bluuebunny/crossref_metadata_2025 huggingface dataset:
Variant Anatomy of the Right Ventricular Moderator Band in Human Heart in Early Antenatal Period of Development
Authors: Yakimov Andrey A.
Published: December 2022

INTRODUCTION: The information about the variants of the structure and topography of the moderator band (MB) that connects the interventricular septum with the anterior papillary muscle and the anterior wall of the right ventricle in the heart of a fetus and a newborn, is of great importance for cardiac surgery. AIM: To establish the prevalence of the MB and describe the variants of its shape, structure and position in the right ventricle of the normal human heart in the early antenatal period of development. MATERIALS AND METHODS: Using Olympus SZX2-ZB10 stereomicroscope with 4.725X to 15X magnification, formalin-fixed hearts of fetuses and stillborns of 1728 weeks were studied. The results are presented in the form of median, 25th and 75th percentiles, extreme values. Correlation analysis was performed. Significance of the difference of proportions was evaluated by one-sided t-test. The results are presented in the form of median (Me), 25th and 75th percentiles (Q25%Q75%). RESULTS: MB was found in 73 of 90 preparations (81.1%), in 48 cases (66%) it was bridge-like, and in 24 of 72 (33.3%) ― parietal. MB had flattened (crest-like) or cylindrical shape (62.5% vs 33%; p = 0.0002). The most common was flattened bridge-like variant. The length of MB was 2.2 (1.753.0) mm, width 1.35 (0.91.75) mm, thickness 1.0 (0.651.5) mm. The band mainly originated from the interventricular septum between the middle and apical thirds of the longitudinal axis, and the anterior and middle thirds of the transverse axis of the interventricular septum. It typically terminated with the attachment to the anterior papillary muscle (47.7%), or to the anterior wall of the right ventricle immediately in front of this muscle (38.5%). In 22.2% of cases, the MB had papillary muscles on it, and in 37.5%, the secondary trabeculae extended from it to the apex of the ventricle. CONCLUSION: MB is a normal, but not obligatory structure of the heart in the antenatal period, its normal anatomy is variable and is manifested by typical and rare variants of the form, position, beginning and end, which in many cases can impede diagnostics and treatment of the pathology of the right ventricle.
Analysis of Causes of Sudden Death Among Russian Railway Workers
Authors: Zhidkova Elena  A. , Gutor Ekaterina  M. , Gurevich Konstantin G. , Makogon Nikita  V. , Shugushev Zaur  Kh. , Orlov Denis  O. , Dzhioyeva Ol’ga  N. , Drapkina Oksana  M.
Published: December 2022

INTRODUCTION: Health protection of railway workers of various professional groups increases the safety of railway transport, the prestige of the profession and reduces morbidity and mortality from the most common causes in this group of patients.
AIM: To analyze the risk factors of sudden death among Russian Railways workers.
MATERIALS AND METHODS: The design of the study is made according to the case-control type. Analysis was carried out of all cases of sudden death (SD) of employees of JSCo Russian Railways (RR) in the period from 2009 to 2021 (n = 412). The comparison group consisted of 411 employees of RR who were undergoing periodical medical examination. The groups were formed on the basis of age, employment period, gender, profession. To assess the diagnostic significance of the quantitative signs in predicting a certain outcome, the method of analysis of ROC curves was used.
RESULTS: The chances of death for workers of RR increased in case of past myocardial infarction, and also depended on the type of intervention (p 0.001). The threshold value of the BMI index in the cut-off point, which corresponded to the highest value of Youden index, was 27.1 kg/m2. In the group of sudden deaths, there were 1.8 times more smokers and 2 times less individuals with total cholesterol level exceeding 5 mmol/l than in the comparison group (p 0.001). A prognostic model was developed by ROC-analysis to determine the probability of mortality. The sensitivity and specificity of the model were 79.5% and 91.9%, respectively.
CONCLUSION: A prognostic model was developed to determine the probability of sudden death in Russian railway workers, with the sensitivity and specificity 79.5% and 91.9%, respectively. However, the present study did not permit to reveal predictors of sudden death specific of the workers of RR.
Gençlerin İnanç Eğilimlerinin Anlaşılması Bağlamında Dua İbadeti
Authors: DOĞAN Mebrure , ÖZCAN Zeynep
Published: December 2022

İnsan hayatının en önemli dönemeçlerinden biri kabul edilebilecek gençlik evresi, dini hayat bakımından da önemli bir döneme tekabül etmektedir. Dini hayatın temelleri bu dönemde atılmamış olsa da ergenliği de içine alan bu dönemde dini hayatla ilgili yol ayrımlarıyla karşılaşıldığı bilinmektedir. Gençlik döneminde dini hayat, tıpkı diğer yaşamsal konularda olduğu gibi bireysel farklılıklardan etkilenmektedir. Dini gelişim karakteristiği olarak özellikle ergenlik döneminde çelişkiler, çatışmalar, kararsızlıklar, arayışlar ve şüpheler bazen yüzeysel bazen de derin bir şekilde yaşanabilmektedir. Dini şüphe ve kararsızlıklarla dinden uzaklaşma veya kopma riskiyle karşılaşan bazı ergenler bir taraftan dini kaygı yaşarken diğer yandan dini başa çıkma yöntemlerini kullanarak yeniden dine sığınabilmektedir. Genç, yaşadığı dini suçluluk duygularının stresi ile başa çıkmak için yine yaratıcısına yönelerek dua etmekte, onun merhametine güvenerek rahatlayabilmektedir. Bu bağlamda yaşanan içsel çelişkiler Yaratıcıyla kurulan içten bir ilişki sayesinde bireysel dindarlığın psikolojik kaynağı haline bile dönüşebilmektedir. Araştırmanın konusu gençlerde dua ibadetidir fakat gençlerin dua ibadeti konusundaki tutumları incelenirken genel anlamda ibadetlerinin ve inanç eğilimlerinin de araştırılması hedeflenmektedir. Araştırmada fenomenolojik desenli nitel yöntem kullanılmış olup yarı yapılandırılmış görüşme tekniği ile veriler toplanmıştır. Elde edilen veriler betimsel analiz ve içerik analizi teknikleri kullanılarak çözümlenmiş ardından yorumlanmıştır. Öncelikle araştırmanın yapılabilmesi için Afyon Kocatepe Üniversitesi Sosyal ve Beşeri Bilimleri Bilimsel Yayın Etik Kuruluna başvuruda bulunulmuş ve gerekli izinler alınmıştır. Araştırmanın örneklemini Afyonkarahisar ve Karabük illerindeki çeşitli liselerde eğitim görmekte olan 25 genç oluşturmaktadır.
APPLICATION OF HOOKE’S LAW TO ANGLE PLY LAMINA
Authors: YİLMAZ Cagatay , ALİ Hafiz Qasim , YILDIZ Mehmet
Published: December 2022

