bluuebunny/crossref_metadata_2025 huggingface dataset:
Bilateral Olecranon Spur: A Rare Anatomical Case Report
Authors: Singal Anjali , Gupta Tulika , Aggarwal Anjali
Published: January 2024

Olecranon spurs are enthesophytes, observed in the posterior part of the proximal olecranon surface. They can be symptomatic in isolation but are frequently mentioned with inflammatory conditions such as triceps tendonitis or olecranon bursitis and gout. Its surgical management entails anatomical information. Olecranon spur has rarely been reported in anatomical studies. We present a case of bilateral olecranon spur in the ulnae of a 62-year-old male skeleton. To the best of our knowledge, this report is the first anatomical report on biletral olecranon spur. The size of the spur was noticed carefully. Thorough anatomical knowledge of the olecranon spur can provide clinicians, radiologists, and forensic experts with better clinical judgment and may add insight to the surgical planning by orthopedic surgeons. Olecranon spur should also be considered in the differential diagnosis of pain at the posterior elbow, which may develop spontaneously, after a traumatic event, or in association with different sports.
Reperfusion Therapies in ST-elevation Myocardial Infarction Equivalents
Authors: Parikh Rujuta , Vyas Pooja , Mishra Ashish , Shah Jayal , Dhariya Saurabh , Singh Gaurav
Published: January 2024

ABSTRACT

Patients presenting with ST-elevation in myocardial infarction (STEMI) have transmural ischemia and require early reperfusion therapy. However, in about half of the patients with such ischemia, ST elevations are not seen on an electrocardiogram (ECG). Such STEMI equivalent ECGs need to be evaluated and reperfusion done at the earliest to salvage the jeopardized myocardium.
Late-onset periodic catatonia with atypical course: A diagnostic quandary
Authors: Kaur Gurneet , Singh Swarndeep , Das Subhash , Gupta Vipin
Published: January 2024

We describe a case of late-onset periodic catatonia with atypical course in an elderly male with onset at the age of 70 years with brief episodes of sudden agitation lasting for a few hours of the day, followed by immobility, mutism, ambitendency, withdrawal, and urinary incontinence for the next few days. Four such episodes with complete recovery over the next few days and no residual behavioral symptoms lasting for several years (up to 7 years) without any long-term prophylactic psychotropic use. During the fourth such episode, the patient presented to our facility with a similar abrupt onset of symptoms. All biochemical investigations and neuroimaging findings were found to be noncontributory. On clinical examination, a diagnosis of periodic catatonia was suspected, which was later confirmed by immediate response to the intravenous diazepam challenge given under vitals monitoring in a high-dependency unit setting.
The gray clouds within: Depression and loneliness among the elderly population in urban Bengaluru – A cross-sectional study
Authors: Sangeetha M. D. , Deepthi R. , Menon P. K. Sreenath
Published: January 2024

Background:

Aging is a global phenomenon. Depression and loneliness among the elderly are significant mental health concerns, often overlooked and underestimated in society. Globally, depression amounts to a loss of 2% disability-adjusted life years. India is 2nd most populous in the world by elderly population, depression and loneliness are often overlooked due to various reasons. Therefore, this study aims to explore the proportion of depression and loneliness and to determine their association with loneliness and other sociodemographic factors.

Methodology:

A community-based cross-sectional study was conducted among 132 elders (age ≥60 years) in three wards of the urban area of Bengaluru. Geriatric Depression Scale 15 and Three-Item Loneliness Scale were used to assess depression and loneliness, respectively. The association between depression and loneliness was analyzed with other demographic variables using Chi-square and Bivariate logistic regression.

Results:

The magnitude of depression and loneliness among the elderly population was found to be 75.7% and 91%, respectively. Depression was significantly associated with elderly 60–69 years, females, with minimal education (illiterate), homemakers, number of family members >4, with no income, and dependent on others. Loneliness is significantly associated with the female gender, with illiterates, those who are not working and homemakers, below poverty line card holders, those with chronic diseases, and those dependent on others compared to their counterparts. There is a significant positive correlation between depression and loneliness scores among the elderly.

