bluuebunny/crossref_metadata_2025 huggingface dataset:
The Implications of High Black Hole Spins for the Origin of Binary Black Hole Mergers
Authors: Olejak A. , Belczynski K.
Published: October 2021

The LIGO–Virgo collaboration has reported 50 black hole–black hole (BH–BH) mergers and 8 candidates recovered from digging deeper into the detector noise. The majority of these mergers have low effective spins pointing toward low BH spins and efficient angular momentum (AM) transport in massive stars as proposed by several models (e.g., the Tayler–Spruit dynamo). However, out of these 58 mergers, 7 are consistent with having high effective-spin parameter (χ
eff > 0.3). Additionally, two events seem to have high effective spins sourced from the spin of the primary (more massive) BH. These particular observations could be used to discriminate between the isolated binary and dynamical formation channels. It might seem that high BH spins point to a dynamical origin if AM in stars is efficient and forms low-spinning BHs. In such a case dynamical formation is required to produce second and third generations of BH–BH mergers with typically high spinning BHs. Here we show, however, that isolated binary BH–BH formation naturally reproduces such highly spinning BHs. Our models start with efficient AM in massive stars that is needed to reproduce the majority of BH–BH mergers with low effective spins. Later, some of the binaries are subject to a tidal spin-up allowing the formation of a moderate fraction (∼10%) of BH–BH mergers with high effective spins (χ
eff ≳ 0.4–0.5). In addition, isolated binary evolution can produce a small fraction of BH–BH mergers with almost maximally spinning primary BHs. Therefore, the formation scenario of these atypical BH–BH mergers remains to be found.
The Dignity of Middle Adult Palliative Patients at Home in Bantul
Authors: Wulandari Bertha Tesma , Arianti Arianti
Published: October 2021

BACKGROUND: The condition of middle adult patients with palliative disease is prone to experiencing physical weakness and psychological suffering, disrupting dignity. As a caregiver at home, the family plays an essential role in providing support to maintain patient dignity.

AIM: This study aims to determine the image of the dignity of the middle adult patient with palliative care needs by family at home.

METHODS: This research is a qualitative study with a phenomenological approach. Participants were seven people with the purposive sampling method. Data collection methods were conducted using in-depth interviews and semi-structured observation. Research instruments included interview guidelines, field notes, and an observation form. Data validity used reference material, rich and thick description, and peer debriefing. Data analysis included data collection, data reduction, data presentation, and conclusion.

RESULTS: The results showed that the dignity of patients was considered by six themes; self-esteem went up and down, the meaning of illness and death, family response to the patient, sources of decision-making, an image of the quality of life, and future wishes.

CONCLUSION: This study had six themes depicting the dignity of patients that consisted of subthemes. The themes included self-esteem went up and down, the meaning of illness and death, family response to the patient, sources of decision-making, an image of the quality of life, and future wishes.
Post-operative Pain and Antibacterial Efficacy of Silver Nanoparticles Formulations Intracanal Medication: A Randomized Controlled Clinical Study
Authors: Hassan Nermine , Diab Alaa , Ahmed Geraldine
Published: October 2021

AIM: To evaluate the effect of using combined calcium hydroxide/silver nanoparticles or silver nanoparticles (AgNPs) or calcium hydroxide (Ca(OH)2) individually as intracanal medications in reducing postoperative pain and intracanal bacterial count. MATERIALS AND METHODS: Thirty patients with necrotic mandibular anterior teeth were randomly divided into 3 groups; Ca(OH)2 + AgNPs or AgNPs gel (Intervention Groups) or Ca(OH)2 (Control Group). Patients received a standard 2-visit endodontic treatment and recorded their pain levels after 4, 24, 48, 72 and 96 hours following the first and second visit on a modified visual analogue scale (VAS). Intracanal bacterial counts were assessed using culturing before and after instrumentation and intracanal medication. Outcome data were statistically analyzed using Kruskal-Wallis and Fisher’s Exact tests to compare between the groups and Friedman’s test to assess the changes by time. RESULTS: At 24 hours interappointment the incidence of pain was statistically significant (P = .005) as well as at 48 hours (P = .001). There was a statistically significant difference between the mean percentage reduction of anaerobic bacterial counts in the three groups with the highest percentage in the Ca(OH)2 + AgNPs group at 98.9% followed by AgNPs group 98.5% and Ca(OH)2 at 85.3% (P <0.001). CONCLUSIONS: Combined calcium hydroxide/silver nanoparticles reduced the intracanal bacterial counts significantly, but adversely affected the interappointment pain. Based on that finding, this combination should be tested in different concentrations with different ratios to reach the most effective combination that reduce pain with high antibacterial efficacy.
Surgical Treatment of Endo-periodontal Lesion – A Case Report
Authors: Shopova Dobromira
Published: October 2021

BACKGROUND: Periapical lesions are a pаthological changes that occur in most of poorly endodontically treated teeth. Endodontic and periodontal diseases are caused by a mixed anaerobic infection. Periodontal disease produces lesions in the tooth-supporting tissues. Generalized periodontitis comprises hard and soft tissue at the whole dentition. Surgical methods of treatment include etiological and pathogenetic methods – removal of pathological tissue, destruction of the bacterial causative agent, and recovery of lost tissue. Recognition and management of risk factors (local and general) increase the chances of a successful treatment outcome. The combined surgical protocol presented in this article is the last step before extraction. Especially in the frontal area, dentist should try to keep the esthetics, maintaining the tooth and the surrounding bone.

