bluuebunny/crossref_metadata_2025 huggingface dataset:
Digging into Detectability: Uncovering How Temperature Influences Detection Probability of the Fossorial Temblor Legless Lizard
Authors: Rose Jonathan P. , Camp Sabrena M. , Pascetto Zarina N. , Johnson Chelsea B. , Lei Samuel H. , Napolitano Giancarlo R. , Schoenig Elliot J. , Macias Daniel A. , Jordan Anna C. , Halstead Brian J.
Published: June 2024

Knowledge of species distributions is critical for conservation, but surveying for rare, understudied species presents many challenges. A two-phase occupancy study can increase knowledge gained from early occupancy studies of a species by quickly using data from the first survey period to revise the study design for a second period. The Temblor legless lizard Anniella alexanderae is a recently described fossorial species found in the southwestern San Joaquin Valley, California, and its status is currently under review by state and federal wildlife agencies. As a fossorial species that is rarely surface active, Temblor legless lizards might be unavailable for detection at certain times of year or under inhospitable conditions (e.g., hot, dry weather), indicating the importance of accounting for false-negative surveys when determining its distribution. We used a multiscale occupancy model to disentangle detection probability, availability for detection, and occupancy for Temblor legless lizards. Focusing our effort from mid-February to mid-April when temperatures are mild and soil moisture is expected to be higher near the surface, we surveyed a total of 89 sites in 2022 (n = 60) and 2023 (n = 68) and detected Temblor legless lizards at 12 sites, including 5 new localities. Detection probability was positively related to temperature during our late winter-early spring survey period, and availability for detection was consistently high with minimal fluctuation within each year. Nevertheless, repeated surveys with nondetection can increase confidence that this fossorial lizard does not occur at a site. Temblor legless lizards were more likely to occur at sites near ephemeral streams and in areas without high clay soil content, but more investigation could help to discern drivers of occurrence. Our study provides valuable information for optimizing surveys for Temblor legless lizards and suggests promising directions for future research on this species’ ecology.
Toucher la peau fragile du monde
Authors: Ombrosi Orietta
Published: June 2024

Je touche ici les textes de J.-L. Nancy portant sur la peau de « notre monde » et sur ce que « nous arrive », par une lecture ou contamination entre ses livres et l’interprétation derridienne, du « toucher » en particulier. Dans une première étape, j’analyse le sens du « toucher », je le sollicite avec et au-delà de Derrida, en insistant sur les perspectives nancéennes quant au sens/poids de la pensée/pesée et jusqu’à l’idée de « transimmanence » ; dans une seconde étape, je considère ses analyses sur le sens en tant que peau du « monde », en démontrant qu’il y a une sorte de dé-ontologisation dans le dernier Nancy : il pèse différemment le poids/le sens du monde, car il touche au presque-sans-poids de la vapeur de la peau et à la circulation des peaux transpirantes qui donnent encore du sens au monde. Finalement, je suppose chez Nancy une contamination du « monde » avec le temps et même avec l’esprit.
Sans Occident/Occident Sans
Authors: Romo Juan Carlos Moreno
Published: June 2024

Je rappelle ici l’une des plus constantes préoccupations de la pensée de Jean-Luc Nancy : celle du destin d’un Occident qui, au moment même où il paraît accomplir son élargissement au monde entier, est amené à faire, de plus en plus, le constat de son propre effacement, de son déclin, ou de sa finitude. Je le fais tout en déplaçant quelque peu le point de vue d’où le problème se pose « normalement » car, comme c’est arrivé maintes fois dans mes échanges avec Nancy lui-même, j’y fais jouer mon écart, ou mon arrabal hispanique.
La jouissance mystique selon Thérèse d’Avila et Jean de la Croix
Authors: Sesé Bernard
Published: June 2024

Dans cet article, initialement publié en 2005 dans l’ouvrage collectif Mystique : la passion de l’Un, Bernard Sesé interroge le concept de jouissance dans l’œuvre de Thérèse d’Avila et de Jean de la Croix. Il en explore le champ sémantique, en propose une phénoménologie, et analyse le rôle que joue cet état dans l’aventure mystique.
Poétique du jardin mystique selon Thérèse d’Avila et Jean de la Croix
Authors: Sesé Bernard
Published: June 2024

Dans cet article, initialement publié en 2005 dans l’ouvrage collectif Le jardin : figures et métamorphoses, Bernard Sesé analyse le motif du jardin mystique dans les œuvres de Thérèse d’Avila et de Jean de la Croix. Il met en évidence la place centrale des images du jardin, et leurs multiples valeurs symboliques, et conclut en s’attardant sur l’allégorie des vertus de l’âme en fleurs et fruits du verger spirituel.
Structure symbolique du poème de la Nuit obscure de Jean de la Croix
Authors: Sesé Bernard
Published: June 2024

Dans cet article, initialement publié en 1993 dans un recueil publié par l’université de Nice en hommage à Nelly Clemessy, Bernard Sesé étudie le poème La Nuit obscure de Jean de la Croix. Il met en évidence la structure du texte à travers les symboles de la nuit, du seuil et de la transgression, de l’union nuptiale et des lis.
La chasse de haut vol selon Jean de la Croix
Authors: Sesé Bernard
Published: June 2024

Dans cet article, initialement publié en 1993 dans l’ouvrage collectif Jean de la Croix : connaissance de l’homme et mystère de Dieu, Bernard Sesé étudie le poème Tras un amoroso lance. Il en fournit une analyse approfondie, s’attachant au contexte de composition, à l’argument, au genre littéraire, aux sources littéraires et symboliques, à la prosodie, mais aussi au traitement des concepts mystiques qui y apparaissent.
Jean de la Croix et la source cachée
Authors: Sesé Bernard
Published: June 2024

