bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of transfusion-related acute lung injury cases investigated in Histocompatibility and Immunogenetics Laboratory, National Blood Centre, Kuala Lumpur
Authors: Mazlan Ailin Mazuita , Hassan Afifah
Published: August 2024

CONTEXT:

Transfusion-related acute lung injury (TRALI) which is associated with passive transfer of antibodies to leukocyte antigens in blood products causes serious morbidity and mortality. Blood donation centers need to determine the best measure to mitigate the risk of TRALI.

AIM:

This study was conducted to evaluate the characteristics of blood donors implicated in TRALI cases and donors who were found to have human leukocyte antigen (HLA) antibodies.

SETTING AND DESIGN:

This was a cross-sectional study based on a retrospective record review in the Histocompatibility and Immunogenetics Laboratory, National Blood Centre, Kuala Lumpur.

SUBJECTS AND METHODS:

All cases investigated for TRALI from January 2017 to February 2022 were included. Donor’s variables analyzed include age, gender, race, history of alloimmunization, and result of HLA antibody test. Corresponding HLA antigen in recipient, recipient outcome and implicated blood product were also studied.

STATISTICAL ANALYSIS USED:

Data were analyzed using SPSS version 22.

RESULTS:

Twenty-seven cases of TRALI with 37 donors were investigated. Majority of the donors were female (73%). Packed red cell was the most frequently implicated blood product (70.3%). There were significant associations between gender (P = 0.029) and history of pregnancy (P = 0.014) with the presence of HLA antibody in the donors. Multiparous donors with HLA antibodies have a higher number of pregnancies compared to their counterparts (mean = 3.93 [1.69] vs. 2.20 [0.84]) with a significant difference (P = 0.044).

CONCLUSION:

The characteristics of blood donors and blood products implicated in TRALI cases and donors who have HLA antibodies were identified. The impact of deferring certain blood donor group needs to be determined before the most appropriate TRALI mitigation strategy can be implemented.
The burden of thalassemia disorder: Past and present: The feedback of patients experience in the COVID-19 pandemic crisis
Authors: Arioua Anis , Shaw David
Published: August 2024

Thalassemia is a genetic blood condition and one of the emerging global public health concerns in the world, with an estimated prevalence of 300,000,000 . The genes controlling hemoglobin production are affected, leading to an anemia of variable severity. Carriers of this hereditary anemia are found globally, but a high frequency is observed around the Mediterranean basin, in the Middle East, in the Indian subcontinent, and in Southeast Asia, so called the thalassemia belt. This article aims to review the history and factors of spreading of thalassemia, to identify the burden of the disease on individuals, population, and public health, and the issues that thalassemia patients have experienced during the pandemic of COVID-19. Online literature and previous studies on the disease are used to prepare this article. We identified various factors that have contributed to the spread of thalassemia in the last decades and affected the health condition of individuals and population. The recent worldwide pandemic of COVID-19 worsened the situation and made it more complicated for most patients, especially in the emerging countries.
A follow-up study of blood donors with vasovagal reaction – Three years’ experience
Authors: Kumatagi Shivanand Hemant , Akash J. , Rajendran Vinu , Nair Amita Radhakrishnan , Gupta Debasish
Published: August 2024

AIM:

The aim of this study was to find out the incidence of seizure recurrence among blood donors who developed vasovagal reaction (VVR).

SETTINGS AND DESIGN:

A prospective survey-based study conducted at the department of transfusion medicine of a tertiary care referral hospital in southern India.

SUBJECTS AND METHODS:

All donors who were diagnosed with VVR and loss of consciousness with or without convulsions during 3½ years study period were telephonically contacted to a maximum of 3 times. Whether they experienced a repeat episode of convulsions during 6-month follow-up period irrespective of blood donation was enquired.

RESULTS:

Out of 66 donors who were included in the study, 45 (68%) donors could be successfully contacted. One donor out of 45 (2.22%) had developed a repeat episode of seizure 5 months postdonation. However, she also had a previous history of seizures which was not revealed during the medical examination.

CONCLUSIONS:

Our study shows that the VVR with convulsions during blood donation can trigger a secondary episode if the donor had convulsions in their past before donation. We did not find any donor who developed a new seizure episode without a past history of seizure. However, more studies are needed to confirm the same.
Navigating the Physical and Mental Landscape of Cardio, Aerobic, Zumba, and Yoga
Authors: Verma Abhijeet , Balekar Neelam , Rai Ayushi
Published: August 2024

This review delves into the effect of cardio, aerobic, Zumba, and yoga on physical, mental, and emotional health. Cardiovascular exercises enhance heart strength, aid weight management, boost lung capacity, increase endurance, and positively impact metabolism. Aerobic exercise contributes to heart health, lowers blood pressure, and promotes mental wellness. Zumba a dynamic dance-fitness program offers cardiovascular benefits, calorie burning, muscle toning, enhanced coordination, and stress reduction, fostering both physical and social well-being. Yoga, a holistic practice, improves flexibility, strengthens muscles, enhances balance, supports joint health, and cultivates good posture. Additionally, yoga positively influences mental and emotional health by promoting relaxation, reducing anxiety, enhancing focus, and fostering self-awareness. The combination of scientific insights across these diverse exercise modalities offers a holistic understanding of how physical activity profoundly shapes our overall well-being, making this review paper a valuable resource for individuals and health-care professionals alike.
The Fallacy of Learning Styles in Medical Education: An Evidence-Based Critique
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: August 2024