Conclusion:

The higher proportion of depression and loneliness among the elderly in our study emphasizes the necessary supportive measures. It needs to be addressed adequately through a coordinated primary care approach with community and social support.
Can basic magnetic resonance imaging along with neuropsychological assessment be used as a cost-effective means for the detection of early dementia in the Indian sub-continent?
Authors: Chepure Ashish Hanmantrao , Subramanyam Alka A. , Ungratwar Apurva Karmveer
Published: January 2024

Introduction:

The mild cognitive impairment (MCI) stage occurs sporadically between healthy aging and the onset of Alzheimer’s disease (AD). MCI shows significant defacement in magnetic resonance imaging (MRI) of the brain along with neuropsychological and behavioral parameters.

Aim:

Assessment of neuropsychological, behavioral, and structural MRI changes in MCI and their relation with each other.

Methodology:

Seventy-eight participants in the MCI group and healthy controls (HC) were assessed using Addenbrooke’s Cognitive Examination (ACE), Mini-Mental Status Examination (MMSE), Clinical Dementia Rating Scale (CDR); and behavioral assessment by using Behavioral Pathology In AD (BEHAVE-AD). MRI brain volumetric analysis was performed using the software MYRIAN. Statistical analysis was performed using the Mann–Whitney U test, unpaired t-test (P = <0.05), and Spearman’s rank correlation.

Results:

MCI group showed significant impairments in ACE, MMSE, and CDR and significantly higher behavioral symptoms on BEHAVE-AD. Episodic memory had a significant positive correlation with normalized right hippocampal volume and total intracranial volume (TICV). Remote memory had a significant negative correlation with normalized left hippocampal volumes. Global CDR score had a moderately negative correlation with normalized right and left hippocampal volumes. Affective disturbances were negatively correlated with TICV.

Conclusions:

Comparable analysis of correctly scaled neuropsychological assessments may provide unbiased proxies for MRI-based measures of dementia risk.
Surgical effect and gastrointestinal functional recovery of laparoscopic-guided total mesorectal excision in patients with rectal cancer
Authors: Jiang Xingli , Cai Zhenfeng , Dai Xintao , Pan Luofeng
Published: January 2024

Introduction:

To explore the surgical effect and gastrointestinal functional recovery of laparoscopic-guided total mesorectal excision (LGTME) in patients with rectal cancer.

Patients and Methods:

A total of 150 rectal cancer patients who underwent surgical treatment in our hospital from July 2022 to July 2023 were selected and randomly divided into two groups using a random number table. There were 75 cases in the control group (CG) who underwent traditional open rectal total mesorectal excision surgery and 75 cases in the experimental group (EG) who underwent LGTME. The surgical effects of the two groups were compared, and the gastrointestinal and anal functional recovery of the two groups were compared before and after treatment.

Results:

Intraoperative bleeding, incision length, time to initial feeding and time to anal exhaust in the EG were significantly lower than those in the CG (P < 0.05). Before treatment, there was no significant difference in gastrointestinal function and anal function between the two groups (P > 0.05). After treatment, the levels of motilin, gastrin, neuropeptide Y and basic fibroblast growth factor in the EG were significantly higher than those in the CG, with statistical significance (P < 0.05); the maximum anal systolic pressure and resting anal sphincter pressure in the EG were significantly lower than those in the CG (P < 0.05); the rectal sensitivity threshold volume (RSTV) and rectal maximum volume threshold in the EG were significantly higher than those in the CG (P < 0.05). There was no significant difference in most postoperative complications between the two groups (P > 0.05).

Conclusion:

LGTME improves the surgical effects of rectal cancer patients, promotes the recovery of gastrointestinal function and has a small effect on anal function indicators, thereby reducing hospital stay.
The use of lidocaine infusion in laparoscopic cholecystectomy: An updated systematic review and meta-analysis
Authors: Awan Bakhtawar , Elsaigh Mohamed , Elkomos Beshoy Effat , Sohail Azka , Asqalan Ahmad , Baqar Safa Owhida Mousa , Elgendy Noha Ahmed , Saleh Omnia S. , Szul Justyna Malgorzata , Juan Anna San , Alasmar Mohamed , Marzouk Mohamed Mustafa
Published: January 2024

