bluuebunny/crossref_metadata_2025 huggingface dataset:
Active Paradoxical and Pulmonary Emboli in a First Trimester Pregnancy
Authors: Suraci Nicholas , Shifman Monica , Kumar Annadita , Haske Michael
Published: October 2022

Capturing a paradoxical embolism in real-time has been a challenge in recent literature. We present the unique case of a 33-year-old, G3P2 female at 8 weeks gestation presenting with dyspnea. An active thrombus through an undiagnosed patent foramen ovale was found requiring emergent surgical intervention with a positive outcome. The presence of a deep vein thrombosis, inferior vena caval thrombus, patent foramen ovale, and pulmonary artery thrombi was contemporarily documented. To our knowledge, there is minimal literature with this presentation.
Citrate does not Change Viscoelastic Haemostatic Assays after Cardiopulmonary Bypass
Authors: Kristobak Benjamin M. , McCarthy Margaret L. , Keneally Ryan J. , Amberman Keith D. , Ellis Harvey J. , Call Robert C.
Published: October 2022

Context:

Viscoelastic hemostatic assays (VHA) are commonly used to identify specific cellular and humoral causes for bleeding in cardiac surgery patients. Cardiopulmonary bypass (CPB) alterations to coagulation are observable on VHA. Citrated VHA can approximate fresh whole blood VHA when kaolin is used as the activator in healthy volunteers. Some have suggested that noncitrated blood is more optimal than citrated blood for point-of-care analysis in some populations.

Aims:

To determine if storage of blood samples in citrate after CPB alters kaolin activated VHA results.

Settings and Design:

This was a prospective observational cohort study at a single tertiary care teaching hospital.

Methods and Material:

Blood samples were subjected to VHA immediately after collection and compared to samples drawn at the same time and stored in citrate for 30, 90, and 150 min prior to kaolin activated VHA both before and after CPB.

Statistical Analysis Used:

VHA results were compared using paired T-tests and Bland–Altman analysis.

Results:

Maximum clot strength and time to clot initiation were not considerably different before or after CPB using paired T-tests or Bland–Altman Analysis.

Conclusions:

Citrated samples appear to be a clinically reliable substitute for fresh samples for maximum clot strength and time to VHA clot initiation after CPB. Concerns about the role of citrate in altering the validity of the VHA samples in the cardiac surgery population seem unfounded.
Effects of Recombinant Erythropoietin on Hemoglobin Levels and Blood Transfusion Needs in Patients with Preoperative Anemia Undergoing Cardiac Surgery
Authors: Totonchi Ziae , Noohi Feridoun , Futuhi Farzaneh , Azarfarin Rasoul , Radbin Pooyan
Published: October 2022

Introduction:

Preoperative anemia is an important and relatively common problem in patients undergoing cardiac surgery, and its treatment is crucial in improving postoperative outcomes. The use of recombinant erythropoietin is one of the suggested methods in this field. Therefore, in the present study, we sought to evaluate the effects of recombinant erythropoietin on hemoglobin (Hb) levels and blood transfusion needs in cardiac surgery in patients with preoperative anemia.

Methods:

This randomized nonblind clinical trial was performed on patients with mild-to-moderate anemia (Hb <12 g/dL in men and Hb <11 g/dL in women) undergoing cardiac surgery at a referral heart hospital (Tehran, Iran). The patients were randomly divided into two groups of 33 patients. In the intervention group, recombinant erythropoietin was administered at a dose of 500 IU/kg one to three days before surgery. Intra- and postoperative Hb levels and the need for blood transfusion were recorded during surgery and for 3 days afterward.

Results:

The use of packed red blood cells in the operating room was similar in the intervention and control groups (P = 0.156), but it was significantly lower in the intensive care unit in the intervention group (P = 0.030). The mean Hb, which was initially identical in the two groups (P > 0.05), showed a significantly lower decrease in the intervention group (P = 0.001). No significant differences were observed concerning other variables.

Conclusions:

The use of recombinant erythropoietin (500 IU/kg/day) one to three days before cardiac surgery in our anemic patients blunted a reduction in Hb levels and decreased blood transfusion needs.
Analgesic Efficacy of Addition of Magnesium Sulfate to Bupivacaine in Wound Infiltration Technique in Perianal Surgeries
Authors: Dave Smitul , Gopalakrishnan Kuppusamy , Krishnan Sanmugapiriya , Natarajan Nagalingam
Published: October 2022

Background:

In peripheral nerve blocks, magnesium sulfate is an excellent adjuvant to local anesthetics. The use of magnesium sulfate as an adjuvant in wound infiltration for postoperative analgesia needs to be investigated.

Aims:

This study was conducted to evaluate the analgesic efficacy of magnesium sulfate as an adjuvant when added to bupivacaine in wound infiltration technique in perianal surgeries.

Settings and Design:

This was a prospective, randomized, double-blind study.

Materials and Methods:

Sixty patients undergoing perianal surgeries were randomly divided into two groups, Group M and Group C. Following perianal surgery, Group M patients received a local wound infiltration of injection magnesium sulfate 750 mg (1.5 mL of injection 50% magnesium sulfate) added to 0.5% bupivacaine 13.5 mL making a total volume of 15 mL, whereas Group C patients received a local wound infiltration of injection 0.5% bupivacaine 13.5 mL and 1.5 mL normal saline. Postoperative vitals and pain scores were assessed.

