bluuebunny/crossref_metadata_2025 huggingface dataset:
Geometric morphometry of the Rhodnius prolixus complex (Hemiptera, Triatominae): patterns of intraspecific and interspecific allometry and their taxonomic implications
Authors: Alvarez Ana Carolina P. C. , Dale Carolina , Galvão Cleber
Published: May 2024

In the subfamily Triatominae, the genus Rhodnius is one of the most studied, not only because of its epidemiological importance, but also because of the difficulty in differentiating its species. Currently, one of the strategies to control Chagas disease, besides other initiatives such as the analysis of donated blood, is focused on fighting the vector. Correctly identifying triatomines is essential for the entomoepidemiological surveillance of Chagas disease. The objective of the present work was to compare the species of the R. prolixus complex using geometric morphometry of hemelytra and heads to evaluate the patterns of intraspecific and interspecific allometry and their taxonomic implications. This method can help in the diagnosis of close species, whose morphological characteristics are insufficient for correct identification. Specimens from five different collections were used, covering the species included in the R. prolixus complex (R. barretti, R. dalessandroi, R. domesticus, R. marabaensis, R. milesi, R. montenegrensis, R. nasutus, R. neglectus, R. neivai, R. prolixus and R. robustus). Morphometric analyses indicated that the hemelytra are not structures with good resolution for separating species and, for this reason, the use of the heads proved to be more adequate for this group (thus allowing differentiation of all species of the R. prolixus complex). The results suggest that R. milesi is a variant of R. neglectus and confirms that R. prolixus and R. robustus are distinct species. Furthermore, we propose the creation of the R. neivai complex comprising R. domesticus and R. neivai.
Taxonomic study on the genus Mongoloniscus Verhoeff, 1930 (Isopoda, Agnaridae) from China: morphological and phylogenetic analyses
Authors: Jiang Chao , Zhong Jing , Wang Zhidong , Li Weichun , Huang Luqi
Published: May 2024

A combination of morphological traits and DNA data (COI and 28S rRNA partial sequences) was used to study the genus Mongoloniscus Verhoeff, 1930 from China. Four new species are described: M. crenatus Jiang, Li & Huang, sp. nov., M. orientalis Jiang, Li & Huang, sp. nov., M. polyacanthum Jiang, Li & Huang, sp. nov., and M. parvus Jiang, Li & Huang, sp. nov. Following an in-depth examination of the Mongoloniscus species, Lucasioides vannamei (Arcangeli, 1927), comb. nov. (from Mongoloniscus) is proposed, and M. chevronus Yang & An, 2021, syn. nov. is synonymized with Koreoniscus racovitzai (Arcangeli, 1927). A restrictive criterion for recognizing the genus Mongoloniscus is also provided in the present study.
On generalised framed surfaces in the Euclidean space
Authors: Takahashi Masatomo , Yu Haiou
Published: May 2024

We have introduced framed surfaces as smooth surfaces with singular points. The framed surface is a surface with a moving frame based on the unit normal vector of the surface. Thus, the notion of framed surfaces (respectively, framed base surfaces) is locally equivalent to the notion of Legendre surfaces (respectively, frontals). A more general notion of singular surfaces, called generalised framed surfaces, is introduced in this paper. The notion of generalised framed surfaces includes not only the notion of framed surfaces, but also the notion of one-parameter families of framed curves. It also includes surfaces with corank one singularities. We investigate the properties of generalised framed surfaces.
A proposal of concentration measures for discount functions
Authors: Rambaud Salvador Cruz , Fernández Piedad Ortiz , García Javier Sánchez , Perals Paula Ortega
Published: May 2024

The framework of this paper was intertemporal choice, that is to say, the process whereby people were required to choose between a smaller-sooner reward and a larger-later income. In this study, the selection of rewards was supported by a discount function instead of direct preferences between the involved rewards. The objective of this paper was to measure the discounting concentration of a discount function through a variant of the Gini index and the Lorenz curve usually used in statistics. Both measures allowed for the comparison of the discounting concentration corresponding to two discount functions. The methodology employed in this paper was based on the parallelism between a discount function and the distribution function of an absolutely continuous random variable. This similarity allowed us to export the measures of concentration from the field of statistics to finance. The main result of this work was the analysis of the discounting concentration depending on other characteristics of the shape of a discount function (regularity and super-additivity) and the total area under the discount function curve.
The effects of synthetic wollastonite microfibers on PVA fiber-reinforced engineered geopolymer composites
Authors: Öz H.Ö. , Güneş M.
Published: May 2024

In this study, first, synthetic wollastonite microfiber (SWM) with a high aspect ratio (44:1) was produced with a special three-stage production method. Then, fly ash and ground granulated blast furnace slag-based engineered geopolymer composites (FA+GGBFS-based EGCs) were developed. SWM was used in different proportions instead of FA. The compressive strength of EGCs, changed in the range of 88.1-111.1 and 95.1-122.6 MPa at 7 and 28 days, respectively. Additionally, EGCs containing 6% SWM performed the best, considering both ‘‘increasing deformation capacity’’ and ‘‘maintaining the bearing strength by fiber bridging after crack’’, since they acted like a fiber owing to the acicular particle structure of SWM. Moreover, it can be said that the presence of the SWM mineral in the pore system, ensured pore discontinuities in the matrix because of its acicular particle structure. Consequently, the mechanical, durability and dimensional stability properties of EGCs improved with SWM.
Reframing the "International" in UK International Scholarship: Perspectives on Diversity and Equity beyond English as Lingua Franca and Multilingualism
Authors: Kiesewetter Rebekka
Published: May 2024

