bluuebunny/crossref_metadata_2025 huggingface dataset:
Battery Arrangement Analysis for Electric Vehicle using Air Cooling
Authors: Mohd Farid Muhammad Faiq Irfan , Jerai Fauziah , Yahaya Nor Afifah , Amir Amalina , Ab Ghani Amir Radzi , Alenezi Hussain A.
Published: December 2024

Effective thermal management is paramount for sustaining the optimal operational temperature of batteries in Electrical Vehicles (EV), thereby enhancing their longevity and ensuring both safety and performance. Air cooling, while being lightweight and economically feasible, frequently encounters difficulties in achieving adequate cooling efficacy, particularly under conditions of elevated load. Consequently, the optimization of battery pack design alongside air cooling configurations becomes imperative to tackle these challenges, thereby ensuring reliability, safety, and efficiency in electric vehicle applications. The objective of this research is to employ Computational Fluid Dynamics (CFD) analysis to ascertain the optimal arrangement of batteries for the enhancement of thermal performance and to pinpoint the ideal inlet location necessary to attain maximum thermal efficacy. The analysis evaluates square, staggered, and other innovative configurations to determine arrangements that optimize cooling efficiency and mitigate hotspots. The findings indicate that the battery configuration with a Staggered Arrangement produced the most favourable battery performance while maintaining uniformity in the temperature differential among cells within the arrangement. It is anticipated that the results of this investigation will facilitate the optimization of the battery thermal management system in electric vehicles, consequently enhancing battery lifespan and performance.
The Role of Digital Culture in Mediating Transformational Leadership on Employee Performance
Authors: Rivan Sumara Andry , Sobandi A. , Sojanah Janah
Published: December 2024

Leadership is one of the factors that influence the business process of an organization. The current era of digitalization is developing rapidly and the leadership factor is still a vital part of changing and improving digital business processes, one of which is in the government sector. This study will examine digital culture in mediating between transformational leadership and employee performance. The study was conducted using quantitative methods. The location of the study was in the work unit of the Human Resources Development Agency of the Ministry of Communication and Informatics. The results of the study indicate that transformational leadership has a strong influence on digital culture and digital culture strongly mediates between transformational leadership and employee performance, but transformational leadership has a weak influence on employee performance.
Penerapan Kepentingan Luar Negeri Indonesia Melalui Mekanisme ASEAN Outlook on The Indo-Pacific dengan Filipina
Authors: Monique Tuhumury Scheline , Novriest Umbu Walangara Nau  , Triesanto Romulo Simanjuntak
Published: December 2024

Konflik kemaritiman antara Indonesia dan Filipina terkait praktik illegal fishing dan tantangan keamanan lainnya di kawasan perairan Asia Tenggara, khususnya setelah diperkenalkannya ASEAN Outlook on The Indo-Pacific (AOIP). Studi ini menyoroti bagaimana teori liberalisme dan konsep kepentingan nasional berperan dalam analisis strategi yang diambil kedua negara untuk menangani masalah ini melalui kerja sama multilateral. Pendekatan liberalisme diterapkan melalui kerangka kerja AOIP, yang mendorong dialog, diplomasi, serta penguatan keamanan maritim yang inklusif. Hasil penelitian menunjukkan bahwa kerja sama melalui AOIP dan peningkatan patroli bersama dapat memperkuat keamanan dan stabilitas kawasan. Implementasi AOIP juga menunjukkan komitmen kedua negara dalam memelihara hubungan damai dan stabilitas regional, meskipun tantangan tetap ada dalam upaya pengawasan yang efektif dan terbatasnya sumber daya. Melalui pendekatan ini, penelitian ini memberikan wawasan tentang pentingnya kerja sama multilateral dan diplomasi dalam menangani konflik kemaritiman di kawasan Indo-Pasifik.
Equation of State Independent Determination on the Radius of a 1.4 M⊙ Neutron Star Using Mass–Radius Measurements
Authors: Huang Chun
Published: December 2024

Traditional methods for determining the radius of a 1.4 M
⊙ neutron star (R
1.4) rely on specific equation-of-state (EOS) models that describe various types of dense nuclear matter. This dependence on EOS models can introduce substantial systematic uncertainties, which may exceed the measurement uncertainties when constraining R
1.4. In this study, we explore a novel approach to constraining R
1.4 using data from Neutron Star Interior Composition Explorer observations of PSR J0030+0451 (J0030) and PSR J0437-4715 (J0437). However, this work presents a more data-driven analysis framework, substantially decreasing the need for EOS assumptions. By analyzing the mass–radius measurements of these two neutron stars, we infer R
1.4 using statistical methods based mostly on observational data. We examine various hotspot configurations for J0030, along with new J0437 observations, and their effects on the inferred radius. Our results are consistent with X-ray timing, gravitational-wave, and nuclear physics constraints, while avoiding EOS-related biases. The same method has also been applied to a simulated mass–radius data set, based on our knowledge of future X-ray telescopes, demonstrating the model's ability to recover the injected R
1.4 value in certain cases. This method provides a data-driven pathway for extracting neutron star properties and offers a new approach for future observational efforts in neutron star astrophysics.
A survey of Hersilia spiders (Araneae, Hersiliidae) from Xishuangbanna, Yunnan Province, China
Authors: Yu Hao , Zhang Chengwen , Lu Qianle , Lin Yejie
Published: December 2024

Hersilia Audouin, 1826 is the largest genus of the Hersiliidae Thorell, 1869, currently including 80 extant species that are widespread throughout most of forests of the Tropical realm. The tropical rainforest in Xishuangbanna is one of the most biodiversity-rich regions in China. However, Hersilia can be regarded as being poorly represented in Xishuangbanna, with only two recorded species so far.