Aerospace-grade carbon fiber reinforced polymer composite plates with four different fiber orientations 0º, 30º, 45ºand 60º is produced with the autoclave curing method and subjected to tensile testing. The stress-strain curves of the composite specimens are compared with Hooke’s law. It is observed that Hooke’s law coincides precisely with the experimental results for samples containing fibers parallel to the loading direction. However, it does not coincide with samples where the fibers make a certain angle with the applied load direction.. Moreover, it is reported that Hooke’s law converges the experimental results for small strain values but diverges significantly from the experimental results at higher strain values.
El casco de Hades y la independencia judicial
Authors: Caamaño Francisco
Published: December 2022

En las actuales democracias se aprecia un deterioro de la política y un progresivo empoderamiento de los jueces. Los jueces no solo controlan al Gobierno, sino también a la legislatura. El modelo europeo de justicia ha convertido el concepto de independencia del juez en un instrumento para reforzar su posición frente a los otros poderes del Estado, como lo prueba la creación de los consejos de la judicatura, que sin pertenecer al poder judicial del Estado, han nacido para defenderlo políticamente. En este trabajo se analiza la evolución del modelo de juez-funcionario y sus diferencias con el modelo de juez anglosajón.
Independencia judicial, medios constitucionales y motivaciones personales. Una nota
Authors: Gargarella Roberto
Published: December 2022

El trabajo busca reflexionar sobre la posibilidad de repensar la organización del Poder Judicial. En particular, en el escrito se llama la atención sobre la necesidad de motivar a los jueces para que decidan imparcialmente y no solo brindarle los medios constitucionales para que lo hagan. En el texto se sugieren algunos caminos posibles para lograr dicho objetivo.
Soil tillage systems in the function of ecological sustainability
Authors: Stošić Miro , Popović Brigita , Ranogajec Ljubica
Published: December 2022

Stationary field experiment pertaining to the winter wheat in Croatia was performed during the three seasons. This study’s intention was to examine and diagnose the effect of tillage systems (TS) on soil chemical properties (soil acidity, phosphorus [P], potassium [K], and organic matter content). The TSs were as follows: CT — ploughing up to 30 cm depth, DT — disking up to 8-12 cm depth, LT — loosening up to 35 cm depth, and NT — no-tillage. The experimental design was a randomised block design in four repetitions, in which the basic TS plot amounted to 540 m2. Soil sampling for 0-30 cm soil layer was performed prior to setting up the experiment and subsequent to the three seasons with a total of 320 soil samples. Chemical analysis was performed according to standard pedological procedures. Economic indicators were calculated using economic equations and standards, whereas statistical analysis was performed with SAS 9.3 and Microsoft Excel 2016. Generated results indicate that the expressed accumulation of phosphorus and potassium appeared with a distinct vertical stratification in the systems with shallower tillage or no-tillage. At the same time, these TSs ensured the soil organic matter and soil fertility preservation. A conservable agricultural production of reduced soil tillage systems has its efficiency and vigor while providing soil degradation.
Proposal for Dynamic and Secure Authentication in IoT Architectures Based on SDN
Authors: Abbassi Younes , Toumi Hicham , Ben Lahmar El Habib
Published: December 2022

The connectivity of private resources on public infrastructure, user mobility, and the advent of new technologies have added new client and server-side security requirements. Security is the major element of the Internet of Things (IoT) that will certainly reinforce an even greater acceptance of IoT by citizens and companies. Security is critical in this context given the underlying stakes. This paper aims to advance the thinking on authentication of connected objects by proposing an authentication mechanism that meets the needs of IoT systems in terms of security and performance. It is based on SDN (Software-Defined Networking), which refers to a set of advanced technologies that allow for centralized control of network resources. OTP (One-Time Password) is a type of authentication that could be useful in connected object environments and smart cities. This research work extends the principle of OTP and proposes a lightweight authentication method using a new approach to OTP generation that relies on two parameters (Two-Factor Authentication, 2FA) to ensure the security of underlying systems. Subsequently, we leverage the combination of SDN and the 2FA algorithm to propose an adaptive authentication and authorization solution in the IoT network.
Editorial: Building Trust in the Digital Economy
Authors: Campbell Leith H.
Published: December 2022

