bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparative Analysis of Pre Operative and Operative Findings in Non Traumatic Acute Abdomen: A Prospective Observational Study
Authors:   Assistant professor, Department of General Surgery, Subbiah Institute of Medical Sciences, Shivamogga, Karnataka 577201., K Prasad , Patel Anil Kumar ,   Senior Resident , Department of General Surgery, Shri Shankaracharya institute of Medical Sciences, Bhilai, Chhattisgarh 490020, India., BP Suresh ,   Professor and HOD, Department of General Surgery, Subbiah Institute of Medical Sciences, Shivamogga, Karnataka 577201.
Published: January 2024

Acute abdomen remains the important cause of morbidity and mortality in emergency. It requires careful history taking and thorough evaluation of symptoms, clinical examination and judicious use of radiological investigation which simplify the evaluation of disease. Aim and Objectives: To assess the accuracy of radiological diagnosis in comparison to postoperative diagnosis in non-traumatic cases of acute abdomen. Materials and Method: A prospective observational study of non-traumatic acute abdomen was carried out at Sahyadri Narayana Multispeciality Hospital, Shimoga, Karnataka. Total of 78 cases of acute abdomen patients were evaluated and operated over a period from December 2018 to February 2020 and included in the study group. Pediatric age group (12 years and below), traumatic cases (blunt and penetrating), acute abdomen in pregnancy and gynecological causes of acute abdomen, urological cases, and conservatively managed cases were excluded from the study. Detailed history was taken and relevant physical examination performed. All patients underwent hematological and biochemical investigations, appropriate radiological investigation (USG, AXR and CT-scan) were performed based on clinical suspicion. Clinical and radiological diagnosis based on clinical examinations and radiological investigations was compared with post-operative diagnosis based on operative findings. Result: The most common age group was 20-60 years with male preponderance. Pain in abdomen was commonest symptom followed by vomiting, anorexia and fever. Tenderness was commonest clinical sign observed followed by rebound tenderness, tachycardia and guarding/rigidity. Acute appendicitis was the most common cause of acute abdomen followed by perforation peritonitis and intestinal obstruction. The overall diagnostic accuracy of clinical examination in acute abdomen was 81.8% and if radiological imaging techniques combined with this, the accuracy raised up to 94%. Conclusion: The study strongly suggested that with thorough history taking and proper clinical examination, clinical diagnosis was successfully achieved in 82% of patients. Radiological investigations help in confirming clinical suspicions and giving added information of underlying pathology with accuracy of 94%. Keywords: Abdomen Injury; Radiological Investigations; Trauma; Diagnostic Test; Perforation.
Review and Follow up of Open Pre-rectus Mesh Repair in the Management of Midline Incisional Hernias
Authors:   Professor, Department of Surgery, NRI Academy of Sciences, China Kakani (vil), Mangalagiri (ml), Guntur, Andhra Pradesh 522503, India., Bandlamudi Suryanarayana
Published: January 2024

Repair of incisional hernia with prosthetic mesh provides tension free closure of the abdominal wall with improved results. Different methods of fixation of mesh have been described with varying results. Mesh fixation to the fascia is the most important part of a hernia repair. Anterior rectus sheaths are tough aponeurotic structures and so are ideal for mesh fixation. This study reports the long-term results of placement of prosthetic mesh in pre-rectus position and fixation to anterior rectus sheaths along with linea alba by open technique, for incisional hernias occurring in the midline. The primary end point was hernia recurrence. Patients and Methods: A total of 126 consecutive patients with incisional hernias occurring in the midline were operated from July 2009 to October2020. After dissection of the plane between rectus muscles and anterior rectus sheath, a polypropylene mesh of suitable size was placed in front of the rectus muscles and fixed to the posterior surfaces of anterior rectus sheaths and the linea alba. In 2013, cases were reviewed and the study continued. The patients were followed on phone or by personal visits up to March 2021. Results: The average period of follow up was 60 months. There were five recurrences. Wound infection was noted in 16 patients with complete healing in all cases with antibiotics and dressings. There were 4 cases of seroma, 5 cases of skin edge necrosis and two cases of suture sinus. There was no mortality, mesh infection or extrusion. Conclusion: Open ‘pre-rectus’ technique for repair of midline incisional hernias is effective with a low recurrence rate.
Study of Surgical Emergenices in Tertiary Care Hospital
Authors:   Resident, Department of Surgery, Sardar Patel Medical College, Bikaner, Rajasthan 334003, India, Choudhary Navin , Chhabara Abhishek ,   Senior resident, Department of Surgery, Sardar Patel Medical College, Bikaner, Rajasthan 334003, India, Kishor Sunder ,   Assistant professor, Department of Surgery, Sardar Patel Medical College, Bikaner, Rajasthan 334003, India, Dawan Manohar L ,   Professor of Surgery, Department of Surgery, Sardar Patel Medical College, Bikaner, Rajasthan 334003, India, Kumar Samridh ,   Resident, Department of Surgery, Sardar Patel Medical College, Bikaner, Rajasthan 334003, India, Halam Irene ,   Resident, Department of Surgery, Sardar Patel Medical College, Bikaner, Rajasthan 334003, India
Published: January 2024