Being one of the most common abdominal surgical procedures, numerous techniques have been adapted to decrease post-operative pain post cholecystectomy. However, the efficacy of intravenous (IV) lidocaine in managing post operative pain after LC is still controversial, according to many recent studies. This study aims to detect the effectiveness of IV lidocaine compared to other medications in managing post-operative pain. PubMed, Scopes, Web of Science and Cochrane Library were searched for eligible studies from inception to June 2023, and a systematic review and meta-analysis was done. According to eligibility criteria, 14 studies (898 patients) were included in our study. The pooled results of the included studies showed that the pain score after 6, 12 and 24 h after the surgery was significantly lower in those who received IV lidocaine as a painkiller (Visual Analogue Scale [VAS] 6H, mean difference [MD] = −1.20, 95% confidence interval [CI] = −2.20, −0.20, P = 0.02; I
2 = 98%, VAS 12H, MD = −0.90, 95% CI = −1.52, −0.29, P = 0.004; I
2 = 96% and VAS 24H, MD = −0.86, 95% CI = −1.48, −0.24, P = 0.007; I
2 = 92%). In addition, IV lidocaine is associated with a significant decrease in the opioid requirement after the surgery (opioid requirements, MD = −29.53, 95% CI = −55.41, −3.66, P = 0.03; I
2 = 98%). However, there was no statistically significant difference in the incidence of nausea and vomiting after the surgery between the two groups (nausea and vomiting, relative risk = 0.91, 95% CI = 0.57, 1.45, P = 0.69; I
2 = 50%). Lidocaine infusion in LC is associated with a significant decrease in post operative pain and in opioid requirements after the surgery.
Management of Recurrence in Retinoblastoma Based on the Source of Tumor Cells
Authors: Thaker Shivna K. , Shah Parag K. , Das Abhishek , Maitra Puja
Published: January 2024

PURPOSE:

The aim was to study the characteristics of recurrence patterns in the form of scar recurrence, new lesions, and vitreous seeds which is necessary in anticipating future events for the management of retinoblastoma (RB).

METHODS:

This retrospective analytical observational study was conducted in a tertiary care hospital in South India; we included 64 eyes of 45 patients having RB from January 2019 to July 2020. The inclusion criterion was treatment-naïve patients with > 12 months of follow-up period. Recurrence patterns were defined as Pattern 1a and Pattern 1b: local and diffuse dissemination of vitreous seeds, respectively. Pattern 2: Scar recurrences: these are new tumor growths over chemoreduced lesions. Pattern 3: New lesions: local dissemination of subretinal seeds leading to new lesions elsewhere in the retina.

RESULTS:

A noncomparative analysis of 64 eyes of 45 patients having 108 lesions was studied; of which 28/45 (62.22%) were male and 17/45 (37.78%) were female. The mean time of presentation since the first clinical sign was 40 days (range: 10–180). The most common sign at presentation was leukocoria 42/64 (65.6%), followed by squint 4/64 (6.34%). Nineteen patients (42.22%) had bilateral RB, while 26 patients (57.78%) had unilateral RB. Primary enucleation was done for 19/26 eyes with advanced unilateral disease. Out of the total 32 eyes with subretinal tumor seeds at presentation, 17/32 eyes had a recurrence in the form of new lesions (Pattern 3) and 22/32 eyes had scar recurrence (Pattern 2). All of these 32 eyes were salvaged by local tumor consolidation methods. Recurrence due to vitreous seed dissemination was found in 18/64 eyes, in which diffuse dissemination (Pattern 1b) was present in 8/18 eyes (44.4%); all required enucleation even after local and systemic chemotherapeutic measures. Rest 10/18 eyes with local vitreous seeds (Pattern 1a) were cured at the end of the follow-up. Globe salvage was more with Pattern 1a rather than Pattern 1b even after additional intravitreal chemotherapy.

CONCLUSION:

All eyes with Patterns 2 and 3 were salvaged at the end of follow-up with local tumor consolidation methods, while the globe salvage rate with Pattern 1 was poor even with multiple doses of intravitreal chemotherapy. The rate of successful treatment for managing these recurrence patterns depends on early identification by regular follow-ups with detailed retina examination.
Eye Health Integration in Southern and Eastern Africa: A Scoping Review
Authors: Ogundo Cynthia L. A. , Bascaran Covadonga , Habtamu Esmael , Buchan John , Mwangi Nyawira
Published: January 2024