This article critically examines dominant models of internationalization in UK higher education, focusing on how initiatives such as the UKRI Global Challenges Research Fund and the UK Government’s Turing Scheme, along with evaluation frameworks such as the Research Excellence Framework (REF), emphasize uniformity, competitiveness, and broad scope. This approach can lead to a homogenization of academic collaboration, often overlooking the diverse operational, sociocultural, linguistic, and epistemic contexts of scholars involved in the United Kingdom’s increasingly internationalized scholarly environment. Drawing on an expanded notion of diaspora influenced by intersectional feminist theory, this article proposes a reconceptualization of what internationalization means in the United Kingdom. Through the case study of two experimental online reading events, The Re-Reading Room at Coventry University, it demonstrates how diasporic academic communities can actively co-create more inclusive and equitable collaborative environments in praxis, challenging the prevailing norms of competition, alignment, and uniformity underlaying the way international scholarship is framed in the United Kingdom.
The Police des Cultes under the Directory
Authors: Harmon Joseph
Published: May 2024

In the period of the Directory, political leaders faced the challenge of sustaining a constitutional republic after a time of revolutionary government. They sought to restore civil peace within the framework of the new liberties achieved by the Revolution. One enduring element of this project was the question of religion, the police des cultes of the Directory, as one of the biggest obstacles to civil peace was the schism within the Catholic Church in France. However, the categories of thought, the philosophical views, and certain specific laws inherited by the Directory all served to constrain the options available to the government and its agents.
Robespierre, monstre de cinéma, 1895-1945
Authors: Huzar François
Published: May 2024

Robespierre est l’une des figures de la Révolution française les plus représentées au cinéma jusqu’en 1945. Par sa faculté de mise en mouvement, le cinéma fait œuvre de synthèse des arts qui le précèdent et offre une incarnation frappante du personnage, qui est généralement défavorable. Les films insistent sur son exercice tyrannique du pouvoir, sa responsabilité dans la condamnation de Danton, sa chute et sa mort. Il est alors difficile de prétendre montrer la face plus lumineuse de l’Incorruptible, celle du promoteur des Droits de l’Homme. Néanmoins, cette représentation négative du personnage ne doit pas être interprétée par un prisme purement politique. S’ancrant dans un mouvement plus large de patrimonialisation de la Révolution française, l’image cinématographique de Robespierre contribue de façon déterminante aux représentations historiques des masses du premier XXe siècle.
« Dis-moi où tu habites… » L’accès à l’avortement au prisme de la dévolution dans le Royaume‑Uni contemporain
Authors: Molinari Véronique , Nedelec Alexandrine
Published: May 2024

Dans un contexte marqué successivement par un référendum sur l’indépendance de l’Écosse, le Brexit, et la pandémie de COVID‑19, le Royaume-Uni a connu, entre 2014 et 2021, une évolution significative de la législation relative à l’avortement. Système fortement décentralisé depuis la fin des années 1990, le pays n’en reste pas moins, contrairement aux États‑Unis, un État unitaire, et non fédéral. Pourtant, la législation relative à l’avortement a différé, historiquement, d’une nation‑région à une autre, de façon parfois significative.Cet article se propose d’analyser, à travers une analyse des jeux d’échelle, les éléments culturels, conjoncturels et constitutionnels qui ont motivé les évolutions récentes des différentes législations relatives à l’avortement. Il questionnera tout d’abord la dimension supranationale de l’avortement pour ensuite examiner les tensions, incohérences, mais aussi influences qui caractérisent les approches nationales et, enfin, s’intéresser aux inégalités dans l’accès à l’avortement à l’échelle locale. Au‑delà des textes de loi, il montrera la pertinence d’interroger les frontières afin de comprendre la question de l’accès à l’avortement dans toutes ses dimensions, et soulignera tout particulièrement combien l’évolution des différents régimes relatifs à l’avortement doit être envisagée dans une relation d’interdépendance entre les différentes composantes du Royaume‑Uni.
L’avortement en Écosse depuis sa légalisation en 1967 : évolution du cadre normatif et des pratiques au sein d’un État d’Union
Authors: Camp-Pietrain Edwige
Published: May 2024

Avant la dévolution du pouvoir, en 1999, le traitement judiciaire de l’avortement était distinct en Écosse, grâce aux particularités protégées par le traité d’Union de 1707 avec l’Angleterre. Cependant, l’avortement n’a été confié au Parlement écossais qu’en 2016. Cet article analyse les raisons de ce retard, à travers l’étude de débats parlementaires, à la Chambre des communes et au Parlement écossais. Il s’intéresse ensuite aux politiques adoptées par ce dernier, au sein duquel les femmes, dont la proportion était élevée, sont restés alignées sur leur parti. Ainsi, après avoir recensé les pressions endogènes, de nature partisane, et les pressions exogènes, venues de l’extérieur des frontières, il conclut à une instrumentalisation politique de la question de l’avortement.
Biosensors for Environmental Monitoring
Authors: Gautam Rajni
Published: May 2024