In a country like ours, the increased number of surgical emergencies presenting to a hospital diverts majority of the resources towards the emergency department. Understanding this growing need makes it important to study and evaluate the distribution of these patients which shall help in developing a more efficient department. Material and Methods: We conducted a prospective study of patients undergoing emergency surgeries from December 2019 to November 2021. Total 300 patients included and study was carried out in the Department of Surgery, S.P. Medical College and P.B.M Hospital, Bikaner. Results: Majority of patients were from 21 to 40 years age group (43.66%). There were 208 males and 92 females. The male to female ration in our study was 2.26:1. Out of 300 patients, 82 patients (21.33%) had acute appendicitis 50 patients (16.66%) had hollow viscus perforation and 40 patients (13.33%) had intestinal obstruction. Most common surgical intervention done was exploratory laparotomy followed by appendectomy. The average hospital stay in our study was 6.6 days. Surgical site infection.
Clinical Study of Deep Vein Thrombosis of Lower Limbs
Authors:   Professor, Department of Surgery, Shri MP Shah Government Medical College, Jamnagar, Gujarat 361008 India, Mehta Amrish P , Upadhyay Riddhi S ,   Third Year Resident, Department of Surgery, Shri MP Shah Government Medical College, Jamnagar, Gujarat 361008 India
Published: January 2024

Understanding the natural history of venous thrombosis is important for optimal management of this condition. Once risk factors are recognized it is possible to avoid these risk factors or to use active prophylaxis to reduce the morbidity and mortality. This study is targeted at identifying the risk factors of deep vein thrombosis in our set up, the role of Heparin in prophylaxis and to do a comparative study of low molecular weight Heparin with unfractionated Heparin in treatment of deep vein thrombosis of lower limb in Guru Gobind Singh Government hospital, Jamnagar. Material and Methods: Study population consisted of 50 consecutive patients with deep vein thrombosis, admitted to Guru Gobind Singh hospital, Jamnagar. We have studied 50 patients above 18 years of age with proven deep venous thrombosis by Doppler ultrasound. A complete clinical history was taken to assess risk factors, level of immobility if present and thorough physical examination was done. Routine investigations such as hemogram, haematocrit, blood indices, and liver and renal function tests were done. Diagnosis of deep vein thrombosis was detected by radiographic imaging like Doppler ultrasonography. Results: In our study, most of patients presented with complaints of swelling (70%) and pain (48%) of the affected lower limb. Few patients (4%) had symptoms of breathlessness (SOB), chest pain and orthopnea suggestive of pulmonary embolism. 34 patients in our study were having reasonably good level of haemoglobin while rests of all were having anaemia of different degree4 patients had haemoglobin below 8gm/dl and that needed separate treatment also. Leukocytosis was present in 16 patients. 16 patients had smoking as associated risk factor along with other acquired risk factors and 5 patients had obesity along with other risk factors. The most common complication of DVT is pulmonary embolism which occurs due to dislodgement of thrombus. Conclusion: Even though it is grievous, DVT can be prevented and treatable. Better and regular availability of drugs like LMWH and safer oral anticoagulants in the smallest possible region of the country can do wonders to save lives. Larger studies focusing more on coagulation cascade, molecular biology and genetics will be even bigger help to mankind.
Outcome of Early Cholecystectomy in Mild Biliary Pancreatitis
Authors:   Resident, Department of Surgery, Sardar Patel Medical College, Bikaner, Rajasthan 334003, India, Jatawat Tarun Kumar , Chhabara Abhishek ,   Senior resident, Department of Surgery, Sardar Patel Medical College, Bikaner, Rajasthan 334003, India, Kishor Sunder ,   Assistant professor, Department of Surgery, Sardar Patel Medical College, Bikaner, Rajasthan 334003, India, Dawan Manohar L ,   Professor of Surgery, Department of Surgery, Sardar Patel Medical College, Bikaner, Rajasthan 334003, India, Halaz Irene ,   Resident, Department of Surgery, Sardar Patel Medical College, Bikaner, Rajasthan 334003, India, Kumar Samridh ,   Resident, Department of Surgery, Sardar Patel Medical College, Bikaner, Rajasthan 334003, India
Published: January 2024

Acute biliary pancreatitis (ABP) caused by gallstones and biliary sludge1 is the most important cause of Acute Pancreatitis (AP). Aim: Effect of early cholecystectomy in mild acute biliary pancreatitis. Methods: This was a hospital based observational study, by convenience sampling recruited 60 patients of mild acute biliary pancreatitis eligible as per inclusion criteria within study duration of one year reported at Department of Surgery, Sardar Patel Medical College, PBM Hospital, Bikaner. Results: mean age was 44.76±9.88 yr (range 30- 70), 60% were female, 51.67% had pain & nausea as chief complaint, 71.66% patients had Cholelithiasis on MRCP. 6.68% had 3 CT severity score preoperatively whereas 1.66% had 3 CT severity score postoperatively. 56.67% cases had surgery after 72-96 hr. Success rate of early cholecystectomy was 98.33%. 56.67% cases had surgery after 72-96 hr mean 101.6± 14.89 hr. Only one case had recurrence on 3 months follow up. Conclusion: Early Cholecystectomy for patients with acute mild gallstone pancreatitis was found to be a safe procedure when performed during the index admission. Keywords: Early Cholecystectomy; Biliary pancreatitis. Introduction Acute biliary pancreatitis (ABP) caused by gallstones and biliary sludge1 is the most important cause of Acute Pancreatitis (AP), accounting for up to 75% of cases.2 Although most cases of ABP are mild and Self-limiting, a small group (20%) of patients may develop severe pancreatitis, which is associated with high morbidity and mortality.3 Commonly, after resolution of the initial attack of APB, patients may experience a recurrent attack (40% to 60%) within 2 weeks or other gallstonerelated complications such as biliary colics, acute cholecystitis, acute cholangitis or common bile duct (CBD) obstruction. Acute pancreatitis is a common disease in the emergency room with an annual incidence rangin.
Role of External Tissue Expansion Wound Closure in the Electrical Burn Wound to the Scalp
Authors:   International visitor, Department of Plastic Surgery & Telemedicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., Nuli Jackson , Chittoria Ravi Kumar ,   Professor & Registrar, Department of Plastic Surgery & Telemedicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., Singh Barath Kumar ,   Senior Resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India.
Published: January 2024