CASE REPORT: The presented patient is a 59-year-old lady with generalized periodontal disease and periodontitis apicalis chronica dentis 21. Bone graft covered by soft-tissue graft was used to fill the defects around the apex and surrounding the teeth. After 5 months, the apical lesion was in very good condition according to radiological and clinical examination. The periodontal lesion was almost at the same vertical condition as the initial situation, but this surgery method aims to make bone thicker for support of the mucosa. The risk factors were smoking, average level of oral hygiene, and osteoporosis.

CONCLUSION: The combination of different clinical protocols is a necessity in surgical practice. Knowledge of the etiology and pathogenesis of the disease allows the application of adequate methods of treatment. The result was satisfactory.
Les métaux et la santé
Authors: Hartemann Philippe
Published: October 2021

Les métaux sont connus et utilisés depuis l’Antiquité pour la vie courante et souvent en thérapeutique pour leurs propriétés antimicrobiennes ou « vitales » (oligoéléments). Ils ont été aussi utilisés comme poisons ce qui illustre bien la dualité de leur rôle dans l’organisme. Ils font actuellement l’objet d’un regain d’intérêt comme médicaments, des micronutriments largement utilisés en médecine conventionnelle, dans les thérapies complémentaires et dans le thermalisme, à l’arsenic en cancérologie. Ils sont également constitutifs de nombreux dispositifs médicaux où, en plus de leurs performances mécaniques, ils doivent répondre à des critères spécifiques de non-toxicité pour un usage de longue durée après implantation (chrome et cobalt). Certains, bien connus pour leurs propriétés microbio-statiques et/ou -cides (cuivre et argent) interviennent dans de nombreuses applications antiseptiques et désinfectantes. Cela conduit à une utilisation grandissante d’argent, en particulier sous forme nano, pour de nombreuses applications dans la vie courante (masques, vêtements, ustensiles divers) pour « protéger » l’usager, en particulier en période pandémique. Il convient de rester prudent car la population française montre un niveau d’exposition aux métaux supérieur à ce qui peut être décrit dans d’autres pays (étude Esteban).
La Recherche et l’Innovation en France
Authors: Nemessany Violette
Published: October 2021

FutuRIS s’est intéressé, en 2014, aux modes d’approche des entreprises par les établissements publics de recherche et à leur manière de nouer des relations avec elles. Cette année, ce chapitre concentre son attention, à l’inverse, sur les entreprises. Sur la base d’une série d’entretiens réalisés avec des représentants de grands groupes, ETI et PME, il met tout d’abord en perspective l’effort de RD privé en France et le volume de recherche contractuelle. Sont ensuite passés au crible les enjeux et les attentes des entreprises, les moyens mis en œuvre pour identifier les résultats de la recherche publique, les difficultés rencontrées et les conditions de la réussite d’un partenariat, dans lesquelles la confiance joue un rôle essentiel. Le chapitre montre que le partenariat avec la recherche publique est devenu une nécessité pour les entreprises qui sont à la recherche de nouvelles compétences et de moyens complémentaires pour innover et rester compétitives dans un environnement concurrentiel. Il peut prendre des formes variées selon les besoins et les enjeux auxquels sont confrontées les différentes catégories d’entreprises. Les modes d’approche diffèrent également : si les grands groupes, les start-up technologiques et, dans une moindre mesure, les ETI initient facilement le contact, les PME, en revanche, rencontrent davantage de difficultés compte tenu de leurs capacités limitées en matière de RD et de l’insuffisance de leurs ressources tant financières qu’humaines. Parmi celles qui s’engagent dans des programmes de recherche bilatéraux, il apparaît que c’est le dirigeant de la PME qui est, le plus souvent, à l’origine de l’initiative. Mais, accaparé par la gestion quotidienne de son entreprise, il peine à tout mener de front. C’est pourquoi, les PME attendent un accompagnement personnalisé pour les orienter vers le bon partenaire, instaurer le dialogue et les guider tout au long du projet. Le renforcement des services de valorisation et le recrutement de nouveaux profils tels que les «  business developers  » et les commerciaux au sein d’un nombre, encore limité, d’établissements publics de recherche témoignent de la prise en compte de cette attente. Enfin, six pistes de progrès, susceptibles d’améliorer le cadre d’ensemble dans lequel s’inscrivent les partenariats public-privé, ont été dégagées. Destinées aux entreprises, établissements publics de recherche et pouvoirs publics, elles se placent dans une perspective d’accompagnement des évolutions en cours. En 2016, FutuRIS publiera un rapport qui combinera les deux études menées au cours des deux dernières années.
La Recherche et l’Innovation en France
Authors: Thoenig Jean-Claude , Paradeise Catherine
Published: October 2021

