares structural equation modelling technique with SmartPLS-3. The results represent that, JS is completely mediated the relationship between CSR and TI while WLC is not moderating among CSR and JS. By providing a more socially responsible environment at the workplace, employee JS will enhance, and it directly reduces the TI of employees since employees feel like responsible citizens in society. The study enriches the available knowledge about the variables in organizational contexts and the understanding of the responses of employees while analyzing the CSR activities from employees’ perspectives.
IL-10 and TGF-β Increase Connexin-43 Expression and Membrane Potential of HL-1 Cardiomyocytes Coupled with RAW 264.7 Macrophages
Authors: Cox Cora B , Castro Mike , Brown Thomas L , Bigley Nancy J
Published: June 2022

Cardiac resident macrophages facilitate electrical conduction by interacting with cardiomyocytes via connexin-43 (Cx43) hemichannels. Cx43 is critical for impulse propagation and coordination between muscle contractions. Cardiomyocyte electrophysiology can be altered when coupled with noncardiomyocyte cell types such as M2c tissue-resident macrophages. Using cocultures of murine HL-1 cardiomyocytes and RAW 264.7 macrophages, we examined the hypothesis that cytokine signals, TGF-β1 and IL-10, upregulate Cx43 expression at points of contact between the two cell types. These cytokine signals maintain the macrophages in an M2c anti-inflammatory phenotype, mimicking cardiac resident macrophages. The electrophysiology of cardiomyocytes was examined using di-8-ANEPPS potentiometric dye, which reflects a change in membrane potential. Greater fluorescence intensity of di-8-ANEPPS occurred in areas where macrophages interacted with cardiomyocytes. Suppressor of cytokine signaling 3 (SOCS3) peptide mimetic downregulated fluorescence of this membrane potentiometric stain. Cx43 expression in cocultures was confirmed by fluorescence microscopy and flow cytometry. Confocal images of these interactions demonstrate the Cx43 hemichannel linkages between the cardiomyocytes and macrophages. These results suggest that TGF-β1 and IL-10 upregulate Cx43 hemichannels, thus enhancing macrophage–cardiomyocyte coupling, raising the cellular resting membrane potential and leading to a more excitatory cardiomyocyte.
Severe Acute Respiratory Syndrome Coronavirus 2 Epitope Mapping for Antibodies
Authors: Yang Jiaan , Zhang Peng , Cheng Wen Xiang , Wu Gang , Niu Qing Tian , Yang Lan , Luo Shun , Lin Xianghua , Zhang Lianshan
Published: June 2022

Epitope mapping of the interactions between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Abs is challenging because of complexity in protein three-dimensional structures. Protein structure fingerprint technology was applied for epitope mapping of 44 SARS-CoV-2 Abs with three-dimensional structure complexes. The results defined how the epitopes were distributed on SARS-CoV-2 and how the patterns of six CDRs from Abs participated in neutralization. Also, the residue–residue recognition revealed that certain residues had higher frequencies on the interfaces between SARS-CoV-2 and Abs, and the activity correlated with the physicochemical properties of the residues at the interface. Thus, epitope mapping provides significant lead information for development of epitope-based designs for Abs, vaccines, and diagnostic reagents. This is a bioinformatics project of structural data analysis; no animals or cells were used.
Primary Vulval Mucinous Adenocarcinoma of Intestinal Type Masquerading as Bartholin's Cyst
Authors: Subramanian Kalaivani Selvi , Sreerekha Jinkala , Badhe Bhawana Ashok , Penumadu Prasanth
Published: June 2022