This editorial comes in two parts: some remarks on government plans for the digital economy and the necessity of building trust; and a brief introduction to the papers in this issue.
Anxiety and Aggressive Behavior in Adolescents: A Correlational Study
Authors: Sari Febriana Sartika , Sulistyaningsih Sulistyaningsih , Batubara Intan Maharani Sulistyawati , Eagle Megan J , Rosyida Ratna Wirawati
Published: December 2022

Background: Aggressive behavior has become a severe behavioral problem in adolescents recently. Some cases have even been deemed an emergency for mental health behavior in adolescents. Many factors are suspected to be associated with aggressive behavior, one of which is anxiety. Anxiety and aggressive behavior remain widely studied in children, but the number of studies is limited to middle and late adolescents. In addition, there is no clear description of the psychosocial aspects between anxiety and aggressive behavior in adolescents based on the psychosocial development tasks. Objective: The study aims to identify the association between adolescents’ anxiety and aggressive behavior.Methods: The research used an analytical correlation design with a cross-sectional approach. The research was conducted in senior high schools in Surakarta in July 2021. Subjects were taken using convenience sampling, in which 626 students filled out the online questionnaire, while 32 students did not complete some items resulting in a total sample of 594 respondents. Then, the research instruments employed DASS 21 for anxiety and Buss Perry Questionnaire for aggressive behavior. The statistical analysis then utilized the Pearson product-moment test.Results: The research revealed that most respondents were female (67,8%). The respondents had a bullying victim history (44.8%), a violence victim history (13.3%), and parental divorce history (10.3%). The statistical test also uncovered a significant correlation between anxiety and aggressive behavior (p-value 0.0001, r: 0.649, OR:7.86, CI 95%).Conclusion: The finding demonstrates the association between adolescents’ anxiety and aggressive behavior. Consequently, the community mental health nurses should organize a partnership mental health program with the senior high schools to manage adolescent anxiety and aggressive behavior
Perceived Incivility and Stress of Final Year Nursing Students
Authors: Purukan Debora , Mamengko Fristy Nemesis , Sopamena Putri Regina , Eka Ni Gusti Ayu , Zega Windy Sapta Handayani
Published: December 2022

Background: Incivility is disruptive behavior that can cause physiological or psychological distress to those involved and can escalate into a potentially dangerous situation such as serious suicidal tendency and engage in self-injury if left untreated. Incivility can be caused by a variety of factors, one of which is stress; however, stress can also be a cause of incivility. Objective: This study aimed to examine the relationship between incivility and stress among final-year nursing students. Methods: This study employed a quantitative research method using a correlation approach. The study used a simple random sampling. The data were analyzed using descriptive statistics and Spearman rank test. The instruments used in this study were the INE-R/Incivility in Nursing Education-Revision (Cronbach Alpha 0.881-0.876) and the PSS/Perceived Stress Scale (Cronbach Alpha 0.684). This study recruited 200 students, the majority of whom were female (87.5%). Result: This study revealed students' perceived levels of incivility (Mean 20.93, SD 6.67); perceived frequency of incivility (Mean 18.01, SD 5.18); and perceived stress (Mean 22.01, SD 4.01). Additionally, this study discovered significant relationships between students' perceived levels of incivility and stress (p value 0.010, r 0.283) as well as their perceived frequency of incivility and stress (p value 0.001, r 0.269). Conclusion: Incivility has been associated with stress levels in nursing students. It is critical for nursing education to foster a positive learning environment. This study provides evidence for a correlation between incivility and stress in nursing students who transitioned from blended to fully online learning due to the Covid-19 pandemic.
An evaluation of effect of hydroxyurea on frequency of blood transfusion, vaso-occlusive crisis and hospitalisation in children of sickle cell anemia
Authors: Gupta Shikha , Choudhary Prachi , Singh Devraj , Malpani Preeti
Published: December 2022

Background: Hydroxyurea therapy is a known effective and safe therapy for the treatment of sickle cell anemia (SCA). Although it is used worldwide in our Indian based setup, it is underutilized not only due to economic reasons but also due to unaware practitioners about its use.Methods: An ambispective observational study was performed at our tertiary care center over a period of 1 year 8 months. One hundred and ninety patients were enrolled after taking a complete history, then started on Hydroxyurea and followed up every 2 months till 1 year. On follow-up, frequency of vaso-occlucive crisis, blood transfusion and hospitalization were noted along with routine investigations and for any side effects.Results: Of 190 total recruited patients, 84 were studied at the end because of loss to follow-up due to various reasons. Significant decrease in the frequency of vaso-occlusive crisis (VOC), blood transfusion and hospitalisation were observed within 1 year of starting hydroxyurea (p<0.05).Conclusions: The use of hydroxyurea in our native population at our setup can decrease the frequency of vasooccluisve crisis, blood transfusion and hospitalisation in sickle cell patients.
Morbidity profile and outcome of low-birth-weight neonates in NICU of a tertiary care hospital
Authors: Chauhan Anuya V. , Gosai Dhara , Patel Urvi
Published: December 2022