Dans cet article, initialement publié en 1987 dans la revue Carmel, Bernard Sesé étudie le poème Aunque es de noche de Jean de la Croix, en livrant un commentaire thématique appuyé sur sa propre traduction du texte.
La criminalité à Londres au xixe siècle : le cas des cambriolages chez les particuliers
Authors: Tran Tri
Published: June 2024

During the 19th century, many Londoners had the impression of living in a dangerous city, under the constant threat of vicious and skilful criminals. The many articles published in the police press, as well as in more serious newspapers, reinforced their fear. However, official statistics tend to show that this impression was not grounded and that crime was contained by the police and the courts after the early 1840s, although the population of London was expanding. Using unpublished archives e.g. Parliamentary Papers, Home Office records, and Sessions’ Papers of the Central Criminal Court, this contribution attempts to assess the extent of robberies, the character of the criminals and their treatment by the judicial system.
La déviance dans l’œuvre de Charles Fourier : un symptôme de la société civilisée
Authors: Saad Mariana
Published: June 2024

This article shows that Charles Fourier considers the world around him with the eyes of a physician and that he criticises the way society produces its own deviants which he sees as so many signs of malfunctioning. Resorting to patterns inspired from Vitalist medecine, Fourier demonstrates that society exerts an oppressive control over individuals and generates imbalance and suffering at every possible level. The novelty of these views lies in the way Fourier transposes a « pathological » analysis of the economic sphere to the political and private spheres.
The Poetics of Social Deviance in Our Mutual Friend by Charles Dickens
Authors: Vanfasse Nathalie
Published: June 2024

During the Victorian period, social deviance became a source of growing interest and anxiety. Charles Dickens’s novels are particularly interesting in this respect because they present an extraordinary range of very striking cases of norms and deviance. Our Mutual Friend, for instance, depicts dubious riverside characters, as well as a suspicious murder and an attempted murder. It also portrays seemingly perfect embodiments of Victorian orthodoxy, such as Lizzie Hexam and the ideal couple formed by Bella Wilfer and John Harmon alias John Rokesmith. This paper analyses the textual construction of social deviance in Our Mutual Friend. It shows that the novel legitimises Victorian orthodoxy by condemning social deviance but that it also deviates from this orthodoxy by combining and opposing systems of norms, and by using disturbing focalisation. It finally takes a closer look at the stylistic, semantic, syntactic and narrative components of the discourse on social deviance in this novel.
South Sea Daggers and the Dead Man’s Eye: Foreign Invasion in Fin-de-Siècle Optogram Fiction
Authors: Goulet Andrea
Published: June 2024

This study looks at four fin-de-siècle texts that revolve around the central conceit of the ‘optogram,’ the photograph of a retinal image in a cadaver’s eye: Villiers de l’Isle-Adam’s Claire Lenoir (1867–87), Rudyard Kipling’s ‘At the End of the Passage’ (1891), Jules Claretie’s L’Accusateur (1897), and Jules Verne’s Les Frères Kip (1902). Starting from the initial observation that these texts share a recurrent theme of violent death linked to colonial travel, this paper relates their optical motif to broader European anxieties about the irruption of a savage Other into the domestic space of a bodily, urban, or national self. This is the age of post-Pasteurian fears of microbial contagion, of pre-Freudian theories of atavistic threats to civilized order, of Lombrosan anthropometry and its identification of the criminal classes in Europe with the ‘primitive’ peoples of Africa, South America, Asia, and the South Seas. These discourses—of biological vulnerability, of psychic pathology, and of social-geographical deviance—allow us to re-read the optical theme of the retinal membrane as symbol for the anxiety-provoking porosity of national and civic boundaries in an age of colonial exchange.
Cracking the Code
Authors: Almuqrin Abdullah , Mutambik Ibrahim , Zhang Justin Zuopeng , Farahat Hashem , Alharbi Zahyah H.
Published: June 2024

With the expanding reach of the Internet of Things, information security threats are increasing, including from the very professionals tasked with defending against these threats. This study identified factors impacting information security behavior among these individuals. Protection motivation theory and the theory of planned behavior were employed along with work-related organizational factors as a theoretical framework. Data were collected through a survey of 595 information security professionals working in Saudi information technology companies. Structural equational modeling was used to analyze the data. Threat susceptibility, threat severity, self-efficacy, response cost, fear attitude, behavioral control, subjective norms, and organizational commitment were found to play a significant role in information security protection motivation and behavior, while job satisfaction did not.
Innovative Strategies for Palliative Care in the Intensive Care Unit
Authors: Harrison Brittany H. , DeGennaro Regina , Wiencek Clareen
Published: June 2024

Palliative care is interdisciplinary care that addresses suffering and improves the quality of care for patients and families when patients are facing a life-threatening illness. Palliative care needs in the intensive care unit include communication regarding diagnosis and prognosis, goals-of-care conversations, multidimensional pain and symptom management, and end-of-life care that may include withdrawal of mechanical ventilation and life support. Registered nurses spend the greatest amount of time with patients and families who are facing death and serious illness, so nurses must be armed with adequate training, knowledge, and necessary tools to address patient and caregiver needs and deliver high-quality, patient-centered palliative care. Innovative approaches to integrating palliative care are important components of care for intensive care nurses. This article reviews 2 evidence-based practice projects, a serious illness support tool and the 3 Wishes Project, to add to the palliative care toolkit for registered nurses and other team members.
Both IRAK3 and IRAK1 Activate the MyD88–TRAF6 Pathway in Zebrafish
Authors: Weng Panwei , Lan Mengjiao , Zhang Hao , Fan Huiping , Wang Xiao , Ran Chenrui , Yue Zirui , Hu Jiaxuan , Xu Anlong , Huang Shengfeng
Published: June 2024