Vulval carcinomas are rare and account for 3%–5% of female genital tract malignancies. Primary vulval adenocarcinoma of intestinal type is an extremely rare tumor which is considered metastatic until otherwise proven with very few case reports available in the literature. A 58-year-old woman presented with recurrent swelling in the genital region associated with pain. She had a past history of surgery done for Bartholin's cyst which was reported as adenocarcinoma. She underwent radical vulvectomy for the recurrent tumor which showed features of adenocarcinoma with glandular and papillary pattern with abundant extracellular mucin production and immunohistochemical (IHC) features favoring a diagnosis of primary vulval mucinous adenocarcinoma of intestinal type after excluding metastasis from other sites. As morphology cannot differentiate it from metastasis, a thorough investigation to rule out any primary in the gastrointestinal tract with a minimum IHC panel of markers including cytokeratin (CK) 20, CK7, carcinoembryonic antigen, and caudal-related homeobox 2 can help in confirming the diagnosis.
A comparative study of the effects of dexmedetomidine added as an adjuvant to bupivacaine, levobupivacaine, and ropivacaine in the brachial plexus blocks
Authors: Moolagani Ramanareddy Venkata , Annabhaktula Ashalatha , Vigrahala Padmavathi , Pilla Prasanna Eswari
Published: June 2022

Context:

Bupivacaine is the most common local anesthetic agent used for brachial plexus blocks (BB). Due to the adverse effects noted with bupivacaine, safer alternative agents such as levobupivacaine and ropivacaine are being used now.

Aims:

Although several studies exist comparing pairs of anesthetic agents, few studies have compared all three agents using dexmedetomidine (DMT) as an adjuvant. To bridge this knowledge gap, we undertook the present study.

Settings and Design:

This was a prospective, randomized, placebo-controlled, triple-blind comparative study.

Materials and Methods:

Eighty patients were randomly allocated to four study groups: group B, given bupivacaine alone, and groups BD, LD, and RD, given twenty-five ml of 0.5% bupivacaine, 0.5% levobupivacaine, and 0.75% ropivacaine, respectively, along with DMT 0.5 μg/kg body weight. Onset of the sensory and motor blocks; duration of the sensory block, motor block and analgesia of the block were compared between the groups.

Statistical Analysis Used:

Differences between the groups were analyzed using one-way analysis of variance and Tukey's honestly significant difference -β post hoc test for parametric data, and for nonparametric data, Chi-square test and Fisher's exact test were used.

Results:

The durations of analgesia observed were 7 ± 0.7, 13.4 ± 0.6, 12.7 ± 1.0, and 12.5 ± 0.6 h in groups B, BD, LD, and RD, respectively; these differences were statistically significant (F = 294.825, P < 0.001). Post hoc tests revealed a statistically significant difference between Group B and all the other groups, between the BD and LD groups, and between BD and RD groups. The times to onset of sensory blocks observed were 11.3 ± 11.3, 7.6 ± 0.8, 8.1 ± 0.8, and 8.4 ± 0.8 min in groups B, BD, LD, and RD, respectively, while the times to onset of motor blocks observed were 17.1 ± 1.5, 11.0 ± 0.9, 10.3 ± 1.0, and 10.2 ± 0.7 min in groups B, BD, LD, and RD, respectively.

Conclusions:

DMT added as an adjuvant to bupivacaine, levobupivacaine, and ropivacaine resulted in a statistically significant enhancement of the duration of analgesia.
How to select a journal for publication?
Authors: Tewari Mallika
Published: June 2022

Medicine is an ever-changing science, and the pace of this change has been rapid in recent years. A researcher in an academic institution is now obliged to publish their research work for career advancement with recognition, access to grants, fellowships, etc., as secondary objectives. Besides, it is paramount for anyone engaging in active clinical practice to remain up to date with recent advances in the field. Hence, it is the author's responsibility to publish authentic data with integrity as it helps modulate opinions on a wide platform globally in today's digital age. While the pressure to publish is immense, it is vital to have a system of checks and balances before publishing and adhere to good research practices because a wrong step may bring lasting discredit to the authors. This article attempts to provide an overview for novice researchers regarding how to select an appropriate journal for publication, evaluate it in view of its reach and relevance, and how to avoid predatory journals. The article also briefly outlines the various databases available, peer-review process, important journal metrics such as impact factor and indexing, and the concept of open access in a simple language to enable young authors to select the best journal for publishing their work.
Mental Health Problems among Mental Health Professionals
Authors: Kar Sujita Kumar , Shankar Akanksha , Singh Amit
Published: June 2022