Les établissements d’enseignement supérieur et de recherche affrontent une période durable de profondes mutations de leurs raisons d’être et de leurs prestations. Faire preuve d’une capacité stratégique est pour eux un défi majeur à relever. L’article a pour ambition, non pas de définir quelle stratégie précise ils doivent adopter, mais de leur permettre par eux-mêmes de développer une compétence appropriée pour bâtir et mettre en œuvre une posture programmatique durable et performante. À partir d’une étude comparative réalisée dans plusieurs pays dont la France, il s’agit de définir les compétences indispensables pour ce faire et de proposer une boîte à outils leur permettant de s’autoévaluer en vue de renforcer leur capacité managériale. L’accent sera mis sur une facette trop souvent négligée, soit leur façon de se gouverner en interne comme organisation.
The top 100 Twitter influencers in cardiology
Authors: Kesiena Onoriode ,   Department of Internal Medicine, Piedmont Athens Regional Medical Center, Athens, USA, Onyeaka Henry K , Fugar Setri , Okoh Alexis K , Volgman Annabelle Santos ,   Department of Psychiatry, Massachusetts General Hospital/Mclean, Boston, USA,   Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, USA,   Division of Cardiology, Cardiovascular Research Unit, RWJ Barnabas Health, NBIMC, Newark, New Jersey, USA
Published: October 2021

Importance

Twitter represents a growing aspect of the social media experience and is a widely used tool for public education in the 21st century. In the last few years, there has been concern about the dissemination of false health information on social media. It is therefore important that we assess the influencers of this health information in the field of cardiology.

Objective

We sought to identify the top 100 Twitter influencers within cardiology, characterize them, and examine the relationship between their social media activity and academic influence.

Design

Twitter topic scores for the topic search “cardiology” were queried on May 01, 2020 using the Right Relevance application programming interface (API). Based on their scores, the top 100 influencers were identified. Among the cardiologists, their academic h-indices were acquired from Scopus and these scores were compared to the Twitter topic scores.

Result

We found out that 88/100 (88%) of the top 100 social media influencers on Twitter were cardiologists. Of these, 63/88 (72%) were males and they practiced mostly in the United States with 50/87 (57%) practicing primarily in an academic hospital. There was a moderately positive correlation between the h-index and the Twitter topic score, r = +0.32 (p-value 0.002).

Conclusion

Our study highlights that the top ranked cardiology social media influencers on Twitter are board-certified male cardiologists practicing in academic settings in the US. The most influential on Twitter have a moderate influence in academia. Further research should evaluate the relationship between other academic indices and social media influence.
Item Count Technique in Ranked Set Sampling
Authors: Cobo Beatriz , Pelle Elvira
Published: October 2021

In situations where the estimation of the proportion of sensitive variables relies on the observations of real measurements that are difficult to obtain, there is a need to combine indirect questioning techniques. In the present work, the authors will focus on the item count technique, with alternative methods of sampling, such as the ranked set sampling. They are based on the idea proposed by Santiago et al., which combines the randomized response technique proposed by Warner together with ranked set sampling. The authors will carry out a simulation study to compare the item count technique under ranked set sampling and under simple random sampling without replacement.
Ratio-Type Estimation Using Scrabled Auxiliary Variables in Stratification Under Simple Random Sampling and Ranked Set Sampling
Authors: Bouza-Herrera Carlos N. , Sautto Jose M. , Ul Islam Rather Khalid
Published: October 2021

This chapter introduced basic elements on stratified simple random sampling (SSRS) on ranked set sampling (RSS). The chapter extends Singh et al. results to sampling a stratified population. The mean squared error (MSE) is derived. SRS is used independently for selecting the samples from the strata. The chapter extends Singh et al. results under the RSS design. They are used for developing the estimation in a stratified population. RSS is used for drawing the samples independently from the strata. The bias and mean squared error (MSE) of the developed estimators are derived. A comparison between the biases and MSEs obtained for the sampling designs SRS and RSS is made. Under mild conditions the comparisons sustained that each RSS model is better than its SRS alternative.
Higher Education as Institution of Decolonization
Authors: Lee Kevin Lujan , Phan Ngoc T.
Published: October 2021

Higher education should be an institution of decolonization––one centered on the repatriation of land and ocean to Indigenous peoples. Quantitative methods are used to perpetuate the historical and ongoing processes of Indigenous dispossession. However, quantitative methods courses often fail to reckon with these colonial histories and are taught in ways that are inaccessible for Indigenous students. Drawing from the first author's experiences as a professor of political science in Hawai‘i, this chapter proposes three classroom-level interventions that educators can pursue to make quantitative methods relatable and empowering for Indigenous students: (1) designing lectures to center the experiences of Indigenous students, (2) designing assignments that invite Indigenous students to interrogate the settler-colonial and neocolonial structures perpetuating Indigenous dispossession, and (3) maintaining university-community partnerships that provide Indigenous students with opportunities to use quantitative methods to support Indigenous sovereignty movements.
Encapsulation of Flavonoids in Nanocarriers
Authors: Shah Ashfaq Ahmad , Gupta Amit
Published: October 2021

The term “flavonoid” is a broad term given to the collection of natural polyphenolic compounds which occur in plants (fruits, vegetables, roots, flowers, stems, bark, leaves) as their secondary metabolites. Subsequent research reveals that flavonoids possess anti-inflammatory, anti-mutagenic, anti-oxidative, anti-ageing, and anti-carcinogenic effects along with their capacity to modulate enzymatic activities, inhibit cell proliferation, and inhibit bacterial growth, among others. The main shortcomings of oral administration of flavonoids as therapeutic that various studies have revealed are related to their stability, bioefficacy, and bioavailability. Novel nanotechnological strategies involving nanocarrier systems are proving promising to overcome the delivery challenge of flavonoids as therapeutics. Nanocapsules, nanospheres, solid lipid nanoparticles, nanoemulsions, micelles are examples of novel nanocarrier systems that are currently being explored for targeted and efficient bio functioning of flavonoids after their oral administration.
Harnessing Social Media to Improve Educational Performance of Adolescent Freshmen in Universities
Authors: Zhou Munyaradzi , Matsika Cyncia , Zhou Tinashe Gwendolyn , Chawarura Wilfreda I.
Published: October 2021