In the field of medical education, to understand how people learn, many learning theories have been proposed, and in the same context, learning styles also have attracted immense attention. Learning style refers to the wide range of approaches people prefer to adopt and process information to ensure learning. Furthermore, many studies have specified the importance of learning styles and the need that it must be given due consideration by teachers to facilitate and expedite learning among medical students. However, questions have even emerged with regard to the actual utility of learning styles in augmenting learning and making a call about learning outcomes. Considering that preference for learning style changes over a period of time, is often multimodal, and that learning results due to the interplay of a wide range of other internal and external factors and not only because of the learning style. In conclusion, even though learning style has its own scope and utility, the available scientific evidence indicates that preference for learning styles might not be able to ascertain learning outcomes.
Prevalence and Etiological Profile of Hypercalcemia in Hospitalized Adult Patients and Association with Mortality
Authors: Sulaiman Shabna , Mukherjee Soham , Sharma Sadhana , Pal Rimesh , Bhadada Sanjay Kumar
Published: August 2024

Background:

The etiology of hypercalcemia varies according to the clinical setting. Hitherto, data on the prevalence and profile of hypercalcemia in hospitalized Asian–Indian patients are limited. Hence, we conducted a prospective observational study to determine the prevalence and etiological profile of hypercalcemia in hospitalized Asian–Indian patients and its association with 6-month mortality.

Materials and Methods:

We conducted a prospective observational study wherein all the patients (aged >12 years) admitted to the general medicine wards of a tertiary care hospital in North India between January 1, 2016, and June 30, 2017, were screened. Finally, patients with sustained hypercalcemia (defined as corrected serum total calcium ≥10.4 mg/dl documented twice at least 24 h apart) were included in this study. These patients were followed up throughout the hospital course and thereafter till 6 months from the date of discharge.

Results:

Out of 9902 patients, 150 patients had sustained hypercalcemia (prevalence 1.5%). The most common cause of hypercalcemia was malignancy (41.3%), followed by primary hyperparathyroidism (PHPT, 32.7%). Vitamin D intoxication was responsible for hypercalcemia in 8.7% of patients; 2.7% of patients had hypercalcemia of advanced chronic liver disease. Nevertheless, a definite etiology could not be identified in 7.3% of the patients with hypercalcemia. At the end of 6 months of follow-up, the cumulative mortality rate was 28%. Underlying malignancy and higher calcium levels were the significant determinants of mortality.

Conclusions:

The prevalence of hypercalcemia in Asian–Indian patients admitted to a tertiary care hospital was 1.5%. The most common etiology was malignancy, followed by PHPT.
Normative Data for Modified Ferriman-Gallwey Score and the Prevalence of Hirsutism in Young South Indians
Authors: Josyula Nitya N. , Guttula Sahithi , Lakkudi Shilpa , Reddy Sagar , Shanthaiah Dhananjaya M. , Sarathi Vijaya
Published: August 2024

Introduction:

The modified Ferriman-Gallwey score (mFGS) cut-offs to define hirsutism vary with ethnicity, whereas no such cut-offs are established for Indian women. Well-conducted studies that report the prevalence of hirsutism in Indian women are limited. Hence, this study was conducted to report the prevalence of hirsutism and population-specific cut-offs for mFGS in South-Indian women.

Methods:

In this cross-sectional, community-based study, adult women in reproductive age (18–40 years) were screened for hirsutism by two trained medical students. Hirsutism was assessed using the mFGS and case record file.

Results:

A total of 453 women were included in the study [age: 22.15 ± 5.27 years; body mass index (BMI): 22.5 ± 3.58 kg/m2]. The median (IQR) mFGS was 1(0-3); only eight participants (1.8%) had mFGS ≥8, and all these eight women had at least another PCOS-related feature (irregular menstrual cycles and/or topical therapy-resistant acne). The median (IQR) mFGS in the PCOS phenotype group (n = 52), non-PCOS-phenotype group (n = 401), non-obese group (<25 kg/m2), non-PCOS-phenotype group (n = 322), obese group (≥ 25 kg/m2), non-PCOS-phenotype group (n = 79), overweight group (BMI: 23–25 kg/m2), non-PCOS-phenotype group (n = 74), normal BMI group (<23 kg/m2), and non-PCOS-phenotype group (n = 248) were 4 (1–6), 1 (0–2), 1 (0–2), 2 (1–3), 1 (0–2), and 1 (0–2), respectively. The 97.5th centile mFGS in all groups except the PCOS phenotype group and the obese and non-PCOS phenotype groups was 5.

Conclusion:

We propose a new mFGS cut-off of 5 in the South-Indian population for evaluation of hirsutism, and the prevalence rates of hirsutism in the South-Indian population were 1.8% and 9.9% using mFGS of ≥8 and ≥5 to define hirsutism, respectively.
Corneal stromal changes following simple limbal epithelial transplantation on Scheimpflug densitometry: Early results
Authors: Jain Mayur , Gupta Nidhi , Lohchab Monica , Gour Abha , Sangwan Virender S , Singh Bhupesh
Published: August 2024

Context:

Chemical injury to eyes causes limbal stem cell deficiency (LSCD), which leads to conjunctival epithelium and underlying stromal changes. Simple limbal epithelial transplant helps to restore corneal epithelium and corneal stromal clarity. These changes are documented in this prospective eye study.

Purpose:

To report the changes in epithelial/stromal (E/S) reflectivity ratio and corneal stromal densitometry following simple limbal epithelial transplantation (SLET) in patients with unilateral chemical burn-induced LSCD.

Methods and Material:

It is a prospective imaging study of cornea before and after SLET. Corneal densitometry with Pentacam and epithelial and stromal reflectivity on anterior segment optical coherence tomography were analyzed for five patients (n = 5 eyes), who underwent autologous SLET for unilateral chemical burn-induced LSCD.

Statistical Analysis Used:

Mann–Whitney U-test and Pearson correlation.