Mental health issues are common among health professionals due to the enormously stressful nature of their work. The paucity of workforce, resources, and high patient load, are liable to make mental health professionals, including psychiatrists, overburdened. The work pressure, demand-output mismatch, and burden of expectations from psychiatrists may make them distressed despite their training in stress management. This review discusses key mental health issues faced by psychiatrists, their possible attributes, and remedial measures.
Open Repair for Juxta-Renal Aortic Occlusion in High-Risk Patients
Authors: Pandey Ashutosh Kumar , Manchikanti Sriram , Sun Neelamjingbha , Rajeev Akash , Gupta Aditya , Ramachandran C Sreekumar , Unnikrishnan Madathipat , Pitchai Shivanesan
Published: June 2022

Background:

Juxtarenal aortic occlusion (JRAO) is an infrequent form of aortic occlusion, resulting from a proximal progression of a distal aortic thrombus. The occlusion at or above the level of renal arteries may present with features of renal failure or intestinal ischemia along with increased severity of pelvic and limb ischemia. Surgical treatment of JRAO is complex and usually involves suprarenal clamping and poses a significant morbidity and mortality risk. Nevertheless, the current literature supports superiority of surgical bypass with excellent long-term outcomes and remains the preferred modality in JRAO. We reviewed the results of open surgical bypass in JRAOs, done at our center over a 5-year period.

Materials and Methods:

A retrospective analysis of 35 patients who underwent JRAO over the past 5 years was performed. Demographic data, comorbidities, clinical presentation, and surgical results were analyzed.

Results:

Of the 35 patients who underwent open surgical bypass, 34 were male, and one was female. The median age of the cohort was 56 years. All the patients had either disabling claudication, rest pain or tissue loss at presentation. The notable comorbid conditions were hypertension (91%), diabetes (51%), coronary artery disease (71%), and chronic obstructive pulmonary disease (37%). Direct aortic reconstruction was done in all cases, seven patients with critical limb ischemia underwent sequential infra-inguinal bypass, additional mesenteric bypass was done in one patient, renal artery revascularisation was done in three patients in the form of endarterectomy for two patients and aortorenal bypass in one patient. There was no perioperative mortality, and a 93% cumulative graft patency rate was noted.

Conclusion:

Open surgical reconstruction is a safe method for JRAO even in patients with comorbidities and offers excellent perioperative and long-term results.
Retrograde Percutaneous Tibial Approach for Complex Infrainguinal Occlusions in Chronic Limb-Threatening Ischemia After Failed Antegrade Transfemoral Approach
Authors: Bharath N R , Narasimhan Sunder , Kumar K N , Aggarwal Ankur
Published: June 2022

Introduction:

A significant proportion (20%) of patients with complex infrainguinal arterial occlusions cannot be recanalized using a conventional antegrade endovascular approach. Most of these patients will be poor candidates for open surgical reconstruction owing to the concomitant cardiovascular and pulmonary comorbidities or poor venous conduit. We present our experience using the percutaneous retrograde pedal approach for revascularization of infrainguinal arterial occlusions after failed conventional endovascular options.

Materials and Methods:

This is a retrospective observational study of all the patients admitted in our center from May 2019 to May 2021 for chronic limb-threatening ischemia with infrainguinal occlusive disease and attempted retrograde tibial approach after failed antegrade transfemoral approach. Procedural success was defined as residual stenosis of <30% after balloon angioplasty or stenting. Limb salvage was defined as freedom from major amputation during the follow-up period.