A survey was undertaken to study the hersiliids in Xishuangbanna. A total of four species are here addressed, raising from two to four the number of species of the genus Hersilia known to the area: H. striata Wang & Yin, 1985 and H. lelabah Rheims & Brescovit, 2004 that were recorded previously and H. asiatica Song & Zheng, 1982 (as well as the new record from Yunnan) and H. sumatrana (Thorell, 1890) that are recorded for the first time. Hersilia lelabah is re-described, based on new materials and the male is described and illustrated for the first time. Detailed morphological descriptions and illustrations for both sexes of H. lelabah are provided. The distribution map of these four species in Xishuangbanna is given.
The MIEM guidelines: Minimum information for reporting of environmental metabarcoding data
Authors: Klymus Katy E. , Baker Jacoby D. , Abbott Cathryn L. , Brown Rachel J. , Craine Joseph M. , Gold Zachary , Hunter Margaret E. , Johnson Mark D. , Jones Devin N. , Jungbluth Michelle J. , Jungbluth Sean P. , Lor Yer , Maloy Aaron P. , Merkes Christopher M. , Noble Rachel , Patin Nastassia V. , Sepulveda Adam J. , Spear Stephen F. , Steele Joshua A. , Takahashi Miwa , Watts Alison W. , Theroux Susanna
Published: December 2024

Environmental DNA (eDNA) and RNA (eRNA) metabarcoding has become a popular tool for assessing biodiversity from environmental samples, but inconsistent documentation of methods, data and metadata makes results difficult to reproduce and synthesise. A working group of scientists have collaborated to produce a set of minimum reporting guidelines for the constituent steps of metabarcoding workflows, from the physical layout of laboratories through to data archiving. We emphasise how reporting the suite of data and metadata should adhere to findable, accessible, interoperable and reproducible (FAIR) data standards, thereby providing context for evaluating and understanding study results. An overview of the documentation considerations for each workflow step is presented and then summarised in a checklist that can accompany a published study or report. Ensuring workflows are transparent and documented is critical to reproducible research and should allow for more efficient uptake of metabarcoding data into management decision-making.
Rare or Overlooked? The Ponerine Ant, Cryptopone ochracea (Hymenoptera, Formicidae): An Updated Distribution in Romania with insights on the species swarming activity
Authors: Tăușan Ioan , Turceanu Cosmin
Published: December 2024

Cryptopone ochracea (Mayr, 1855) is a hypogeous ant species with a poorly known biology. Usually, alate or dealate queens are recorded by myrmecologists. Data on the species distribution is scarce. However, the species occurs mainly in the southern part of Europe. In Romania, the species was previously known from only two locations. Herein, we report new records of the species during a 6-year observation period. Insights on the species swarming activity are given.
AI-Powered Innovations Transforming Adaptive Education for Disability Support
Authors: Ramaiah Munikrishnaiah Sundara , Nagarajan Sevinthi Kali Sankar , Whig Pawan , Dutta Pushan Kumar
Published: December 2024

This chapter examines artificial intelligence's (AI) transformative impact on adaptive education for students with disabilities. This chapter explores how AI-driven technologies, including intelligent tutoring systems, speech recognition tools, and personalized learning algorithms, are reshaping educational experiences to be more inclusive and effective. By leveraging these innovations, educators can tailor content and support to meet individual learning needs, enhance accessibility, and overcome barriers to education. Drawing on case studies and practical examples, the chapter highlights the ability of AI to revolutionize traditional educational models by delivering customized, responsive support for diverse disabilities. Emphasizing the potential of AI to foster equity and inclusion, the chapter underscores its role in advancing opportunities for all learners and creating a more accessible educational landscape.
Assistive Technology and Accessibility Tools in Enhancing Adaptive Education
Authors: Oyedokun Tunde Toyese
Published: December 2024

The integration of assistive technology and accessibility tools is transforming education for students with disabilities. This chapter examines the development, significance, and future potential of these technologies within adaptive education frameworks. It analyzes tools such as wearable technology, virtual and augmented reality, artificial intelligence, and universal design, highlighting their role in fostering independent learning and personal growth. The discussion includes successful implementation strategies and case studies that demonstrate how assistive technology enhances self-advocacy and participation. Additionally, it addresses challenges, financial, logistical, and attitudinal that hinder adoption, along with proposed solutions. The chapter emphasizes the need for inclusive policies and partnerships to create a sustainable ecosystem for assistive technology deployment, ensuring equitable access to learning materials for all students as these tools evolve.
Experimental Study of the Bearing Capacity of Hybrid Fiber-Reinforced Concrete Pipes
Authors: González Federico Alejandro , Rougier Viviana Carolina
Published: December 2024