IL-1R–associated kinases (IRAKs) are signal transducers of the TLR/IL-1R–MyD88–TRAF6 pathways. Vertebrates possess two IRAK lineages, IRAK1/2/3 and IRAK4. In mammals, IRAK4/IRAK1 and IRAK4/IRAK2 are pathway enhancers, whereas IRAK3 is a repressor. However, in bony fish, IRAK2 is absent, and it remains elusive how fish IRAK1/3/4 functionally differ from their mammalian counterparts. In this study, we explored this using the zebrafish model. First, we showed that in human 293T cells, zebrafish IRAK1 and IRAK4 were components of the Myddosome (MyD88–IRAK4–IRAK1) complex, with IRAK1 serving as a potent pathway enhancer. Then, we discovered two zebrafish IRAK3 variants: one (IRAK3a) contains an N-terminal Death domain, a middle pseudokinase domain, and a C-terminal TRAF6-binding domain, whereas the other (IRAK3b) lost both the kinase and TRAF6-binding domains. This truncation of IRAK3 variants could be a conserved phenomenon in fish, because it is also observed in trout and grass carp. We proceeded to show that zebrafish IRAK3a acts as a pathway enhancer by binding with MyD88 and TRAF6, but its activity is milder than IRAK1, possibly because it has no kinase activity. Zebrafish IRAK3b, however, plays a sheer negative role, apparently because of its lack of kinase and TRAF6-binding domains. Moreover, zebrafish IRAK3a/3b inhibit the activity of IRAK1/4, not by interacting with IRAK1/4 but possibly by competing for MyD88 and TRAF6. Finally, we have verified the essential activities of zebrafish IRAK1/3a/3b/4 in zebrafish cells and embryos. In summary, to our knowledge, our findings provide new insights into the molecular functions of fish IRAKs and the evolution of the IRAK functional modes in vertebrates.
COMMUNAL CONFLICTS AND POLITICAL TRANSITIONS: THE CASE OF HYDERABAD STATE (1935-1948)
Authors: Mangiarotti Emanuela
Published: June 2024

Il saggio analizza come le transizioni politiche che hanno accompagnato l’annessione dello Stato principesco dell’Hyderabad all’Unione indiana nel 1948 abbiano definito le dinamiche di comunitarizzazione della vita pubblica. In particolare, l’antagonismo tra le comunità religiose è emerso come una caratteristica distintiva dei dibattiti politici sull’annessione dello Stato principesco e sulla riconfigurazione dei rapporti di potere nel successivo ordinamento amministrativo. Lo scopo del saggio è illustrare come e perché la rapida e violenta transizione politica, insieme all’altrettanto repentina burocratizzazione di un sistema socio-politico basato su un’organizzazione feudale, abbia favorito la riconfigurazione dell’appartenenza comunitaria lungo linee di polarizzazione sociale basate sull’appartenenza religiosa e l’elaborazione di un discorso politico basato sul paradigma del comunitarismo.
I PALEOCONSERVATORI E LA TRASFORMAZIONE DELLA POLITICA ESTERA STATUNITENSE
Authors: Zuccarelli Simone
Published: June 2024

The rise of Donald Trump has triggered a discernible metamorphosis in U.S. foreign policy. For the first time since the end of World War II, the internationalist consensus that has guided Washington’s decisions in the international arena for the past seven decades has been at least partially rejected. Although the practice of American action in the world has undergone some changes during the Trump presidency, the roots of this vision of foreign policy are not new. Rather, they can be found in the thinking of paleoconservatives, a group that has remained a minority on the American right since its beginnings, but has since gradually gained support until becoming particularly influential during Trump’s four years in the White House. This paper examines the intellectual origins and historical development of paleoconservatism, its foreign policy visions, and the ways in which it has shaped the actions of the Trump administration.
A Young Male with Delayed Puberty and Poor Social Skills
Authors: Shahid Mohammad Moin
Published: June 2024

ABSTRACT

Klinefelter syndrome (KS) is a chromosomal disorder characterized by the presence of one or more extra X chromosomes in males, affecting physical, cognitive, and social development. This case report describes a rare mosaic variety of KS with a karyotype of 48, XXXY. We present the clinical features, diagnostic process, and management of a patient with this unique mosaic chromosomal pattern. The case highlights the importance of recognizing atypical presentations of KS and the challenges associated with the diagnosis and treatment of rare mosaic varieties.
Comparative evaluation of the remaining dentin thickness using Solite RS3 and ProTaper Universal retreatment files: A nanocomputed tomography study
Authors: Sairaman Sruthi , Solete Pradeep , Jeevanandan Ganesh , Antony S. Delphine Priscilla , Kavoor Sowmya , Sandeep Adimulapu Hima
Published: June 2024

Aim:

One of the main goals of instrumentation during retreatment is to preserve the remaining dentin during gutta-percha retrieval. The current study assesses the remaining dentin thickness after retreatment using two different retreatment file systems.