Environmental monitoring is essential to safeguard our planet's ecosystems, public health, and natural resources. Biosensors have emerged as powerful tools for assessing environmental parameters due to their sensitivity, specificity, and versatility. From the detection of pollutants to the monitoring of water and air quality, biosensors offer a wide array of applications that contribute to comprehensive environmental assessment. In this chapter, the principles, applications, and significance of biosensors in the context of environmental monitoring are explored in detail. Future prospects and challenges are discussed as well.
Harnessing Nature
Authors: Banu A. Naseema , Vani G. Sangeetha , Grace P. Sarah
Published: May 2024

This chapter discusses the role of whole-cell biosensors in monitoring the impact of human advancements on the environment, leading to an imbalance that threatens ecosystems. Biosensors are cost-effective devices known for their specificity, sensitivity, and portability. The advancement in biosensors includes using genetically engineered microbial cells as whole-cell biosensors. These manipulated cells respond to external stresses, making them effective tools for detecting pollutants. The stress-response mechanisms of bacterial species are harnessed for environmental monitoring. The customizable nature of whole-cell biosensors is displayed in the text, and it also discusses applications such as water contamination detection and the design of engineered bacterial cells. The chapter aims to provide a comprehensive understanding of whole-cell biosensors, their principles, and their applications in addressing environmental issues in air, water, and soil pollution.
Explainable AI-Based Semantic Object Detection for Autonomous Vehicles
Authors: A. Elamathiyan , Dhivya G.
Published: May 2024

A goal is to facilitate the recognition and segmentation of the route driven by autonomous vehicles through the use of machine learning (ML) models. The pixel-wise road detection task, the semantic segmentation architectures underwent training and comparison. By using XAI, the authors are able to interpret and read the predictions generated by these abstract models. They generated arguments for the recommended segmentation model for autonomous vehicle road detection using a range of XAI approaches. Supervised learning is enabled by KNN, Decision Tree, and Random Forest, which are the current algorithms used for comparison. On the other hand, the newly built K means clustering function best when paired for image processing since they are good with images. To display the results of computations for the evaluation parameters of each algorithm, including accuracy, sensitivity, recall and precision, tables, and the necessary features from the evaluation matrices are utilised. The k-means clustering system for explainable AI-based semantic object detection in automated cars achieves 94.58% accuracy on both train and test sets.
IoT in Day-to-Day Life
Authors: Pai Kuchelkar Rajaram Vassudev , Jawale Anupama
Published: May 2024

One of the analyses is fatigue analysis which helps determine the durability of the product for its intended life. The fatigue analysis requires an input data from vehicle-road interaction obtained as vertical acceleration. The input data is then used in finite element analysis software or in a test rig instrumentation to perform a fatigue analysis. The focus of this study is about collecting the input data using a data acquisition device. OEM of the automobiles use proprietary data acquisition device for testing their vehicles for durability. However, the automotive body building companies or vehicle body builders which are 1-Tier companies below OEM have a limited budget for such an analysis and therefore they principally lag in advance analysis approach such as a fatigue analysis for the design of vehicle body. Instead, to sustain durability of vehicle, the design is made heavier. This research study is an effort to provide an affordable setup for data acquisition by making use of IoT and web technologies which are cost effective.
Design and Fabrication of a Softrobotic Gripper for Involving Underwater Vehicles in Seaweed Farming
Authors: Gunasekaran Prabhakar , S. Meenakshi , A. Jainulafdeen , N. Ayyanar , Murugesan Rajalakshmi
Published: May 2024

Seaweeds, crucial components of marine ecosystems, thrive in marine and coastal waters, notably in the Gulf of Mannar Biosphere. Despite their ecological importance, certain seaweed species pose a threat to coral reefs due to the release of hydrophobic allelochemicals. Fisherwomen, risking their lives in collecting seaweed seed stock from littoral zones, rocky shores, and deep-sea waters, encounter hazards such as sharp rocks, poisonous algae, cyanobacteria, and coral reefs. Societal research pinpoints risks, overexploitation, unorganized harvesting, and algal blooms as significant issues. The proposed solution involves integrating intelligent Soft Robotic Grippers into underwater vehicles for precise seaweed farming without harming coral reefs. Abacus FEA software aids in deformation analysis, guiding the gripper's design to safeguard fisherwomen and preserve coral reefs.
Advanced Biomimetic Compound Continuum Robot for Minimally Invasive Surgical Applications
Authors: Barua Ranjit
Published: May 2024

the bio-inspired compound continuum robot represents a groundbreaking innovation in the realm of minimally invasive surgery (MIS). Drawing inspiration from the flexibility and adaptability observed in nature, this robotic system employs a novel approach to navigating complex anatomical structures with enhanced precision. Mimicking the serpentine motion of snakes, the robot utilizes a compound continuum structure composed of interconnected segments. This design allows for unparalleled maneuverability, enabling the robot to navigate through confined spaces and intricate pathways within the human body. By emulating the biomechanics of natural organisms, the robot can reach anatomical locations that traditional rigid instruments might struggle to access. In this chapter, the authors will discuss the advanced biomimetic compound continuum robot for minimally invasive surgical applications.
Unmanned Aerial Vehicle Fire Detection Platform Based on Semantic Yolov5 and Autonomous Recognition
Authors: Chen Yihang , Song Xiaoying
Published: May 2024