Results:

A significant improvement in E/S reflectivity was noted at 1 month (P < 0.05) after SLET, and this was maintained until the end of 6 months. The densitometry measurements decreased in the entire cornea at every level, that is, anterior, central, and posterior cornea. However, the values did not normalize till the last follow-up at 6 months.

Conclusions:

A trend of normal corneal epithelization exists in eyes undergoing SLET. Densitometry at all the levels, the anterior, central, and posterior cornea, also decreases after SLET. SLET improves visual outcomes in LSCD eyes not only by epithelization but also by reducing stromal scarring.
Decoding glaucoma module premium edition
Authors: Ramesh Prasanna Venkatesh , Parthasarathi Sathyan , Ramesh Shruthy Vaishali , Devadas Aji Kunnath , Ray Prajnya , Rajasekaran Ramesh
Published: August 2024

Background:

Traditional methods for neuroretinal rim width measurement in spectral domain optical coherence tomography (SD-OCT) employs the Bruch‘s membrane opening (BMO) as the anatomical border of the rim, referenced to a BMO horizontal reference plane, termed as “Bruch’s Membrane Opening-Horizontal Rim Width” (BMO-HRW). BMO-HRW is defined as the distance between BMO and internal limiting membrane (ILM) on the horizontal plane. In contrast, the Spectralis OCT (Heidelberg Engineering, Germany) employs a new parameter called “Bruch’s Membrane Opening–Minimum Rim Width” (BMO-MRW) with Glaucoma Module Premium Edition (GMPE). GMPE provides a novel objective method of optic nerve head (ONH) analysis using BMO, but the neuroretinal rim assessment is performed from the BMO to the nearest point on the ILM, rather than on the horizontal reference plane. It is the BMO-MRW and is defined as the minimum distance between the BMO and ILM in the ONH.

Purpose:

In this video, anatomy of the ONH and GMPE is decoded from a neophyte user’s point of view, as to why BMO-MRW is more important than the traditional BMO-HRW for glaucoma evaluation.

Synopsis:

The GMPE concepts are depicted in a novel dynamic (Clinical vs OCT Vs Histology) screenplay, detailing the below focal points with 2D & 3D animations: True Margin of ONH, Bruch’s Membrane (BM), Histology Vs OCT, BMO, Bruch’s Membrane Opening-Minimum Rim Width, Bruch’s Membrane Opening-Minimum Rim Width Versus Bruch’s Membrane Opening-Horizontal Rim Width, Alpha, Beta, Gamma Zone of ONH in OCT, Anatomic Positioning System, Impact of Fovea Bruch’s Membrane Opening Centre Axis.

Highlights:

This video also highlights, how with the advent of Anatomic Positioning System, scans were able to align relative to the individual’s Fovea-to-BMO-center (FoBMOC) axis at every follow-up, for accurately detecting changes, as small as 1 micron in BMO-MRW, thus creating a new world in diagnosing glaucoma and detecting glaucomatous progression with precision.

Video link:

https://youtu.be/6RqF5guAziw
Estimation of pupil size at iris plane and its magnification after cataract surgery
Authors: Camellin Umberto , Camellin Massimo , Prantera Marcello , Di Pietro Roberta , Ponzetto Francesca , Aragona Pasquale
Published: August 2024

Purpose:

To estimate the pupil size (at the iris plane) under photopic (PPH) and scotopic (PS) conditions after phacoemulsification with intraocular lens (IOL) implantation.

Methods:

This retrospective observational cohort study included 190 virgin eyes from 190 patients who underwent cataract surgery with IOL implantation. Data collected with Aladdin (Topcon), AS-OCT MS-39 (CSO), and iTrace (Tracey) were SimK, mean pupillary power at 6 mm (MPP), anterior chamber depth (ACD), lens thickness (LT), axial length (AL), lens rise (LR), PPH and PS before and after surgery at 30 days, dysfunctional lens index, and opacity grade. The position of the postoperative iris plane (PIP) was measured manually with MS-39, and a multivariate regression formula was developed to predict it. Statistical analysis was performed using Statistical Package for Social Science (SPSS) (IBM).

Results:

The mean and standard deviations were 42.61 ± 3.20 D for MMP at 6 mm, 3.35 ± 0.37 mm for ACD, 3.89 ± 0.18 mm for PIP (P < 0.01), 4.55 ± 0.42 mm for LT, 0.43 ± 0.24 mm for LR, and 25.91 ± 3.03 mm for AL. The mean preoperative and postoperative topographic pupil magnification was 12% and 14.22%, respectively (P < 0.01). Despite an increase in magnification, the postoperative pupil was smaller than the preoperative one both for scotopic and photopic conditions: The larger the preoperative pupil, the more it tends to reduce in the postoperative period.

Conclusions:

Analysis of the preoperative topographic pupil alone is not sufficient for a correct indication of the optical zone and total diameter of IOL to be implanted but must be correlated with biometric data. The topographic pupil, therefore, undergoes a change in magnification from the preoperative period to the postoperative period. Furthermore, the real pupil presents a modification and, in most cases, tends to be smaller postoperatively in both photopic and scotopic conditions.
Isolated IgG4-related disease of terminal ileum: Report of a rare case and review of literature
Authors: Bhowmik Subham , Bhattacharjee Hemanga K. , Abraham Joyner , Sharma Raju , Das Prasenjit
Published: August 2024

Background:

Among the class of immune-mediated diseases, immunoglobulin G4-related diseases (IgG4-RDs) are of particular interest due to their occurrence in a vast number of organ systems with varied presentations. Isolated bowel involvement in IgG4-RD is, however, very rare.