Background: Birth weight has been accepted as the most important reliable index of the health status of the community and is an indicator of neonatal morbidity and mortality. Aims and objectives were to determine the incidence, clinical and epidemiological profile of low-birth-weight (LBW) neonates in NICU in tertiary care settings and to assess the distribution of various morbidities, mortalities and outcome based on the weight of the neonates.Methods: This hospital-based prospective study was conducted for one year in NICU at a tertiary care centre, Ahmedabad. All neonates with birth weight <2.5 kg admitted in NICU were included in study. Data on gestational age and birth weight, congenital anomalies, morbidities and mortalities along with their outcomes was collected and analysed.Results: Total admissions in NICU over a period of one year of the tertiary care centre, Ahmedabad were 4275 of which 64.63% were LBW. The maximum number among the LBW of the new-borns (72.47%) were having a birth weight ranging from 1500-2499 gm. The sex ratio was 1.46:1, indicating males (59.39%) more than females (40.61%) NICU stay of the babies in <1 kg, 1 to 1.499 kg and 1.5 kg were maximum at 8 to 10 days. The main cause of mortality in <1 kg and 1-1.499 kg babies were prematurity.Conclusions: The prevalence of LBW neonates accounted for 64.63% of NICU admission. Common morbidities observed in LBW babies were perinatal asphyxia, RDS/HMD, jaundice. The early outcome was that 46.9% of babies were discharged while 39.3%.
Clinico-epidemiological profile and outcome of children with severe acute malnutrition
Authors: Bhat Irfan B. , Jan Muzafar , Bhat Abdus S.
Published: December 2022

Background: Severe acute malnutrition is a significant crisis which can cause great morbidity and mortality in children. The aim of this study was to study the clinic-epidemiological profile and outcome of these children in a tertiary care hospital.Methods: The study was an observational prospective study conducted from November 2018 to April 2020. A total of 61 patients were enrolled in our study. All Children were managed in nutritional rehabilitation centre as per WHO protocol.Results: Male to female ratio was 1:1.6. Majority of patients were of age less the 2 years (83.4%) and were of birth order 3 or more (65.5%). The mean age of presentation was 12.016±7.72 months. Mean duration of exclusively breast feeding in our study was 3.643±1.81 months. Weight-for-height <-3 SD was the most commonly used diagnostic criteria. 67.2% patients recovered completely, 24.6% patients recovered partially and 8.2% patients were defaulters. Mean duration of hospital stay of patients in our study was 12.918±7.9735 days and average weight gain in our study was 8.808±3.7312 g/kg/day. The most common presenting symptom in our study was fever (45.9%). The most common co-morbidity in our study was bronchopneumonia (27.9%).Conclusions: The problem of severe malnutrition is multi-dimensional and inter-generational in nature. Most of patients come to hospital with complaints like fever, cough, loose motions, vomiting and are then discovered as patients of severe acute malnutrition. Thus, screening the patients who report to hospital with various complaints can help in early detection and proper rehabilitation. NRCs provide live-saving care for children with SAM as demonstrated by the high survival rates in this study.
Prevalence of extraarticular manifestations in rheumatoid arthritis and their relationship with serological status and disease severity
Authors: Mathkhor Abdulsatar J.
Published: December 2022

Background: Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that attacks the synovial joints. It affects body systems, such as the skin, cardiovascular, respiratory systems, and other systems, which manifest as extraarticular manifestations. This study aimed to correlate RA with extraarticular manifestations and its relationship with serological status.Methods: One hundred fifty patients (30 male and 120 female) RA patients with a mean age of 49.9±11.9 attending the Rheumatology outpatient department and biological therapy center in Basrah Teaching Hospital were enrolled in the study and fulfilled the 2010 RA classification criteria of the American college of rheumatology/European league against rheumatism for RA. All the subjects underwent a thorough history, clinical examination, and laboratory investigations. Body mass index (BMI), the severity of pain using a visual analog scale (VAS) and disease activity using 28 joints (DAS28), and erythrocyte sedimentation rate were calculated for all patients. The relevant data were analyzed with appropriate statistical methods after 12 months.Results: The mean age, age at onset, disease duration, and BMI were 49.9±11.9, 41±2.1, 14.6±5.8, and 26.8±4.8 respectively. The disease onset was acute in 45 (30%) and insidious in 105 (70%) patients. Anemia, rheumatoid nodule, sicca syndrome, Felty syndrome, Sjogren syndrome, and joint erosions were more frequent in seropositive than seronegative patients. There is no difference in joint deformities between seropositive and seronegative patients. DAS28, VAS, ESR, and CRP were higher in patients with extraarticular manifestations.Conclusions: Extraarticular manifestations are significantly associated with seropositive disease and correlate to disease severity.
The relationship between age and parity of pregnant women with the incidence of disrupted ectopic pregnancy at Wangaya hospital
Authors: Pemaron Ida Bagus M. , Bandem I. Ketut M. P. , Seputra Dewa Ketut A.
Published: December 2022

Background: Ectopic pregnancy is a phenomenon in pregnancy where after being fertilized, the egg cell implants and grows in the outer area of the endometrium of the uterine cavity. All ectopic pregnancies are at risk for spontaneously ruptured ectopic pregnancies. The incidence of ectopic pregnancy in the world is 0.25-2.0% of all pregnancies. In Indonesia, cases of ectopic pregnancy range from 5-6 per thousand pregnancies. One of the factors that influence the incidence of disrupted ectopic pregnancy is the age of the pregnant woman.Methods: A cross-sectional study was conducted at Wangaya regional general hospital in Denpasar among pregnant women with ruptured ectopic pregnancies between 2021 and 2022.Results: Based on the age category, the incidence of disrupted ectopic pregnancy was most common in the age range of 20-35 years old. Based on the parity category, the incidence of disrupted ectopic pregnancy was most common in the multigravida category.Conclusions: Based on age category, the incidence of disrupted ectopic pregnancy in Wangaya regional general Hospital in 2021-2022 mostly occurs at the age of 20-35 years, and based on the parity category of pregnant women, it is most common in multi gravida, which is found to be 65% of the total 40 cases.
The aspartate aminotransferase platelet count ratio index as an ideal predictor of dengue severity
Authors: T. Percy Priyanka , Harika Rachapudi Lakshmi , Faujdar Dharamjeet Singh , Nagarjuna Pundla
Published: December 2022