This paper presents the results of an experimental study on hybrid fiber-reinforced concrete pipes (HFRCP). The mechanical behavior of HFRCP, including load capacity, failure mode, and energy dissipation capacity, was evaluated through diametral compression tests. The results were compared with those obtained for reinforced concrete pipes (RCP) using traditional steel cage reinforcement and steel fiber-reinforced concrete pipes (SFRCP). A total of 26 pipes with a 600 mm internal diameter were tested, including 4 RCP, 14 HFRCP, and 8 SFRCP pipes. For the hybrid fiber reinforcement, macro steel fibers (SF) and macro polypropylene fibers (PPF) were used, combined at two different doses: 20-0.5 kg/m3 and 20-1.0 kg/m3 of SF and PPF, respectively. The results indicated that HFRCP achieved a load capacity equivalent to RCP and greater than SFRCP for the fiber dosages utilized. Additionally, HFRCP exhibited a ductile failure mode without concrete detachment or diametral crushing.
An Experimental Investigation on Geopolymer Bricks Using Quarry Dust as Fine Aggregate
Authors: Baby Bukke , Murali M. , Venkata Sindhuri B.
Published: December 2024

Environmental pollution in the construction industry is mostly caused by the manufacture of Portland cement, which releases pollutants like CO2. In this study, geopolymer bricks constructed with fly ash, GGBS, and quarry dust as fine aggregates have undergone experimental work. An activator used in the mixture of sodium hydroxide (NaOH) and sodium silicate (Na2SiO3) is also used. For each combination, the molarity of sodium hydroxide was kept constant at 1M, while the ratios of sodium silicate to sodium hydroxide solution varied between 0.25, 0.5, and 1. Brick samples of 230 mm by 110 mm by 70 mm are collected. Tests on the test specimens were performed on the brick qualities, including efflorescence, water absorption, and compressive strength.
Experimental Study on Properties of Concrete with Coconut Shells and Fly Ash
Authors: Dhanabal P. , Lohith C. G. , Banu D. Shakeera , Sailatha P. , Naveen G. , Naresh D.
Published: December 2024

This work's primary goal is to assess the qualities of concrete that has been hardened and fresh using fly ash and coconut shell. These days, a lot of research is being done to identify substitute building materials because cement and other elements required to make concrete are becoming scarce. In this experimental inquiry, we consistently employed 30% fly ash as cement and 10% to 30% of shell of coconut as CA. Concrete covering fly ash and coconut shell was compared to conventional concrete, both in its fresh and hardened states, without any substitutions. Upon completion of this study, it was found that a rise in the proportion of coconut shell replacement would result in a notable decrease in workability. The highest workability is achieved in concrete that has 30% FA as binding cement and 10% CS as a CA. Additionally, it was shown that concrete containing 30% FA and 10% shell of coconut as coarser aggregate had the highest compressive potency and tensile parameter strength.
Preparation and Properties of Iron Tailings-Fly Ash Based Geopolymers
Authors: Wang Hai Tao , Yang Yi , Zhang Yu , Xin Yue , Zhou Ying
Published: December 2024

Iron tailings are the main component of industrial solid waste. The long-term storage and landfill of iron tailings have caused great pressure on the environment. In this paper, Anshan type high-silicon iron tailings and fly ash were used as the main raw materials to prepare geopolymer. The activity of raw materials was determined by XRD, and geopolymer was prepared by high temperature water culture. The effect of iron tailings content, liquid-solid ratio and curing temperature on geopolymer mechanics was studied. The optimal ratio was determined by regression equation analysis with compressive strength as index. The reaction process of geopolymer was studied through microscopic analysis (XRD, SEM, FTIR), and the changes before and after the reaction of geopolymer were compared to prove the reaction degree of geopolymer, and representative specimens were selected to verify the strength changes under different ratios. The durability of the prepared polymers was tested, and the relevant parameters were determined. The gelling material with good freezing resistance and chemical corrosion resistance was successfully prepared, and the industrial waste was transformed into treasure.
Spatial inequities: Child-friendly spaces and ethnic sensitivity in Balukhali Rohingya 1 Refugee Camp, Cox’s Bazar, Bangladesh
Authors: Hossain S. M. A. , Podder A. K.
Published: December 2024

Child-Friendly Spaces (CFS) are crucial architectural interventions designed to provide psychosocial support to children during refugee crises. The unprecedented influx of refugees globally in recent decades has underscored the urgent need to address children's vulnerability to psychosocial issues. Despite the widespread use of prototypical CFS models by various NGOs and humanitarian organizations to address the crises, there is a significant gap in the spatial analysis of these responses under precarious refugee camp conditions. This study focuses on CFS in the Balukhali Rohingya refugee camp in Bangladesh, the world's largest refugee camp. Children here face crises such as abuse, life-threatening situations, gender violence, and child trafficking, mirroring their experiences in Myanmar. Utilizing the Octonary Framework, a comprehensive tool for evaluating architectural spaces, this research conducts a qualitative spatial analysis of CFS. The findings reveal that CFS primarily emphasize a superficial cosmetic ‘representation of childhood’, neglecting the need for ethnically sensitive spatial cultures that can address the specific needs of the displaced community. This oversight results in spaces that fail to provide the therapeutic and healing environment necessary. The research findings contribute to developing sustainable CFS practices, aiming to create a more spatially just environment for vulnerable children in future refugee crises.
Limitations of traditional building materials for sustainable construction in Sri Lanka
Authors: Wickramanayake N. D. , Jayalath J. A. C. D. , Kulatunga U. , Siriwardhana S. D.
Published: December 2024