Case Report:

A 54-year-old woman presented with acute-onset colicky abdominal pain located in the right lower quadrant for the past 6 months with abdominal distention. Abdominal contrast-enhanced computed tomography (CECT) depicted short-segment symmetrical and circumferential thickening of distal ileal loops and the ileocecal junction with accompanying mesenteric lymphadenopathy, raising the possibilities of ileocecal tuberculosis or Crohn’s disease, or malignancy. A right hemicolectomy was performed, and the histological examination revealed it to be an isolated ileal IgG4-RD. After a one-year follow-up, no radiological or clinical recurrence or related symptom was noted.

Conclusion:

This is the second reported case of isolated ileal IgG4-RD to the best of our knowledge, and IgG4-RD should be kept in mind even when the patient presents with segmental bowel thickening along with common possibilities such as tuberculosis or Crohn’s disease in this anatomical region.
Expression of stem cell biomarker CD44 in oral squamous cell carcinoma and its association with lymph node metastasis and TNM staging
Authors: Chakraborty Satadruti , Suresh T. N. , Azeem Mohiyuddin S. M.
Published: August 2024

Background:

Oral squamous cell carcinoma (OSCC) is one of the most prevalent cancers in the world. OSCC is a highly invasive lesion frequently having soaring morbidity as well as substantial mortality, attributed to resistance to therapy, metastasis, and recurrence driven by specific populations of cancer stem cells (CSC). The evidence of the association of expression of stem cell biomarker CD44 and metastatic potential of the tumor is inconclusive in OSCC and hence needs further evaluation.

Objectives:

To determine the immunohistochemical expression of CD44 in OSCC and to find its association with lymph node metastasis and TNM staging.

Materials and Methods:

One hundred and five histologically proven cases of OSCC were studied. Histopathological parameters like depth of invasion, presence of lymph node metastasis, grading, and TNM staging were done according to the new AJCC staging criteria. Both intensity and proportion of CD44 expression were recorded.

Results:

The mean age observed in this study was 52.59 years with a male: female ratio of 1:3.76. Forty-nine cases (46.6%) showed a depth of invasion of more than 10 mm. Fifty-two out of one hundred and five cases (49%) had nodal involvement. TNM staging was 5.7%, 7.6%, 44.7%, and 42% for stages I, II, III, and IV, respectively. The majority of the cases (87.5%) showed CD44 expression in the tumor. There was a significant association between the CD44 expression and lymph node metastases (P < 0.001). Higher CD44 expression was seen in stages III and IV (P < 0.001).

Conclusion:

CD44, a stem cell biomarker is significantly associated with higher TNM stage and lymph node metastases. This may be useful in predicting the tumor behavior in the small biopsy.
Ampullary mixed neuroendocrine non-neuroendocrine neoplasm (MiNEN) is an exceptionally rare case presenting as abdominal pain
Authors: Meedimale Santhosh , Panda Soumya S. , Mohanty Subhashis , Mohanty Swati S. , Biswas Ghanashyam
Published: August 2024

Mixed neuroendocrine non-neuroendocrine neoplasm (MiNEN) is a rare tumor of the gastrointestinal tract with both neuroendocrine and non-neuroendocrine components accounting for 30% of the tumor volume each. We describe the case of a 51-year-old gentleman who presented with a complaint of abdominal pain. On upper gastrointestinal endoscopy (UGIE), a superficial ulcer over the ampulla with antral gastritis was noted and the biopsy was suggestive of neuroendocrine tumor grade 1. A pylorus-preserving pancreatoduodenectomy was performed, and the histopathology examination of the resected sample has an adenomatous component of 33% and the rest (67%) is a neuroendocrine component. This was confirmed by neuroendocrine markers (synaptophysin, chromogranin, and CD56) with Ki-67 of 4–5%. Hence, the diagnosis of ampullary MiNEN intermediate grade was established. Ampullary location of this tumor is extremely rare and is usually aggressive in nature with frequent distant metastasis. The treatment option for such low-prevalence cancers is not yet standardized, suggesting future clinical research for the same.
Clinical Features of Candida Catheter-related Bloodstream Infections and Persistent Infections Associated with Early Catheter Reinsertion: A 6-year Retrospective Study
Authors: Kobayashi Takehito , Nakamura Itaru , Machida Masaki , Watanabe Hidehiro
Published: August 2024

Introduction:

Catheter-related persistent Candida infections (CRPCI) may develop after Candida catheter-related bloodstream infections (CRBSI) due to colonization of the newly inserted catheter. However, the optimal timing for new catheter insertion remains controversial. The aim of this study was to determine the clinical features of CRBSI due to Candida species and CRPCI. This was a retrospective study conducted in a teaching hospital in Japan.

Methods:

We retrospectively collected clinical information on hospitalized patients diagnosed with Candida CRBSIs by catheter tip culture from 2015 to 2020. CRPCI was defined as the growth of the same Candida species from the tip culture of a newly inserted catheter after the onset of a Candida CRBSI. The Chi-squared and Fisher’s exact tests were used to compare differences between the case and control groups.

Results:

Sixty-three cases of Candida CRBSI were collected. Fifty-four (85.7%) received total parenteral nutrition. CRPCI developed in 12 (48%) patients of the 25 in whom cultures of newly inserted catheters were performed. Despite antifungal therapy in these patients, persistent fungemia incidence was significantly higher (50.0% vs. 9.1%, odds ratio = 10.0, P = 0.033). The mean number of days from removal of infected catheter to reinsertion was significantly shorter for patients with CRPCI (0.27 days vs. 3.08 days, P = 0.038).