Results:

In a total of 20 patients managed with retrograde tibial approach, procedural success was achieved in 18 patients (90%). Limb salvage was achieved in 17 of the 18 patients who had procedural success during the follow-up period. One patient underwent below-knee amputation due to spreading infection.

Conclusion:

Retrograde tibial approach to recanalize infrainguinal arterial occlusions after failed traditional endovascular methods is safe and effective and should be advocated to avoid more invasive, time-consuming, and high-risk procedures as it offers high technical and procedural success rates with minimal complications.
Antegrade Access for Peripheral Vascular Disease Intervention of the Lower Limb – Our Experience at a Tertiary Center
Authors: Basavanthappa Rajendra Prasad , Mitta Nivedita , Ramswamy Chandrashekar Anagavalli , Desai Sanjay C , Chowdary R Hemanth Kumar , Kunapareddy Harikamal , Vishnumolakala Vijay Kumar
Published: June 2022

Purpose:

Antegrade superficial femoral artery (SFA) access for peripheral artery disease reduces the time, radiation, and contrast required as compared with contralateral common femoral access (CFA). However, this technique remains underutilized and understudied in the treatment of SFA, popliteal and tibial disease, and there remains limited data on the safety and efficacy of antegrade SFA access.

Materials and Methods:

An observational review of lower extremity peripheral arterial interventions was conducted from January 2014 to July 2021. Interventions necessitating CFA access such as iliac, common femoral, or deep femoral artery revascularization were excluded. In addition, interventions potentially requiring large sheaths were excluded. Relevant demographic and treatment variables including postoperative complications were abstracted.

Results:

We identified 482 patients, who underwent revascularization of the SFA, popliteal and tibial arteries. Antegrade SFA access was chosen in all these patients. Access was attained either through ultrasound or fluoroscopy guidance in 94.6% of patients. The overall rate of complications was low (access site complications, hematoma, pseudoaneurysm, etc.).

Conclusions:

Percutaneous antegrade SFA access can be performed safely and remains an effective alternative to retrograde CFA access with significantly less complications and is also associated with lesser utilization of fluoroscopy and contrast.
Quantification of Hemodynamic Parameters in Primary Great Saphenous Reflux using Colour Doppler in Clinical Settings and Effect of GSV Ablation on the Venous Arterial Flow Index
Authors: Jha Manvendu , Mukherji Ruchira , Mopagar Vishwajeet , Kumari Kirti
Published: June 2022

Purpose:

The aim of our study was to quantify venous reflux in outpatient settings using color Doppler and document objective improvement in hemodynamic parameters post ablation.

Methods:

Venous reflux was measured using color Doppler using venous-arterial flow index (VAFI), recirculation index (RCI), and percentage diameter change (PDC) (n = 30) and compared with healthy volunteers (n = 30), adjusted for age, sex, and body mass index (BMI). Patients with concomitant peripheral arterial disease (PAD), past history of deep venous thrombosis, chronic venous insufficiency, and venous ulcers were excluded from the study. Patients with reflux underwent RFA and VAFI was measured 6 months after treatment. Data were analyzed using IBM SPSS statistics software version 25. Tests of normality were applied before choosing statistical tests. Box-and-whisker plots with outliers were used to illustrate the difference between case and control groups. VAFI scores were compared pre- and postoperatively and Wilcoxon signed-rank test was applied for the comparison. P < 0.05 defined statistical significance.

Results:

Thirty patients with primary GSV reflux along with 30 healthy volunteers were adjusted for age, sex, and BMI. Clinical part of CEAP classification was C0 = 2, C1 = 6, C2 = 16, and C3 = 6 in reflux group and C0 = 26 and C1 = 4 in (n = 30) in healthy volunteers. There was a statistical difference in RCI, PDC, and VAFI across both groups (P < 0.5). In addition, VAFI decreased significantly after treatment at 6 months (1.38 preoperative to 0.95 postoperative, SD P < 0.5). Of the 30 patients, 21 had pain as the primary presenting symptom; 81% (17) reported a significant decrease in pain scores associated with hemodynamic improvement.