In recent years, as fire image detection has become a research hotspot. One class of methods is color-based methods, which are very sensitive to brightness and shadows. As a result, the number of false alarms generated by these methods is high. Aiming at the task requirements of airborne binocular vision obstacle avoidance and target tracking, this paper establishes the verification platform architecture of UAV (Unmanned Aerial Vehicle) binocular vision obstacle avoidance and target tracking. For the update and maintenance of boundary regions, we can also continuously extract richer information from the boundary, make more elaborate plans, and develop an incremental method to detect locally updated maps within the boundary. The fire point can be independently and quickly identified through deep learning to extinguish the fire accurately. Assuming that the system incorrectly identifies 2 out of 80 non-fire sources as fire sources, so the results indicate a precision of about 88%, a recall of 90%. However, the traditional fire detection is around 80%.
How to Complete Supply Chain Integration and Improve Supply Chain Performance Through Relationship Governance in the Digital Age
Authors: Zhou Yan , Xu Yi , Wang Qifeng
Published: May 2024

In the process of manufacturing supply chain development, because appropriate governance mechanisms are lacking, manufacturing supply chain stability, integration and other aspects face many challenges. Such as opportunism, “free riding” and data leakage affect supply chain development. Thus, many manufacturing firms are adopting supply chain relationship governance (SCRG) as a strategic to enhance performance. Using data collected from a survey of 295 manufacturing firms, this paper confirms the influence of SCRG on supply chain performance (SCP). The mediating effect of supply chain integration (SCI) and the moderating effect of digital capabilities (DCs) are explored. The results show that SCRG has a beneficial effect on SCP. SCI plays a partial mediating role in SCRG and SCP. DCs positively moderate the relationship between SCRG and SCI. This study is one of the first to explore the role of DCs in the relationship between supply chain partners and the impact on performance. It provides fresh perspectives and real-world evidence for determining the importance of SCRG strategies.
Retrieval of dislodged ASD device
Authors: Pathinayaka A.D. , Hussain N. , Harischandra D.V.T.
Published: May 2024

No abstract available.
The chest drainage system
Authors: Mihiran A.K.K.A. , Pitigala P. , Harischandra D.V.T. , Piyasiri G.
Published: May 2024

No abstract available.
Review of the management of empyemas
Authors: Ilangamge S. , Handagala D.M.S.
Published: May 2024

An empyema is a collection of pus in the pleural cavity. It is a serious pathological condition of the pleural space and it can have high morbidity and mortality rates. The most frequent cause of empyema is infection stemming from a parapneumonic effusion. Special challenges in management arise with post-surgical empyemas and those linked to Tuberculosis. This article concentrates on addressing the management of parapneumonic effusions/empyemas.
A dual approach to re-do coronary artery bypass graft (CABG) using midline sternotomy and left anterior thoracotomy
Authors: Gupta V. , Senanayake G. , Suranimala C.
Published: May 2024

No abstract available.
Knowledge, Attitude, and Practice around Diabetic Eye Disease among Diabetic Patients in Jazan Region, Saudi Arabia
Authors: Najmi Hatim , Otaif Wael , Najmi Muath , Basehi Mohammed , Tobaigy Mohannad , Alsalim Wasan , Awaji Mariam , Najmi Abdulmalik
Published: May 2024

PURPOSE:

This study aims to assess knowledge, attitude, and practice (KAP) around diabetic eye disease in patients with diabetes mellitus (DM) attending primary health-care centers (PHCCs) in Jazan region, Saudi Arabia.

METHODS:

All diabetic patients attending eight PHCCs in Jazan region between December 2018 and December 2019 were invited to participate in this cross-sectional study. Face-to-face interviews were held to gather responses to a validated 20-item questionnaire.

RESULTS:

In total, 293 patients aged 9–90 years (mean 50 years, standard deviation 14 years) agreed to participate, including 189 (64.5%) females and 104 (35.5%) males. Most (n = 251; 85.7%) had type 2 DM, the remainder (42; 14.3%) having type 1 DM. The mean duration of DM was 8.2 ± 6.4 years. Eye complications were self-reported by 114 (38.9%) participants. More than one-third (36.2%) of the participants had never undergone an eye examination. Less than one-third of participants (29% and 28% respectively) had an excellent level of knowledge or practice about diabetic eye disease, and only 12% demonstrated very positive attitude. KAP levels were independently predicted by patients' age, gender, and eye complication status.

CONCLUSION:

KAP relating to eye disease and eye care among Saudi patients with DM were less than desired. Rigorous efforts are required to raise awareness of eye complications among diabetic patients.
AccuVein® fails to facilitate venous marking for saphenous veins harvesting in untrained students
Authors: Ramondou Pierre , Bura-Rivière Alessandra , Mokaddem Wassim , Hersan Jeanne , Josse Charlotte , Abraham Pierre , Fouquet Olivier , Bossavy Jean-Pierre , Lapébie François-Xavier , Henni Samir
Published: May 2024

CONTEXT:

Ultrasound marking of saphenous veins before vein harvesting facilitates the surgical procedure but is time-consuming.

AIM:

We evaluated the time benefit of saphenous veins marking by the AccuVein® AV400 system (AccuVein Inc., NY, USA) coupled with ultrasound, over ultrasound alone.

SETTINGS AND DESIGN:

Multi-center open-label randomized interventional study in two parallel groups.