Conclusions:

Total parenteral nutrition may be a major risk factor in the development of Candida CRBSI. CRPCI often leads to persistent fungemia. Early insertion of a new catheter after removal of an infected catheter may be a risk factor for CRPCI.
A Peculiar Case of Disseminated Melioidosis with Atypical Features Likely Linked to Bong/Water Pipe Use
Authors: Jang Kisen , Sharma Anmol
Published: August 2024

Melioidosis, caused by Burkholderia pseudomallei, is a challenging infectious disease with global implications, primarily affecting Southeast Asia. We present the case of a 24-year-old male with a curious history of tobacco use, presenting with fevers, weight loss, and genitourinary symptoms. Diagnostic challenges arose as symptoms mimicked other diseases. Disseminated melioidosis was confirmed via Gram staining and positron emission tomography scan findings, emphasizing the disease’s diverse clinical manifestations. Treatment with ceftazidime and cotrimoxazole led to prompt recovery. Notably, the patient’s tobacco use linked to contaminated water highlights a unique transmission route. This case underscores the need for heightened awareness and preventive measures in endemic regions.
Impact of Interproximal Features on Marginal Bone Level Changes of Autograft, Allograft, and Xenograft after Functional Loading: A Retrospective Study
Authors: Win Kaung Zaw , Pimkhaokham Atiphan , Kaboosaya Boosana
Published: August 2024

Aim:

This study aims to investigate the marginal bone level changes (MBLCs) concerning interproximal features of posterior implant-supported single crowns using different bone grafts.

Materials and Methods:

This retrospective study included 27 patients requiring 46 dental implants using autograft, allograft, or xenograft between January 2007 and December 2016. MBLCs were assessed using digital periapical radiographs at 3 months (T1), 12–15 months (T2), and 21–24 months (T3) after prosthesis delivery. The influence of interproximal features, such as embrasure surface area, emergence angle, and horizontal distance to adjacent teeth/implants, was assessed. Secondarily, age, gender, diabetes and smoking, arch distribution, implant locations, implant characteristics, average gonial angle, antagonist type, clinical crown-to-fixture ratio, retention method, and nearby tooth/implant were considered. Wilcoxon signed-rank test, Mann–Whitney U tests, and Kruskal–Wallis tests were employed with statistical significance set at a P value of <0.05.

Results:

The results revealed that mean MBLCs at T3–T1 were similar (autograft 0.5 ± 0.47 mm, allograft 0.51 ± 0.35 mm, and xenograft 0.57 ± 0.42 mm). There were significant increases in MBLCs associated with EA ≤ 30° in autograft (P = 0.04), and HD ≤ 3 mm in allograft (P = 0.03). Mesial/distal MBLCs showed no significant differences, except in cases with HD ≤ 3 mm in the distal area of autograft (P = 0.03). Regarding secondary factors, significant differences in MBLCs emerged between autograft and xenograft in the molar area (P = 0.03), and between premolar and molar areas within the xenograft group (P = 0.01).

Conclusion:

This study concludes that interproximal features, EA ≤ 30° and HD ≤ 3 mm, markedly influenced MBLCs for specific types of bone grafts. Furthermore, MBLCs exhibited a direct relationship with the posterior placement of dental implants.
Laser-assisted Root Canal Filling Removal of Lower Incisors – A Micro-CT Study
Authors: Dogandzhiyska Violeta , Tsenova-Ilieva Irina , Raykovska Miriana , Karova Emilia
Published: August 2024

Abstract

Aim:

To compare the efficiency of root canal filling removal from oval-shaped root canals with high-energy Er:YAG laser and additional instrumentation with a rotary Ni-Ti XP-Endo Finisher R system.

Materials and Methods:

The in vitro study was accomplished on 12 freshly extracted single-rooted mandibular incisors with one straight oval-shaped root canal, shaped with XP-Endo Shaper 30/.04 and obturated by using the warm vertical condensation technique subjected to further endodontic orthograde retreatment. Group 1: the first retreatment was carried out using a high-energy Er:YAG laser (n = 12). Group 2: the additional retreatment of the same specimens was performed with the XP-Endo Finisher-R system (n = 12). The effectiveness of the retreatment techniques was evaluated by a threefold micro-CT examination. The amount of the remaining root canal filling material was analyzed by Mann–Whitney U test and Friedman tests.

Results:

A significant decrease in the quantity of the root canal filling was found following the first and after the second retreatment, compared to the initial values in all examined sections (P < 0.001). Within groups, additional application of the Ni-Ti system resulted in no significant removal of the filling materials (P > 0.05).

Conclusions:

None of the systems resulted in complete root canal filling removal. Despite the improved results after the application of the supplementary retreatment protocol, none of the root canal walls were completely clean in the apical area. The high-energy Er:YAG laser and XP-Endo Finisher R rotary system can be successfully used in endodontic orthograde retreatment under relevant operating parameters.
Health-care Professionals’ Perspectives on Ultrasound Evaluation of Arteriovenous Hemodialysis Fistula: A Narrative Review
Authors: Fu Chung-Ming , Leong Foong-Fah , Chung Sheng-Ying , Lee Wen-Chin
Published: August 2024

Arteriovenous hemodialysis fistulas play a critical role in maintaining life on hemodialysis. With the growing use of Doppler ultrasound in nephrology, its utility has expanded to improve the prognosis and quality of life of patients receiving hemodialysis. On a fistula care team, different health-care professionals, including nephrologists, dialysis technicians, and surgeons or vascular interventionalists, require different information. This review article comprehensively explains how Doppler ultrasound evaluation can be beneficial in the management of arteriovenous fistulas from different perspectives of health-care professionals. The article also introduces the pathophysiology of arteriovenous fistula disease and provides a thorough introduction to the use of Doppler ultrasound for the evaluation of arteriovenous fistulas and their associated diseases, addressing the need for a comprehensive understanding among ultrasound practitioners.
Comparison of two different volumes of 0.5%, ropivacaine used in ultrasound-guided adductor canal block after knee arthroplasty: A randomized, blinded, controlled noninferiority trial
Authors: Govil Nishith , Tripathi Mukesh , Goyal Tarun , Bhardwaj Bharat B. , Krishna Vamshi , Choudhury Arghya K.
Published: August 2024

Background and Aims:

The aim of this study was to establish noninferiority of 10 mL of 0.5% ropivacaine as compared to 20 mL of 0.5% ropivacaine; for choosing right dose in adductor canal block (ACB) after knee arthroplasty (KA), this trial was conducted.