The global construction industry has long been a significant driver of economic growth and a major force behind environmental degradation, given its heavy resource and energy consumption. This study reveals the drawbacks of conventional building materials through an analysis of their limitations in terms of environmental, economic, and social impacts. The review of literature and expert interviews highlighted that traditional materials have high embodied energy, high greenhouse gas emissions, depletion of resources, and inefficiencies that result in costs and time overruns. The study emphasizes the urgent need for the construction industry to adopt sustainable practices, such as reducing waste, recycling, and reusing materials, to mitigate aforementioned impacts. Furthermore, the importance of selecting environmentally friendly materials that meet both user needs and societal development goals is emphasized as a critical factor in achieving sustainability. The findings suggest that overcoming the challenges posed by traditional materials requires a comprehensive approach that includes identifying barriers to sustainability within the Sri Lankan context and implementing targeted strategies. This research serves as a pilot study, laying the groundwork for future exploration into sustainable construction practices with a focus on material application in Sri Lanka’s construction industry.
The impact of reproductive health knowledge, reproductive health-promoting behavior, and sexual communication on intention to visit obstetrics and gynecology in unmarried women: a cross-sectional study
Authors: Kang Da-In , Park Euna
Published: December 2024

Purpose: Women are experiencing reproductive health abnormalities at younger ages, and the incidence of cervical cancer in women in their 20s and 30s is increasing. Various factors hinder visits to obstetrics and gynecology. The current study aimed to explore how health knowledge, reproductive health-promoting behavior, and sexual communication influenced the degree of intention to visit obstetrics and gynecology in unmarried women.Methods: The participants included 170 Korean unmarried women in their 20s and 30s. The data were collected via an online survey from December 11 to 22, 2023. Data analysis was conducted using descriptive statistics, the t-test, one-factor analysis of variance, Pearson correlation coefficients, and hierarchical multiple regression. Results: On average, participants were 24.64±0.31 years of age. The intention to visit obstetrics and gynecology was high (11.46±3.51). Visiting obstetrics and gynecology was positively correlated with knowledge of reproductive health (r=.26, p=.001), reproductive health-promoting behavior (r=.43, p<.001), and sexual communication (r=.37, p<.001), all with statistical significance. Experience of visiting obstetrics and gynecology (β=0.40, p<.001), reproductive health-promoting behavior (β=.25, p<.001), sexual experience (β=0.22, p<.001), sexual communication (β=0.20, p=.001), and reproductive health knowledge (β=0.12, p=.033) explained 54.2% of variance in intention to visit obstetrics and gynecology in unmarried women.Conclusion: The findings of this study can be used to develop programs for unmarried women to improve reproductive health-promoting behavior, sexual communication, and reproductive health knowledge, and increase the intention to visit obstetrics and gynecology.
Factors associated with future fertility intentions among Korean women of childbearing age in Seoul: a cross-sectional study
Authors: Nguyen Thi Thanh Lan , Nguyen Van Cuong
Published: December 2024

Purpose: South Korea currently has the lowest fertility rate among Organization for Economic Co-operation and Development countries, with a total fertility rate of less than one child per woman. This study explored the factors influencing future fertility intentions (FFI) among Korean women of childbearing age.Methods: Using a cross-sectional design, we analyzed data from the 2022 Survey on Low Birth Policy Demand in Seoul, conducted by the Seoul Women and Family Foundation. This study focused on women of childbearing age. Bivariate analyses and a multivariate logistic regression model were employed to investigate the FFI rate and its associated factors. Results: The observed overall FFI rate among Korean women of childbearing age was 25.6%, with rates of 27.9% among unmarried women, and 22.0% among married women. Factors associated with FFI included education level, employment status, weekly working hours, number of children, age at first sexual education, monthly income, and perspectives on marriage, childbearing, and gender inequality. High FFI rates were noted among self-employed individuals (33.3%); those who received sexual education in adulthood (48.6%), those who believed in having children after marriage (44.0%), those who thought children strengthen relationships (32.5%), and those who perceived gender equality in family or workplace culture (31.7%).Conclusion: This study assessed the FFI rate among Korean women of childbearing age, identifying the sociodemographic characteristics and perspectives on marriage, childbearing, and gender inequality that influence it. The findings provide valuable insights for policymakers and nurses to engage with women and increase birth rates in Seoul and throughout South Korea.
The muscle hypothesis of shortness of breath in patients with cachexia
Authors: Anker Stefan D. , Shahzeb Khan Muhammed , Arshad Khan Laibah , Rosano Giuseppe M.C. , Volterrani Maurizio , Lainscak Mitja , Ponikowski Piotr , Coats Andrew J.S.
Published: December 2024