Integrated health systems are deemed necessary for the attainment of universal health coverage, and the East, Central, and Southern Africa Health Community (ECSA-HC) recently passed a resolution to endorse the integration of eye health into the wider health system. This review presents the current state of integration of eye health systems in the region. Eight hundred and twelve articles between 1946 and 2020 were identified from four electronic databases that were searched. Article selection and data charting were done by two reviewers independently. Thirty articles met the eligibility criteria and were included in the narrative synthesis. Majority were observational studies (60%) and from Tanzania (43%). No explicit definition of integration was found. Eye health was prioritized at national level in some countries but failed to cascade to the lower levels. Eye health system integration was commonly viewed in terms of service delivery and was targeted at the primary level. Eye care data documentation was inadequate. Workforce integration efforts were focused on training general health-care cadres and communities to create a multidisciplinary team but with some concerns on quality of services. Government funding for eye care was limited. The findings show eye health system integration in the ECSA-HC region has been in progress for about four decades and is focused on the inclusion of eye health services into other health-care programs. Integration of comprehensive eye care into all the health system building blocks, particularly financial integration, needs to be given greater emphasis in the ECSA-HC.
Preoperative and Intraoperative Spontaneous Scleral Rupture: A Case Report and Review of Literature
Authors: AlAmry Mohammed , Alahareef Esraa , Aljebreen Abdulrahamn , AlJudaibi Ramzi
Published: January 2024

Scleral rupture is a rare but significant complication that can occur due to multiple risk factors. In this report, we discuss two instances of scleral perforation that happened during a silicone oil injection and after a peribulbar injection. Our study suggests that prior ocular surgery is a further risk factor for intraoperative scleral rupture, and more investigation is required to identify additional relevant risk factors that weaken the sclera.
Parent’s Awareness of Preventive Measures for Digital Eye Strain Syndrome among Saudi Students after 1 Year of Online Studies – A Survey
Authors: AlHarkan Dora H.
Published: January 2024

PURPOSE:

The digital eye strain (DES) is of public health magnitude in students undertaking online studies during the COVID-19 pandemic. The DES prevention strategies will be effective if all stakeholders, including parents, work together. We present an awareness level of preventive measures among parents of students studying online for 1 year.

METHODS:

This web-based survey was held in December 2021. Parents of Saudi students in the Qassim region responded to 15 questions about the preventive measures for DES. The responses were summed up and graded into very poor, poor, good, and excellent. The level of awareness was associated with determinants.

RESULTS:

The awareness was excellent in 566 of 704 (80.4%) (95% confidence interval 77.5–83.3) participants. Parents had poor awareness about the importance of the 20-20-20 rule (43.8%), frequent blinking (56.7%), using digital devices beyond studies (57.4%), using eye lubricants while using a digital device (56%), and using devices at night in lying position (69.6%). Excellent awareness was significantly associated with primary-level students (P = 0.0004), those having ophthalmic consultation in the past (P = 0.02), and students with DES (P = 0.0006). Parents with excellent awareness were not satisfied with online studies of their wards (P = 0.001).

CONCLUSION:

Awareness of parents about preventive measures to address DES in students is relatively high. However, health promotion is recommended, especially focusing on the weak areas to improve DES and its impact on students.
Single Low-dose Suprachoroidal Triamcinolone Acetonide Injection in Macular Edema Secondary to Noninfectious Posterior Uveitis
Authors: Anand Abhishek , Sinha Shivani , Gupta Abhishek , Shree Srishtee , Ambasta Anita , Sinha Bibhuti P. , Azad Rajvardhan
Published: January 2024

PURPOSE:

The purpose was to study the anatomical and functional outcome following single low-dose suprachoroidal triamcinolone acetonide (LD-SCTA) (2 mg) injection in noninfectious posterior uveitis.

METHODS:

Eleven patients with macular edema (ME) more than 280 μ secondary to noninfectious uveitis were included in the study. A single LD-SCTA (0.5 ml) injection was performed in the study eye with the help of a novel suprachoroidal microneedle (Pricon, Iscon Surgicals, Jodhpur, Rajasthan, India). The study parameters were noted at 4 and 12 weeks post LD-SCTA injection.

RESULTS:

Ten of 11 patients had a significant decrease in central macular thickness (CMT). The mean CMT measurement at baseline was 513.6 ± 191.73 μm for the 10 patients who responded to the treatment, which reduced significantly to 265.1 ± 34.72 μm (P < 0.003) and 260.6 ± 34.72 μm (P < 0.002) at 4 and 12 weeks, respectively. The mean best-corrected visual acuity (BCVA) at baseline was 0.84 ± 0.41 logMAR unit which improved to 0.52 ± 0.33 (P < 0.001) and 0.25 ± 0.22 (P < 0.000) at weeks 4 and 12, respectively. The mean intraocular pressure at baseline recorded was 16.36 ± 2.97 mmHg, 19.45 ± 4.80 mmHg (P = 0.06) at 4 weeks, and 17.27 ± 2.53 mmHg (P = 0.35) at 12 weeks. One eye which did not respond to LD-SCTA was a case of recurrent Vogt–Koyanagi–Harada disease.