Material and Methods:

Forty patients undergoing bilateral KA with postoperative ultrasound-aided ACB were randomized: Group A patients received 20 mL 0.5% ropivacaine in the right limb and 10 mL 0.5% ropivacaine in the left limb. Group B patients received 10 mL of 0.5% ropivacaine in the right limb and 20 mL of 0.5% ropivacaine in the left limb. Catheter is positioned for intermittent boluses every 12-h up to 48 h.

Results:

In the final analysis (excluding six patients) based on split-body design between Group I (comprising 34 limbs which received 20 mL of 0.5% ropivacaine) and Group II (comprising 34 limbs which received 10 mL of 0.5% ropivacaine), baseline demographic data were collected. Length of the limb from anterior superior iliac spine (ASIS) to the base of the patella was comparable between two groups: Group I (in cm; 149 ± 1.63) versus Group II (in cm; 149.5 ± 1.51) (P = 0.49, 95% CI of – 1.98 to 0.98). Primary outcomes, that is, quadriceps muscle strength, show a significant difference (P < 0.025) at various timeline. Secondary outcome pain scores and degree of knee flexion at various time intervals showed no significant difference. There was zero incidence of fall of the patient and no significant complication due to catheter was reported leading to discontinuation of catheter use in both groups.

Conclusion:

10 mL of 0.5% ropivacaine is noninferior to 20 mL of 0.5% ropivacaine in providing postoperative analgesia with preserved quadriceps muscle strength.
Heterotopic pancreas: A diagnosis of exclusion not to ignore
Authors: Thalasta Puneeth , Rathore Yashwant Singh , Kataria Kamal , Chumber Sunil , Yadav Rajni , Puri Gopal , Arumugaswamy Prasanna Ramana , Soni Gagan , Anand Ankit
Published: August 2024

The diagnosis of heterotopic pancreas (HP) is typically made by histopathology rather than a clinical examination which is frequently challenging. Gastric outlet obstruction (GOO) is one among its many manifestations. Although it is extremely uncommon, HP should always be considered a possibility when treating a with GOO. In this article, we discuss the management and treatment of HP in its many manifestations.
Artificial intelligence software for assessing brain ischemic penumbra/core infarction on computed tomography perfusion: A real-world accuracy study
Authors: Li Zhu-Qin , Liu Wu , Luo Wei-Liang , Chen Su-Qin , Deng Yu-Ping
Published: August 2024

BACKGROUND

With the increasingly extensive application of artificial intelligence (AI) in medical systems, the accuracy of AI in medical diagnosis in the real world deserves attention and objective evaluation.

AIM

To investigate the accuracy of AI diagnostic software (Shukun) in assessing ischemic penumbra/core infarction in acute ischemic stroke patients due to large vessel occlusion.

METHODS

From November 2021 to March 2022, consecutive acute stroke patients with large vessel occlusion who underwent mechanical thrombectomy (MT) post-Shukun AI penumbra assessment were included. Computed tomography angiography (CTA) and perfusion exams were analyzed by AI, reviewed by senior neurointerventional experts. In the case of divergences among the three experts, discussions were held to reach a final conclusion. When the results of AI were inconsistent with the neurointerventional experts’ diagnosis, the diagnosis by AI was considered inaccurate.

RESULTS

A total of 22 patients were included in the study. The vascular recanalization rate was 90.9%, and 63.6% of patients had modified Rankin scale scores of 0-2 at the 3-month follow-up. The computed tomography (CT) perfusion diagnosis by Shukun (AI) was confirmed to be invalid in 3 patients (inaccuracy rate: 13.6%).

CONCLUSION

AI (Shukun) has limits in assessing ischemic penumbra. Integrating clinical and imaging data (CT, CTA, and even magnetic resonance imaging) is crucial for MT decision-making.
Multimodal imaging for the diagnosis of oligodendroglioma associated with arteriovenous malformation: A case report
Authors: Guo Peng , Sun Wei , Song Ling-Xie , Cao Wen-Yu , Li Jin-Ping
Published: August 2024

BACKGROUND

The rare co-occurrence of oligodendroglioma and arteriovenous malformation (AVM) in the same intracranial location.

CASE SUMMARY

In a 61-year-old man presenting with progressive headaches, is described in this case study. Preoperative multimodal imaging techniques (computed tomography, magnetic resonance imaging, magnetic resonance spectroscopy, digital subtraction angiography, and computed tomography angiography) were employed to detect hemorrhage, cystic and solid lesions, and arteriovenous shunting in the right temporal lobe. The patient underwent right temporal craniotomy for lesion removal, and postoperative pathological analysis confirmed the presence of oligodendroglioma (World Health Organization grade II, not otherwise specified) and AVM.