Statistical Analysis Used:

Student's t-test for normally distributed continuous data, Mann–Whitney U-test for ordinal data, and Chi-square test or Fisher's exact test, whichever is appropriate for categorical data, were used.

Results:

The magnesium sulfate group had a lower postoperative pain score, a longer duration of postoperative analgesia, and a lesser number of rescue analgesic doses in the first 24 h.

Conclusion:

We conclude that magnesium sulfate is an effective adjuvant to bupivacaine for wound infiltration in terms of postoperative analgesia quality and duration following perianal surgeries.
Association of Hypovitaminosis D with Poor Bone Health in Patients of Rheumatoid Arthritis – A Case–Control Study
Authors: Sood Vivek , Sharma Mandeep , Chauhan Parikshit , Dogra P M , Kumar Abhishek , Subramanian Shankar
Published: October 2022

Background:

Data on correlation between hypovitaminosis D and disease activity indices in patients with rheumatoid arthritis (RA) are varied. In this context, this prospective, case–control study aimed to evaluate the contribution of hypovitaminosis D toward bone health in patients with RA and correlate it with clinical, functional, and radiological disease activity indices. The study objectives were to assess the occurrence of hypovitaminosis D, to determine baseline bone mineral density (BMD), and to evaluate factors likely to contribute to poor bone health in patients of RA.

Results:

Hypovitaminosis D was observed in 76% of patients of RA with all of them having poor bone health as evident by statistically significant correlation between low Vitamin D levels and poor BMD. Poor bone health was observed in 80% of patients with femoral measurements, exhibiting greater severity of reduced BMD than lumbar spine values. Bivariate analysis revealed significant correlation of low Vitamin D, parathyroid hormone, Modified Sharp Score (MSS), and steroid intake with poor BMD at both spine and femur neck. Furthermore, binary logistic regression analysis among these four variables showed that only MSS had statistically significant association with osteoporosis, and there was a trend towards significance with poor BMD.

Conclusions:

This study has observed that RA patients indeed have poor bone health. Consequent osteoporosis has multifactorial etiology, and hypovitaminosis D remains one of the prime contributors, yet underappreciated and consequently undertreated.
Acute chest syndrome in pediatric sickle cell disease
Authors: Yousef Abdullah A. , Shash Hwazen A. , Almajid Ali N. , Binammar Ammar A. , Almusabeh Hamza Ali , Alshaqaq Hassan M. , Al-Qahtani Mohammad H. , Albuali Waleed H.
Published: October 2022

INTRODUCTION:

The most common cause of death among sickle cell disease (SCD) patients is acute chest syndrome (ACS). Since SCD is a common condition in the Eastern province of the Kingdom of Saudi Arabia (KSA), we aimed to provide a detailed description of the clinical characteristics and ACS management.

METHODS:

We retrospectively studied pediatric (<14 years) patients with SCD diagnosis who were admitted with ACS or developed ACS after admission from January 2002 to December 2020. The absence of chest X-ray or hemoglobin electrophoresis was the reason to exclude patients from the study. The primary objective of the study was to evaluate and report the clinical, laboratory, and management characteristics of ACS.

RESULTS:

Ninety-one ACS episodes (42 patients) were included, with a mean diagnosis age of 7.18 ± 3.38 years. Twenty-two (52.4%) patients were male. Twenty-five patients had recurrent ACS episodes. The median absolute number of ACS was 3.5 (interquartile range [IQR], 2–9), with maximum ACS episodes of 13/1 year and a minimum of 1 ACS episode per year. At the first ACS episode, the mean age was 6.62 ± 3.38 years, while the overall mean age at ACS episode diagnosis was 7.18 ± 3.38 years. The most common antecedent events were vaso-occlusive crisis (12 episodes, 13.2%) and upper respiratory tract infections (8 episodes, 8.8%). The most frequently encountered presenting symptoms were fever (70.3%) and cough (70.3%). The most common antibiotics used were azithromycin (82.4%) and ceftriaxone (75.8%). Nine patients (9.9%) required pediatric intensive care unit (PICU) admission. Of the 91 ACS episodes, there was no in-hospital mortality. The median hospital and PICU length of stay were 8 days (IQR, 5–10.25) and 4 days (IQR, 3–5.5), respectively.

CONCLUSION:

This study has reported the most common clinical characteristics and management of ACS among pediatric SCD patients in the Eastern province of KSA.
Stabilization occlusal appliance therapy for cervical dystonia
Authors: Alzahem Abdullah Mohammed
Published: October 2022

Cervical dystonia (CD) is a neurological movement disorder causing awkward head position, affects very few people with unknown clear etiology, and has no full cure. The patient diagnosed with CD can be managed by botulinum toxin therapy and antidystonic agents. Understanding the biomechanics of skull structure used in jaw alignment and raising the vertical dimension of occlusion (VDO) through occlusal stabilization appliance (OSA) therapy to improve the symptoms of the CD. This case report showed significant improvement of CD symptoms by OSA therapy. Vertical distraction of temporomandibular joints and jaw alignment achieved by OSA with gradual increase in VDO. Stabilization occlusal appliance therapy improved the cervical muscles contraction and the skull cervical collapse in case diagnosed with CD.
Acceptability and feasibility of the Heartfulness Way: A social-emotional learning program for school-going adolescents in India
Authors: Shinde Sachin , Pereira Bernadette , Khandeparkar Prachi
Published: October 2022

Background:

The interest in life skills education programs in schools is growing. Yet, there is limited evidence on implementation indicators for such programs in low-income countries.