Social media use in different industries and commerce is high. Little exists on harnessing Facebook and YouTube to improve the educational performance of adolescent students. Researchers support that the use of social media has a positive correlation with educational performance. However, ‘little' or ‘no' research has been done on how social media platforms are customized to improve the academic performance of adolescents. Data was collected using interviews in the qualitative case study. The chapter proffers solutions like coming up with a private resource center hosted by university departments. The resource center is solely accessible for accessing research content and making contributions by academics, students, and industry. Further research might include a framework for the coalition of universities in sharing educational content on a global scale and designing local social media platforms.
The Impact of Mindfulness Practices and the Implementation of Technology in Higher Education
Authors: Sharif Shaakira , Statti Aubrey , Torres Kelly M.
Published: October 2021

Maintaining efficient time management and learning how to balance different facets of life can be difficult for undergraduate students. Students can have difficulty with maintaining their schedules and academic responsibilities, which can disrupt daily living functionality. Mindfulness is an evidence-based practice that can help students establish a self-care routine. Additionally, establishing a mindfulness regimen can help to improve students' academic performance. With the inclusion of technology, mindfulness mobile applications have gained popularity over the past decade and have provided a convenient method for students to engage in guided meditations.
An Isolated and Behind-the-Scenes Work Called Conservation
Authors: Putranto Widiatmoko Adi , Sari Indah Novita , Mayzana Regina Dwi Shalsa
Published: October 2021

Conservation is a type of work which requires specific skills, a lengthy experience, particular infrastructures, and arguably extensive time and money. In fact, preserving collections by managing all the aspects required is an important and mandatory task. However, as a developing country in tropical climate, Indonesia is still in a phase where financial aid, skillful experts, and moral support for preserving the cultural heritage are much less than needed. As a result of complex organizational dynamics, building a formal partnership for frequent collaborative conservation work between archives, libraries, and museums nevertheless is far from simple. On the other hand, engaging the community to participate in the practice is particularly challenging due to the nature of conservation work as an isolated activity within an exclusive ecosystem. This chapter aims to discuss whether developing community engagement and collaboration between LAM can serve as an alternative support to constructively improve current conditions and cope with the aforementioned issues.
Salar Jung Museum Library in the Heritage City of Hyderabad
Authors: Ghosh Soma
Published: October 2021

This is an analytical review of engagement and outreach of Salar Jung Museum Library's collection (MSS, printed, and digital). The chapter aims to visualize the benefits of being located in a heritage city, viz., Hyderabad, in India. The method adopted is first to trace impressions of researchers and scholars and second to gather data of its presence in libraries across the world. Tracing such variety and distinctness will open doors for further exploring the impact factors. The original collector, viz., Salar Jung, had open doors for diversity and open mind to welcome all cultural depictions of the world. Its diversity is evident in artifacts and resources that represent samples from East and West. So also is its inclusiveness – the entire collection is without bias of gender, race, or religion. The data analysis shows the engagement in heritage building is reciprocal. A study in the post-COVID era with a larger variety of data (viz., survey, virtual visits, digital impression) will reveal the full picture of reciprocity and will also highlight the actual needs and demands.
Managing Human Resources in the Artificial Intelligence Era
Authors: Srivastav Shalini , Kaur Amanjot
Published: October 2021

Man-made reasoning's (AI) coordination into HR practices will improve associations in light of the fact that these applications can dissect, anticipate, and analyze to help HR groups settle on better choices. Computer-based intelligence can be inserted in capacities like enlistment, preparing, onboarding, execution investigation, maintenance, and so forth. A large part of associations are as yet slacking in coordinating AI to their HR practices due to cost. Man-made intelligence execution ought to be seen as an idealistic chance, since AI improves lives. Computer-based intelligence makes a superior future in case it is plainly perceived and used in an appropriate manner. Hence, this chapter gives a description about artificial intelligence and its history, its importance in every arena of the society, and the use of AI in human resources management.
Psychrophiles
Authors: Bhatt Shreyas Anantray
Published: October 2021

Life on the Earth has evolved in the cold environments. Such cold habitats pose special challenges to the microbes in cold ecosystems, such as minimum metabolic activities, very limited nutrient availability, and often extreme conditions such as pH and salinity apart from temperature. Microbial communities surviving under these extreme conditions must have evolved complex structural and functional adaptations. Prokaryotic adaptations to cold environments are through physiological adaptations by increasing membrane fluidity through large amount of unsaturated fatty acids. These microbes also possess some cold adapted proteins whose steady state levels are maintained. They also produce certain compounds such as polyamines, sugars, polyols, amino acids, and some antifreeze proteins to protect themselves under freezing conditions. They also produce exopolymeric substances that promote adhesion of microbes to moist surfaces to induce biofilm formation which helps getting nutrients and protect the cells from harsh conditions. Antioxidants help destroying toxic reactive oxygen species.
Oral Health Complications in Type 2 Diabetes
Authors: Sanyal Palash Kumar , Srirammohan Pramod , Chaudhuri Sirshendu
Published: October 2021

Background:

Oral health evaluation is one aspect of diabetes care, that is usually not practised in majority of health care settings in India.