Background: Now a days, majority of dengue patients with an abnormal aspartate aminotransferase level, and a decreased blood platelet count is linked to the severity of dengue fever. However, just a few researchers, assessed its predictive relevance for determining the severity of dengue. Hence, we aimed to assess the diagnostic value of aspartate aminotransferase platelet count ratio index for predicting dengue severity. Methods: A prospective study done among 115 patients with confirmed dengue fever (based NS1 antigen/IgM antibody positive report) who were admitted in tertiary care hospital from June 2021 to December 2021. All patients were clinically assessed and investigated for Serum transaminases and platelet count on day 1, day 4 and day 7 or on the day of discharge/death. Data was analysed using Microsoft excel and SPSS version 21.Results: A total of 115 patients, 76 (66.1%) males and 39 (33.9%) females, with the median age of the patients was 27 years (range from 15-45). Most of the patients (65, 56.5%) had dengue fever without warning signs and 20 patients (17.4%) had severe dengue disease. The aspartate aminotransferase (AST), leukocyte count, platelet count (PLT), aspartate aminotransferase/platelet count ratio index (APRI) showed a significant association with severe dengue (p<0.05). With the observed 2.5 cut off value, we found the sensitivity and specificity of APRI for prediction of dengue severity as 80.0% and 76.8% respectively.Conclusions: Our study revealed that Aspartate aminotransferase/platelet count ratio index (APRI), can be useful for clinicians to predict the severity of dengue fever infection during the onset of symptoms and course of treatment for better outcome.
A case of Evans syndrome
Authors: Kaluvai Sai Indraneel , V. Rajalakshmi K. , Y. Dayanandan
Published: December 2022

Evans syndrome is an autoimmune disorder described by Robert Evans in 1951 specifying that a link exists between primary thrombocytopenic purpura and acquired haemolytic anaemia. It is a rare autoimmune disorder characterised by the simultaneous or sequential development of autoimmune haemolytic anaemia (AIHA) and immune thrombocytopenia (ITP) with or without immune neutropenia. Approximately, Evans syndrome represent 5-10% of warm autoimmune haemolytic anaemia cases and 2-5% of ITP cases. It is basically a diagnosis of exclusion. We present a 50-year-old female presented with anaemia, jaundice and petechia. Patient indirect bilirubin was raised, Coombs test was positive, lactate dehydrogenase and reticulocyte count were raised. Based on the Coombs positive haemolytic anaemia and thrombocytopenia patient was diagnosed with Evans syndrome. ANA profile was positive for SS-A suggestive of underlying autoimmune disorder. Evans syndrome is difficult to diagnose and treat. Typically, corticosteroids and other immunosuppressive medications are used to manage the syndrome.
Isolated neutropenia: an unexplored side effect of amiodarone
Authors: Purnesh Boppana Venkata , Periyasamy Manimekalai , Vinatha Mullangi Chenchu , Alex J.
Published: December 2022

Amiodarone has long been used to treat a variety of arrhythmias. It's a strong P450 inhibitor, which means it'll interact with many widely given medications. Unfortunately, it can also produce a wide spectrum of toxicities due to lengthy half-life, immunophilicity, and widespread tissue distribution. Neutropenia associated with mechanistic target of rapamycin (mTOR) inhibitors can be improved by avoiding other medications that cause cytopenias, including proton pump inhibitors (PPIs), H2 blockers and the sulpha group of drugs. A 62-year-old presented in disoriented state and had one episode of involuntary jerky movements. The patient went into atrial fibrillation, was intubated and changed the drug to amiodarone. Before the initiation of amiodarone patient's blood work seemed to be normal. After 10 days of amiodarone, his hemodynamic status was deranged, and he recovered. Neutropenia is present constantly and reduced to normal only after discontinuation of amiodarone.
Trends in otolaryngology-head and neck surgery procedural volumes during the COVID-19 pandemic
Authors: Qatanani Anas M. , Kshirsagar Rijul S. , Douglas Nerone O. , Andrade Cynthia , Adappa Nithin D. , Eide Jacob G.
Published: December 2022

Background: The COVID-19 pandemic significantly impacted procedural volumes across all surgical specialties. This study aims to assess trends two years after the start of the pandemic and analyze the current surgical volume in Otolaryngology-Head and Neck Surgery.

Methods: The COVID-19 TriNetX database, consisting of 67 health care organizations (HCOs) was utilized to collect de-identified data patients that underwent otolaryngologic surgical procedures from February 1, 2018 to January 31, 2022. The pre-pandemic (2018 to 2019) and post-pandemic (2020 to 2021) periods were analyzed and compared for surgical volumes by season, surgical subspecialty, and procedure type. Student's t-test was utilized to test for statistical significance of trends between seasonal averages pre- and post-pandemic.  

Results: A total of 2,005,796 otolaryngology surgical procedures from 45 HCOs were included. When comparing the average monthly post-pandemic (2020 and 2021) volumes to their pre-pandemic (2018 and 2019) seasonal counterparts, there were statistically significant decreases in the averages of all seasons. Post-pandemic seasonal volumes assessed by individual years depicted a significant decline in the total otolaryngology surgical volumes in all seasons, with the steepest reduction from Winter 2019 to Spring 2020.