Electrical burns constitute 3–5% of all burn cases; in developing countries, this ratio increases up to 21–27% and the mortality rate is reported to be between 3.75% and 58.8%. Most of the acute burns are life threatening, and require various types of surgical interventions such as eschar excision or split thickness skin grafting, depending on the size, location and depth of the lesion. The deep electrical burns to the scalp were difficult to manage as it was more prone to exposure of the calvarial bone. In our case, a calvarial bone at the vertex was exposed post-eschar excision. Tissue expansion is based on the principle that all living tissues respond in a dynamic fashion to mechanical stress placed on them. Below we present a case of electrical burns wound to the calvarium utilizing the use simple cost-effective external tissue expansion technique for preventing wound retraction and for holding the dressing of the scalp wound.
Colorado Needle Assisted Cross-Leg Flap
Authors:   Intern, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., .. Bhagyalakshmi , Chittoria Ravi Kumar ,   Professor, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India.,   Senior Resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., Singh P Barath Kumar
Published: January 2024

Lower limb injuries are most commonly due to road traffic accidents which cause lower limb defects.The management of lower limb fractures is guided by the Gustilo-Anderson classification of injuries. Simple leg defects are covered by localflap and complex defects by free flap. Complex defects of the lower limbs which were unfit for free flap require management by conventional cross leg flap. Colorado needle allows meticulous dissection of flaps due to the sharp tip and increases the efficiency in raising the flaps.
Venous Leg Ulcer: A Review
Authors:   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry 605006, India., Chakiath Jacob Antony , Chittoria Ravi Kumar ,   Professor, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry 605006, India.
Published: January 2024

Chronic venous disease (CVD) is prevalent in the aging population and leads to venous leg ulcers (VLUs). These wounds can last and recur for years, significantly impacting quality of life. A large body of literature exists on CVD and VLU diagnosis and treatment. Multiple algorithms, guidelines, and consensus documents have been published on this topic, highlighting the importance of this issue in clinical practice. Compression is still the mainstay of treatment for CVD and VLUs. Compression is needed long term, but it does not suffice by itself to prevent recurrences without interventional correction. Venous intervention should be offered early to prevent or slow disease progression and reduce recurrence.
Plasma or Fibrin Matrix? A Comparative Study between PRP versus PRFM Therapy in Diabetic Foot Ulcer
Authors:   Postgraduate, Department of General Surgery, Bangalore Medical College & Research Institute, Bangalore 560034, Karnataka, India., Rao Ashwath , K. S. Manikanta ,   Assistant professor, Department of General Surgery, Bangalore Medical College & Research Institute, Bangalore 560034, Karnataka, India., Hassan Mir Md Noorul ,   Professor, Department of General Surgery, Bangalore Medical College & Research Institute, Bangalore 560034, Karnataka, India.
Published: January 2024

Introduction: Diabetic foot ulcer is one of the most common conditions encountered in surgical OPD. The incidence of a diabetic foot ulcer is around 15% among the diabetic population. Around 80% of non-traumatic amputation is due to chronic diabetic foot ulcer. Recent advances are made in treating wounds in which platelet-rich plasma (PRP) and platelet rich fibrin matrix (PRFM) therapy have proven beneficial. Materials and Methods: A prospective study was conducted from February 2021 to February 2023, for a period of 2 years which included 42 patients. Group A received autologous platelet rich plasma therapy (PRP) and group B received autologous platelet rich fibrin matrix therapy (PRFM) each consisting of 21 patients. Results: PRFM Group showed better reduction in ulcer size compared to respective PRP Group, and demonstrated statistically significant p-values. Around 47% of the subjects had complete closure of the ulcer after 5 sessions of PRP dressing while it was 90% with PRFM dressing.
Retrospective Study of Fournier Gangrene and it’s Co-relation with FGSI Scores in its Management at a Tertiary Hospital in Mauritius
Authors:   Professor, Department of Surgery, Anna Medical College and Research Centre, Flacq, Mauritius., Rao Sarangam Venkata Satyanarayana , .. Matabudul ,   Consultant Surgery, Department of Surgery, Dr Bruno Cheong Hospital, Flacq, Mauritius., .. Cahoolessur ,   Clinical tutor, Department of Surgery, Anna Medical College and Research Centre, Flacq, Mauritius, 2Consultant Surgery, Department of Surgery, Dr Bruno Cheong Hospital, Flacq, Mauritius., .. Saulick ,   Clinical tutor, Department of Surgery, Anna Medical College and Research Centre, Flacq, Mauritius, 2Consultant Surgery, Department of Surgery, Dr Bruno Cheong Hospital, Flacq, Mauritius., Suleman Mohammad ,   Medical Student, Department of Surgery, Anna Medical College and Research Centre, Flacq, Mauritius.
Published: January 2024