Aim:

We present a qualitative evaluation of the acceptability and feasibility of the Heartfulness Way program—a secondary school-based social-emotional program, based on mindfulness techniques delivered by teachers in India.

Methods:

This qualitative study collected data from 12 schools in four Indian cities, namely, Chennai, Hyderabad, Prayagraj, and Pune. Data collection included focus group discussions with adolescents (n = 24) and teachers (n = 12), semistructured interviews with school principals (n = 12), program delivering teachers (n = 7), and program staff (n = 4). A thematic analysis was performed using NVivo 12.

Results:

Overall, the mindfulness-based classroom curriculum was strongly supported by participants. Acceptability was determined by positive responses, prosocial behavior, self-acceptance, and supportive bonds, according to students. Several themes of perceived benefits of the program including, improved relationships among peers and between students and teachers were identified. In general, the teachers’ interviews indicated that there was a high level of satisfaction with the training and curriculum provided by the program. Teachers were able to provide high coverage (75%–80%) of the program activities, but several potential barriers were also identified, including insufficient training for teachers and the need for direct supervision.

Conclusion:

The Heartfulness Way program, a social-emotional learning intervention, has shown strong support for acceptance and delivery by school communities. Future studies are needed to examine the effectiveness and cost-effectiveness of this program for improving the health and well-being of school-aged adolescents.
Suicide and suicidal ideation in the times of the Covid-19 pandemic: A scientometric analysis
Authors: Palod Rajat Jagdish , Joshi Mahika Milind , Kumar Rupali , Ligade Virendra Siddharam
Published: October 2022

Objectives:

The article aims to explore the studies performed on suicide because of coronavirus disease 19 through a bibliometric analysis. A quantitative analysis of the topic furnishes data on the publication pattern, influential research journals, highly cited articles, productive countries and organizations, the authorship pattern, and the collaborative pattern between authors.

Methods:

Data regarding the type of documents, most cited articles, influential research journals, contributions per country, and so on were extracted for the study from the Scopus database. Data analysis and visualization were performed through R-Studio and the VOSviewer application.

Results:

A bibliometric analysis encompassing scientific contributions based on suicide or suicide-related ideation because of the coronavirus pandemic showed a total of 494 documents published in 230 journals/books. The articles published by proficient authors in reputed journals highlighted the key areas of research in the field. USA dominated the list of scientific production of countries contributing to 340 documents.

Conclusion:

The results provided by this analysis could act as a steppingstone for experts to design a roadmap for mental health research during the pandemic. Studies can be designed to gather information on mental health conditions across specific age groups. Research collaborations that facilitate the publication of pooled protocols and data are encouraged.
Impact of COVID-19 lockdown on substance availability, accessibility, pricing, and quality: A multicenter study from India
Authors: Arya Sidharth , Ghosh Abhishek , Mishra Shree , Swami Mukesh Kumar , Prasad Sambhu , Somani Aditya , Basu Aniruddha , Sharma Kshitiz , Padhy Susanta Kumar , Nebhinani Naresh , Singh Lokesh Kumar , Choudhury Shinjini , Basu Debasish , Gupta Rajiv
Published: October 2022

Background and Aim:

Pandemic and consequent lockdowns are likely to affect the drug market by the sudden disruption of the supply chain. We explored the change in the availability, access, purity, and pricing during lockdown from respondents seeking treatment for drugs, alcohol, and tobacco dependence.

Materials and Methods:

A cross-sectional survey was conducted among 404 respondents from seven treatment centers across India. A structured questionnaire assessed the change in availability, access, quality, and price of substances used during the first phase (March 24–April 14) and the second phase (April 15–May 3) of lockdown.

Results:

A majority of the respondents in treatment used tobacco (63%) and alcohol (52%). Relatively few respondents used opioids (45%) or cannabis (5%). Heroin (44%) was the most common opioid the respondents were treated for. Seventy-five percent, 65%, and 60% of respondents treated for alcohol, tobacco, and opioid problems, respectively, reported a reduction in the availability and access during the first phase of the lockdown. In the second phase, respondents with alcohol and tobacco dependence reported greater availability than those with opioid and cannabis dependence. The reported price of all substances increased more than 50% during the first phase of lockdown and remained higher throughout the second phase. Deterioration in purity was reported by more than half of the people who used opioid.

Conclusion:

Lockdown could have affected both licit and illicit drug markets, albeit to a varying degree. The observed changes seemed short-lasting, as suggested by the recovering trends during the second phase of lockdown.
Metabolic Syndrome and Breast Cancer: Is There a Cause-and-Effect Relationship?
Authors: Negi Preety , Kingsley Pamela A. , Jacob Jubbin Jagan , Sachdeva Jaineet , Jomi Chinnu
Published: October 2022

Background:

Metabolic syndrome (MetS) has an important role in the development as well as the progression of breast cancer (BC). This syndrome is defined as having three or more central obesity, hypertension, insulin resistance, low low-density lipoprotein cholesterol, and high triglycerides (TGs). Multiple studies have demonstrated that early recognition of MetS may have a positive impact on decreasing BC incidence. We compared the prevalence of MetS in newly diagnosed carcinoma breast patients with controls in the general population and thereby provide insight into its role as an emerging risk factor for BC.