Aims:

To-identify the various complications related to oral health among Type 2 diabetics in a secondary care hospital in South India; and to identify the various determinants associated with it.

Methods:

In this cross-sectional study among the employees state insurance beneficiaries, we conveniently sampled the Type 2 diabetes patients attending the outpatient department for routine diabetic care and evaluated for some preidentified oral health conditions.

Results:

We recruited 124 participants, 76 (61.3%) males. The average duration of diabetes was 6.5 years (inter-quartile range-3–7 years). Gingivitis (n = 97, 78.2%) was the most common complication. Other important complications include-loss of functionality (n = 88, 71%), calculous (n = 87, 70.2%), and gingival recession (n = 56, 45.2%). In multivariate logistics regression modeling, young diabetics (adjusted odds ratio [AOR] −6.2; 95% confidence interval [CI] −2.2,17.6) and male populations (AOR − 2.6; 95% CI − 1.1, 6.0) were at higher risk of developing multiple complications.

Conclusions:

Diabetic population frequently suffers with oral complications. Health care professionals can include the importance of dental health care in the routine health education session for diabetics. In addition, clinicians can recommend dental evaluation to the diabetics apart from other clinical biochemical evaluation.
The burden of diabetic kidney disease in Nigeria − systematic review and meta-analysis
Authors: Azeez Taoreed A. , Efuntoye Oluwafemi , Abiola Busayo I. , Adeyemo Segun P. , Adewale Boluwatife A.
Published: October 2021

Background

Diabetic kidney disease (DKD) is a microvascular complication of diabetes mellitus. Considering that the burden of diabetes mellitus is rising in Nigeria, there is a need to ascertain the burden of one of its most common complications. The objective of the meta-analysis was to determine the pooled prevalence of DKD in Nigeria and identify its risk factors.

Patients and methods

The study is a meta-analysis and it followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Google scholar, PubMed, AJOL, SCOPUS, medRxiv, and the gray literature were systematically searched using appropriate key terms. Statistical analysis was done with MetaXL. The inverse-variance heterogeneity model was used for the meta-analysis and heterogeneity was determined using the I
2 statistic and the Cochran's Q test. Publication bias was checked with the Doi plot and LFK index.

Results

Nineteen studies met the eligibility criteria. The total sample size was 56 571. The pooled prevalence of DKD in Nigeria was 28% (95% confidence interval 3–58). The Cochran's Q was 747 (P<0.001), while the I
2 statistic was 97.6%. The Doi plot was drawn and the LFK index was 6.22. The most common risk factors for DKD were suboptimal glycemic control, hypertension, obesity, duration of diabetes, male sex, and advancing age.

Conclusion

The prevalence of DKD in Nigeria is high and greater attention should be focused on managing the risk factors so as to alleviate the burden of the disease.
The interrelation between body mass index and post-dural puncture headache in parturient women
Authors: Beyaz Serbülent Gökhan , Ergönenç Tolga , Saritaş Aykut , Şahin Fatih , Ülgen Ali Metin , Eman Ali , Doğan Burcu
Published: October 2021

Background and Aims:

Post-dural puncture headache is seen more frequently in pregnant women due to stress, dehydration, intra-abdominal pressure, and insufficient fluid replacement after delivery. Obesity protects against post-dural puncture headache in pregnant women; increased intra-abdominal fat tissue reduced cerebrospinal fluid leakage by increasing the pressure in the epidural space. Therefore, this study investigated the influence of body mass index on post-dural puncture headache in elective cesarean section patients in whom 27G spinal needles were used.

Material and Methods:

The study included 464 women who underwent elective cesarean section under spinal anesthesia. Dural puncture performed with a 27G Quincke spinal needle at the L3-4 or L4-5 intervertebral space and given 12.5 mg hyperbaric bupivacaine intrathecally. The patients were questioned regarding headache and low back pain 6, 12, 24, and 48 h after the procedure, and by phone calls on days 3 and 7.

Results:

Post-dural puncture headache developed in 38 (8.2%) patients. Of the patients who developed post-dural puncture headache, 23 (60.5%) had a body mass index <30 and 15 (39.5%) had a body mass index ≥30. Of the patients who did not develop post-dural puncture headache, 258 (60, 6%) had a body mass index <30 and 168 (39, 4%) had a body mass index ≥30. Conclusion: This prospective study found the body mass index values did not affect post-dural puncture headache in the elective cesarean section performed under spinal anesthesia.
Effect of intraabdominal hypertension on splanchnic blood flow in children with appendicular peritonitis
Authors: Perova-Sharonova Valentyna M. , Albokrinov Andrew A. , Fesenko Ulbolhan A. , Gutor Taras G.
Published: October 2021

Background and Aims:

Intraabdominal hypertension (IAH) is poorly diagnosed condition that cause splanchnic hypoperfusion and abdominal organs ischemia and can lead to multiple organ failure. There are no scientific data regarding effect of intraabdominal pressure (IAP) on splanchnic circulation in children.

Material and Methods:

Ninety-four children after surgery for appendicular peritonitis were enrolled in the study. After IAP measurement children were included in one of two groups according IAP levels: “without IAH” (n= 51) and “with IAH” (n= 43). Superior mesenteric artery (SMA) and portal vein (PV) blood flows (BFSMA, BFPV, mL/min) were measured, and SMA and PV blood flow indexes (BFISMA, BFIPV, ml/min*m2) and abdominal perfusion pressure (APP) were calculated in both groups.