SUBJECTS AND METHODS:

After randomization, saphenous veins markings were performed using either AccuVein®coupled with ultrasound or ultrasound alone. One-leg marking time, vascular physician postexamination satisfaction rating, and number of single-use felt markers used were recorded.

STATISTICAL ANALYSES:

The continuous variables were compared using the Fisher test, whereas Likert scale scores were compared using the nonparametric Mann−Whitney test. The learning effect was evaluated by linear and nonlinear regression models.

RESULTS:

The average duration of saphenous veins marking (459 ± 184 vs 555 ± 226 s, P = 0.116) and the number of felt markers used were not significantly different between the two techniques. Vascular physician satisfaction was significantly lower with than without the AccuVein® associated to ultrasound.

CONCLUSIONS:

AccuVein® examination coupled with ultrasound as part of the marking process does not provide a significant benefit in terms of time, satisfaction, or need for markers.
Comparison of the Influence of Intraoperative Use of Sevoflurane and Isoflurane on Postoperative Nausea, Vomiting, and Cough
Authors: Chouhan Akansha , Bhat Sonal N , Rao Sunil Vasudev
Published: May 2024

Introduction:

Postoperative nausea, vomiting, and cough are the most common adverse effects of general anesthesia resulting in high discomfort to the patient resulting in uneasiness during the recovery period. This study aimed to compare the influence of intraoperative use of sevoflurane and isoflurane on postoperative nausea, vomiting, and cough.

Materials and Methods:

After approval from the institutional ethical committee, this quantitative observational institutional study was conducted on all patients aged between 18 and 65 years undergoing surgery under general anesthesia at KMC Hospital, Mangalore. Patients were allocated into the sevoflurane group or isoflurane group.

Results:

All demographic parameters such as age, sex, American Society of Anesthesiologists physical status, and duration were comparable (P > 0.05). The sevoflurane group had higher number of patients (11 [14.86%]) with postoperative nausea at 0 h as compared isoflurane group (7 [9.45%]). Two patients in the isoflurane group reported postoperative vomiting at 0 h, whereas no patient in the sevoflurane group reported vomiting. For cough, a statistically significant correlation was seen between the two groups (P = 0.000) with majority of patients in the isoflurane group, i.e., 50 (67.6%) patients reporting cough at 0 h while only 15 (20.3%) reported cough in the sevoflurane group.

Conclusion:

Sevoflurane was found to be better than isoflurane in terms of postoperative nausea vomiting and cough immediately after emergence in our study. Isoflurane cause the emergence of cough whereas no significant difference in nausea and vomiting was observed in both groups.
Permanent longitudinal strain damage of cardiotoxic drugs in childhood cancer: What is the safe level?
Authors: Mohammadi Hamid , Hosseini Hossein , Bordbar Mohammadreza , Mehdizadegan Nima , Amoozgar Hamid , Edraki Mohammad Reza , Naghshzan Amir , Naderi Nima , Abedi Elham , Keshavarz Kambiz
Published: May 2024

Objective:

Anthracycline administration in children is associated with cardiac dysfunction. Speckle-tracking echocardiography (STE) can detect subclinical cardiac damage that may go undetected by conventional two-dimensional (2D) echocardiography. This study aims to investigate medium-term anthracycline cardiotoxicity using STE and determine a safer administrable level of anthracyclines (ACs).

Methods:

This observational case–control study enrolled 37 healthy controls and 78 pediatric cancer survivors who received chemotherapy. The patients were divided into two groups: cardiotoxic received (CR) and cardiotoxic free (CF). Data on segmental longitudinal strain (LS), global LS (GLS), and 2D echocardiographic parameters were collected after a drug-free period of at least one year.

Results:

A total of 115 children with a mean age of 108 ± 55 months, of whom 66% were males, were included in the study. Both the groups of cancer survivors exhibited significantly reduced GLS compared to healthy controls (CR vs. controls, P = 0.001; CF vs. controls, P = 0.013), but no significant difference in left ventricular ejection fraction (LVEF) was observed (P = 0.75). Overall, cancer survivors treated with ACs demonstrated a significant reduction in strain in 10 left ventricular segments, particularly in the basal segments (P < 0.05). Among CR patients, those with impaired GLS (n = 43, GLS worse than −21.9) had significantly higher mean age and cumulative anthracycline dose compared to CR patients with normal GLS (age, P = 0.024; anthracycline dosage, P = 0.036). Using an anthracycline cutoff of 223 mg/m2 resulted in a higher detection rate (49% vs. 25%) and fewer missed cases (51% vs. 74%) compared to the 360 mg/m2 anthracycline cutoff.

Conclusion:

Childhood cancer survivors demonstrate significantly reduced GLS while preserving a normal LVEF, which does not differ significantly from reference values of healthy children. The reduction in strain appears to be associated with higher anthracycline doses and older age. Lowering the anthracycline threshold to 223 mg/m2 may improve the predictability of a decline in cardiac function using strain imaging at medium-term follow-up.
Innominate vein occlusion by the fabric of covered stent during transcatheter closure of sinus venosus defects – Causes, management, and outcome
Authors: Sivakumar Kothandam , Sagar Pramod , Thejaswi Puthiyedath , Ramaswamy Rajeshkumar , Chandrasekaran Ramyashri
Published: May 2024