Conclusion:

RCI, PDC, and VAFI are accurate quantitative measurements of reflux in outpatient settings. VAFI is useful in objectifying the results of treatment. Symptomatic improvement in terms of pain score can be used to supplement the hemodynamic improvement though further substantiation of the above would be required in a larger cohort.
Contemporary Portrait of Aortic Bifurcated Bypass Procedures for Occlusive Disease in Indian Population
Authors: Kota Prajna B , Kota Albert Abhinay , Samuel Vimalin , Premkumar Prabhu , Selvaraj Dheepak , Stephen Edwin , Agarwal Sunil
Published: June 2022

Purpose:

We sought to scrutinize the current clinical profiles and postoperative outcomes, following aortic bifurcated bypass (ABB) for occlusive arterial disease, over the past ten years and compare them with our formerly published dataset.

Methods:

From January 2011 to December 2020, a prospective single hospital database was maintained for ABB procedures in patients with occlusive disease. Clinico-demographic profile and postoperative outcomes were surveyed and assessed for associations. Graft patency, amputation-free survival, and mortality were the primary end points. In addition, we did a comparison analysis with our historical cohort to appraise the shift in trends.

Results:

Over the past ten years, 140 patients (mean age of 54.5 years) underwent ABB procedures for aortoiliac occlusive disease (AIOD). Majority were males (94.3%) with chronic limb-threatening ischemia (88.6%). Atherosclerosis was the most common etiology (85.7%). There was a significant increase in smoking (P < 0.001), dyslipidemia (P < 0.001), coronary artery disease (P < 0.001), chronic kidney disease (P = 0.05), flow limiting infra-inguinal disease (P < 0.001), intermediate graft thrombosis and primary amputation rates in the contemporary cohort (P = 0.050). No significant changes were noted in the 30-day mortality rates. The contemporary primary patency rate is 76.9%, and secondary patency rate is 94.2%, compared to an overall patency of 84% in the historical cohort.

Conclusion:

Our study highlighted the epidemiological shift transpiring in patients affected by AIOD in India. Despite challenging clinical profiles, our outcomes remain unchanged and are comparable to western literature.
Unusual Etiologies of an Unusual Problem
Authors: Kadam Sameer , Pappu Vamsi Lakshman , Sharma Saakshi
Published: June 2022

We report on four patients, patient 1 with left upper quadrant pain as a result of splenic infarction; the patient was subsequently found to have a thoracoabdominal aortic thrombus extending through the celiac axis. Patient 2 with breathlessness due to COVID-19 and incidental finding of aortic thrombus. Patient 3 with right lower limb gangrene due to an embolus from a partial lumen occluding thrombus in the abdominal aorta and COVID-19 positive. Patient 4 with left lower limb ischemia As this remains a relatively rare disease, there is no consensus on the nature of disease, prognostic assessments, or optimal treatment strategy.
Clinical Profile and Outcomes in Surgically Treated COVID-19 Patients Presenting with Acute Limb Ischemia
Authors: Patel Jayesh , Rangwala Varin , Thakkar Zeel , Bhatt Ravi
Published: June 2022

Background:

Acute limb ischemia (ALI) refers to a sudden decrease in blood flow to the limb which threatens its viability. Such a sudden event of decreased or absent arterial supply to the limb causes ischemia and poor perfusion outcomes. The most common causes of ALI include embolism and thrombosis. Others include acute on chronic peripheral arterial occlusive disease or major trauma. It is well known to us that COVID-19 is a hypercoagulable state. In this prothrombotic state, patients can also present with ALI, with clinical features of pain, paresthesia, pulselessness, pallor, poikilothermia, and paralysis of the affected limb. Such patients rapidly progress to severe stages of limb ischemia that need immediate treatment to save the limb. Thus, our study aims to revisit the clinical features and outcomes of procedures performed on such patients.