Results:

Median BFISMAand BFIPVin group “with IAH” were lower by 54.38% (P, 0.01) and 63.11% (P< 0.01) respectively compared to group “without IAH”. There were strong significant negative correlation between IAP and BFISMA(rs= –0.66;P, 0.0001), weak significant negative correlation between IAP and BFIPV(rs= –0.36;P= 0.0001) in group “with IAH” and weak significant negative correlation between IAP and BFISMA(rs= –0.30;P= 0.0047) in group “without IAH”. There were no statistically significant correlations between IAP and BFIPVin group “without IAH”, between BFISMAand APP in both groups and between BFIPVand APP in both groups.

Conclusion:

Elevated IAP significantly reduces splanchnic blood flow in children with appendicular peritonitis. BFISMAand BFIPVnegatively correlate with IAP in these patients. There is no correlation between BFISMA/BFIPVand APP in children with IAH due to appendicular peritonitis.
Influence of gender on postoperative pain in percutaneous nephrolithotomy: A prospective observational study
Authors: Jonnavithula Nirmala , Garg Heena , Allenki Prashanthi , Aavula Kireeti
Published: October 2021

Background and Aims:

Percutaneous nephrolithotomy (PCNL) is the procedure of choice for managing large renal calculi. Although minimally invasive, it is associated with pain due to dilatation of renal capsule, parenchymal tract, and nephrostomy tube placement. Gender differences in pain perception and analgesic requirement have not been studied in PCNL surgeries. This study was done to evaluate the influence of gender on pain.

Material and Methods:

It was a prospective observational study including 60 ASA physical status I and II patients. The number of males and females were 29 and 31, respectively. Analgesic requirement and postoperative pain score were assessed by visual and dynamic visual analog scales (VAS, DVAS) score fourth hourly for first 24 h. Rescue analgesia was IV paracetamol 1 g when pain score exceeded four. VAS scores were assessed using Mann–Whitney test. Rescue analgesia was calculated as frequency and proportions. APvalue of <0.05 was considered statistically significant.

Results:

The mean pain score values (VASP= 0.361; DVASP= 0.332) and postoperative fentanyl (P= 0.703) did not show a statistically significant difference in males and females. The requirement of rescue paracetamol was higher in females with 30 out of 31 females demanding a rescue analgesic in comparison to 15 out of 29 male patients (P= 0.001).

Conclusion:

No significant difference was observed in postoperative pain among males and females in patients undergoing PCNL surgery. The analgesic requirement, however, was found to be more in females than in males.
A comparative evaluation of Airtraq and Hansraj Video laryngoscopes in patients undergoing tracheal intubation with cervical spine immobilization - A randomized prospective study
Authors: Varshney Poojangi , Ahmed Syed M. , Siddiqui Obaid A. , Nadeem Abu , PM Ajmal
Published: October 2021

Background and Aims:

Airway management is a key concern in trauma patients with cervical spine fracture. Application of manual inline axial stabilization (MIAS) has become the standard of care in these patients. Indirect laryngoscopy only requires alignment of the pharyngeal and laryngeal axis. Hence the primary objective of the study was to compare two indirect laryngoscopes, Airtraq (with adaptor) and Hansraj Video laryngoscopes based on its Intubation Difficulty Score.

Material and Methods:

Sixty anesthetized patients were divided into two groups using computer-based randomization, and tracheal intubation was performed using either Airtraq or Hansraj Videolaryngoscope with cervical spine immobilization.

Results:

Both Airtraq and Hansraj groups were comparable in terms of percentage of glottic opening (POGO) scoring (92 ± 9.88% vs. 89.3 ± 10.4%.) and duration of intubation attempt (14.9 ± 4.36 sec vs. 16.97 ± 3.64 sec). Intubation difficulty scale (IDS) score was significantly shorter with Airtraq (1 ± 0.58 vs. 1.8 ± 0.805;P< 0.0001). The mean duration of time taken for laryngoscopy in Airtraq (12.9 ± 2.07 s vs. 19.06 ± 3.83 s;P< 0.0001)) was significantly shorter and also the duration of time taken to secure airway in Airtraq VL was significantly shorter (29.47 ± 4.75 s vs. 36.03 ± 5.80 sec;P< 0.0001). The heart rate and MABP changes were modest in both groups, but was significantly more in Hansraj VL as compared to Airtraq VL, post-intubation.

Conclusion:

Both Airtraq and Hansraj videolaryngoscope can be used as first-hand device in the scenario of cervical spine stabilization. Airtraq videolaryngoscope is better than Hansraj videolaryngoscope due to shorter IDS and lessor hemodynamic changes.
A retrospective study comparing analgesic efficacy of ultrasound-guided serratus anterior plane block versus intravenous fentanyl infusion in patients with multiple rib fractures
Authors: Diwan Sandeep , Nair Abhijit
Published: October 2021

Background and Aims:

Inadequately managed pain due to multiple rib fractures (MRFs) can lead to atelectasis, pneumonia, prolonged ICU stay thereby leads to significant morbidity, morbidity and cost of treatment. Opioids, non-steroidal anti-inflammatory drugs and regional anaesthesia techniques like thoracic epidural or paravertebral blocks, intercostal nerve blocks are used to manage pain. Serratus anterior plane block (SAPB) is an ultrasound (US) guided interfascial plane block which has been used in managing pain due to MRFs. In this retrospective study, we compared analgesic efficacy and 24 hr fentanyl consumption in patients with MRFs who were managed with continuous SAPB versus patients who were managed with fentanyl infusion alone.