Methods:

Forty extracted single-rooted teeth were obturated and decoronated at a standard root length of 16 mm. Two groups of twenty single-root teeth each were randomly divided from the samples, and Solite RS3 retreatment and ProTaper Universal retreatment (PTUR) files were used for instrumentation, respectively. Pre- and postoperative nanocomputed tomography scans were obtained, and 3D reconstruction was carried out for analysis. The remaining dentin thickness was determined by taking sections of the preoperative and postoperative samples at 7, 5, and 3 mm from the apex. The mean volume of dentin removed was also calculated. The statistical analysis between the two groups was conducted using an independent t-test.

Results:

When compared to PTUR files, Solite RS3 retreatment files demonstrated a significant difference at all three levels: 3, 5, and 7 mm from the apex (P < 0.000). The mean volume of dentin removed was lesser in Solite RS3 files in comparison to PTUR files (P < 0.001).

Conclusion:

Based on the aforementioned findings, we conclude that Solite RS3 preserves more dentin in comparison to the PTUR system.
Alteration of gastric microbiota in Helicobacter pylori-infected individuals suffering from GERD, DU, and gastritis
Authors: Sharma Prateek , Singh Sarika , Singh Aditya V. , Das Kunal , Bhaskar Yogendra , Goel Isha , Singh Harpreet , Das Rajashree
Published: June 2024

Background/Aim:

Helicobacter pylori (H. pylori) colonization affects the gastric microbiome, causing gastrointestinal (GI) diseases. Modern sequencing technology provides insights into GI microbe interaction with H. pylori and their metabolic pathways in causing GI diseases. We aim to compare the gastric microbiota alteration due to H. pylori infection in patients suffering from GI diseases.

Materials and Methods:

Genomic DNA were isolated from gastric antrum tissue from 37 H.pylori-infected patients diagnosed with GERD, duodenal ulcers, and gastritis. We conducted the genomic library preparation and sequencing of the amplified product using 16S rRNA NGS analysis. Using microbiome analyst tool diversity analysis, random forest analysis and ANOVA were conducted to find out the comparison of microbial abundance. We have also conducted functional pathway prediction analysis using PICRUSt.

Results:

Metagenomic analysis shows high bacterial diversity in H. pylori-positive gastritis patients. Streptococcus infantis and Neisseria subflava were significantly higher in duodenal ulcer (DU) and gastritis groups. Acinetobacter lwoffii and Helicobacter pullorum were significantly high in the gastritis group only. The functional metabolic pathway analyses revealed that gastroesophageal reflux disease (GERD) samples were significantly enriched with the energy metabolism and xenobiotic biodegradation and metabolism pathways, whereas fructose-1,6-bisphosphatase III was found less in gastritis and DU groups.

Conclusion:

There is a difference in microbiota composition in different disease outcomes. We found positive association between microbial diversity and H. pylori in gastritis group only, whereas negative association was found in DU and GERD groups. The functional metabolic pathway analysis revealed significant differences in various disease outcomes.
Serum IgG level in autoimmune liver diseases and its significance: Is there a need to revisit existing criteria? Experience from a tertiary care center
Authors: Varadarajan Annapoorani , Rastogi Archana , Maiwall Rakhi , Bihari Chaggan , Thomas Sherin , Shasthry Saggere Muralikrishna
Published: June 2024

Background:

Serum immunoglobulin G (IgG) level is elevated in autoimmune liver diseases (AILDs), especially autoimmune hepatitis (AIH). However, its utility is limited in current practice as different criteria propose different cut-off values leading to considerable ambiguity.

Materials and Methods:

A cross-sectional study was conducted among patients with AILD who underwent a liver biopsy over a ten-year period. From 17644 liver biopsies, 630 patients were included and divided into three groups—AIH (455 patients), primary biliary cholangitis (PBC) (97 patients), and overlap (78 patients). Clinical and laboratory details were collected and histological findings were reviewed. Non-cirrhotic non-alcoholic steatohepatitis (NASH) cases were taken as the control group for IgG level comparison.

Results:

Among AIH patients, IgG values of >2 times the upper limit of normal (ULN) were associated with significant elevation of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), bilirubin, and necroinflammatory activity. IgG level of >1.1 times ULN lacks specificity in differentiating AIH from the control group. The receiver operating characteristic (ROC) curve demonstrates maximum sensitivity and specificity at a cut-off value of >1.3 times ULN.

Conclusion:

Serum IgG cut-off value for diagnosing AIH, either in isolation or as a component of overlap syndrome, needs revision and uniformity. IgG value of >2 times ULN in AIH is associated with severe AIH. A new cut-off value of >1.3 times ULN is proposed.
The curious case of light chain cast nephropathy in a renal allograft recipient
Authors: Choudhury Debarun , Chadha Shiv , Gupta Pallav , Malik Manish
Published: June 2024

Myeloma cast nephropathy in renal allograft recipients without pre-transplant diagnosis of multiple myeloma is rare. A 32-year-old hypertensive male presented to our institute as a prospective renal allograft recipient. Hemoglobin was 10.1 mg/dl. He did not have hypercalcemia, and the albumin/globulin ratio was 1.33. Urinalysis did not show any proteinuria or active sediments. Ultrasonography of the abdomen showed bilateral contracted kidneys. He underwent an uneventful renal transplant surgery and had immediate graft function. After 1 month, he tested positive for severe acute respiratory syndrome coronavirus 2 and developed graft dysfunction. Graft biopsy showed features of myeloma cast nephropathy. He had elevated lambda chains with an involved-to-uninvolved free light chain ratio of >100. Serum immunofixation electrophoresis showed a monoclonal band in the lambda region. Bone marrow biopsy showed plasmacytosis with 18.6% immature plasma cells. He improved on cyclophosphamide, bortezomib, and dexamethasone regimens.
Comparison of Single Dose with Continuous Infusion of 0.2% Ropivacaine in Interscalene Brachial Plexus Nerve Block for Pain Relief in Rotator Cuff Repair Surgery
Authors: Shetty Sanath Kumar , Mehta Meher Pradeep Kumar , Mathias Lawrence John , Shetty Siddharth M. , Kandavar Siri , Ballal Arjun
Published: June 2024