Patients and Methods:

A prospective, case–control study was conducted at Christian Medical College and Hospital, Ludhiana, between September 2018 and October 2019. One hundred and four subjects each of BC and age-matched controls were enrolled. The measurement of waist circumference (WC), blood pressure (BP), fasting blood glucose levels, and lipid profile was performed for women with newly diagnosed BC and controls.

Results:

MetS was significantly more prevalent among BC (65.4%) compared to controls (30.8%). On assessing each component of MetS, it was evident that the prevalence of WC and BP, as well as the metabolic parameters, namely fasting blood sugar, TGs, and high-density lipoprotein cholesterol, was higher in Group A as compared to Group B. The majority of the women with BC and MetS were postmenopausal. The majority (66.2%) of BC patients with MetS were receptor positive.

Conclusions:

This study unveils a hidden link between MetS and BC, and hence, BC awareness programs should stress the need for lifestyle changes and healthy living to nip this evil in the bud. Opportunistic screening should be undertaken for women presenting to the medical facility with MetS. Future studies are required to design effective strategies to raise the possibility of MetS as an established risk factor in BC.
Predicting Cardiac Index Using the Electrocardiogram in Pulmonary Hypertension Patients
Authors: Mirtajaddini Marzieh , Naderi Nasim , Mohammadi Khadije , Taghavi Sepideh , Maharloo Maryam , Mazloomzadeh Saeideh , Amin Ahmad
Published: October 2022

Background:

Pulmonary hypertension (PH) is a fatal disease where on-time treatment can change the prognosis. The selection of treatment is dictated by the severity of PH. The cardiac index (CI) is a robust indicator of PH severity. This trial aimed to find out the association between electrocardiogram (ECG) data and CI as a prognostic factor of PH.

Methods:

Ninety-five patients with precapillary PH were included in the study. The cardiac output of patients was calculated using the right heart catheterization and the Fick formula. Patients were categorized into low- and high-risk groups based on the CI. Their ECGs were interpreted by an expert cardiologist. The association between ECG parameters and severity of PH was evaluated based on the CI.

Results:

The median age of patients was 36 years. The mean of CI was 2.35 L/min/m2 with a standard deviation of 0.74. About 36% of patients were in the high-risk category based on the CI. Among ECG parameters, ST segment depression in V1-V6 and R/S ratio ≥1 in V1 were found significantly correlated with CI for high-risk category (P = 0.026).

Conclusion:

ST segment depression in V1-V6 and R/S ratio ≥1 in V1 had a significant association with CI in the range lower than 2 L/min/m2, which is an indicator of poor PH prognosis. Therefore, these variables can be used as an inexpensive and available prognostic factor in patients with precapillary PH.
A Clinical Trial of Comparing Dexmedetomidine and Remifentanil on the Oximetry Parameters in the Patients with End-Stage Renal Disease Undergoing Arteriovenous Fistula Formation
Authors: Dolatabadi Mahmoud Reza Mohaghegh , Motlagh Soudabeh Djalali , Ghodraty Mohamadreza , Shafeinia Amineh , Maleki Alireza , Norouzi Zeinab , Khaleghparast Shiva
Published: October 2022

Background:

Oximetry is a method for measuring the arterial hemoglobin saturation (SpO2) using pulse oximeter and is essential in any type of anesthetic procedures. The growing population of geriatrics in the recent decades in combination with an increase in the prevalence of chronic diseases including diabetes and hypertension are some of the leading causes for an increase in the prevalence of chronic kidney disease and end-stage renal disease (ESRD). The definite treatment for ESRD is renal transplant but unfortunately, it may take a long time to find a suitable kidney and continuing the patient's life may depend on dialysis. Arteriovenous fistula (AVF) formation is one of the first steps to prepare the patient for hemodialysis. ESRD itself is a reason for physical and psychosocial issues. Preparing a favorable condition for AVF surgery is essential to decrease the burden of the underlying disease. An efficient respiratory supply is necessary in all parts of an anesthetic procedures.

Aims and Objectives:

This study is a double-blind clinical trial to compare two anesthetic agents, dexmedetomidine and remifentanil in patients with ESRD who underwent AVF formation.

Materials and Methods:

SpO2 was measured on different phases including the time of initial incision, and after 10, 30, 60, 90, and 120 min of finishing the surgery. The data were analyzed using SPSS version 22, two-way repeated measures (ANOVA), and independent t-test.

Results:

This study showed that there was no any significant difference in using any of these two agents with regard to SpO2 in the different times of measurements during the anesthetic procedure and after the surgery in the recovery phase.