Conclusions: Specialties that experienced significant reductions in volume without sufficient evidence of rebounding trends include paediatric otolaryngology and otology, while general/rhinology/endoscopy, laryngology, head and neck surgery, and facial plastics and reconstructive surgery are trending towards pre-pandemic baselines.
Utility of local flaps in the reconstruction of oncologic resection defects of the oral cavity
Authors: Munnangi Ashwini , Dravid Chandrasekhar , Gatla Nagarjuna R. , Ram Priya S. , Mahantshetty Umesh
Published: December 2022

Background: Objectives of the study were: to report on the utility of local flaps for oral cavity reconstruction in patients undergoing radical surgery for oral cavity cancers, to enumerate different local flaps used for oral cavity reconstruction, and to assess survival and sequelae associated with various flaps.

Methods: The study is a retrospective analysis of data on patients with oral cancer treated with resection and local flap reconstruction between January 2018 to February 2021. The study includes patients treated at a tertiary care cancer hospital in South India. Patients of oral cancer who underwent resection followed by local flap reconstruction between January 2018 to February 2021 were included. Data was analysed for the extent of resection and type of flap used. Details of flap outcomes in the form of major and minor flap loss, functional outcomes and sequelae if any, were documented.  

Results: 46 patients, 15 women and 31 men, were included in our series. The median age was 51.5 years with an interquartile range (IQR) of 20.5. Tongue was the most common subsite (n=26; 56.5%) followed by buccal mucosa (n=7; 15.2%). Of the 46 flaps done, the most commonly employed flap was the facial artery myo-mucosal flap (FAMM flap) (n=27;58.6%) followed by the nasolabial flap (n=7;15.2%). There was no case of complete flap loss. Grade II trismus (n=5) was the main sequela observed in this study.

Conclusions: Local flaps are a reliable option in oral cavity reconstruction post oncologic ablation.

 
A rare case of sialolipoma of submandibular gland
Authors: Paramasivam Praveen K. , Sahu Pankaj K. , Bishnoi Tapasya , Yadav Mukesh K.
Published: December 2022

Lipomas in head and neck region are common but prevalence in salivary glands is rare with majority in parotid. Sialolipoma is a rare tumour of the salivary gland that is composed of mature adipocytes and normal salivary gland tissue. We report an extremely rare case of sialolipoma of left submandibular gland in a 39-year-old male who presented with complaints of insidious onset gradually progressive swelling in left submandibular region with no pain, discolouration or discharge. On examination, a 5×4 cm soft, non-tender swelling was noticed in (L) submandibular region. Ultrasonography of neck revealed enlarged (L) submandibular gland with hypoechoic area of 5 mm diameter and small areas of echogenic foci with no cervical lymphadenopathy. Contrast enhanced computed tomography (CECT) neck showed a 5.6×2.7×4 cm well defined fat attenuated lesion in (L) submandibular space, suggestive of lipoma with a well-defined enhancing soft tissue component within the lesion. He underwent excision of (L) submandibular gland along with fibrofatty tissue under general anaesthesia. Histopathological examination revealed submandibular gland with normal histomorphological features along with mature adipocytes in fibrofatty tissue. The patient is on regular follow-up with no recurrence.

 
Consequence of smoking on hematological parameters in apparently healthy medical students
Authors: Mohsen Zahraa Al , Mufarah Mohammed A. Al , Alharbi Naif O. , Aqeeli Anfal Y. , Bokhedher Rawan F.
Published: December 2022

One of the greatest causes of death in the globe is tobacco cigarette smoking. Smoking affects hematological markers both acutely and chronically. The current study's objective was to evaluate the severity of the negative effects of cigarette smoking on biochemical traits in healthy smokers.

This study included 280 participants, only 56 smokers and 100 non-smokers. They were smoking for three years, the smokers regularly smoked 10 to 20 cigarettes per day. The fully automatic hematological analyzer CELL-DYN 3700 examined the total number of blood cells.

White blood cells (p0,001), hemoglobin (p=0,042), mean corpuscular volume (p=0,001), and mean corpuscular hemoglobin concentration (p0,001) were all considerably greater in the smokers. No other measured metrics varied considerably from one another. Red blood cells, white blood cells, hemoglobin, hematocrit, and mean corpuscular hemoglobin were all significantly higher (p0,001) in male smokers compared to female smokers after smoking cigarettes.

: Our study concluded that smoking cigarettes continuously has severe negative effects on hematological variables, including hemoglobin, white blood cell count, mean corpuscular volume, mean corpuscular hemoglobin concentration, red blood cell count, and hematocrit. These modifications may be linked to an increased risk of polycythemia vera, atherosclerosis, chronic obstructive pulmonary disease, and/or cardiovascular diseases.
Clinical observation of recombinant human nerve growth factor in the treatment of neurotrophic keratitis
Authors:   Department of Ophthalmology, First Affiliated Hospital of Northwest University, Xi’an No.1 Hospital, Shaanxi Institute of Ophthalmology, Xi’an 710002, Shaanxi Province, China, Hao Mi , Wu Jie ,   Department of Ophthalmology, First Affiliated Hospital of Northwest University, Xi’an No.1 Hospital, Shaanxi Institute of Ophthalmology, Xi’an 710002, Shaanxi Province, China, Cheng Yu ,   Department of Ophthalmology, First Affiliated Hospital of Northwest University, Xi’an No.1 Hospital, Shaanxi Institute of Ophthalmology, Xi’an 710002, Shaanxi Province, China, Wang Jing ,   Department of Ophthalmology, First Affiliated Hospital of Northwest University, Xi’an No.1 Hospital, Shaanxi Institute of Ophthalmology, Xi’an 710002, Shaanxi Province, China
Published: December 2022