Background:

Severe postoperative pain is the most common complication after arthroscopic rotator cuff surgery. Peripheral nerve blocks, whether single-shot interscalene block (SSISB) or continuous interscalene nerve block, have consistently demonstrated superior analgesia after upper extremity surgery compared to general anesthesia alone.

Aims:

The aim of this study was to evaluate the difference in pain relief provided by single shot versus catheterized interscalene block.

Materials and Methods:

A prospective observational study was conducted in the Department of Orthopedics of Justice K.S.Hegde Charitable Hospital, Mangalore, from January 2020 to June 2021. Thirty patients who were diagnosed of complete rotator cuff tear were included in the study. All of them underwent arthroscopy-assisted single-row rotator cuff repair by the same surgeon under general anesthesia. They were randomly allocated into Groups I and B of 15 each. Patients in Group A received a SSISB and Group II received continuous infusion after the insertion of catheter. The catheter was removed after 24 h of surgery. Both groups followed the same postoperative management protocol. The pain perception assessment was measured using the Visual Analog Scale (VAS) at 6, 24, 48 h after surgery, and at 2nd week postoperative during suture removal. Power was assessed for the wrist (wrist flexion and extension) and for the fingers (finger flexion and abduction) at 6 h, 24 h, 48 h, and after 2 weeks on day 14 when suture removal was done. The results were calculated and tabulated using an independent “t-test” and “Chi-square test.”

Results:

The patients in Group A had a higher VAS score with a mean of 0.26 ± 0.06 as compared to Group B which showed a mean VAS score of 0 (P = 0.01). Six patients needed analgesia of postoperative day 2. Eight patients of Group B required rescue analgesia on postoperative day 2.

Conclusion:

Continuous infusion scalene block was noted to be superior to SSISB in the management of postoperative pain postarthroscopy assisted single-row rotator cuff repair.
Evaluation of Proprotein Convertase Subtilisin/Kexin Type 9 in Patients with Acute Coronary Syndrome: An Observational Study
Authors: Sanober Arshi , Noorjahan M , Kumari J Ashwini , Satish Oruganti Sai , Sreedevi N N , Bhaskar M Vijaya , Kompella Sai Baba S S , Khan Siraj Ahmed
Published: June 2024

Background:

Proprotein convertase subtilisin kexin/type 9 (PCSK9) plays a pivotal role in low-density lipoprotein cholesterol (LDL-C) metabolism, by decreasing the clearance of LDL-C by promoting the degradation of the LDL receptor and prevents it from recycling to the membrane. Thus, in this study, we aim to assess the serum PCSK9 levels in patients of acute coronary syndrome (ACS) and to evaluate its association with the severity of coronary artery disease based on angiographic findings.

Materials and Methods:

A cross-sectional case–control study comprised 60 cases and 30 age- and sex-matched healthy controls. Sixty cases were divided into groups depending on the number of vessels involved based on coronary angiogram; Group 1 (single vessel) – 20, Group 2 (double vessel) – 20, and Group 3 (triple vessel) – 20. The serum PCSK9 levels were assessed using the sandwich enzyme-linked immunosorbent assay.

Results:

The mean concentrations of PCSK9 in single-vessel disease (SVD), double-vessel disease (DVD), and triple-vessel disease (TVD) were 153 mg/ml, 214.5 mg/ml, and 290 mg/ml, respectively, whereas, in controls, it was 133 mg/dl. The serum PCSK9 levels were significantly higher in cases compared to controls (P < 0.0001). There was a significant difference in serum PCSK9 when compared between various groups (controls vs. DVD, controls vs. TVD) (P = < 0.0001), except controls versus SVD which was not statistically significant (P = 0.113).

Conclusion:

The levels of serum PCSK9 were high in cases compared to healthy controls and were positively associated with the disease severity. Hence, it can be used as a marker in assessing the disease severity in ACS patients with coronary angiography.
Cardiovascular Risk Assessment and Utilization of Pharmacological Agents for the Management of Cardiovascular Disease Risk among Diabetic Patients with Variable Risk Profiles
Authors: Deb Pooja , Mohanty Ipseeta Ray , Rai Sandeep
Published: June 2024

ABSTRACT

Background and Aims:

The adverse cardiovascular disease (CVD) outcomes in diabetes mellitus can largely be prevented by using effective utilization of CVD risk-modifying medications such as oral hypoglycemic agents (OHAs), anti-hypertensives, anti-platelets, and hypolipidemics. Results of the study will aid in planning appropriate preventive measures to decrease morbidity and mortality from cardiovascular events with the help of CVD risk classification and analysis of CVD risk modification medications prescribed among diabetic patients of various risk categories.

Materials and Methods:

Two hundred and twenty people with Type 2 diabetes who matched the inclusion and exclusion criteria for the study were enrolled after giving their consent. The stratification of CVD risk using the World Health Organization/International Society of Hypertension CVD risk prediction tables was done to possibly prevent CVD. A case record form was presented to these patients, which contained details about their medical treatment, patient profile, and CVD risk factors.