Cachexia is a major contributor to dyspnea (shortness of breath), particularly in conditions like heart failure and chronic obstructive pulmonary disease (COPD) with a prevalence of up to 100%, but also develops frequently in patients with chronic kidney disease (circa 60%) as well as in advanced cancer with an estimated prevalence of about 50% in patients in palliative care settings. In all conditions muscle wasting impacts respiratory function and exercise capacity. The muscle hypothesis of the development of shortness of breath in cachexia presented here provides a pathophysiological framework for understanding muscle wasting induced dyspnea. Persistent systemic inflammation, elevated cytokines such as tumor necrosis factor-alpha and interleukin-6, and hormonal imbalances like insulin resistance drive a catabolic state, resulting in skeletal muscle myopathy and respiratory muscle fatigue.  This contributes to hyperactivation of the metabo-ergoreflex, a cardiorespiratory reflex involving mechanoreceptors and metaboreceptors.  The hyperactive reflex increases ventilatory drive, exacerbating dyspnea, and triggers sympathetic excitation, leading to vasoconstriction and reduced peripheral blood flow.  These mechanisms create a feedback loop of worsening myopathy, reduced exercise tolerance, and heightened breathlessness. In specific diseases, cachexia-related muscle wasting amplifies dyspnea through disease-specific mechanisms.  In advanced cancer, dyspnea affects up to 80% of patients and is often caused by respiratory muscle fatigue, independent of cardiopulmonary pathology in 24% of cases.  In heart failure, muscle wasting worsens dyspnea beyond reduced cardiac output and pulmonary congestion, with mortality increasing by 50% within 18 months in cardiac cachexia. COPD cachexia impairs respiratory muscles, independently predicting mortality beyond airflow obstruction. Current management of cachexia includes nutritional support, physical activity, pharmacological agents, and experimental therapies targeting inflammation, cytokines, and anabolic pathways.  Despite these efforts, cachexia remains largely irreversible.  Future directions include precision diagnostics leveraging artificial intelligence and interdisciplinary therapeutic strategies aimed at mitigating its devastating impacts on morbidity, mortality, and quality of life.
Advanced cancer as a heart failure like syndrome due to cardiac wasting cardiomyopathy: facts and numbers
Authors: Shahzeb Khan Muhammad , Butler Javed , Arshad Khan Laibah , Anker Markus S.
Published: December 2024

Cancer remains a leading cause of global morbidity and mortality, with nearly 20 million new cases and 9.7 million deaths reported in 2022. Cardiovascular disease is one of the most common causes of death in cancer patients, accounting for over 40% of fatalities. While the field of cardio-oncology has greatly focused on mitigating cardiotoxicity from cancer therapies, mounting evidence suggests that cancer itself induces significant cardiovascular dysfunction. Treatment-naïve cancer patients often have impaired left ventricular ejection fraction, reduced exercise capacity, lean mass loss, and altered heart rate variability. Patients with advanced cancer, who often face symptoms resembling heart failure, including dyspnea, exercise intolerance, and muscle wasting, also exhibit structural and functional cardiac alterations. Cachexia, prevalent in 50–80% of advanced cancer cases, contributes to cardiac wasting characterized by ventricular thinning, fibrosis, and loss of myocardial mass. Studies reveal significant reductions in left ventricular mass, left and right atrial volumes, and myocardial wall thickness in cancer patients, with these structural abnormalities linked to declines in physical performance and quality of life. Echocardiographic analysis revealed a significant reduction in left ventricular (LV) mass by 25% and 28% in cancer patients with and without cachexia, respectively.  During on average 4 months of follow-up, 90 patients with cancer lost on average 9.3% of LV mass, and 44% of these patients lost >10% of LV mass. Loss of LV mass >10% may be a new way to define cardio-toxicity and presence of cardiac wasting cardiomyopathy.  Wasting of the heart was independently associated with poor prognosis, but only when raw data or adjustments for height were used, but not when body surface area adjustment was applied. Body surface area contains body weight and is hence not useful in a setting of whole body cachexia. Proposed mechanisms for cardiac wasting in cancer include cancer-induced pro-thrombotic states, oxidative stress, local hypoxia, disordered neovascularization, and direct myocardial injury from oncometabolites. Preclinical studies highlight the potential of heart failure therapies, such as beta-blockers (e.g., bisoprolol) and mineralocorticoid receptor antagonists (e.g., spironolactone), in mitigating cardiac wasting and improving survival in cancer. These drugs reduce ventricular mass loss, attenuate cardiac dysfunction, and enhance survival outcomes. Given the strong parallels between advanced cancer and heart failure syndromes, clinical trials are urgently needed to explore the benefits of heart failure therapies in cancer patients. Such interventions may offer both clinically meaningful symptomatic relief and quality of life benefits, reshaping the approach to cardio-oncology care.
Comparison of the Effect of Adding Dexmedetomidine as an Adjuvant to Bupivacaine for Postoperative Pain Management in Patients Undergoing Shoulder Rotator Cuff Repair – A Randomized Clinical Trial
Authors: Sane Shahryar , Mahoori Alireza , Tabrizi Ali , Koohsoltani Hamed
Published: December 2024

Background:

Shoulder rotator cuff repair postoperative pain management is more critical than orthopedic surgeries in other limbs. This study aimed to investigate the effect of adding dexmedetomidine as an adjuvant to bupivacaine for postoperative pain management.

Materials and Methods:

This double-blind, randomized clinical trial was performed on 80 patients aged 20 to 60 with ASA I and II who were candidates for elective shoulder rotator cuff repair. Forty candidates in the control group received 0.1% bupivacaine intra-articular and extra-articular before surgical wound closure, and 40 patients in the intervention group received 0.1% bupivacaine and dexmedetomidine 1 µg/kg intra-articular and extra-articular. Postoperative sleep disturbance and pain intensity were measured at recovery, 4, 8, 12, 18, and 24 hours after surgery. The results were analyzed by SPSS software version 23, and a P value ≤0.05 was considered significant.