Conclusion:

This study showed that there is not any superiority in using DEX or REM in the patients undergo AVF formation. More studies on the other groups of the patients with different surgeries.
Idiopathic Radial Artery True Aneurysm
Authors: Sharma Ruhi , Darbari Anshuman , Sharma Rahul , Kumar Ajay
Published: October 2022

True idiopathic radial artery aneurysm is a rare entity. There are only a few cases reported in the literature. Asymptomatic radial arterial aneurysm in young patients is even rarer. Here, we present a successfully managed case report of a left radial artery aneurysm in a young female who presented to us with a painless, pulsatile swelling at the wrist.
Zebrafish models for glucocorticoid-induced osteoporosis
Authors: Lin Wen-Ying , Dharini Kameshwara Kumar , Peng Cheng-Huan , Lin Chung-Yen , Yeh Kuang-Ting , Lee Wen-Chih , Lin Ming-Der
Published: October 2022

Glucocorticoid-induced osteoporosis (GIOP) is the most common form of secondary osteoporosis due to excessive or long-term glucocorticoid administration, disturbing the homeostasis between bone formation and bone resorption. The bone biology of zebrafish shares a high degree of similarities with mammals. In terms of molecular level, genes and signaling pathways related to skeletogenesis are also highly correlated between zebrafish and humans. Therefore, zebrafish have been utilized to develop multiple GIOP models. Taking advantage of the transparency of zebrafish larvae, their skeletal development and bone mineralization can be readily visualized through in vivo staining without invasive experimental handlings. Moreover, the feasibility of using scales or fin rays to study bone remodeling makes adult zebrafish an ideal model for GIOP research. Here, we reviewed current zebrafish models for GIOP research, focused on the tools and methods established for examining bone homeostasis. As an in vivo, convenient, and robust model, zebrafish have an advantage in performing high-throughput drug screening and could be used to investigate the action mechanisms of therapeutic drugs.
Robot-Assisted in Hip and Knee Surgery: Are we ready?
Authors: Rhatomy,MD Sholahuddin , Phatama Krisna Yuarno , Santoso Asep , Hernugrahanto Kukuh Dwiputra , Budhiparama Nicolaas
Published: October 2022

The word 'robot' is derived from the Polish word "robota," which means forced labor. It describes a machine that carries out various tasks either automatically or with minimal external input, especially one that is programmable. There are two main types of robotic surgery systems: haptic and autonomous. Haptic or tactile systems allow the surgeon to use or drive the robot to perform a surgical procedure. This technology requires constant input by the surgeon for the procedure to proceed. In contrast, autonomous robotic systems require the surgeon to perform the approach and set up the machine, but once engaged, the robot completes the surgery without the surgeon's help. The use of robotic technology has, in some cases, facilitated minimally invasive surgery, which has gained popularity with some patients. In spinal surgery, robotic technology has been successfully used to increase the accuracy of implant placement. Furthermore, robotic technology can improve the radiological alignment of implants following the pre-operative plan.1,2
Total Knee Replacement Epidemiology Before and After the COVID-19 Pandemic: A Descriptive Comparative Study
Authors: Sumargono Endrotomo , Anastasia Maria , Saleh Ifran , Pitarini Astuti , Deslivia Maria Florencia , Santosa Claudia , Kholinne Erica
Published: October 2022

Background: The purposes of this study were (1) to describe the characteristics of patients underwent TKR during COVID-19 Pandemic and (2) to compare the demographic of patients underwent TKR before and after COVID-19 Pandemic in St. Carolus Hospital, Jakarta, Indonesia.Methods: Data were extracted from January 2016 to December 2020 from the annual reports of arthroplasty registry (single surgeon). Patient demographic data were collected (Gender, age, comorbidity). Post-operative characteristics were defined as: (1) Length of hospitalization (days); (2) Complication rate (%); (3) Revision event (%). The complication rate included: (1) Deep vein thrombosis; (2) Prosthetic joint infection; (3) Periprosthetic fracture. The above parameters were compared before and after the COVID-19 Pandemic.Result: A total of 730 primary TKR procedures (12.3 cases per month) were performed from January 2016 to February 2020, meanwhile there were 54 primary TKR (6 cases per month) done in 9 months after COVID-19 Pandemic from March 2020 to December 2020. The lowest case monthly after the COVID-19 Pandemic was found on April 2020 (1 case per month), on the other hand, the highest case monthly was found on December 2020 (14 cases per month). The complication rate decreased from the Pre COVID-19 Pandemic (8.6% to 1.8%).Conclusion: The number of cases was reduced during Indonesia large-scale social restriction (40 %) and returned to the Pre-Pandemic period on December 2020.Level of Evidence : Descriptive study, level III
State of the Art : Current Acetabulum Fracture Management
Authors: Dilogo Ismail Hadisoebroto , Hartanto Bernadus Riyan , Routt Milton Lee Chip
Published: October 2022