Results:

The percentage of diabetic individuals with low CVD risk was 64.5%, medium CVD risk was 17.7%, high CVD risk was 6.4%, and extremely high-risk CVD risk was 11.4%. Aside from antidiabetic medicines, the analysis indicated that 72% of patients in the extremely high-risk group were administered anti-hypertensive drugs, 60% were on concomitant antiplatelet drugs, and 64% were prescribed hypolipidemic drugs for cardiovascular risk reduction.

Conclusion:

It is desirable to increase the usage of CVD risk-modifying medications, especially antiplatelet and hypolipidemic medications, in Type 2 diabetes patients with a high CVD risk.
Epidemic of Coronary Artery Disease in Young Indians: Comparative Study of Lipid Indices in Children of Patients with and without Premature Coronary Artery Disease
Authors: Shetty Laxmi H , Reddy Vijay Kumar J , Patil Rahul S , Jayaprakash Shilpa , Sheethal K C , Manjunath Cholenahally N
Published: June 2024

Aims and Objectives:

The aim is to study the role of routine and advanced lipids in predicting the premature coronary artery disease (PCAD) risk in children of patients who have presented with PCAD.

Subjects and Methods:

Our study enrolled 193 children (of PCAD patients-as cases) and 193 children of healthy adults as controls after satisfying the inclusion and exclusion criteria. Both groups had children aged between 4 and 21 years and were age-matched. Fasting samples were drawn for conventional lipid profile, lip (a), small dense low-density lipoprotein (SD LDL), Apolipoprotein-A1 (Apo A1), and Apolipoprotein-B (Apo B). Furthermore, lipid indices such as lipid pentad index (LPI), lipid tetrad index, atherogenic index, and lipid ratios such as Apo B/Apo A1, total cholesterol/high-density lipoprotein (TC/HDL), and HDL/LDL ratio were calculated.

Results:

The group had 51.8% males and 48.2% females. Body mass index was normal in the study group, but reached statistical significance in cases (19.2 ± 3.27 vs. 17.6 ± 2.98; P = 0.01). History of smoking, either active or passive, and gender had a neutral effect on the lipid parameters. The levels of TC, LDL-C, non-HDL, triglycerides, non-HDL, very LDL, Lip (a), and Apo-B were higher and reached statistical significance in cases and the levels of HDL-C and Apo A-I were low in cases. The LDL-C/HDL-C ratio (2.99 ± 1.31 vs. 2.3 ± 0.74; P < 0.001) and TC/HDL-C ratio (5.35 ± 3.2 vs. 4.0 ± 1.01; P < 0.001) was higher in cases. In addition, the LDL-C/HDL-C ratio and LPI were found to be a better predictors of PCAD.

Conclusions:

Children of PCAD patients were noted to have a higher association of dyslipidemia when compared to controls. Conventional lipids and Lip (a) were high whereas Apo A-I levels were found to be low when compared to controls. SD LDL, LDL/HDL ratio, and LPI can be used as screening tests to predict the occurrence of premature CAD. Therefore, these children should undergo screening for the presence of dyslipidemia. Thereby measures for a healthy life can be initiated early.
Abnormal Electrocardiogram after a Pacemaker
Authors: Agarwal Rakesh
Published: June 2024

After implanting a right ventricular pacemaker lead, it is common to have a left bundle branch block pattern on the electrocardiogram (ECG) in paced QRS complexes. We report a case of an elderly female who demonstrated a right bundle branch block (RBBB) pattern in the right-sided precordial leads V1-V2 after undergoing a pacemaker implantation. This was a cause of worry as it usually indicates a complication of the surgery and may require lead revision. However, we demonstrated that such a pattern could be normally seen. In this article, we review the features that can help in differentiating a RBBB pattern associated with pacemaker implant-associated complications from an uncomplicated one. An intelligent analysis of the ECG can help in differentiating the complicated from benign forms of RBBB in such cases.
Manual Thrombus Aspiration during Percutaneous Coronary Intervention: Cherish as “Blessing of Thanksgiving” in a Case of Spontaneous Coronary Artery Dissection Presenting with Large Intracoronary Thrombus Burden
Authors: Sharma Sanjay Kumar
Published: June 2024

ABSTRACT

Spontaneous coronary artery dissection (SCAD) presenting with a large intracoronary thrombus burden is an exceedingly rare scenario. We report a 27-year-old male who presented with SCAD and subsequently was found to have a large intracoronary thrombus burden in the left anterior descending artery. Our tailored approach for the removal of thrombus by thrombus aspiration before stent deployment has been proved to be fruitful.
Quality of Life among Myocardial Infarction Patients Attending a Tertiary Care Center in Puducherry, South India
Authors: Sahanaa Chandar , Purty Anil Jacob , Prabakaran Stalin , Arokiaraj Mark Christopher , Manjunatha Chalawadi H
Published: June 2024

Background:

Coronary artery disease (CAD) is a major cause of mortality and morbidity worldwide. The prevalence of CAD in India is estimated to vary from 2% to 4%. Quality of life (QOL) is an essential component in the assessment and follow-up of CAD patients. The QOL of acute myocardial infarction (MI) survivors improves over time. This study aims to assess the QOL of MI and also find the association between clinico-epidemiological factors and QOL among MI patients attending a tertiary care center.