Background: Fournier’s gangrene is an acute rapidly progressive necrotizing fasciitis of infectious etiology. It usually affects scrotum, penis, perineum, perianal region and anterior abdominal wall occasionally. It is a poly-microbial infection resulting in thrombotic occlusion of small subcutaneous blood vessels leading to cutaneous gangrene. In spite of low prevalence at present FG carries considerable morbidity and mortality. It affects all age groups and both sexes. It is more prone in individuals with Diabetes Mellitus, chronic alcoholism, urogenital, anorectal diseases and immune-compromised persons. The diagnosis of FG is mostly clinical but radiological imaging was also needed to assess the extent of the disease. The management comprises of mainly aggressive surgical debridement under broad spectrum antibiotics coverage and ICU support. Material and Methods: It is a retrospective study comprising 30 number of FG cases clinically diagnosed and admitted in Dr Bruno Cheong Hospital, Flacq, Mauritius from 2019-2023. The data collected from hospital records comprising of routine and emergency cases. The preexisting co-morbidities, socio-economic status and outcome of management as per FGSI scores were assessed and recorded. Statistical Analysis: Standard statistical method, like SPSS was adopted for the analysis. Results: In the present study FGSI scores were co-related with the clinical picture and biochemical parameters of 30 no. of cases to assess severity of the disease. Moreover, FG being a serious and complicated disease, it was managed by a team comprising of surgeons and ICU team. Conclusion: FGSI scoring system is an excellent tool to assess the severity of the disease, in terms of mortality risk and outcome of management.
Retrospective Comparative Study between Stapled (Longo’s) Haemorrhoidopexy v/s Suture Rectopexy (Chivate’s) in Management of Haemorrhoids
Authors:   Professor, Department of Surgery, Anna Medical College and Research Centre, Flacq, Mauritius, Rao Sarangam Venkata Satyanarayana , .. Matabudul ,   Consultant Surgery, Department of Surgery, Dr Bruno Cheong Hospital, Flacq, Mauritius., Bachoo Vandana Gourvee ,   Clinical tutor, Department of Surgery, Anna Medical College and Research Centre, Flacq, Mauritius., Rampudaruth Shirishsing ,   Clinical tutor, Department of Surgery, Anna Medical College and Research Centre, Flacq, Mauritius., Suleman Mohammad ,   Medical Student, Department of Surgery, Anna Medical College and Research Centre, Flacq, Mauritius.
Published: January 2024

Background: Haemmoroids refer to anal cushions and when it becomes pathological, it will produce symptoms of bleeding, mucus discharge, itching, pain and prolapse. The objective of the present study was to compare between the results of Longo’s and Chivate’s procedure in terms of operative time, post-operative pain and complications, return to normal work and recurrence. Materials and Methods: In the present study 30 number of patients clinically diagnosed as second degree, third degree and fourth degree haemmrhoids are enrolled and operated. 15 number of cases were selected under Group A category and Stapled Haemorrhoidopexy was perfomed. Another 15 number of patients were put under Group B category and Suture Rectopexy was performed. The results of both these procedures were compared. Post-operative check-ups at 12 hours, 24 hours and upto 48 hours were done. Follow-up of all the cases were done at 2 weeks, 4 weeks, 8 weeks and upto a period of 6 months. Statistical Analysis: Standard statistical analysis method like SPSS (software version 200) was adopted for the analysis. The data were evaluated by comparing two groups using Chi Square Test with a P value <0.05 as significant. Results: In Stapled Haemorrhoidopexy, there was less post-operative pain as per visual analogue score, less of operating time, fewer days of hospital stay and early return to normal work. In Suture Rectopexy, there were also similar results. Hence, no significant differences in post-operative complications were found in both the procedures. There were four recurrences with stapled haemorrhoidopexy and two recurrences with sutured rectopexy in the presentstudy. Conclusion: At present many surgical procedures are practiced for haemorrhoids. However, we found that stapled haemorrhoidopexy of Longos’s offers better results in terms of fewer post-operative complications, good patient compliance and better long term results.
Doenças diagnosticadas pelo Laboratório de Patologia Veterinária em 2022
Authors: Miglioranza Cesar Augusto , Neumann Schuck Bruna Luiza , Pelisser Giovana , Horn Vitor Waldir , Begnini Ana Flavia , Tonin Raphael Adenir Valeriano , Boldori Érica , Lima Landim Guilherme , Rovere Laura Dala Riva , Gomes Teane Milagres Augusto , Mendes Ricardo Evandro
Published: January 2024

Este trabalho apresenta a casuística de diagnósticos no ano de 2022 do Laboratório de Patologia Veterinária do IFC Campus Concórdia. Foram 292 diagnósticos em bovinos, 13 em ovinos e 34 em suínos, totalizando 339. Destes, 289 (85,2%) foram através de necropsias e 50 (14,8%) através de amostras formolizadas enviadas por veterinários. Em bovinos as doenças mais incidentes foram babesiose (20 casos - 6,8%), eletroplessão (12 casos - 4,1%), leucose enzoótica bovina com 11 casos (3,8%); seguidos por botulismo, miosite clostridial e síndrome do jejuno hemorrágico, cada um com 10 casos (3,4%).
Mediation effects of Actual-Ought Self-Discrepancy and Maladaptive Self-focused Attention
Authors:   The Society for Cognitive Enhancement and Intervention, Dong Eunsoo , Kim Eunjung
Published: January 2024