Results:

There were no significant differences between the two groups regarding the hemodynamic variations (P > 0.05), except 4 hours after surgery when the mean arterial pressure in the intervention group was significantly lower than the control group (P = 0.026). There was a significant reduction in pain scores at 8 and 12 hours after surgery in the intervention group. The night after surgery, sleep quality and the overall RCSQ score in the intervention group were significantly higher than those in the control group.

Conclusion:

Administering 0.1% bupivacaine and dexmedetomidine 1 µg/kg intra-articular and extra-articular before surgical wound closure effectively reduced the pain intensity and analgesic consumption. Also, it maintained patients’ hemodynamic stability and enhanced sleep quality without significant adverse effects.
Multiple Myeloma-Associated Kidney Disease Complicated by Sudden Death in a 68-Year-Old Man
Authors: Ogala-Akogwu Victoria L. , Uduagbamen Peter K. , Galadanci Habib , Anteyi Emmanuel A.
Published: December 2024

Abstract

Kidney disease can complicate multiple myeloma, and this carries a poor prognosis. The multidisciplinary management involves the use of some cardiotoxic drugs which could be fatal. We present the management of a 68-year-old man with chronic back pain, recurrent vomiting, numbness, and tingling sensation for 4 weeks. He had proteinuria, anemia, hypercalcemia, hyperuricemia, serum and urinary paraproteins, lytic bone lesions, and bone marrow plasmacytosis. He was managed for multiple myeloma-associated kidney disease with rehydration, lenalidomide, dexamethasone, antibiotics, and hemodialysis. He became stable and continued treatment till he died suddenly in his sleep. A detailed cardiovascular assessment and drugs pharmacodynamics is essential to prevent sudden death.
The Effect of Povidone Iodine Combined with Sodium Bicarbonate against Staphylococcus aureus and Escherichia coli, the Antagonism and Synergism
Authors: Hamid Baqer Hazim , Saadoun Safa Abbas , Al-Khikani Falah Hasan Obayes
Published: December 2024

Abstract

Background:

Povidone iodine (PVP-I) has a broader spectrum of antimicrobial activity against Gram-negative and Gram-positive bacteria. Also, sodium bicarbonate (SBC) was used as antibacterial agent due to its ability to alter the pH of the bacterial environment that lead to cell death. So evaluation of the antibacterial activity of PVP-I and SBC combination as a modified disinfectant may be useful by detecting the possible synergism or antagonism.

Material and Methods:

A total of 30 samples (15 isolates of Staphylococcus aureus and 15 isolates of Escherichia coli) were investigated in this study. For preparation of 5% SBC, 5 gm of SBCs powder was dissolved in 100 mL of 7.5% PVP-I solution. The solution was mixed well and used directly on bacteria. Antibacterial activities of PVP-I alone and combination of PVP-I and SBC against bacteria were evaluated using the well diffusion method on Mueller–Hinton agar.

Results:

The study showed that from a total of 30 bacterial isolates, 24 (80%) were sensitive to PVP-I alone, whereas 17 (56.6%) were sensitive to PVP-I and 5% SBC combination. From a total of 15 isolated S. aureus samples, 10 (67%) were sensitive to PVP-I alone, while the sensitivity decreased to 4 (27%) when combined with PVP-I and SBC. From a total of 15 isolated E. coli, 14 (93%) were sensitive to PVP-I alone, while sensitivity reduced to 13 (87%) with the PVP-I and SBC combination. The mean comparison of the inhibition zone of PVP-I for E. coli was 20.47 ± 3.92 mm higher than that of the inhibition zone of S. aureus (13.47 ± 3.09 mm) with statistically significant differences (P < 0.001).

Conclusion:

We have found that E. coli is more sensitive to PVP-I than S. aureus. SBC inhibits the effect of PVP-I. This antagonism may be due to the neutralizing of the pH of these agents that play an important role in antimicrobial activity.
Growth patterns and characteristics of cardiac pediatric patients attending Assiut University Children’s Hospital and Sidi Galal Health Insurance Clinic
Authors: Ali Safaa A.M. , Mahran Dalia G. , Raafat Duaa M. , ElGyar Noha
Published: December 2024

Background and objectives

Congenital heart disease (CHD) is the most common congenital anomaly, and it is one of the most debilitating diseases that affect physical growth disorders in children.

Aim

This study aims to assess growth patterns and identify probable risk factors in children with CHD.

Patients and methods

A case series study included 150 pediatric patients with CHD. The study comprised patients who visited Assiut University Children’s Hospital from July 2023 to February 2024. A personal interview questionnaire was used, which included sociodemographic characteristics, obstetric and neonatal history, feeding history, type of CHD, and anthropometric measurements.

Results

The noncyanotic group exhibited low weight for height/length and low height/length for age (P=0.028 and 0.003), whereas the cyanotic group only showed low weight for height/length (P=0.007). For the noncyanotic group, higher maternal age (P=0.023), multiparity (P=0.026), and delayed diagnosis of cardiac disease (P=0.005) could be risk factors for malnutrition, while vaginal delivery (P=0.034) and delayed physical development (P=0.034) could be risk factors for malnutrition in the cyanotic group.