CONCLUSION:

Single LD-SCTA injection is efficacious in reducing CMT in ME, improving BCVA, and controlling the inflammation in noninfectious posterior uveitis. LD-SCTA can be used as a first-line therapy in noninfectious uveitis over other routes of steroid administration with a favorable outcome and safety profile.
Lung cancer screening for never smokers: current evidence and future directions
Authors: See Kay Choong
Published: January 2024

Screening for lung cancer using low-dose computed tomography is an established means for early lung cancer detection in smokers, but the role of screening for never smokers is unclear. In the 13 lung cancer screening studies involving unselected never smokers, detection rates ranged from 0.1% to 1.1% and positive predictive values ranged from 0.4% to 4.5%. In three lung cancer screening studies involving selected never smokers, selection was based primarily on occupational asbestos exposure, environmental radon exposure and family history of lung cancer in first-degree relatives. Detection rates ranged from 0.3% to 2.6%, and positive predictive values ranged from 0.7% to 15%. Also, 80%–100% of lung cancer cases discovered by screening were early stage, with limited data suggesting survival benefit. Lung cancer screening for never smokers with selected risk factors may achieve detection rates similar to those of screening for high-risk ever smokers. However, further research on optimal subject selection, alternative screening methods and clinical/economic outcomes is needed.
Functional Outcome of Subvastus versus Medial Parapatellar Approaches for Total Knee Replacement in Patients with Knee Osteoarthritis: A Prospective Cohort Study
Authors: Aladraii Adnan Ahmed , Allehaibi Lama Zaki , Fattani Amjad Abdulrahman , Alkhudairy Taif Abdullah , Al-Margan Albatoul Mohammed , Al-Dubai Sami Abdo Radman , Mohammed Abdulrahman Abdulraof , Mohorjy Doaa K. , Alqarni Abdulhakeem Saeed
Published: January 2024

Background:

Subvastus approach and medial parapatellar approach are two major approaches for total knee replacement (TKR). There is no global consensus on the superiority of either approach in terms of functional outcomes.

Objective:

The present study aimed to evaluate the functional outcome of TKR through subvastus approach and medial parapatellar approach by using patient-reported scores at 3-, 6-, and 12-month post-operative follow-ups.

Methods:

This prospective cohort follow-up study included patients with knee osteoarthritis who underwent elective primary TKR either through the subvastus or medial parapatellar approaches at King Abdullah Medical City, Makkah city, Kingdom of Saudi Arabia, from January 2019 to December 2022. Scores from the self-reported Oxford Knee Score (OKS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were compared in the two groups of patients at 3-, 6-, and 12-month post-operative follow-ups.

Results:

A total of 98 patients were included, of which 37 underwent TKR through the subvastus approach and 61 through the medial parapatellar approach. There was an overall significant change over time in both WOMAC and OKS scores (P < 0.001). Patients who underwent the subvastus approach had significantly higher mean of WOMAC and OKS than patients with the medial parapatellar approach at the 3- and 6-month follow-ups (P < 0.05), but not at the 12-month follow-up.

Conclusions:

For TKR, the medial parapatellar approach results in better functional outcomes at the 3- and 6- month follow-up periods compared with the subvastus approach.
Spectrum of Organic Aciduria Diseases in Tunisia: A 35-year Retrospective Study
Authors: Jelassi Awatef , Nasrallah Fahmi , Talbi Emna , Hammami Mohamed Bassem , Ghodbane Rihab , Sanhaji Haifa , Feki Moncef , Kaabachi Naziha , Hadj-Taieb Sameh
Published: January 2024

Background:

Organic aciduria diseases (OADs) occur worldwide, with differences in prevalence and patterns between populations.

Objectives:

To describe the spectrum of OADs identified in Tunisia over a 35-years period.

Materials and Methods:

This retrospective study included patients who were diagnosed with OADs between 1987 and 2022 in the Laboratory of Biochemistry, Rabta Hospital, Tunisia. Organic acids were analyzed using gas chromatography–mass spectrometry.