CONCLUSION

The preoperative utilization of multimodal imaging examination can help clinicians reduce the likelihood of misdiagnosis or oversight of these conditions, and provides important information for subsequent treatment. This case supports the feasibility of craniotomy for the removal of glioma with AVM.
The Economy of Political of Media on the News on the 2017 Banten Governor Election
Authors: Priatna Achmad Nashrudin
Published: August 2024

Mass media, both print and broadcast (TV and radio), play an essential role in disseminating critical messages to the public/community. Because the media in the current era has become an economic and political commodity because of its function and ownership, which is owned by individuals (owners of capital). This positions the media and processes as disseminators of information and motivates for-profit and political interests. This article discusses the position of the local Press in Banten, namely Radar Banten and Baraya TV. In the euphoria of the gubernatorial election, these two media inevitably convey political messages. At the same time, these two media will try to make a profit just like an economic institution. How is the positioning of these two media, which have the function of disseminating information and education but simultaneously practicing economic and political activities? Are these two media able to maintain independence
MODEL DISCOVERY LEARNING BERBANTUAN GEOGEBRA UNTUK MENINGKATKAN KEMAMPUAN BERPIKIR KRITIS MATEMATIS DAN KEMANDIRIAN BELAJAR SISWA
Authors: Maharani Deswita , Rafianti Isna , Novaliyosi Novaliyosi
Published: August 2024

Mathematics, as an important foundation in education, contributes to the advancement of science and technology and teaches students logical, analytical, and creative thinking. This is in accordance with the Merdeka Curriculum which emphasizes the development of 21st century skills and character development, including critical thinking and self-regulated learning. However, the low mathematical critical thinking skills and self-regulated learning in Indonesia is still a challenge. One of the factors that influence this is the use of inappropriate learning models. The Discovery Learning learning model supported by technology such as GeoGebra is a potential solution to improve both capabilities. The purpose of this study was to determine the increase in mathematical critical thinking skills and determine the increase in self-regulated learning of students who obtained the GeoGebra-assisted Discovery Learning model compared to students who obtained conventional learning models. This research method is a quasi-experiment with the nonequivalent pre-test post-test control group design. Sampling is done by purposive sampling technique. This research was carried out in one of the Junior High Schools in Serang City in the 2023/2024 school year, involving two classes of grade VII students as an experimental and control group. The instruments in this study consisted of tests of mathematical critical thinking skills and learning independence scales. The results showed that the improvement of mathematical critical thinking skills and increased self-regulated learning of students who applied the GeoGebra-assisted Discovery Learning model were better than students who applied conventional learning models
PENGEMBANGAN MODUL AJAR MATEMATIKA MATERI TRIGONOMETRI BERBASIS COGNITIVE LOAD THEORY UNTUK MEMINIMALISIR MATHEMATIC ANXIETY SISWA FASE E
Authors: Zahroh Umy , Sutopo Sutopo , Fitri Devin Anggraeni
Published: August 2024

This research aims to: 1) determine the process of developing teaching module, 2) determine the validity of teaching modules, 3) determine the practicality of teaching modules, and 4) determine the effectiveness of teaching modules. In general, the development of this CLT-based teaching module is to find out whether the taching module can minimize students’ mathematical anxiety.The research follows a development model, specifically the Plomp development model which consists of 5 phase, 1) preliminary phase, 2) design phase, 3) realization phase, 4) test, evaluation and revision phase, 5) implementation phase. The developed teaching module focuses on trigonometry material for phase E students at MAN Se-Tulungagung. Data collection methods include validation, objective observation, and questionnaires. Practicality data were obtained from teacher questionnaires, while effectiveness data were derived from students’ mathematical anxiety questionnaires. Based on data analysis, the following results were obtained: 1.) The validation score for the teaching module was 3.754, categorizing it as valid. 2.) The practicality score for the teaching module was 4.02, indicating high practicality. 3.) The teaching module effectively minimized mathematical anxiety, as evidenced by anxiety levels in experimental classes compared to control classes. Control classes using conventional learning showed higher anxiety levels, with MAN 3 Tulungagung at 2,89 (‘anxious’), MAN 2 Tulungagung at 2.615 (‘anxious’), and MAN 1 Tulungagung at 2.204 (‘anxious’). Meanwhile, experimental classes, after using the teaching module, showed lower anxiety levels: MAN 3 Tulungagung at 1.98 (‘moderate anxiety’), MAN 2 Tulungagung at 1.96 (‘moderate anxiety’), and MAN 1 Tulungagung at 1.44 (‘moderate anxiety’)
3D LoD2 modelling of Halong City based on UAV point cloud
Authors: Le Ha Thu Thi , Nguyen Nghia Viet , Nguyen Trung Van , Nguyen Hang Le Thi , Phan Lan Thi , Pham Cam Dinh , Nguyen Ha Duy , Tran Hai Thanh , Nguyen Tai Thanh , Do Dai Trong , Dinh Tuan Thanh , Nguyen Long Huu ,   Hanoi University of Mining and Geology, Hanoi, Vietnam  Hanoi University of Natural Resources & Environment, Hanoi, Vietnam  College of Electro - Mechanics, Construction and Agro - Forestry in Central, Binh Dinh, Vietnam  Binh Tri Dong B Ward, Binh Tan District, Hochiminh, Vietnam  Dong Hai Surveying Company Limited, Hochiminh, Vietnam
Published: August 2024