Materials and Methods:

This is a single-center, retrospective study. COVID patients with ALI who underwent any surgical procedure, from February 2021 to July 2021, were identified from the surgical operation theater's list of the hospital. Detailed information regarding these patients was obtained from the digital software of the hospital. Detailed computed tomography angiography findings were also obtained from the radiology department. A required statistical study was done.

Results:

Nineteen COVID patients presenting with ALI and requiring surgical treatment were identified during the study period of 6 months. A complete study of their clinical presentations, surgical procedures performed and the outcomes, is done. The study shows that the most common site affected was the lower limb (95%) with occlusion occurring mainly in the popliteal artery, i.e., the lower limb artery.

Conclusion:

Recognition of limb ischemia at an early stage, considering it as a symptom or complication of COVID-19, may allow for early and prompt diagnosis and treatment of this condition.
Angioembolization of Renal Artery Pseudoaneurysm in Blunt Trauma Abdomen
Authors: Patel Jayesh , Patel Arya , Limbad Vishakha , Kapadiya Navneet
Published: June 2022

Pseudoaneurysm of the renal artery is a presentation of blunt abdominal injury. We present the case of a 40-year-old male with a history of road traffic accident with a complaint of severe abdominal pain and distention of the abdomen. Contrast-enhanced computed tomography (CECT) shows large perinephric hematoma with free fluid in the abdomen. He was treated conservatively for 48 h but having persistence hypotension with increase free fluids in the abdomen, so mesenteric injury and bowel ischemia was suspected and laparotomy performed and found retroperitoneal hematoma and rest are normal. After that he had persistent hematuria with shock. Repeat CECT showed large pseudoaneurysm of the right renal artery with extravasation of contrast with clot in the bladder. In view this condition, renal artery angioembolization was done.
Hybrid Procedures for Thoracoabdominal Aortic Aneurysms
Authors: Kattoor Tom Thomas , Nair Harishankar Ramachandran , Pandey Ashutosh Kumar , Kumar PM , Pitchai Shivanesan
Published: June 2022

The surgical repair of thoracoabdominal aortic aneurysm (TAAA) remains one of the most technically demanding surgical procedures in vascular surgery. High-volume centers still have significant morbidity and mortality rates of 12%–15%. Emergence of thoracic endovascular aneurysm repair (TEVAR) improved these figures but was limited by the availability of customized grafts and cost factors. An effective alternative approach hence is a hybrid procedure that involves the combination of open technique for debranching of viscerorenal aorta and use of standard TEVAR stent graft to cover aneurysmal segment. We report a case of an elderly male who underwent a successful staged Hybrid TEVAR procedure for Type 3 equivalent TAAA.
A Case Series of Lower-Limb Ischemia due to Thromboembolic cOmplication of COVID-19
Authors: Madhukar Kumar Premjeet , Bhuta Maunil , Shenoy Chetan , Shetty Aashik , Shetty Tilakdas
Published: June 2022

The World Health Organization was notified on December 31, 2019, that a cluster of pneumonia patients with an unknown origin had been discovered in Wuhan City, Hubei Province, China. Severe acute respiratory syndrome coronavirus 2 caused the pneumonia (coronavirus disease 2019 [COVID-19]). Fever, dry cough, and shortness of breath are among the most prevalent symptoms described by COVID-19 patients. In this case series, we discuss three cases of patients presenting with deep vein thrombosis for which they underwent inferior vena cava filter placement with thrombolysis and mechanical thrombectomy. These cases were unusual as they belong to the moderate category of COVID rather than severe category which commonly presents with coagulopathy.
The Cinch Knot Technique of Anatomical Fibular Collateral Ligament Reconstruction
Authors: Sahanand K. Santosh , Pandian Prashanth , Rajan David V.
Published: June 2022