Conclusion

Patients with noncyanotic cardiac lesions could suffer from acute or chronic malnutrition, while cyanotic lesions could suffer mainly from chronic malnutrition.
Assessment of proteinuria by urine dipstick as a predictive marker for dengue hemorrhagic fever in pediatric patients
Authors: Jarutunyaluk Pornchanun , Pradermdussadeeporn Ekachai , Chaya Weerapong , Tangnararatchakit Kanchana , Chuansumrit Ampaiwan , Apiwattanakul Nopporn
Published: December 2024

Objective:

To investigate whether urinary dipstick proteinuria or urine protein creatinine ratio (UPCR) could predict leakage in children with dengue virus infection.

Methods:

This was a prospective cross-sectional study. A total of 141 hospitalized patients with confirmed dengue virus infection were enrolled from three hospitals in Thailand. Once daily, complete blood count, serum albumin, and random morning urine dipstick protein were collected from the day of admission to the day after defervescence. Morning UPCR was only measured in patients from one hospital due to logistic reasons.

Results:

There were 81 and 60 patients in the dengue fever (DF) and DHF groups, respectively. The proportion of patients with proteinuria detected using urine dipstick in the DHF group was higher than that in the DF group from Day-1 (one day before defervescence) to Day +1 (one day after defervescence). Urine dipstick for proteinuria of ≥1+ had sensitivity and specificity of 12.8% and 94.4% on Day-1, and 18.9% and 98.6% on Day 0 (the day of defervescence) to differentiate DHF from DF. For UPCR, cut-off values of approximately 0.2 g/g from Day-2 to Day+1 yielded a sensitivity of 71.6%-94.4% and a specificity of 55.6%-100% in differentiating between DF and DHF.

Conclusions:

Dipstick proteinuria of ≥1+ on Day-1 to Day+1 after defervescence had poor sensitivity but good specificity in differentiating DHF from DF. UPCR performed better but was less convenient and more expensive than urine dipsticks.
Anti-DENV-ED3 antibody cross-talks generate immune interference among the four DENVs
Authors: Islam Md. Din , Yesmin Sanjida , Sharmin Tahmina , Khan Md. Ayoub , Kuroda Yutaka , Islam M. Monirul
Published: December 2024

Objective:

To evaluate the effects of primary anti-dengue virus envelop protein domain 3 (DENV-ED3) antibodies on secondary heterotypic anti-DENV ED3 antibody responses and the status of anti-DENV antibody responses against multivalent DENV ED3s in mice.

Methods:

Four different DENV-ED3s were purified and their biophysical characteristics were confirmed. Swiss albino mice aged 3-4 weeks were immunized with four different DENV-ED3s and the anti-ED3 IgG responses were determined by ELISA.

Results:

Firstly, the primary 1ED3-2ED3-3ED3 cross-reactive anti-DENV1 ED3 response boosted the secondary anti-2ED3 and anti-3ED3 antibody responses. In contrast, primary anti-2ED3 and anti-3ED3 antibodies neither had cross-recognition of 1ED3, nor had any effect on secondary anti-1ED3 response. Besides, the strict serospecificity of the anti-4ED3 sera did not affect other secondary anti-DENV ED3 responses. Secondly, 1ED3, 2ED3, and 3ED3 were co-dominantly immunogenic in trivalent ED3 formulations. However, the poorly immunogenic 4ED3 became almost non-immunogenic when injected after or together with 2ED3 and 3ED3, but showed slightly increased immunogenicity when injected with 1ED3, suggesting an adjuvanticity of 1ED3 on 4ED3’s immunogenicity.

Conclusions:

Although DENV1~4 ED3s share similar sequence homologies and structures, their immune induction potentials differ significantly in terms of immune magnitude, sero-specificity, and sero-cross-reactivity. Such intrinsic features of DENV1~4 ED3s may lead to ‘antigen interference’, limiting both the understanding of dengue etiology and the success of dengue vaccine development, which needs to neutralize all four DENV serotypes equivalently.
Assessment of interleukin-35 expression in adult Egyptian immune thrombocytopenic purpura patients
Authors: Abdou Dina M. , Saber Heba M. , Moussa Mohamed M. , Mostafa Nevine N. , Nabeeh Nermeen A. , El Razzaz Mostafa K.
Published: December 2024

Background

Immune thrombocytopenic purpura (ITP) is an autoimmune disease, in Egypt, it is one of the common disorders, this disease causes a considerable drop in the platelets rendering the patient at a very high risk of bleeding. For this, ongoing research to determine an accurate diagnostic tool that would help in rapid diagnosis and also the remote prognosis of the disease is continuous.

Interleukin 35 (IL-35) is one of the interleukin family that now has been highlighted as a useful prognostic marker in many autoimmune diseases e.g.: SLE (1). In light of its significance that was detected in other autoimmune disease. This study was to specify this interleukin in the context of the diagnosis of ITP.

Patients and method

This pilot observational study was carried out on 60 patients and 20 normal controls. The patient group was categorized into newly diagnosed, relapsed, and resistant groups. IL-35 was measured in serum by enzyme-linked immunosorbent assay.