3D urban building models are crucial for linking, converging, and integrating economic and social urban data. They are extensively utilized in numerous domains such as smart city development, comprehensive social management, and emergency decision-making. Advanced technologies like affordable UAV (Unmanned Aerial Systems) imagery enable a greater level of automation in data acquisition compared to traditional digital photogrammetry methods. The main objective of this research is to build a 3D LoD2 CityGML model with dense point clouds from UAV images. This study presents a completed workflow for generating 3D CityGML models of the city at LoD2 using UAV data. The use of dense point cloud data from UAV technology in the experimental area has been performed using a DJI Phantom 4 Pro. The original point clouds should be denoised using the statistical outlier remover (SOR), the main goal is to reduce noise while preserving the building's geometry. After that, the point clouds of object features were vectored for the level of detail 2 (LoD2) of the object's 3D volume corresponding to its actual height, and objects belonging to the Feature Class 3D layer will represent LoD2 on SketchUp Pro 2021 software to generate a highly accurate 3D model. The evaluation results show that the square errors calculated from the test points for the three axes X, Y, Z are 1.4 cm, 1.6 cm, 1.7 cm, respectively. Conducting research to choose the UAV photography method aims to offer an efficient and cost-effective solution, saving time and human resources, to address the 3D mapping challenges in urban areas across Vietnam.
The impact of ex vivo ozone injection into the synovial fluid in patients with knee osteoarthritis: A controlled clinical trial
Authors: Ata Emre , Özgüç Semiha , Hüseyin Temel Mustafa , Beyaztaş Hakan , Aktaş Selman , Güler Eray
Published: August 2024

Objectives: This study aimed to examine the effect of varying ozone doses on proinflammatory cytokine levels in the synovial fluid collected from individuals with knee osteoarthritis.

Patients and methods: The controlled clinical trial was conducted with 82 patients (61 females, 21 males; mean age: 63.1±10.0 years; range, 40 to 73 years) between 21 April 2023 and 20 May 2023. Synovial fluid samples were collected from the patients under ultrasound guidance and divided into three tubes, one of which was not injected with ozone, and the other two were injected with 10 and 30 gamma (γ) ozone, respectively. The total antioxidant status, total oxidant status, oxidative stress index, interleukin (IL)-1 beta (β), IL-6, and tumor necrosis factor-alpha (TNF-α) in the joint fluids were measured.

Results: The oxidative stress index and IL-1 β, IL-6, and TNF-α levels in the synovial fluid were lower at 10 and 30 γ compared to 0 and 10 γ, respectively. In vitro ozone injection at 30 gamma was more effective in reducing proinflammatory cytokines in the synovial fluid than that at 10 and 0 γ. Ozone injection into the pathological joint fluid was more effective in terms of total antioxidant status at 10 and 30 γ compared to 0 and 10 γ, respectively. No significant difference in total oxidant status was observed between the groups.

Conclusion: This study showed that in vitro ozone injection at 30 γ was more effective in reducing proinflammatory cytokines in the synovial fluid and in improving total antioxidant status than that at 10 and 0 γ. The results showed the potential significance of the ozone injection dosage in treating knee osteoarthritis.
Monument und Misserfolg: Leone Leoni idealisiert Karl V.
Authors: Pfisterer Ulrich
Published: August 2024

Denkmäler sind nicht erst heute problematisch geworden. Schon ihre nachantike Geschichte beginnt mit Krisen, wie Leone Leonis Statue »Karl V. über dem Furor« zeigt Denkmäler sind nicht erst in den letzten Jahren zu einer problematischen Kategorie geworden. Die ersten Bemühungen in Italien ab dem 13. Jahrhundert, nachantike Personenmonumente zu errichten, lassen sich nur als Versuche verstehen, auf jeweils unterschiedliche Krisen zu reagieren - oder aber, die Monumente selbst lösten Krisen aus. Den Höhepunkt dieser Versuche bildet die leicht überlebensgroße Bronzestatue für Kaiser Karl V. über dem Furor, die Leone Leoni um 1551-1555 in Mailand fertigte. Das Werk stellt eine künstlerische Ausnahmeleistung dar, trotzdem wurde es offenbar nicht positiv aufgenommen und durch eine verspätete Aufstellung vor den Toren Madrids quasi „entsorgt“. Die Indizien für eine solche Krisengeschichte der frühen Denkmäler und für ein heroisches Scheitern von Leonis Statue werden in diesem Band erstmals untersucht.
BİR KİRAL KAFES YAPININ TASARIM VE OPTİMİZASYONU
Authors: Bostancıoğlu Yusuf , Kacar İlyas
Published: August 2024

Kiral kafes yapıları zikzak şeklinde kübik hücrelerin üst üste ve yan yana çoğaltılmasıyla oluşturulan ökzetik davranışa sahip yapılardır. Bu çalışmada bir kiral kafes yapının tasarımı ve optimizasyonu yapılmıştır. Malzeme Ti-6Al-4V titanyum alaşımıdır. Kafes yapının ayrıt kesiti daireseldir. Yapısal analiz için sonlu eleman esaslı simülasyon yapılmıştır. Simülasyonda yapı bir ucundan ankastre bağlantı ile mesnetlenmiştir. Yük olarak da yapının serbest ucuna eksenel yer değiştirme uygulanmıştır. Simülasyon sonunda gerilme, deformasyon, enerji, Poisson oranı elde edilmiştir. Bu parametreler ve kafesin boyutları, uygulanan yük değerleri genetik algoritma esaslı optimizasyona tabii tutulmuştur. Optimizasyonda minimum boyut ile maksimum dayanımın elde edilmesi amaçlanmıştır. Sonuç olarak optimum değerler elde edilmiş ve parametrelerin birbirleri ile ilişiklerini veren cevap yüzey fonksiyonları sunulmuştur. Buna göre ayrıt kesitin yarıçapı 1 mm olduğunda yapı 0,12 mm yer değiştirmeye dayanmaktadır. Bu durumda yapı içerisinde 266,05 MPa değerinde çekme ve 233,34 MPa değerinde basma gerilmeleri oluşmaktadır. Bu değerler yapının akma dayanımının altındadır. Bu hâli ile yapının kütlesi 0,4549 g değerindedir.