Materials and Methods:

This study was a hospital-based cross-sectional study. The study participants include patients attending cardiology outpatient department, who have had MI in the past, i.e. between 3 months and 3 years. The study was conducted between January 2018 and December 2019. The study recruited 330 study participants. The patient’s perspective on QOL post-MI was collected using a short form 36 questionnaire. The data analysis was performed using SPSS software version 24.0.

Results:

The maximum number of participants was 51–60 years of age, and the majority were men. More than 93% underwent invasive procedures such as angioplasty, percutaneous transluminal coronary angioplasty, and coronary artery bypass graft, whereas 6.8% of the participants were medically managed. The physical functioning and energy components had a median score of 70 and 57.5, respectively. Increasing age has a significant association with QOL. The QOL scores in the domains of physical functioning (P = 0.003), physical role (P = 0.017), general health (P = 0.005), energy (P = 0.001), and social functioning (P = 0.047) decrease as age advances. The QOL score was greater in the study participants 1–2 years post-MI (65–100 across all domains), whereas the scores were less in the 3 months to 1 year period (0–64 across all domains) and the 2–3 year period (60–87 across all domains).

Conclusion:

Quality of life scores had improved, were estimated in one year post myocardial infarction patients.
Assessment of Willingness and Ability of Doctors to Manage Tobacco Abuse
Authors: Khan Abdul Allam , Jain Peeyush
Published: June 2024

ABSTRACT

Background:

Tobacco is a major concern in the field of public health which is a contributor to high morbidity and mortality. In the year 2017, tobacco usage caused 7.1 million deaths worldwide, and it has rightfully claimed the word silent pandemic.

Main body:

The research was based on a questionnaire form filled out by 412 doctors belonging to varied age groups and clinical specialties. Doctors were not only asking their patients about tobacco usage but also 83% of them advised their patients to quit or at least cut down tobacco use. Based on the survey report of our questionnaire, we are reassured that most doctors are aware of the public health implication of tobacco users although a very small number prescribes pharmacotherapy for tobacco cessation.

Conclusion:

This silent pandemic needs to be acknowledged and doctors need to be better equipped in their skills to help the patients quit using tobacco.
Applications of Ultrasonography in Limb Lengthening and Reconstruction
Authors: Munger Alana M. , Amick Michael , Frumberg David B.
Published: June 2024

Introduction:

Ultrasound technology offers multiple benefits including cost-effectiveness, portability, and lack of radiation. It allows for a wide range of diagnostic and therapeutic applications to the musculoskeletal health. We examined the utility of ultrasound in the field of limb lengthening and reconstruction (LLR), believing that this technology’s ability to improve surgical safety and improve diagnostic accuracy has a large potential to improve patient outcomes and satisfaction.

Methods:

A literature review was performed to determine the musculoskeletal applications of ultrasound that could be applied to LLR. In addition, four cases are presented to highlight the examples of diagnostic and therapeutic functions of ultrasonography in LLR.

Results:

Many widely accepted uses of ultrasonography for musculoskeletal pathologies have diagnostic and therapeutic utility in LLR. Diagnostic purposes include the evaluation of vascularity and assessment of regenerate bone quality, size, and shape. Therapeutic benefits include localization of anatomic structures, enhancing bone formation with the use of low-intensity pulsed ultrasound bone stimulation, and assisting percutaneous procedures including injections, biopsies, and drilling for nonunion/docking.

Conclusions:

Ultrasound can be effectively utilized for both diagnostic and therapeutic purposes in LLR. Its portability and cost-effectiveness pose a great asset to those practitioners who are trained in the techniques to utilize the technology properly. The ability to use a radiation-free modality is attractive as a means to improve the safety profile of treatment, as there is often a high radiation burden for these patients. More research is required to determine the reliability of this technology in its applications for LLR.
New Minimal-Invasive Technique for Cosmetic Treatment of Pin Site Scars after Removal of External Fixations
Authors: Laymouna Khaled , Hammouda Ahmed I. , Elbatrawy Yasser , Artemiev Alexander
Published: June 2024

Introduction:

Scars and dimpled skin appearance is a common complaint in patients undergoing surgery using external fixators. Former studies described different methods to manage these scars. In current study, we demonstrate in details a new surgical technique to release the scars.

Patients and Methods:

Twenty-five females (mean age of 28 years) underwent cosmetic lower limb (16 Femurs and 34 tibias) lengthening or deformity correction using circular hybrid Ilizarov frame.

Results:

Time interval between frame removal and surgical release using the technique was 30 days. Average number of scars released using the technique was 382 (144 femur scars and 238 tibia scars). Two and half minutes is the average time for the whole procedure. Immediate scar release and disappearance of dimples was the result in all patients. This maintained for the whole time of follow-up after the procedure.

Conclusion:

This surgical technique is a quick, easy, efficient, and cost-effective while managing scar dimpling after using external fixator elements.
Radiological and Functional Outcomes of Bone Transport in Lower-extremity Long-bone Segmental Bone Loss Using Rail Fixator
Authors: Dhawan Manish , Arvind Navneet , Nandan Brajesh , Thakur Kamparsh , Prasad Manish
Published: June 2024

Background:

Segmental bone loss in the femur and tibia is most often due to traumatic bone loss, resection of septic and aseptic nonunion, and resection of bone tumors. Reconstruction of these segmental defects incurs significant economic and social costs. The segmental bone defect has been treated with Masquelet’s induced membrane technique and bone transport using the Ilizarov circular external fixator and six-axis correction systems. Similarly, rail fixators for bone transport are an excellent and viable alternative for such cases.