Results

This study demonstrated significantly lower plasma IL-35 levels in patients diagnosed with ITP than in healthy controls. Moreover, serum IL-35 levels and circulating platelets were positively correlated. Moreover, it was noted that a decrease in IL-35 contributes to the pathogenesis of ITP and an association of statistical significance between disease outcomes and IL-35 levels (P=0.033). Specifically, patients with elevated IL-35 levels exhibited higher remission rates (28.8%) than patients experiencing only partial remission or resistance to treatment.

Conclusion

IL-35 may play a role in predicting or potentially influencing disease prognosis as suggested by these results.
Anatomical, Physiological, and Technical Considerations of the Trapezius–rhomboid Plane Block
Authors: Gálvez Leonardo Arce , Mora Jesús Daes , Abuchaibe David Hernández , Pulgarín José Luis Cuervo , Marcelo Christian Vladimir Guauque , Gómez Rafael Enrico Valencia
Published: December 2024

Introduction:

Myofascial pain syndrome (MPS) is a common cause of pain. The trapezius and rhomboid muscles in the dorsal region are a frequent location because of their anatomical location and mechanical loading. An interfacial block technique has been described that intervenes this syndrome in this specific location.

Materials and Methods:

A trapezius–rhomboid plane block (TRB) was performed in six patients diagnosed with dorsal MPS. The procedure was performed with ultrasonographic guidance, using 10 mL of 0.25% bupivacaine and 40 mg of methylprednisolone. An additional 2 mL of contrast was applied for fluoroscopic confirmation of the interfacial distribution.

Results:

A pain improvement of up to 80% was achieved in a follow-up performed up to week 10. No complications occurred, and we were able to illustrate the interfacial distribution in this plane, in addition to being able to theorize its mechanism of action in the blockade of the ventral cutaneous sensory branches, the terminal branches of the accessory nerve, and the dorsal nerve of the scapula.

Conclusions:

Our study develops an anatomical analysis of a recently described procedure and demonstrates a wide interfacial distribution with favorable clinical outcomes without complications, making it an interesting therapeutic tool in the management of dorsal MPS.
Beyond Borders: Understanding the Role of Drones in Healthcare Services in India and Abroad
Authors: Sharma Ankita , Rani Bhavna
Published: December 2024

Drones can gather real-time data cost-effectively and deliver payloads, and they have initiated the rapid evolution of many healthcare sectors. Drones are used to surveillance disaster sites and areas with biological hazards and in epidemiology for research and tracking disease spread. This technology is efficiently employed for rapid blood and blood product delivery for better maternal care. Telecommunication drones are used for diagnosis and treatment, perioperative evaluation and telementoring in remote areas. Drones have the potential to be reliable medical delivery platforms for microbiological and laboratory samples, pharmaceuticals, vaccines, emergency medical equipment and patient transport. Government agencies have placed drone use on the national agenda. The following steps include aggressive research initiatives in safety, industry expansion, increased public awareness and participation. The purpose of this article is to document the utilisation of drone technology in India compared to outside India.
Two Fractures of the Cervical Spine in Ankylosing Spondylitis 8 Years Apart
Authors: Krishnan Prasad , Raju Dimble , Das Sayan
Published: December 2024

The cervical spine is the most common site of spinal fractures in patients with ankylosing spondylitis (AS). These fractures can occur either through the disc space or through the vertebral body itself. Due to the long lever arms of the fused spine acting on the site of fracture, these fractures are unstable and need surgical stabilization. Although the incidence of spinal fractures in these patients is far greater than in the normal population, a second fracture in the ankylosed cervical spine several years after the initial injury has not been reported. We present a case where a patient of AS had two fractures 8 years apart one of which happened through the disc space and the other through the vertebral body one level above the construct applied previously.
Minimally Invasive Laminoforaminotomy for Cervical Foraminal Narrowing Using Tubular Retractor System - A Prospective Study
Authors: Rao Tejus M. N. , Kumar V. R. Roopesh , Ramesh A. S. , Barathi Deepak
Published: December 2024

Background:

A minimally invasive approach to spinal pathology has significantly progressed in the past few years. Laminoforaminotomy using a tubular retractor system directly removes compressive pathology while maximally preserving segmental motion.

Objective:

Our study aimed to evaluate the outcome in patients undergoing microscopic posterior cervical foraminotomy for single-level cervical disease using a tubular retractor system.

Material and Methods:

All patients presenting with cervical radicular pain not responding to conservative management for 6 weeks were screened with magnetic resonance imaging of the cervical spine. Patients with refractory pain were subjected to minimally invasive discectomy using a tubular retractor system by posterior approach. Postoperative patients were followed with a visual analog scale (VAS) and 36-item Short Form Health Survey (SF-36).

Results:

A total of 13 patients were included in the study. 25%–30% of the facet was resected for foraminotomy. The mean VAS score for radicular pain was nine preoperatively, which improved postsurgery, at 6 months follow-up, the radiculopathy was 0.54 ± 0.52 with P < 0.001. In all eight domains of SF-36 data, statistically significant improvement was noted. Among the variables of SF-36, it has been reported that there was a significant improvement in the emotional component after surgery.

Conclusion:

The minimally invasive posterior approach using a tubular retractor system minimizes paraspinal muscle injury, reducing postoperative neck discomfort with no operative site infection. Minimal facet capsule dissection and facet drilling help in early recovery and less postoperative morbidity.