Objective: The present study investigated whether actual-ought self-discrepancy and maladaptive self-focused attention would mediate the relationship between socially-prescribed perfectionism and social anxiety among college students.
Methods: Two hundred and twenty college students were asked to complete an online survey questionnaire to assess actual-ought self-discrepancy, maladaptive self-focused attention, socially-prescribed perfectionism, and social anxiety. The responses from the 220 students were used for the final analysis. Results: The results were as follows: First, maladaptive self-focused attention mediated the relationship between socially-prescribed perfectionism and social anxiety. Second, actual-ought self-discrepancy has not statistically significantly mediated the relationship between socially-prescribed perfectionism and social anxiety. Finally, the relationship between socially-prescribed perfectionism and social anxiety was sequentially mediated by actual-ought self-discrepancy and maladaptive self-focused attention.
Conclusions: The results suggest the need for an approach to mediators such as actual-ought self-discrepancy or maladaptive self-focused attention in therapeutic intervention for a person who has socially-prescribed perfectionism.
Evaluation of the financial performances of the medical device companies among Fortune 500 companies before, during and after the COVID-19 pandemic
Authors: Tümer Tolga , Tengilimoğlu Dilaver , Çelik Eşref Uğur , Demiray Emine Kübra Dindar
Published: January 2024

The purpose of this study was to evaluate the financial performances of the six medical device companies among Fortune 500 companies before, during and after the COVID-19 pandemic. We first conducted ratio analysis by using liquidity, turnover, leverage and profitability ratios; then we conducted Wilcoxon signed-rank tests by using the calculated values of the financial ratios. We obtained the required data from the annual financial statements of the medical device companies among Fortune 500 companies. In the analyses, we took 2019 as the year before the COVID-19 pandemic, 2020 and 2021 as the year of the COVID-19 pandemic and 2022 as the year after the COVID-19 pandemic. The medical device companies among Fortune 500 companies were able to keep their financial performances strong when the COVID-19 pandemic began; they were able to increase their profits in the second year of the COVID-19 pandemic; and they were able to start using their assets more efficiently after the COVID-19 pandemic. The findings of the study suggests that the overall financial performances of the medical device companies among Fortune 500 companies were strong before, during and after the COVID-19 pandemic. The evaluation of the financial performances of the medical device companies among Fortune 500 companies before, during and after the COVID-19 pandemic may be beneficial for managers and policy makers in the medical device industry to determine the areas that requires to be strengthened in order to be better prepared for possible future pandemics and crisis periods.
Dosimetric effects of prone immobilization devices on skin in intensity-modulated radiation therapy for gynecologic cancer: a retrospective study
Authors: Wang Donghui , Li Bin , Li Zhenghuan , Kong Fantu , Yan Huamei , Xu Xiangying , Dong Jie
Published: January 2024

Objective
The dose perturbation effect of immobilization devices is often overlooked in intensity-modulated radiation therapy (IMRT) for gynecologic cancer. This retrospective study assessed the dosimetric effects of a prone immobilization device combined with a belly board (PIDBB) on the skin.
Methods
We recruited 63 women with gynecologic cancer undergoing postoperative IMRT at our institute. A 0.3 cm thick skin contour and body contours with or without PIDBB system were outlined for each patient. Dose calculations were performed for the two sets of contours using the same plan, named Plan− and Plan+, respectively. The accuracy of calculated doses was verified by gafchromic EBT3 film and anthropomorphic phantom.
Results
The V40 Gy, V30 Gy, V20 Gy, V15 Gy and Dmean of skin increased by 56.94%, 65.48%, 53.12%, 41.91%, and 1.91%, respectively. Even after excluding the effect of prescription dose coverage, the V40 Gy, V30 Gy, V20 Gy, V15 Gy and Dmean of skin still increased by 46.90%, 92.07%, 72.81%, 52.25%, and 18.06%, respectively. No significant differences were observed in doses to other organs at risk. The EBT3 measurements showed that the skin dose map to the anthropomorphic phantom was 23.66% higher than that calculated by the treatment planning system without the PIDBB system.
Conclusions
While the PIDBB system effectively reduces the low dose to small intestine, it also induces radiation attenuation, leading to a sharp increase in skin dose, particularly in patients receiving radiation in the groin and perineum area. Therefore, immobilization devices should be included in the external contour to account for dose attenuation and the increment in skin dose.
Trial registration:
This study does not report on interventions in human health care.
Neural Machine Translation for Low Resource Bantu Languages in East and Southern Africa
Authors: Omwoma Vincent , Nderu Lawrance , Ogada Kennedy , Mwalili Tobias
Published: January 2024

Neural machine translation systems have recorded tremendous performance in data-intensive application, where the performance declines when we have limited training examples. In this paper we benchmark NMT between English and four African Bantu LRL pairs (Luganda, Swahili, Shona Tsonga [LSST]). Our aim was to evaluate current state of NMT for LRLs especially Bantu languages. Being the most morphological rich languages, but with OOV (Out of Vocabulary Problem) we proposed an NMT model using Multi-head self-attention. The model worked along with pre-trained BPE and Multi-BPE embeddings to develop a state-of the art translation system for low resourced morphological rich Bantu languages which have scarce translations online. We were able to address the issues with the publicly available corpora after refining the data for further use. We subjected our results to BLEU score for our system performance evaluation. Our experiments showed exemplary and first ever LRL translation BLEU score of; Eng.-Tsonga, Eng.-Swahili, Eng.-Shona and Eng.-Luganda as 62, 37, 22 and 20 respectively.
Analysis of Resource Allocation Fairness of Registered Nurses in the Guangdong Province
Authors: Meng Wei , Wu Xiaomai , He Jingwen , Kuang Qinglan , Peng Xianglan , Li Fang
Published: January 2024