The annual incidence of acetabulum fractures is estimated to be 8.1 per 100.000 patients. In young adults, high energy trauma is the primary mechanism, but in the elderly, low energy trauma is the primary mechanism. Comorbidities, poor bone quality, and delayed presentation are all linked to a poor outcome. From diagnosis to treatment, the goal of this study is to describe the required procedures in reaching a satisfactory result.It is essential to be able to correctly classify acetabular fractures using the Joudet and Letournel classifications, especially when planning definitive therapy. Non-surgical and operative treatment methods are available for acetabulum fractures. All acetabulum fractures that result in hip joint instability and/or incongruity require surgical treatment. Although the prognosis is lower than in younger patients, Open Reduction Internal Fixation (ORIF) remains the mainstay of therapy for most elderly acetabular fractures. Central fracture dislocation of the hip with medial migration of the quadrilateral plate is common in patients with both column, transverse, T-shaped, and anterior column-posterior hemi-transverse fractures. Failure to repair the quadrilateral plate will result in an incongruent hip and a poor outcome since it has a thin medial wall that fractures with less force than the superior weight-bearing portion of the acetabulum.The goals of postoperative care are to maximize the patient's function, allow a quick return to function, and detect early problems. Complications with acetabulum fractures might occur with any treatment option. Post-traumatic arthritis is the most common complications, followed by Deep Vein Thrombosis (DVT), heterotrphic ossification, infection, and iatrogenic sciatic nerve damage.
NDC Enhancement: Opportunities Through Water
Authors: Swedenborg Eliza , Timboe Ingrid , Hebart-Coleman David , Kjellen Marianne , Matthews John , Davis Katharina , Stein Neil , Sato Ichiro
Published: October 2022

This guide is part of a larger series exploring NDC enhancement in various sectors. It is intended to inform future rounds of NDC revision and any implementation planning that follows. The guidance presented here can also assist in the development of long-term strategies, National Adaptation Plans, and domestic and local water policymaking that will effectuate the NDCs. Audiences for this guide include stakeholders responsible for enhancing and updating NDCs, as well as domestic, local, and international actors whose activities have substantial implications for water resources and services.
Keterampilan Guru Kelas dalam Pembelajaran Tematik pada Masa Pandemi di Kelas IV Sekolah Dasar
Authors: Marisa Heni , Mardiah Mardiah
Published: October 2022

This study aims to describe the skills of classroom teachers in thematic learning during the pandemic and find out the barriers to the skills of classroom teachers in thematic learning during the pandemic. This research is qualitative research, the subject of this research is the fourth-grade teacher and two female students, and the object of the research is the skills of the classroom teacher in thematic learning during the pandemic. Data collection techniques used in this study were observation, interviews, and documentation. Furthermore, the data that has been collected is analyzed by reducing the data, presenting the data, and drawing conclusions. Based on the results of the study, it can be concluded that the results of the observations are classified as "good enough" because the answers are at 43%, which is in the 41%-60% interval. This can be seen from several indicators, namely teachers are able to understand the character of students, are able to utilize educational technology, are able to evaluate student learning outcomes. The obstacles in the skills of classroom teachers are the educational background of the teacher, the lack of guidance and training and educational infrastructure.
INCREASING THE EFFICIENCY OF RENEWABLE ENERGY SOURCES IN A VIRTUAL POWER PLANT BASED ON MULTI-AGENT CONTROL
Authors: Sosnina Elena N. , Shalukho Andrey V. , Erdili Natalya I.
Published: October 2022

The article is devoted to the problem of increasing the efficiency of renewable energy sources (RES). The development of distributed energy based on renewable energy sources is one of the most important areas for ensuring the energy security of consumers and reducing the anthropogenic load on the environment. Combining distributed sources of electricity into virtual power plants (VPP) with a general control system makes it possible to use the potential of renewable energy sources more efficiently. An approach to the management of energy exchange in a virtual power plant (VPP) based on a multi-agent system (MAS) is proposed and substantiated, taking into account the criterion of environmental friendliness of distributed generation (DG) installations and ensuring the efficient use of environmentally friendly renewable energy sources. Algorithms for the operation of generation and load agents have been developed to control energy exchange in a virtual power plant based on a multi-agent system. The algorithms differ in taking into account the environmental friendliness rating of distributed generation installations and allow you to maximize the renewable energy sources potential, ensuring the balance of electrical power in the virtual power plant and minimal losses during its transmission. A 20 kV virtual power plant is considered, combining 10 decentralized power supply systems (DPSS) with sources of distributed generation of various types and having the ability to exchange electricity with a centralized power system (CES). With the help of software complexes JADE and “RastrWin”, a study of the effectiveness of the method for controlling energy exchange in virtual power plant based on multi-agent system was carried out, taking into account the environmental rating of distributed generation installations. The results of the research showed that the use of a multi-agent approach to control the virtual power plant made it possible to increase the share of the use of renewable energy sources and reduce power losses in the electrical network.
RECURRENT USE OF A PERCEPTRON FOR SIGNAL STRUCTURAL ANALYSIS
Authors: Andreev Oleg N. , Slavutskii Leonid A. , Slavutskaya Elena V.
Published: October 2022

The paper is devoted to the use of an artificial neural network (ANN) of direct propagation (multilayer perceptron) for signal processing in electrical engineering and electric power industry. It is proposed to use such simple neural networks instead of ANN with a more complex structure (convolutional, recurrent), but within the framework of a sequential recurrent algorithm. This allows checking and controlling the quality of signal processing at each stage of calculations. The proposed algorithm is tested on the example of structural analysis of a signal with nonlinear distortions in a sliding time window. It is shown that the amplitude, frequency and phase of an industrial frequency signal with a high level of harmonics and an aperiodic component can be isolated with an accuracy of units of percent for a time not exceeding units of milliseconds. To increase the accuracy at each step of the calculations, traditional methods can be used, in addition to the ANN: averaging, median smoothing, etc.
ANALYSIS OF EXISTING APPROACHES AND METHODS OF DIAGNOSTICS OF ON-LOAD TAP CHANGER OF POWER TRANSFORMERS
Authors: Mikheev Georgi M. , Dimitriev Anton A. , Huseyjon Kalandarov U. , Fedorov Oleg V.
Published: October 2022