Transcatheter sinus venosus defect (SVD) closure with covered stents is emerging as an alternative to surgery. An adequate anchor zone in the superior vena cava is mandatory for the stability of the covered stent to prevent caudal embolization. There is a potential risk of innominate vein occlusion by the fabric of the covered stent in patients with a very short superior caval vein. Three among a total of 105 patients who underwent SVD closure at our institution developed innominate vein occlusion. Predisposing anatomical factors, identification and management of occluded innominate vein, and follow-up outcomes are discussed.
Evaluation of left ventricular function and volume by two-dimensional echocardiography in a pediatric population: Correlation with cardiac magnetic resonance imaging
Authors: Bhansali Suneet , Tokar Ella , Saharan Sunil , Khalil Ramzi , Bhatla Puneet
Published: May 2024

Background:

Echocardiographic quantification of left ventricular (LV) volume and ejection fraction (EF) is widely used in the pediatric population. However, there is no consensus on the most accurate method of quantifying ventricular volumes and systolic function.

Purpose:

The purpose of this study is to compare two commonly used echocardiographic methods for the evaluation of LV volume and quantification of EF, the five-sixth area-length (5/6 AL) and the modified biplane Simpson (BS), to cardiac magnetic resonance (CMR) imaging in children.

Methods:

CMR studies were paired with echocardiograms and retrospectively analyzed in children 18 years of age and younger. Studies performed more than 3 months between modalities, patients with congenital heart disease, and patients who had changes in medication regimen between corresponding CMR and echocardiograms were excluded. LV volumes and EF were calculated using the 5/6 AL and BS methods and compared to volumes and EF measured on corresponding CMR studies. Subgroup analyses were conducted based on LV function, pathology, and weight.

Results:

We retrospectively analyzed 53 CMR and corresponding echocardiogram studies (23 studies for myocarditis and 30 studies for cardiomyopathy) in 46 patients. LVEF derived by both echocardiographic methods showed a good correlation to CMR (5/6 AL r = 0.85 and BS r = 0.82). However, both echocardiographic methods overestimated LVEF and underestimated LV volumes when compared to CMR.

Conclusion:

Left ventricular volumes and EF, as measured by echocardiography, correlate well with CMR measurements. Echocardiography underestimates LV systolic and diastolic volumes and overestimates LVEF. While echocardiography is a good surrogate for estimating LVEF, CMR should be considered in patients for whom accurate measurements are needed for critical clinical decision-making.
An inciteful perspective on bacterial species involved in the persistence of apical periodontitis
Authors: Gutmann James L , Manjarrés Vivian , De La Espriella Catalina Mendez
Published: May 2024

Recalcitrant bacteria play an important role of the persistence of periapical disease following root canal procedures, especially when they a part of a complex and stable biofilms that are found in the intricacies of the apical root canal anatomy. This is particularly true in cases that are deemed as a “failure in root canal treatment.” However, the literature is replete with confusion with regard to this concept of failure, as general terms, such as endodontic pathology or endodontic infection are used to denote factors implicated in the failure, without specifically identifying the issues of concern and their eradication, especially as they relate to the overall systemic health of the patient. Thus, attention for the cause of the failure immediately focuses on bacterial species without considering a vast array of potential causes. In doing so many studies tend to look at only one specific species as being the causative agent in the presence of the diagnosed failure (E. faecalis) and this bacterial species has been the focus of a wide range of investigative studies used for proof of concept. Is it possible that this focus has missed the bigger picture and potentially more virulent, invasive, and persistent species are involved? Have too many studies relied on short-term, single-bacterial biofilms, negating the very essence of the long-term interplay of multiple species within these colonies? This short communication will address this perspective, attempting to expand the investigative process for the presence and persistence of periapical disease and its impact on the host.
Prevalence of pregnancy complications in Nnewi, South-East Nigeria
Authors: Afonne Anulika J. , Okafor Jerome O.
Published: May 2024

Aims

This study was set to determine the prevalence of pregnancy complications and associated sociodemographic factors in Nnewi, South-East Nigeria, from 2014 to 2018.

Patients and methods

This was a retrospective, descriptive study of pregnant women, who received antenatal care and/or delivered at the Nnamdi Azikiwe University Teaching Hospital, Nnewi.

Results

Of the 821 deliveries documented at Nnamdi Azikiwe University Teaching Hospital, Nnewi, 435 (52.98%) had complications. Sixteen clinical conditions were identified in the complicated pregnancies; the most common being malaria (20.23%), hemorrhage (13.79%), and HIV infection (10.11%). The least were ectopic pregnancy (2.07%), uterine rupture (2.07%), and placenta abruption (2.30%). The number of pregnancies with complications were significantly higher than those without (P=0.039). There was a statistical association between pregnancy complication and the woman’s occupation (P=0.028).

Conclusion

The prevalence of pregnancy complications in Nnewi was found to be 52.98%, with malaria being the most common complication (22.23%), and ectopic pregnancy and uterine rupture the least (2.07%).

Recommendation

Women are advised to access antenatal care during pregnancy to stem complications, while efforts should be intensified by relevant bodies to control malaria in pregnancy.
Response of nurses toward interim infection prevention and control recommendations for coronavirus disease 2019 in healthcare settings at the early stage
Authors: Abdulah Deldar M. , Mohammedsadiq Hawar A.
Published: May 2024

Background

Healthcare workers are at high risk for coronavirus disease 2019 (COVID-19). The nurses need to ensure the minimal risk of infection during treating and caregiving to patients with COVID-19 through using personal protective equipment.