Background
This study aimed to assess the fairness of resource allocation of registered nurses in the Guangdong Province, based on the Healthy China strategy. It aimed to identify the issues with resource allocation fairness and provide optimisation suggestions.
Methods
To assess the allocation fairness of registered nurses, the study used the Gini coefficient, health resource density index, Lorenz curve, and index of dissimilarity. Additionally, the study employed three methods to calculate the Gini coefficient to analyse equity among registered nurses.
Results
In 2021, the allocation of registered nurses in hospitals accounted for 71.22% of registered nurses in the province, that of registered nurses in general hospitals accounted for 72.73% of the hospitals, and that of registered nurses in tertiary medical institutions accounted for 62.28% of the medical institutions at all levels. In terms of health resource allocation density, the demographic density of registered nurses in Guangzhou and Zhuhai was greater than 1; the difference index was 0.44 and 0.43 by geography and population, respectively. Calculated by population, three methods were used to calculate the Gini coefficient, taking the mean value to be 0.31; according to the geographical distribution, the average of the three calculation methods was taken, and the Gini index of registered nurses in the functional districts was 0.39.
Conclusion
When considering the geographical allocation, it is evident that there are disparities in the fair distribution of registered nurses in Guangdong. Specifically, the allocation of registered nurses in the west wing of the coastal economic belt and the ecological development zone (mountain area) of northern Guangdong is insufficient, as indicated by the Gini coefficient of different functional zones. This study recommends improving regional coordinated development to enhance the fairness of registered nurses’ allocation in the Guangdong province.
Clinicopathological characteristics, treatment patterns and out-comes in patients with HER2-positive breast cancer based on hormone receptor status: a retrospective study
Authors: Ran Ran , Zhao Shidi , Zhou Yan , Hang Xinyue , Wang Hui , Fan Yuan , Zhang Yusi , Qiao Yifan , Yang Jin , Dong Danfeng
Published: January 2024

Background
Different hormone receptor (HR) expression patterns have significant biological and therapeutic implications in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer. However, the distinction between HR-positive /HER2-positive (HR+/HER2+) and HR-negative/HER2-positive (HR-/HER2+) subtypes remains unclear.
Methods
This retrospective study analyzed 828 patients with HER2-positive breast cancer at the First Affiliated Hospital of Xi'an Jiaotong University from 2012 to 2022. Baseline characteristics were compared by chi-square test. Survival outcomes were estimated by Kaplan-Meier method.
Results
In total, 56.3% (n = 466) had HR-positive and 43.7% (n = 362) had HR-negative disease. Comparatively, HR+/HER2 + breast cancers presented favorable clinicopathological features. At a median follow-up of 49 months, 199 disease-free survival (DFS) events and 99 deaths were observed. HR+/HER2 + patients significantly had significantly better survival outcomes than HR-/HER2 + patients. HR-positive status was an independent protective factor for overall survival (OS) [P = 0.032; hazard ratio, 0.61; 95% confidence interval (CI), 0.39–0.96] and DFS (P = 0.001; hazard ratio, 0.61; 95% CI, 0.46–0.81). HR+/HER2 + patients were significantly less sensitive to neoadjuvant therapy than HR-/HER2 + patients. In the first-line treatment for HR+/HER2 + advanced breast cancer, receiving endocrine therapy significantly improved advanced-OS (P < 0.001; hazard ratio, 0.33; 95% CI, 0.18–0.59) and progression-free survival (PFS) (P < 0.001; hazard ratio, 0.38; 95% CI, 0.25–0.58) compared with not receiving endocrine therapy. Moreover, maintenance endocrine therapy after HER2-targeted therapy and chemotherapy is associated with significant advanced-OS and PFS benefits compared with no maintenance endocrine therapy (advanced-OS: P < 0.001; hazard ratio, 0.05; 95% CI, 0.03–0.12; PFS: P < 0.001; hazard ratio, 0.35; 95% CI, 0.21–0.57).
Conclusions
This study reveals the high heterogeneity of HER2-positive breast cancer related to HR status in clinicopathological features, metastasis patterns, and outcomes. Large randomized controlled trials are warranted to optimize treatment strategies for the HER2-positive breast cancer population.
“Atypical Radiological Findings In Colloid Cyst Of Third Ventricle- Rare Findings In Rare Tumour”
Authors: Verma Rajat
Published: January 2024