In electrical networks of almost all voltage classes, the main link in the work on the transmission of electrical energy is a power transformer. At the moment, about 60% of them are operated in our country with a significant excess of service life, which increases the requirements for their technical control and diagnostics of all units. Switching devices are an integral part of power transformers. They are necessary to regulate voltage on substation busbars depending on the load of consumers. Not only the reliability of power supply of industrial enterprises, cities and agriculture, but also the quality of electrical energy depends on their operation. At the same time, they are one of the vulnerable nodes of voltage converters. Although the parameters of diagnostic signs for switching devices are not as extensive as the power transformer itself, they nevertheless require special attention from the operating personnel. This is due not only to the variety of switchgear types that exist, but also to the methods used to diagnose them. For this reason in this work an attempt has been made to analyze the existing approaches and methods of diagnosing these mechanical controlled voltage regulators. We propose a new approach in terms of diagnostics of high-voltage equipment, including power transformers – introdiagnostics. It is based on methods of non-destructive (without opening tanks and draining dielectric liquids) control of parameters that characterize the state of electrical equipment. We present an original method of diagnosing the on-load tap changer, based on oscillography and subsequent analysis of operation of the on-load tap changer contact system without draining transformer oil from the diverter switch’s tank.
APPLICATION FEATURES OF A TRAVELING WAVE FAULT LOCATOR ON A DOUBLE-CIRCUIT POWER LINE
Authors: Semenova Anastasia G. , Fedorov Aleksey O. , Petrov Vladimir S. , Dmitrenko Aleksandr M.
Published: October 2022

The accuracy and stability of a single-end traveling wave fault locator directly depend on the correct construction of electrical network model in fault regime. In the regime of ground short circuits this task is complicated by the need to take into account the components of aerial and ground modes of power line in the electrical network of fault regime model. Its incorrect solution leads to a decrease in the accuracy of determining the arrival time of the used traveling wave, which, in turn, decreases the accuracy in calculating the distance to the fault. In order to correctly construct the electrical network of fault regime model and accurately estimate the used traveling wave arrival times in locators, phase-modal transformation is performed. Such a transformation for single-circuit power line can be one of the invariant Clarke, Karrenbauer or Wedepohl transformations. The classical representation of these transformations cannot be directly applied to the electrical values of a double-circuit power line, consisting of six wires and, accordingly, having six independent modes. The purpose of the article is to illustrate the application of the modal transform to divide the electrical values of a double-circuit power line into independent components.
CONCEPT, CHARACTERISTICS AND STRUCTURE OF THE LEGAL SPACE
Authors: Vereshchak Svetlana B. , Abramova Lyudmila A.
Published: October 2022

The article deals with theoretical issues concerning the essence, content and key characteristics of the concept of "legal space", which are on the current scientific agenda in the context of modern tasks of ensuring constitutional legality, the development of Russian legislation, strengthening territorial integrity, sovereignty, national security of the Russian state. The relevance of the topic is also due to the lack of legislative consolidation of the definition of the concept of "legal space". The term "legal space" has been quite actively used in the language of regulatory legal acts for more than 20 years, including designating one of the key areas of public administration activities of justice bodies. All this makes it necessary to conduct scientific research in this area. The purpose of the study is to reveal the concept of "legal space", its features and structure, formulate and propose a possible definition of this term based on the analysis of various scientific approaches, normative legal acts. The goals and objectives of the research determined its methodological basis, which was made up of general scientific, private scientific and private legal research methods: dialectical approach, systematic, logical methods, formal legal, comparative legal and other methods of scientific cognition. The authors believe that the legal space is an independent and universal legal category that reflects the state of consistency, correlation and subordination of legal norms stipulated by the Constitution of the Russian Federation, based on their legal force and taking into account the federal structure of the Russian state operating within its territory, ensuring the strengthening of constitutional legality, sovereignty and integrity of the state, the rule of rights and the freedoms of man and citizen, the order and quality of legal regulation at various levels. Revealing the structure, its elements are highlighted as a normative element formed by a system of legal norms expressed in their sources; a subjective element represented by participants acting within the legal space; an ideological element including key constitutional principles of the legal space ((the principle of the supremacy of the Constitution and federal laws, recognition of a person, his rights and freedoms as the highest value, federalism, sovereignty and territorial integrity of the state, etc.).
PREVENTION OF TELEPHONE FRAUD (CRIMINOLOGICAL ASPECT)
Authors: Kuzmin Yury A.
Published: October 2022