AIM: To characterize changes of corneal nerve morphology and tear indices in patients with neurotrophic keratitis (NK) treated with recombinant human nerve growth factor (rhNGF).
METHODS: In a prospective observational study, six patients (nine eyes) were locally treated with rhNGF. Visual acuity, corneal fluorescein staining score, the heights of the tear river, lipid layer thickness (LLT), tear ferning (TF) test, conjunctival impression cytology (CIC) examination, the densities of cornea subbasal nerve fibers were determined before and after treatment.
RESULTS: Compared with baseline, there was a significant difference in corneal fluorescence staining scores (P<0.01); all patient corneal epithelial defects recovered completely within 8wk, but there was no significant improvement in the height of the tear river (P=0.202). LLT was significantly increased when compared with baseline (P=0.042); however, the function of conjunctival goblet cells and mucin content did not significantly improve using the TF test and CIC examination (P=0.557, P=0.539). After 8wk of treatment, the average corneal subbasal nerve fiber density increased significantly (P<0.01), as did the number of corneal nerve fiber branches (P=0.001).
CONCLUSION: RhNGF can increase the density of corneal subbasal nerve fibers, promote the healing of persistent corneal epithelial defects and corneal ulcers in patients with NK, also improving tear function partially.
Efficacy of custom-made soft keratoconus lenses on corneal aberrations and photic phenomena in patients with keratoconus: a corneal topography imaging based study
Authors:   Department of Ophthalmology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Health Science University, Semsi Denizer Caddesi, E-5, Kartal Istanbul 34890, Turkey, Penbe Aysegul , Arsan Aysu Karatay ,   Department of Ophthalmology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Health Science University, Semsi Denizer Caddesi, E-5, Kartal Istanbul 34890, Turkey, Kurna Sevda Aydın ,   Department of Ophthalmology, Fatih Sultan Mehmet Training and Research Hospital, Health Science University, E-5,  Icerenkoy 34752, Istanbul, Turkey
Published: December 2022

AIM: To evaluate the efficacy of custom-made soft keratoconus (KC) lenses on corneal aberrations and photic phenomena in two different optical zones in patients with KC.
METHODS: Sixty eyes of 42 patients with KC were examined at baseline and after fitting HydroCone (Toris K) soft silicone hydrogel lenses. Best spectacle-corrected visual acuity (BSCVA) and contact lens-corrected visual acuity (CLCVA) were recorded. Lower- and higher-order corneal aberrations (LOAs and HOAs) were measured with and without Toris K lenses and compared in central 4.5 mm and 7 mm zones. Mesopic pupil diameter and subjective photic phenomena were also assessed.
RESULTS: Mean CLCVA was significantly improved compared to BSCVA (P<0.0001). Corneal curvature and refractive measurements were found to be significantly reduced by the use of Toris K lenses, except for posterior corneal curvature values. In the 4.5 mm central optical zone, all wavefront aberrations decreased significantly after lens fitting (P<0.0001). In contrast, in the 7 mm (peripheral) optical zone, values for HOAs, spherical and residual aberrations, and optical path differences were increased, while LOAs, trefoil, and quadrifoil coefficients were decreased. The rate of photic phenomena was significantly higher in participants with a pupil size >6.00 mm (85.7%).
CONCLUSION: Toris K lenses provide good visual results and a significant reduction in central corneal aberrations in patients with KC but could cause an increase in peripheral aberrations. This practical and nonsurgical approach appears to be an effective method for the visual management of KC.
Recurrence risk factors of intravitreal ranibizumab monotherapy in retinopathy of prematurity: a retrospective study at one center
Authors:   Department of Ophthalmology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China, Wu Feng-Yue , Zhao Dai-Xin ,   Department of Ophthalmology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China, Pu Wei ,   Department of Ophthalmology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China, Zhang Xue ,   Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China, Gai Chun-Liu ,   Department of Ophthalmology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Published: December 2022

AIM: To identify risk factors of recurrence of this disorder after intravitreal ranibizumab (IVR) monotherapy.
METHODS: Totally 33 eyes of 19 patients who underwent initial IVR treatments for type 1 retinopathy of prematurity (ROP) at our center were retrospectively reviewed between April 1, 2016 and December 31, 2017. Patient demographics, the side of ROP, multiple gestations, Apgar scores, zone, stage, plus disease, postmenstrual age at injection, surfactant therapy, blood transfusion therapy, hemorrhage before IVR, hemorrhage after IVR, gestational diabetes mellitus, pregnancy-induced hypertension, anemia, intraventricular hemorrhage, sepsis, respiratory distress syndrome, carbohemia, and congenital heart defects were recorded. Adjusted hazard ratios (HRs) and 95% confidence intervals were determined after adjusting for potential confounders using multivariate proportional Cox regression.
RESULTS: Of the 33 eyes, 12 (36.4%) had ROP recurrences 45.3 (5.1, 50.9)mo after initial IVR treatments. The independent risk factors for ROP recurrences were zone (¢ò vs ¢ñ, HR: 0.056, P=0.003) and gestational diabetes mellitus (no vs yes, HR: 0.095, P<0.001). The mean uncorrected visual acuity for four recurrence eyes was 0.46 logMAR (0.13, 0.70) at 55.0 (51.0, 58.9) mo after the initial IVR treatment. The mean uncorrected visual acuity for 10 eyes without recurrence was 0.46 logMAR (0.19, 0.63) at 48.0 (43.8, 58.4) mo after the initial IVR treatment.
CONCLUSION: Two independent risk factors for type 1 ROP recurrence after IVR treatment involving zone¢ñand gestational diabetes mellitus are identified, and the mean uncorrected visual acuity is 0.46 logMAR at 51.0 (44.0, 58.9)mo. The findings of this study are important for follow-up management and for improving the visual function of ROP patients.
IFMUSIC EM TEMPOS DE PANDEMIA: VIVÊNCIAS, EXPERIÊNCIAS E TRAJETÓRIAS EM NARRATIVAS DA MÚSICA NO BREJO PARAIBANO
Authors: Viana José Augusto Lopes , Ferreira Líbna Naftali Lucena , De Lima Pedro Gustavo Santos
Published: December 2022