Aim

This study aimed to explore the nurses’ response toward interim infection prevention and control recommendations for patients with suspected COVID-19.

Participants and methods

In this cross-sectional study, 232 nurses who dealt with suspected COVID-19 patients were invited from four public hospitals between 14 and 18 March 2020.

Results

Nurses adhered to minimizing close exposure to a suspected person by disinfecting contaminated areas. However, 36.2% did not limit the entry number to the rooms dedicated to patients infected with COVID-19. Moreover, 58.2% reported that triage stations outside the facility to screen patients have not been set up yet. The hospital’s administration limits the visit of patients’ facilities by 89.7% and using personal protective equipment (72.4–97.4%). About 31.9% of nurses did not launder clothes after they finished a day and entered a room with suspected patients. In addition, 49.1% of the nurses reported that dedicated rooms are in a single-person room with the door closed. Specimen collection was performed in a normal examination room with the closed door (63.4%). Also, 81.0% of the nurses reported that the clinical ward limits the transport and movement of nurses outside of the room.

Conclusion

This study showed that one-third of the nurses do not adhere to interim prevention and control recommendations for suspected COVID-19.

Recommendation

The study suggests that healthcare workers and their family members be monitored for the suspected symptoms of COVID-19 because they are at a high risk of exposure and may impose a high risk on their colleagues.
Impact of sodium-glucose co-transporter 2 inhibitors on renal outcomes in patients of diabetes mellitus
Authors: Bose Debdipta , Maurya Miteshkumar , Konwar Mahanjit
Published: May 2024

Sodium-glucose co-transporter 2 inhibitors (SGLT2is) are recommended as the next step therapy for the management of diabetes mellitus. The large clinical trials of SGLT2is demonstrated benefits on various renal endpoints. We conducted this meta-analysis of large trials on cardiovascular and renal safety trials to explore the renoprotective effect of this group of drugs. PubMed, Cochrane CENTRAL, and EMBASE databases were searched with specific keywords till January 19, 2021. Randomized trials of SGLT2is that evaluated the cardiovascular or renal composite outcome as a primary outcome measure were eligible. Random-effects model was used to calculate the overall risk ratios. The search yielded 716 studies and 10 studies were included. The SGLT2is reduced the risk of composite renal outcome (risk ratio [RR] = 0.64, 95% confidence interval [CI] = 0.58–0.72), decline in estimated glomerular filtration rate (eGFR) (RR = 0.62, 95% CI = 0.50–0.77), doubling of serum creatinine (RR = 0.67, 95% CI = 0.56–0.81), dialysis or renal replacement therapy (RR = 0.71, 95% CI = 0.59–0.86), sustained eGFR of <15 ml per min per 1.73 m2 for at least 30 days or more (RR = 0.66, 95% CI = 0.55–0.81), end-stage renal disease (RR = 0.70, 95% CI = 0.56–0.87), and acute kidney injury (RR = 0.79, 95% CI = 0.71–0.89). This analysis establishes the renoprotective effect of SGLT2is. This benefit is noted in patients who had eGFR of more or <60 ml per min per 1.73 m2. This benefit was uniform across all the SGLT2 inhibitors except ertugliflozin and sotagliflozin.
An Analysis of Patients with Chronic Pain amid COVID-19 Pandemic: A Cross-Sectional Observational Trial
Authors: Ahuja Vanita , Thapa Deepak , Mitra Sukanya , Singh Kushagrita , Nair Lekshmi V.
Published: May 2024

Context:

The unpredictable nature of COVID-19 pandemic and the limited patient–doctor interaction led to the change in chronic pain management during the pandemic.

Aims:

The study aimed to compare pain scores and bio-psycho-social aspects of chronic pain in patients during prepandemic versus COVID-19 pandemic period.

Settings and Designs:

This was a prospective, cross-sectional observational trial conducted in a tertiary care hospital.

Subjects and Methods:

The study was conducted between September 2021 and January 2022 which corresponded with the end of the second wave and beginning of the third wave of COVID-19 pandemic. A set of 20 web-based questionnaires were sent to adult patients of both genders and who had visited pain clinic before the onset of pandemic.

Statistical Analysis Use:

Discrete categorical data were presented as n (%); continuous data were written either in the form of its mean and standard deviation or in the form of its median and interquartile range. All statistical tests were two-sided and were performed at a significance level of P < 0.05.

Results:

A total of 408 patients of chronic pain participated in the web-based questionnaire. The most common diagnosis was low back pain, facial pain, and knee pain. The patients continued to consume analgesics during the pandemic, had ≥2 burnout score, and reported “poor to fair” quality of sleep score. During the pandemic, pain score increased in those subsets of patients who earlier had no pain (odds ratio [OR]: 68.33, confidence interval [CI]: 24.10–193.72, P = 0.000), mild pain (OR: 22.78, CI: 9.49–54.64, P = 0.000), and moderate pain. On the contrary, chronic pain decreased or remained same in the population having moderate or severe pain before the pandemic. Patients with increased pain during the pandemic wanted the outpatient department to reopen for consultation with pain physician. The majority of the patients 350 (85.78%) who had participated in the study did not suffer from COVID-19 infection.