Materials and Methods:

This ambispective observational study was done in 50 patients with segmental bone loss of the femur or tibia with a mean age of 34 years (range: 17–56 years) and operated with rail fixator application and underwent bone transport between January 2015 and October 2020. The functional and radiological outcomes were assessed. The outcomes were assessed using the Association for the Study and Application of the Methods of Ilizarov functional and bone criteria. The radiological outcomes were the bone healing index, distraction duration, and consolidation duration, which were assessed using regular postoperative radiographs.

Results:

The mean bone defect was 7.01 cm (range: 5–9.5 cm). The mean healing index was 35.92 days/cm. The mean distraction duration was 11.86 weeks (range: 7–24 weeks), and the mean consolidation duration was 22.94 weeks (range: 15–49 weeks). The mean time in the frame was 35.8 weeks (23–74 weeks). The most common complication was pin tract infection (12/50), followed by knee stiffness, ankle stiffness, and pin loosening. The functional results were excellent, good, and fair in 26, 22, and two patients, respectively. The bone results were excellent, good, and fair in 29, 17, and four patients, respectively.

Conclusion:

Segmental bone defects in the lower limb are difficult clinical scenarios to manage, which need a meticulous and deliberate approach while planning and execution of surgery. The surgical procedure of rail fixator application is simple; the learning curve is not steep, and patient acceptance is good with good to excellent functional and bone results.
Educational and Training Opportunities on Limb Deformities for Surgeons and Trainees in Low- and Middle-income Countries: Hardly Any Peer-reviewed Studies
Authors: Flores Michael J. , Brown Kelsey E. , Simister Samuel K. , Sabharwal Sanjeev
Published: June 2024

Context:

Orthopedic education and training can increase surgical capacity and improve clinical outcomes in low- and-middle income countries (LMICs).

Aims:

We aimed to identify the published reported outcomes of education and training programs pertaining to limb deformities in LMICs.

Settings and Design:

A state-of-the-art review was conducted using seven databases (Africa-Wide Information, Aim, CINAHL, Embase, Global Health, Medline, and Web of Science).

Subjects and Methods:

The search included articles with keywords related to limb deformities AND education AND LMICs published between 2017 and 2021. The search yielded 4511 articles for the title and abstract screening. Screening yielded eight articles for full-text review and three articles for extraction. Data on the mechanics, topics, and outcomes of each educational opportunity were extracted using REDCap.

Statistical Analysis Used:

This was a state-of-the-art review.

Results:

Three studies met inclusion criteria. The studies were published from 2018 to 2020 and based on the African continent, with partners from the US and UK. Study designs included retrospective comparative, systems approach, and mixed methods all with level IV level of evidence. One study was conducted virtually, with 259,986 viewers of video-based content created by medical students related to various orthopedic topics, including limb deformities. The other two studies were related to an in-person clubfoot training program with 113–185 participants. These two studies included pre- and posttraining evaluation, with outcomes related to participation, knowledge gained, and efficacy. All the studies reported an overall positive effect of the intervention.

Conclusions:

There is limited available information regarding limb deformity educational interventions in LMICs. The current review suggests a positive impact of such educational interventions and emphasizes a need for more research on the topic.
Polyethylene glycol fusion repair of severed rat sciatic nerves reestablishes axonal continuity and reorganizes sensory terminal fields in the spinal cord
Authors: Hibbard Emily A. , Zhou Liwen , Yang Cathy Z. , Venkudusamy Karthik , Montoya Yessenia , Olivarez Alexa , Bittner George D. , Sengelaub Dale R.
Published: June 2024

JOURNAL/nrgr/04.03/01300535-202507000-00030/figure1/v/2024-09-09T124005Z/r/image-tiff

Peripheral nerve injuries result in the rapid degeneration of distal nerve segments and immediate loss of motor and sensory functions; behavioral recovery is typically poor. We used a plasmalemmal fusogen, polyethylene glycol (PEG), to immediately fuse closely apposed open ends of severed proximal and distal axons in rat sciatic nerves. We have previously reported that sciatic nerve axons repaired by PEG-fusion do not undergo Wallerian degeneration, and PEG-fused animals exhibit rapid (within 2–6 weeks) and extensive locomotor recovery. Furthermore, our previous report showed that PEG-fusion of severed sciatic motor axons was non-specific, i.e., spinal motoneurons in PEG-fused animals were found to project to appropriate as well as inappropriate target muscles. In this study, we examined the consequences of PEG-fusion for sensory axons of the sciatic nerve. Young adult male and female rats (Sprague–Dawley) received either a unilateral single cut or ablation injury to the sciatic nerve and subsequent repair with or without (Negative Control) the application of PEG. Compound action potentials recorded immediately after PEG-fusion repair confirmed conduction across the injury site. The success of PEG-fusion was confirmed through Sciatic Functional Index testing with PEG-fused animals showing improvement in locomotor function beginning at 35 days postoperatively. At 2–42 days postoperatively, we anterogradely labeled sensory afferents from the dorsal aspect of the hindpaw following bilateral intradermal injection of wheat germ agglutinin conjugated horseradish peroxidase. PEG-fusion repair reestablished axonal continuity. Compared to unoperated animals, labeled sensory afferents ipsilateral to the injury in PEG-fused animals were found in the appropriate area of the dorsal horn, as well as inappropriate mediolateral and rostrocaudal areas. Unexpectedly, despite having intact peripheral nerves, similar reorganizations of labeled sensory afferents were also observed contralateral to the injury and repair. This central reorganization may contribute to the improved behavioral recovery seen after PEG-fusion repair, supporting the use of this novel repair methodology over currently available treatments.