A música tem se mostrado um importante elemento estimulador da qualidade de vida das pessoas, gerando bem-estar e equilíbrio emocional. Com esse propósito, o presente projeto teve como objetivo a realização de transmissões on-line, denominadas lives, mediadas pelo grupo musical IFMusic, do IFPB/Campus Guarabira. As lives foram desenvolvidas com a participação de produtores, mestres e autodidatas da música na região do brejo paraibano, indicados e convidados por parceiros sociais e componentes do IFMusic que residem na região. Os convidados fizeram apresentações e falaram de suas vivências, experiências e trajetórias com a música. Para a realização das transmissões on-line foi criado um canal na plataforma YouTube e a sua divulgação ocorreu nas plataformas digitais do grupo musical e parceiros sociais. Dessa forma, entende-se que as ações do projeto contribuíram para amenizar os impactos negativos do isolamento social em tempos de pandemia, além de funcionar como um espaço democrático para entusiastas da música servindo de inspiração para aqueles que assistiram às lives, fortalecendo os laços do IFPB com parceiros sociais e comunidade em geral. Ao todo foram realizadas três lives com a participação de 10 entrevistados e as lives contam, até o momento, com cerca de 1300 visualizações.
O CINEMA VAI À SALA DE AULA E À SALA DE CASA: POSSÍVEIS DIÁLOGOS ENTRE EDUCAÇÃO, CINEMA E INFÂNCIA
Authors: Silveira Luana De Gusmão , Spessatto Marizete Bortolanza
Published: December 2022

Este trabalho apresenta o relato de uma experiência que visa estreitar os laços entre cinema e educação, especialmente com as crianças da Educação Infantil e dos Anos Iniciais do Ensino Fundamental. As atividades estão vinculadas a um projeto de extensão desenvolvido desde 2015 pelo Instituto Federal de Educação, Ciência e Tecnologia de Santa Catarina-IFSC, em parceria com escolas de redes municipais de Educação catarinenses. O caso específico aqui relatado trata de ações implementadas em 2021, em meio à pandemia da Covid-19 e que levaram o projeto da sala de aula para as salas das casas de mais de 400 famílias de estudantes de Garopaba, no litoral sul catarinense. Os resultados aqui descritos revelam que, por meio de produções cinematográficas que fogem do circuito comercial, é possível instigar a imaginação infantil e contribuir com o processo formativo das crianças.
REPÓRTER LITERÁRIO: DISSEMINAÇÃO DE OBRAS LITERÁRIAS A PARTIR DO PODCAST “ODS LITERÁRIO”
Authors: Rodrigues Golbery De Oliveira Chagas Aguiar , Menezes Antônio Simões , Mendes Iasmin Araújo Bandeira , Barbosa Cinthya Ariadna Ferreira , Dotta Luiza , Da Silva Letícia Ferreira , Moreira Elaine Cristina Silva , Andrade Neto José Gomes de , Da silva Wanderlécio Rodrigues
Published: December 2022

O ato de ler traz consequências produtivas para o sujeito leitor a curto e a longo prazo, seja através da leitura de textos denotativos ou conotativos. No âmbito destes últimos, é fato que, no mínimo, uma dupla dimensão é promovida para os leitores de quaisquer idades: (i) a de ampliar o gosto pela leitura e a de (ii) provocar/despertar engajamento sociocultural, tendo em vista que, conforme Candido (2014), as ideias literárias também são contribuintes para a formação cidadã. Nesta perspectiva, três forças que atuam com mídia e comunicação se uniram para favorecer esse processo literário e promover o protagonismo juvenil através da comunicação para público de bairros periféricos do IFPB, campus Campina Grande: IFNEWS – imprensa colegial (IFPB), Feira Literária de Campina Grande (FLIC) (parceiro social) e Anti-horário (UEPB) (parceiro social). O objetivo foi levar literatura infanto-juvenil que tenha como tema alguns dos Objetivos de Desenvolvimento Sustentável (ODS), propostos pela Organização das Nações Unidas, para o público beneficiário do projeto, quais sejam, alunos da rede pública de ensino, vulneráveis socioeconomicamente. Com base nos conceitos de Educomunicação (SOARES, 2000), foi proposta a facilitação de oficinas no âmbito da comunicação para o público beneficiário, para capacitá-los na produção de podcasts sobre literatura e ODS. Em âmbito metodológico, a execução foi planejada nas seguintes etapas: (i) seleção bibliográfica, com apoio do Programa Nacional do Livro Didático - PNLD literário; (ii) Leitura coletiva da equipe e preparação de oficinas e (iii) facilitação de oficinas organizadas pelos alunos do IFNEWS e Anti-horário para o público beneficiário; (iv) produção de roteiros para podcasts; (v) gravação de podcasts e (vi) edição e divulgação dos podcats produzidos. Do ponto de vista teórico, as discussões ampararam-se em CANDIDO (2014), SOARES (2000), CHAUÍ (1984) e ORTIZ (1994). Do ponto de vista dos resultados, atestamos autonomia de fala, através do uso responsável e qualificado de mídias comunicativas, além do interesse por livros de gêneros literários.