Conclusions:

Regular intake of analgesics during the COVID-19 pandemic reduced the number of patients experiencing severe pain. However, the patients suffering from moderate-to-severe pain during the pandemic had a direct correlation between higher pain severity and poor quality of sleep.
Predictive ability of complete blood count, mean platelet ratio, mean platelet volume, and neutrophil/lymphocyte ratio for severe pneumonia among RT-PCR or radiologically proven COVID-19 patients
Authors: Bohra Harishkumar R. , Suthar Om P. , Rehana V R , Baskaran Pritish , Nivedita A , Lakra Prima Suchita , Raghav Pankaja R. , Tandon Ashwani
Published: May 2024

ABSTRACT

Background:

Immuno-inflammatory markers related to white blood cells, and platelets are shown to be associated with COVID-19 infection, and considered to be independent markers for clinical outcomes and mortality. The present study aimed to study the predictive value of these hematologic parameters in progression of COVID-19 to severe pneumonia.

Methods:

This was an analytical cross-sectional study conducted among RT-PCR or radiologically proven COVID-19 patients in a tertiary care hospital in Rajasthan. Semi-structured questionnaire was used to collect the epidemiological information of the patients with COVID-19. Complete blood count and other laboratory parameters were also studied among the patients.

Results:

Mean age of participants in the study was 52 years, with about 70% being males. Cough and breathlessness were the most common symptoms among the patients. It was found that the parameters related to white blood cells were significantly different between patients with COVID-19 infection and severe pneumonia (except absolute monocyte count). NLR was significantly higher among those with severe pneumonia. In the univariate analysis, age (OR - 1.02), NLR (OR - 1.16), and albumin (OR - 0.45) were found to be significant predictors of progression to severe pneumonia. In the final model, adjusted for confounders, only NLR and albumin levels significantly predicted progression to severe pneumonia among COVID-19 patients.

Conclusion:

The study consolidates the predictive ability of NLR for severe pneumonia. It is an important finding, as health facilities with limited access to laboratory investigations can rely on simple markers in routine practice to predict the progression of COVID-19 infection to severe pneumonia.
Birt–Hogg–Dubé syndrome presenting with bilateral pneumothorax, skin, kidney, liver, and brain lesions
Authors: Bajpai Jyoti , Roy Shubhajeet , Zanwar Vishal , Kant Surya
Published: May 2024

ABSTRACT

Birt–Hogg–Dubé syndrome (BHDS) is a rare hereditary autosomal dominant condition characterized by benign cutaneous lesions, lung cysts, and increased risk of spontaneous pneumothorax and renal cancer. We report a case of a young Indian boy with bilateral pneumothorax as the first symptom of BHDS. Detailed history examination and investigation showed multiple facial lesions; his computerized tomography was suggestive of renal angiomyolipoma, hepatic angiomyolipoma, pulmonary cyst with pneumothorax, and small bilateral subependymal soft tissue density lesion with calcification in the brain, all of which were collectively suggestive of BHDS. Identification of the above commonly presented clinical features as a syndrome is important for even a primary care physician so as to ensure the timely management and if required referral to a higher center.
A parallel-arm randomised control trial to study the effects of risk communication methods for prevention of cardiovascular diseases: EFFRICO trial
Authors: Singhal Kritika , Prasad Pankaj , Pal Deb Kumar , Bhagtana Parneet Kaur , Gupta Suruchi
Published: May 2024

ABSTRACT

Introduction:

Cardiovascular diseases (CVDs) have many risk factors; few can be modified through health education. Traditional patient counselling methods fail to impact health behaviours to prevent or reduce the risk of CVDs.

Objectives:

This study was conducted to estimate the effect of various risk communication methods on CVD risk reduction and medication adherence.

Design:

An open-label superiority randomised control trial was conducted where 159 patients were randomised into three groups: Communication of 10-year Framingham CVD risk score, heart age, and routine care. Follow-up was done 3 months after recruitment. The primary outcome was a difference in excess 10-year Framingham CVD risk score in the end-line compared to baseline. The status of modifiable behavioural risk factors at baseline was expressed as ‘yes’ and ‘no’, and follow-up was defined as ‘action’, ‘positive maintenance’, ‘negative maintenance’, and ‘defaulter’. The trial was registered with the Clinical Trials Registry India (CTRI NO. CTRI/2020/10/028614).

Setting:

The study setting was screening outpatient department (OPD), General Medicine OPD, and Cardiology OPD of a tertiary care hospital in Central India.

Participants:

Participants aged >30 years, residing in Bhopal for more than 6 months, diagnosed with hypertension or diabetes mellitus or both, and having any of the four CVD behavioural risk factors: tobacco use, alcohol use, physical inactivity, or unhealthy diet.

Results:

Median excess 10-year Framingham CVD risk scores were 0.945% (CI: 1.275–4.297), –0.850% (–3.932–2.075), and –1.300% (–5.100–0.900) (10-year Framingham CVD risk score vs Heart age vs Routine care) and 0.000% (–3.125–5.925), –1.600% (–3.760–1.475), and –1.400% (–6.600–5.900) before and after intervention, respectively (P > 0.05). Positive maintenance was higher in both intervention groups concerning all modifiable behaviours, with a higher proportion reported in the 10-year Framingham risk score. The action phase was reported higher in intervention groups for medication adherence, addiction, and dietary changes.

Conclusion:

Systematic risk communication methods reduced the probability of contracting CVD in the future, though this finding was statistically insignificant.