Results:

A total of 30,670 urine samples were analyzed for OADs, of which 471 were positive for OADs. The estimated incidence of OADs in Tunisia was 6.78 per 100,000 live births. Methylmalonic (n= 146) and propionic (n= 90) acidurias were the most common OADs (estimated incidence: 2.10 and 1.30 per 100,000 live births, respectively). There were 54 cases of L-2-hydroxyglutatric acidurias and 30 cases of pyroglutamic acidurias, which makes it one of the highest in the world. The main clinical features were hypotonia (65%) and feeding difficulties (41%). Age at diagnosis was highly variable, ranging from 1 day to 49 years. Only 27% of the patients were diagnosed within the first month of life. The prevalence of OADs was highest in the Center-East and Southeast regions.

Conclusions:

In Tunisia, OADs are relatively frequent, but there are shortcomings regarding the diagnosis of these disorders. The frequency and health/social impact of these disorders warrant the need for implementing newborn screening programs and suitable patient management.
Primordial and Primary Prevention of Ischemic Stroke in Saudi Arabia: A Combination Approach and Evolving Concepts
Authors: Algahtani Hussein , Shirah Bader , Hachinski Vladimir
Published: January 2024

Ischemic stroke is a considerable public health hazard and a significant cause of disability and mortality in Saudi Arabia. Primary prevention strategies in the country are currently limited. With the health sector transformation program that depends on the principles of value-based care and applying the new model of care in disease prevention, aggressive and serious steps for primary stroke prevention are expected to be implemented. This article reviews primordial and primary prevention of ischemic stroke in Saudi Arabia and suggests a combination approach and framework for implementation. We provide a pragmatic solution to implement primordial and primary stroke prevention in Saudi Arabia and specify the roles of the government, health professionals, policymakers, and the entire population. Currently, there are several key priorities for primordial and primary stroke prevention in Saudi Arabia that should target people at different levels of risk. These include an emphasis on a comprehensive approach that includes both individual and population-based strategies and establishing partnerships across health-care providers to share responsibility for developing and implementing both strategies. This is an urgent call for action to initiate different strategies suggested by experts for primary stroke prevention in Saudi Arabia.
Lipid Management in Kidney Transplant Recipients Per KDIGO and American Heart Association Guidelines: A Single-Center Experience
Authors: Arabi Ziad , Tawhari Mohammed , Alghamdi Abdullah Ashour , Alnasrullah Ahmad
Published: January 2024

Background:

The 2013 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommends statin treatment for all adult kidney transplant recipients (KTRs), except those aged <30 years of age and without prior cardiovascular risk factors (CVRF), but does not specify on-treatment low-density lipoprotein cholesterol (LDL) target levels. The 2018 American Heart Association (AHA) guidelines addressed the management of hyperlipidemia in the general population based on an individualized approach of the CVRF with a specific on-treatment LDL target.

Objective:

To analyze dyslipidemia management according to the recommendations of the KDIGO and AHA guidelines.

Methods:

This retrospective study included all KTRs who underwent transplantation between January 2017 and May 2020 at King Abdulaziz Medical Center, Riyadh, Saudi Arabia. The rate of statins prescription in general, rate of statins prescription among KTRs per their CVRF, and rate of achieving the proposed LDL goals, as defined by the AHA, were analyzed.

Results:

A total of 287 KTRs were included. Of the 214 (74.6%) patients aged ≥30 years, 80% received a statin. Statins were prescribed in 93% and 96% of KTRs with diabetes or coronary artery disease, respectively. In patients aged ≥30 years, LDL targets, per AHA guidelines, were achieved in 62% with a target of 2.6 mmol/l, and in 19% with a target of 1.8 mmol/l. Statin therapy resulted in non-significant changes in the mean LDL values from baseline to 12 months after transplantation (P = 0.607), even when only patients prescribed statin after transplantation were included (P = 0.34).