Reconstructing the lateral collateral ligament (LCL) has started gaining importance with better appreciation of the knee anatomy and biomechanics. Over the years, a multitude of reconstructive techniques have been described. Among these, the anatomical reconstructions closely reproduce the native anatomy with better functional outcomes. In this technical note, we have described the cinch knot technique of anatomical LCL reconstruction, an implant free technique at the fibular end which satisfactorily recreates the native footprint of the LCL.
Extensor Mechanism Failure Following Total Knee Arthroplasty
Authors: Sharkey Samantha , Ejiofor Ikechukwu , van Duren Bernard , Akrawi Hawar , Pandit Hemant , Anand Sanjeev , Veysi Veysi T. , Palan Jeya
Published: June 2022

Extensor mechanism failure following total knee arthroplasty is a rare but potentially devastating complication with an overall incidence of 0.17%–2.5%. The 3 main causes of disruption include quadriceps tendon rupture, patellar fracture, or patellar tendon rupture. Clinical presentation can vary from asymptomatic to the acutely painful and swollen knee, but for most patients, there will be evidence of extensor lag and/or difficulty performing straight leg raise. A variety of treatment options have been described in the literature to date including nonoperative management with immobilization, particularly for patients with an extensor lag of <20°. Direct repair may be useful in the management of acute tendon ruptures; however, augmentation is now also recommended in addition. Options for augmentation include tendon autografts or synthetic materials. The use of allografts such as Achilles tendon allografts or complete extensor mechanism allografts and rotational flaps has also been described. Treatment of patellar fractures varies depending on fracture pattern, degree of extensor lag, presence of patellar component loosening, and patellar bone stock. The potential options for treatment include nonoperative management with immobilization, open reduction and internal fixation, patellectomy (either partial or complete), or revision surgery, although this list is not exhaustive. Outcomes are poor with complications including rerupture, postoperative infection, nonunion, or residual extensor lag with associated poor functional outcomes and high reoperation rates. There is a distinct lack of high-quality evidence in the literature at present, and as such, further research is required to make any recommendations for treatment.
Total Hip Arthroplasty in Ochronotic Arthropathy
Authors: Prabhakar R. Ponnaian , Gopal Parikshat , Prasad Rupesh , Pathania Kunjan
Published: June 2022

Ochronotic arthropathy is a rare amino acid metabolic disorder that causes arthritis knee and hip in the 4th and 5th decades of life. There are only a few documented cases in the literature. We report one such case of a 46-year-old washer man, its clinical presentation, imaging findings, intraoperative findings, and treatment by uncemented total hip replacement.
Posterior midline approach to odontoidectomy
Authors: Erdogan Koral , Solmaz Serdar , Abbasoglu Bilal , Caglar Yusuf Sukru , Dogan Ihsan
Published: June 2022

Background:

Basilar invagination (BI) is a common malformation of the craniocervical region where the odontoid process protrudes into the foramen magnum. Surgery in this region is difficult because of the complex anatomy of the craniocervical junction. Serious life-threatening complications have been observed with previously described approaches. Therefore, we conceived a novel surgical approach that can be implemented by neurosurgeons with different skill levels to facilitate better outcomes.

Methods:

We describe a new surgical technique for the treatment of BI that we used in two patients in whom cervical myelopathy and direct ventral compression of the cervicomedullary junction were confirmed through clinical and radiological findings. We present the technique of posterior odontoidectomy in a step-by-step, didactic, and practical manner with surgical tips and tricks.

Results:

The resection was completed without intraoperative or postoperative complications in both cases. The patients experienced substantial neurological improvements, and full recovery was observed during the 9-month and 12-month follow-up visits after discharge. Compared with the transoral approach, our technique provides a larger decompression area.

Conclusions:

We describe a novel method for the treatment of BI that was applied in two patients and suggest that the posterior approach might be a safe and effective method for ventral decompression of the craniocervical junction. Posterior odontoidectomy followed by craniocervical fixation helped achieve complete cervicomedullary decompression.