The problems of committing fraud using telephone communication are updated. The relevance of issues related to the prevention of telephone fraud, first and foremost caller ID spoofing and phishing, is substantiated. The article analyzes the methods of preventing telephone fraud, such as the possibility of establishing the number of fraudsters through electronic search services, special free services, Viber and WhatsApp messengers, Sberbank Online, caller ID for incoming calls on "Avito" and "Yula", through applications for iPhone and Android, caller ID from "Kaspersky Lab" – Kaspersky Who Calls, through the Internet search engine "Yandex" and other applications. It is recommended to use the methods of victimologic counter-strategy in relation to telephone fakers, such as psychological self-defense, criticality (prudence) in their own actions (mainly those of a financial nature), safe behavior in a non-standard situation, a critical level of trust, awareness of possible risks. It is necessary to take precautions not to become a victim of telephone fraud, not to lose self-control and vigilance, to use all opportunities to check the source of telephone fraud, to report such cases to law enforcement agencies. Personal interest in maintaining personal security, the desire for self-defense and timely informing law enforcement agencies will become an obstacle to the spread of telephone fraud.
Creation of a GIS project of the results of testing technologies
to reduce the accumulation of radionuclides in agricultural products
Authors: Krechetnikov Viktor V. , Krechetnikova Evgenia O. , Titov Igor E. , Ivankin Nikolai G.
Published: October 2022

The article presents the results of the use of drones and GIS technologies during pilot testing of new types of agro-ameliorants and humic preparations to assess the effectiveness of reducing the accumulation of radionuclides in agricultural products grown on radioactively contaminated agricultural land in the Bryansk region. In the course of the work, an assessment of experimental farms was carried out to select the optimal sites for testing, as well as their digitization using an unmanned aerial vehicle equipped with a two-piece geodetic receiver to determine the exact geographical coordinates. Subsequently, with the help of a drone, fertilizer application was monitored, and the germination of agricultural plants was assessed after the application of agromeliorants.
Based on the received materials, a library of electronic maps of the territories where the work was carried out was created in the ArcGis software environment. They included 4 farms of the Novozybkov district and 2 farms of the Krasnogorsk district. The library of electronic maps included cartographic information on the types of land use, surface contamination of soils with 137Cs, types and granulometric composition of soils, their agrochemical parameters, germination, yield, reduction ratio of 137Cs inflow into crop and forage production, as well as on the boundaries of elementary experimental plots with the designation type of fertilizer applied.
A Rare Presentation of CVT
Authors:   Yenepoya University, Mangalore, Suhana Dr. Salma
Published: October 2022

Cerebral Venous Thrombosis (CVT) is an uncommon condition presenting with varying clinical symptoms, posing difficulty in diagnosis. Patients present with headaches, focal neurological deficits, seizures, and altered consciousness. CVT does not have a single clinical presentation, and it is important to consider CVT in all brain syndromes, especially young patients, and confirm it through imaging studies. Other uncommon presentations of CVT include single or multiple cranial nerve palsies.
Forming an Approach to Effective Integration of Higher Education Institutions into the National Innovative System
Authors:   Doctoral student, Tashkent State University of Economics, Odilova Dilnoza Barnaevna
Published: October 2022

The article considers subjects of the national innovation system of higher education institutions: on the basis of the study of the content, directions and subject of cooperation relations with the state, technology parks, business incubators, commercial enterprises, small innovative enterprises and other subjects, higher education institutions were evaluated instead, to act as the system’s primary kernel.
Quarterly Trends of TB Treatment Outcomes as Xpert MTB/Rif Rolled Out in Manicaland, Zimbabwe for 2017 and 2018
Authors:   Africa University, Department of Health Sciences, College of Health and Natural Sciences, Fairview Road, off Nyanga Road, Old Mutare, Zimbabwe, Zvinoera Katherine
Published: October 2022

Background: The World Health Organization target is to reduce to zero the number of death due to Mycobacterium tuberculosis by the year 2035. The earlier TB treatment is commenced, the less chance of a TB associated death and the higher the chance of successful treatment outcomes. Objective: The objective of the study was to evaluate quarterly trends of TB treatment outcomes as Xpert MTB/Rif testing services rolled out in Manicaland for 2017 and 2018.The study gave an opportunity for the Zimbabwe National TB Program to generate some evidence showing implementation of the intervention, Xpert MTB/Rif diagnostic test. Method: In the retrospective study , a total of 3277 TB patient variables were captured from facility TB registers .The population was all TB patients recorded in the 304 health facilities as having received TB treatment between 1 January 2017 and 31 December 2018. The scope of the study did not include capturing the full range of variables that are determinants of TB treatment outcomes. Results: The study demonstrates that the proportion of TB treatment outcome of died had a steady decrease from quarter one of 2017, which had 30/238 (12.6%) to quarter two 2018 which had 41/431 (9.5%). Then quarter three of 2018 the outcome died had a slight increase to just slightly above 10.0% , before going back to just below 10.0% in quarter four of 2018. The proportion of cured for 2017 first quarter was 90/238(37.8%) and that for 2018 quarter four was 147/313 (47.0%). TB treatment outcome of treatment completed for 2017 quarter one was 91/238(38.2%) then for 2018 quarter one, it was 205/464(44.1%).There was no noticeable trend in the two TB treatment outcomes of cured and treatment completed during the eight evaluated quarters. Conclusion: Overall the TB treatment outcome of died showed a decreasing trend over the eight quarters. In order to avoid inferring the decrease to Xpert MTB/Rif roll out, more variables that are determinants of TB treatment outcomes have to be analysed in future studies.