Material and Methods:

After Institutional Ethics Committee approval, we retrospectively collected data of 72 patients (38 in SAPB group and 34 in fentanyl group). Demographic data, VAS scores and 24 hrs fentanyl consumption was analysed in both groups.

Results:

There were statistically significant lower pain scores in patients of SAPB group when compared to that of fentanyl group (p=0.001) and in 24 hrs fentanyl consumption in patients who received continuous SAPB versus that in fentanyl group(p=0.001). No complications were observed in patients who received US guided SAPB.

Conclusion:

US guided SAPB is an opioid sparing, effective interfascial plane block which is safe and should be considered early in all patients who sustain MRFs. Continuous SAPB by placing a catheter can provide pain relief for longer duration, facilitate early mobilization, physiotherapy and early ICU discharge.
Determination of the efficacy of ultrasound-guided bilateral transversus abdominis plane (US-TAP) block in laparoscopic total extraperitoneal (TEP) repair of unilateral hernia surgeries: A randomized controlled trial
Authors: Sivapurapu Vijayalakshmi , Gopal Sri Vengadesh , Solomon Ashley
Published: October 2021

Background and Aims:

Bilateral ultrasound-guided transversus abdominis plane (US-TAP) block has been successfully used to provide analgesia for most lower abdominal procedures. Our aim was to determine the efficacy of US-TAP block with levobupivacaine in laparoscopic total extraperitoneal (TEP) repair of unilateral hernia surgeries under general anaesthesia (GA) as compared to no block.

Material and Methods:

It is prospective randomised controlled study done in a tertiary care centre in South-East Asia. After obtaining Institute Ethics Committee approval and consent, 60 patients of ASA I-II aged between 18 to 80 years were randomized into two groups. After receiving GA, Group TAP - received bilateral US-TAP block with levobupivacaine 0.25% 0.3ml kg-1on either side whereas, the control group did not receive any block. The time taken to first request for rescue analgesic (T Rescue) by the patient and the Numeric Rating Scale (NRS) at that time point were noted and tramadol 50mg i.v. was administered, followed by 50mg i.m. PRN for 24 h from the time of extubation. The 24 h analgesic requirement was noted in mg kg-1.

Results:

Results were analysed using SPSS 16 andP < 0.05was considered significant. T Rescue was significantly longer in the TAP Group(P = 0.02)with lower NRS at time points 24 h(P = 0.02)and 12 h(P = 0.004). Postoperative nausea and vomiting were significantly less in TAP Group(P < 0.001).

Conclusion:

Bilateral US-TAP block provided better analgesia and side effect profile as compared to no block when administered in laparoscopic TEP repair of hernia surgeries.
Fentanyl versus nalbuphine for intubating conditions during awake fiberoptic bronchoscopy: A randomized double-blind comparative study
Authors: Chaudhary Sujata , Chaudhary Sachin , Kumar Mahendra , Salhotra Rashmi
Published: October 2021

Background and Aims:

Patient cooperation, sedation, anxiolysis, and topicalization are important prerequisites for the successful and safe conduct of awake intubation. Because of the pharmacological properties, opioids can facilitate this process. Fentanyl is an opioid agonist and nalbuphine is an agonist-antagonist. This study aims to compare these two opioids for their effect on sedation and intubating conditions during awake fiberoptic intubation.

Material and Methods:

This randomized double-blind controlled study was conducted on 62 ASA I/II patients of either sex between the age of 20 and 60 years, weight between 40 and 80 kg, with MP class I/II airways requiring general anesthesia with endotracheal intubation. All patients received standard airway topicalization and nebulization. Patients were randomly allocated to one of the two groups according to a computer-generated random number table. Group F (n= 31) received fentanyl 2 µg/kg i.v. and group N (n= 31) received nalbuphine 0.2 mg/kg i.v. over 10 min before intubation. Fiberoptic intubation was attempted and lignocaine spray and propofol boluses were administered as and when required. Hemodynamic responses and intubating conditions were recorded. Repeated measure ANOVA, McNemar test, and Chi-square test or Fischer's exact test were used for data analysis. AP< 0.05 was considered significant.

Results:

Cough score (P= 0.458), post-intubation score (P= 1.000), and sedation score (P= 1.000) were comparable among the two groups. Hemodynamic responses and propofol and lignocaine requirements were also comparable.

Conclusion:

Both fentanyl and nalbuphine provide comparable intubating conditions when used before awake fiberoptic intubation with minimal adverse effects on hemodynamic profile.
Beta-human chorionic gonadotropin levels as early predictor for progression to Gestational Trophoblastic Neoplasia after molar pregnancy evacuation at a Philippine tertiary hospital
Authors: Galingan May Delight G. , Cagayan Ma. Stephanie Fay S.
Published: October 2021

OBJECTIVE:

This study aimed to determine if the beta-human chorionic gonadotropin (hCG) levels during the first 5 weeks after a molar evacuation predict progression to gestational trophoblastic neoplasia (GTN).

MATERIALS AND METHODS:

This was a retrospective cohort study of complete mole cases managed at a Philippine tertiary hospital from January 2009 to December 2018. Extracted data were analyzed using applicable statistical tools. The level of significance was set at a P< 0.05 using two-tailed comparisons.