Introduction-Colloid cysts are rare intracranial tumours occurring in 3 individuals per million per year. They constitute around 2% (range 0.5 to 3%)3-5 of all primary brain tumours.
Materials and methods- We retrospectively studied the imaging of 47 patients of colloid cyst of third ventricle who were admitted in PGIMER, Chandigarh in last 10 years for surgical excision. Of them 31 underwent endoscopic excision while 16 went microsurgical excision. Preoperative NCCT head and MR imaging of all patients were studied.
Results-Analysis revealed that in 91.5% cases cyst size was between 1 to 3 cm with mean cyst diameter of 17.55±8.32mm. We encountered 3 giant cysts (>3 cm) in our study. On NCCT head, cyst was hyperdense in 85.11% of cases, hypodense in 4.25% of cases and isodense in 10.64%. On T1 weighted MRI sequences, 42.55% of cysts were hyperintense, 31.92% were hypointense, while 25.53% were isointense. On T2 weighted sequences 57.45% of cysts were hyperintense, 38.30% were hypointense while 4.25% were isointense. Peripheral contrast enhancement was present in 8.51% of cysts. Two cysts showed intracystic haemorrhage, out of which one was giant cyst and one showed intramural nodule.
Conclusion-This article describes case studies of patients with atypical findings in imaging like giant colloid cysts, peripheral contrast enhancement, intracystic haemorrhage & intramural nodule.
Construction of prognosis prediction model and visualization system of acute paraquat poisoning based on improved machine learning model
Authors: Li Long , Han Xinxuan , Zhang Zhigang , Han Tingyong , Wu Peng , Xu Yisha , Zhang Liangjie , Liu Zhenyi , Xi Zhenzhong , Li Haoran , Yu Xiangjiang , He Pan , Zhang Ming
Published: January 2024

Objective: This study aims to develop a prognosis prediction model and visualization system for acute paraquat poisoning based on an improved machine learning model.
Methods: A total of 101 patients with acute paraquat poisoning admitted to 6 hospitals from March 2020 to March 2022 were selected for this study. The patients were divided into two groups, the survival group (n=37) and the death group (n=64), based on treatment results. The biochemical indexes of the patients were analyzed, and a prognosis prediction model for acute paraquat poisoning was constructed using HHO-XGBoost, an improved machine learning algorithm. Multivariate logistic analysis was used to verify the value of the self-screening features in the model.
Results: Seven features were selected in the HHO-XGBoost model, including oral dose, serum creatinine, alanine aminotransferase (ALT), white blood cell (WBC) count, neutrophil count, urea nitrogen level, and thrombin time. Univariate analysis showed statistically significant differences between the survival group and death group for these features (P<0.05). Multivariate logistic analysis identified four features that were significantly associated with prognosis-serum creatinine level, oral dose, ALT level, and WBC count - indicating their critical significance in predicting outcomes.
Conclusion: The HHO-XGBoost model based on machine learning is highly valuable in constructing a prognosis prediction model and visualization system for acute paraquat poisoning, which can provide important help for clinical prognosis prediction of patients with paraquat poisoning.
The protective effect of imatinib against pancreatic β-cell apoptosis induced by dexamethasone via increased GSTP1 expression and reduced oxidative stress
Authors: Semprasert Namoiy , Maneethorn Petcharee , Kooptiwut Suwattanee
Published: January 2024

Glucocorticoids (GCs) are known to stimulate pancreatic beta (β)-cell apoptosis via several mechanisms, including oxidative stress. Our previous study suggested an increase in dexamethasone-induced pancreatic β-cell apoptosis via a reduction of glutathione S-transferase P1 (GSTP1), which is an antioxidant enzyme. Imatinib, which is a tyrosine kinase inhibitor, also exerts antioxidant effect. This study aims to test our hypothesis that imatinib would prevent pancreatic β-cell apoptosis induced by dexamethasone via increased GSTP1 expression and reduced oxidative stress. Our results revealed that dexamethasone significantly increased apoptosis in INS-1 cells when compared to the control, and that imatinib significantly decreased INS-1 cell apoptosis induced by dexamethasone. Moreover, dexamethasone significantly increased superoxide production in INS-1 cells when compared to the control; however, imatinib, when combined with dexamethasone, significantly reduced superoxide production in INS-1 cells. Dexamethasone significantly decreased GSTP1, p-ERK1/2, and BCL2 protein expression, but significantly increased p-JNK, p-p38, and BAX protein expression in INS-1 cells – all compared to control. Importantly, imatinib significantly ameliorated the effect of dexamethasone on the expression of GSTP1, p-ERK1/2, p-JNK, p-p38 MAPK, BAX, and BCL2. Furthermore – 6-(7-nitro-2,1,3-benzoxadiazol-4-ylthio) hexanol (NBDHEX), which is a GSTP1 inhibitor, neutralized the protective effect of imatinib against pancreatic β-cell apoptosis induced by dexamethasone. In conclusion, imatinib decreases pancreatic β-cell apoptosis induced by dexamethasone via increased GSTP1 expression and reduced oxidative stress.
The phase composition and electrochemical performance of CaZr1-xYbxO3-δ proton conductor
Authors: Lei Chong gui , Zhang Fenglong , Wu Xi , Ruan Fei , Bao Jinxiao , Zhang Yonghe , Ma Yuwei
Published: January 2024

To study the electrochemical properties of Yb doped CaZrO3 in more detail, the CaZr1 − xYbxO3−δ (x = 0.000, 0.025, 0.050, 0.075 and 0.100) solid electrolyte specimens were prepared by high temperature solid state method at the temperatures of 1523 K and 1873 K for 8 h. XRD, SEM, EDS and electrochemical workstation were used to test the micro morphology and electrochemical performance of the electrolyte samples. According to the experimental results, the total conductivity of electrolyte CaZr1 − xYbxO3−δ is 6.30×10− 6 to 1.28×10− 3S/cm and the conductivity activation energy falls in 0.69 ~ 1.34 eV in hydrogen and oxygen atmosphere at 973 ~ 1173℃. The chemical diffusion coefficient of hydrogen in CaZr1 − xYbxO3−δ electrolyte is between 1.55×10− 6 and 5.82×10− 6 cm2/s in the temperature range of 973 to 1373K and the diffusion activation energy is 12278kJ/mol. When the doping amount of Yb is 0.05, the electrolyte sample has excellent electrical properties.
Intra- and Interspecific variation of Amblyomma ticks from southern Africa
Authors: Smit Andeliza , Mulandane Fernando , Labuschagne Martinet , Wójick Stephané Heike , Malabwa Choolwe , Sili Gourgelia , Mandara Stephen , Dlamkile Zinathi , Stoltsz Wilhelm Hein , Vineer Hannah Rose , Huber Karine , Horak Ivan , Morar-Leather Darshana , Makepeace Benjamin , Neves Luis
Published: January 2024

Amblyomma spp. ticks, known for their bright ornate appearance and aggressive hunting behaviour, are vectors of a number of important pathogens. In southern Africa, 17 Amblyomma spp. are currently documented. Of these species, Amblyomma hebraeum and Amblyomma variegatum have been well studied due to their wide geographical range and their status as competent vectors of pathogens that are of veterinary and medical importance. Studies on other Amblyomma spp. in southern Africa have been neglected, fostering ongoing debates on the validity of certain species such as Amblyomma pomposum. This study investigated the inter- and intraspecies variation of Amblyomma ticks collected in southern Africa, focusing on resolving the dispute about A. pomposum and A. variegatum as distinct species. Four tick species were collected from Angola, Mozambique, South Africa, Zambia, and Zimbabwe and were identified morphologically as Amblyomma eburneum, A. hebraeum, A. pomposum and A. variegatum using identification keys. Gene amplification was done targeting the 12S and 16S rRNA, cytochrome oxidase I, cytochrome B and internal transcribed spacer-2 genes, and Bayesian inference analyses were performed in MrBayes. These revealed little geographic structuring amongst ticks of the same species from different countries, although intraspecific variation within A. variegatum was high for the 16S and cytB loci. Our study concluds that there is insufficient molecular evidence to differentiate A. pomposum and A. variegatum from each other. We highlight the need for whole mitochondrial genome sequencing of these two species to resolve the ongoing debates. Furthermore, we propose mating and hybrid viability studies between the two species to confirm their reproductive isolation.
Identification of Selection Signatures and Genetic Diversity in the Sheep
Authors: KARABAŞ Mustafa , YILMAZ Onur
Published: January 2024

The study utilized genome-wide data from the Illumina OvineSNP50K platform and specifically targeted the Eşme sheep population. The integrated haplotype score (iHS) and runs of homozygosity (ROH) statistical approaches were used to identify selection signatures. Using the iHS analysis, it was discovered that there are 10 genomic regions and 51 genes on chromosomes 1, 9, 11, and 12 that are under selection. Three genomic regions and 97 genes on chromosomes 6 and 11 were found to be under selection using the ROH analysis. Candidate genes associated with economic and ecological traits were detected using both approaches. Among the genetic diversity parameters considered in the study, the minor allele frequency (MAF), genetic distance between individuals (D), observed heterozygosity (Ho), and expected heterozygosity (He) values were found to be 0.300, 0.309, 0.388, and 0.390, respectively. The ratio of polymorphic SNPs (PN) was 0.947, and the average values of FROH and FHOM were 0.030 and 0.029, respectively. The study demonstrates that selection signature approaches can define the economic and ecological characteristics of farm animals using phenotypic information. The information obtained through these approaches can be utilized in breeding and conservation programs for the genetic resources of farm animals.
Greening of vegetation in northwest India causes positive shortwave radiative forcing
Authors: Mishra Manoj Kumar , Singh Randhir , Vadnathani Rakesh , Thapliyal P. K.
Published: January 2024

The CERES (Clouds and the Earth’s Radiant Energy System) onboard Aqua and Terra has been providing measurements of outgoing shortwave and longwave fluxes since 2000. The analysis of more than 20 years of CERES TOA (top of the atmosphere) clear-sky outgoing radiation flux data revealed significant negative trends in reflected shortwave radiation (i.e., positive shortwave radiative forcing) over northwest India. Trends in surface reflectance, AOD (Aerosol Optical Depth), NDVI (Normalized Difference Vegetation Index), and land surface temperature observed by the MODIS during the same period over the same region have also been investigated to better understand the origin of these secular negative trends in the TOA reflected shortwave radiation flux. Surface reflectance and AOD are both decreasing, whereas NDVI is increasing over this time period. Surprisingly, despite positive shortwave radiative forcing, the land surface temperature significantly declined during the day and increased only marginally at night. The sensitivity study using the radiative transfer model indicates that TOA shortwave fluxes are more responsive to changes in surface reflectance than AOD changes. In recent years, various irrigation projects in northwest India have expanded agricultural practices, which have resulted in greater vegetation. Increased vegetation reduces surface reflectance and aerosol production, which in turn reduces TOA shortwave radiative flux. Furthermore, declining trends in daytime land surface temperature despite positive shortwave radiative forcing suggest that increasing greenery is one of the most efficient strategies to minimize global warming through evapotranspiration and photosynthesis processes. The study of regional trends in climatic variables is vital for understanding climate change and its quantification; hence, the results of this study will have a significant bearing on climate change impact studies.