RESULTS:

One hundred and fifty-five complete patient records were available for review. Disease progression in 15.48% of cases while regression in 84.52% were noted. Uterine size was larger in those who eventually had postmolar GTN (t: −3.12, df: 32.64, P: 0.01). Analysis of the receiver operating characteristic curve showed that optimum cut-off levels for predicting GTN at 1, 3, and 5 weeks after evacuation were 4,152 mIU/ml (sensitivity: 50%, specificity: 94.7%, area under the curve [AUC]: 0.75), 804 mIU/ml (sensitivity: 62.5, specificity: 96.9%, AUC: 0.94), and 541 mIU/ml (70.8%, specificity: 97.7%, AUC: 0.96), respectively.

CONCLUSION:

The level of hCG within the first 5 weeks after molar pregnancy evacuation is predictive of progression to GTN.
A series of missing primaries
Authors: Gonzalez Gillian Patrick C. , Soriano-Estrella Agnes L
Published: October 2021

Gestational trophoblastic neoplasias (GTN) are extremely aggressive tumors derived from placental trophoblasts. These tumors are always the sequalae of a pregnancy. Choriocarcinoma, which is the most common of these, is typically characterized by early extra-pelvic hematogenous spread. Since the progression of illness is rapid, timely diagnosis and treatment will favor improved chances for cure, whereas late commencement of therapy will make resolution difficult. The diagnosis of GTN is straightforward with an elevated beta-human chorionic gonadotropin (β-hCG) and distinct sonographic features of the tumor inside the uterus. However, very rarely, this disease may occur in the absence of uterine tumors. Practicing physicians must be mindful that GTN may initially manifest with pulmonary symptoms and/or radiographic evidence of metastatic lung lesions. In this series, the features pertaining to the clinical course of three patients are described, all of whom presented with pulmonary masses, elevated β-hCG, and normal transvaginal sonograms.
A cone-beam computed tomography evaluation of bone density for insertion of pterygoid implants in dentulous and edentulous patients
Authors: Sahoo Pradyumna Kumar , Awinashe Vaibhav , Bali Yashika , Gupta Nitika , Parihar Anuj Singh , Jagadeesh Kyatsandra Narasimhaiah , Babaji Prashant
Published: October 2021

Objectives:

The bone quantity and quality determine the prosthetic success outcome. This research was performed to evaluate the bone density for insertion of pterygoid implants in edentulous and dentulous participants with cone-beam computed tomography (CBCT).

Materials and Methods:

CBCT evaluation was done for 66 dentate and edentulous patients for pterygoid implants at the pterygomaxillary region. The calculation of joint width, height, and volume of bone was done. Density of the bone was evaluated at the superior and inferior aspects of the pterygomaxillary column.

Results:

It was observed that average pterygomaxillary joint height for dentulous (dentate) was −12.7 ± 7.2 mm, edentulous −12.4 ± 7.1 mm, the average pterygomaxillary joint width for dentulous was 8.15 ± 7.3 mm, and 8.13 ± 6.2 mm for edentulous. The average pterygomaxillary joint volume in dentulous participants was 279.4 ± 189.2 mm3 and for edentulous was 254.5 ± 176.4 mm3. There was expressively greater density of the bone in dentulous participants over edentulous participants (P < 0.05).

Conclusion:

There was better bone density found in dentate participants in comparison to edentulous participants. CBCT is a recent investigative device which measures pterygoid area efficiently. Pterygoid implants may be deliberated as an alternative method for resorbed (atrophic) maxilla.
COVID-19 PANDEMİ SÜRECİNDE ÇOCUKLARIN EL YIKAMA ALIŞKANLIĞININ NESNELERİN İNTERNETİ TABANLI SİSTEM İLE İZLENMESİ
Authors: AYDEMİR Fırat , ARSLAN Seyfullah
Published: October 2021

2019 yılı aralık ayında başlayan ve tüm dünyayı etkisi altısına alan yeni koronavirüs salgını hız kesmeden insanlığı etkilemeye devam ediyor. Etkili bir tedavinin olmadığı ve herkesin aşılanma imkânının bulunmadığı şu durumda hastalıktan korunmak için en etkili yöntemler; sosyal mesafeye, maske kullanımına ve kişisel hijyene dikkat etmektir. Ne yazık ki küçük çocukların bu önlemlere tek başlarına dikkat etmeleri kimi zaman mümkün olmamaktadır. Bu bağlamda, geliştirilen bu çalışmada küçük çocukların dış ortamdan eve geldiklerinde ellerini yıkayıp yıkamadıklarının takibini yapan nesnelerin interneti tabanlı bir sistem tasarımı sunulmuştur. Kapı girişine yerleştirilen kameralı IoT düğümü sayesinde eve giren çocuğun kimlik tespiti yapılmakta ve bu durum bulut veritabanına yazılmaktadır. Ardından lavabonun bulunduğu yere yerleştirilen ikinci bir IoT düğümü ile çocuğun lavaboya geldiğinde önce kimlik tespiti yapılmakta ardından el yıkama işlemini gerçekleştirip gerçekleştirmediği el tanıma ve ses tanıma fonksiyonları ile tespit edilmektedir. El yıkama gerçekleştirilmediği durumda ise ebeveyne gerekli uyarı maili gönderilmektedir.