Conclusion:

By applying the KDIGO guidelines, a high rate of statin prescriptions was achieved among KTRs with multiple CVRF and KTRs in general. However, a significant proportion of these KTRs did not achieve the LDL targets proposed by the AHA guidelines, suggesting that higher-intensity statins would be required to achieve these targets.
Endoscopic transmaxillary approach to the inferior rectus muscle in correcting traumatic diplopia
Authors: Chang Jin-Yu , Chao Yun-Ting , Wang An-Gour , Yu Wei-Kuang
Published: January 2024

Traumatic diplopia can be caused by an entrapped, ruptured, or lost extraocular muscle, which is clinically challenging. Numerous surgical approaches can be tailored, depending on which muscle is involved. We present a patient suffering from inferior rectus muscle disruption treated with endoscopic transmaxillary approach and muscle plication procedure. This surgical technique is a novel and effective surgical technique in managing traumatic diplopia.
Selection of Study Sites and Participants for Research into Nepal’s Federal Health System
Authors: Wasti Sharada Prasad , van Teijlingen Edwin , Simkhada Padam , Rushton Simon , Balen Julie , Subedi Madhusudan , Karki Jiban , Adhikary Pratik , Sapkota Sujata , Gautam Sujan , Marahatta Sujan , Panday Sarita , Bajracharya Bikesh , Vaidya Anju ,   for the Nepal Federal Health System Team
Published: January 2024

Introduction:

This article offers insights into the process of selecting representative study sites and participants in a longitudinal study in Nepal. As part of the research design process, the selection of representative areas in a large-scale study requires both intellectual and practical considerations.

Methods:

We briefly introduce our study into the impact of federalization on Nepal’s health system before outlining the criteria considered for the identification of fieldwork sites and the most appropriate study participants for the qualitative interviews and participatory components of this research.

Findings:

The selected areas are presented with an overview of the areas selected and their justification. The study sites and participants should consider a broader coverage with diverse participants’ backgrounds. Several factors can influence the identification and recruitment of the right participants, including the use of appropriate gatekeepers, gaining access to recruit participants, logistical challenges, and participant follow-up.

Conclusion:

We conclude that longitudinal qualitative research requires a carefully selected diverse set of study sites and participants to assess the complexities and dynamics of the health system and service provision to ensure that longitudinal research is representative and effective in addressing the research question(s) being investigated.
On the cross-product conjecture for the number of linear extensions
Authors: Chan Swee Hong , Pak Igor , Panova Greta
Published: January 2024

We prove a weak version of the cross-product conjecture:

$\textrm {F}(k+1,\ell ) \hskip .06cm \textrm {F}(k,\ell +1) \ge (\frac 12+\varepsilon ) \hskip .06cm \textrm {F}(k,\ell ) \hskip .06cm \textrm {F}(k+1,\ell +1)$

, where

$\textrm {F}(k,\ell )$

is the number of linear extensions for which the values at fixed elements

$x,y,z$

are k and

$\ell $

apart, respectively, and where

$\varepsilon>0$

depends on the poset. We also prove the converse inequality and disprove the generalized cross-product conjecture. The proofs use geometric inequalities for mixed volumes and combinatorics of words.
Associations of depressive symptoms with lower extremity function and balance in Korean older adults
Authors: Kim Bong Jo , Ha Kyupin , Kim Hyun Soo , Bae Hye Ran , Son Minkook
Published: January 2024

OBJECTIVES: The relationship of depressive symptoms to lower extremity function and balance, especially in older adults without a depression diagnosis, remains unclear. Therefore, our study analyzed this relationship using a large sample of Korean older adults.METHODS: We used data from the Korean National Health Insurance Service’s Health Screening Program database. Individuals aged 66 years who had undergone the National Screening Program for Transitional Ages in Korea and were without a diagnosis of depressive disorder were included. The lower extremity function and balance were evaluated using 2 physical tests, while depressive symptoms were assessed using a 3-question survey. Multivariable-adjusted logistic regression analysis was used to examine the association between depressive symptoms and lower extremity function and balance.RESULTS: Among 66,041 individuals, those with depressive symptoms showed significantly higher rates of abnormal lower extremity function and abnormal balance. The adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association of depressive symptoms to abnormal lower extremity function and abnormal balance were (aOR, 1.34; 95% CI, 1.25 to 1.44) and (aOR, 1.38; 95% CI, 1.29 to 1.48), respectively. Assessment of the relationship based on depressive symptom scores revealed that higher scores were associated with higher aORs (p for trend <0.001). Subgroup analyses further confirmed this relationship, especially among patients with cerebrovascular disease or dementia.CONCLUSIONS: This study revealed an association between depressive symptoms and the abnormal lower extremity function and balance of 66-year-old individuals without a diagnosis of depressive disorder.
Torque, Threaded Application, Electrical Connector, Accessory and Terminal Board Installation
Authors:   AE-8C1 Connectors Committee
Published: January 2024

This SAE Aerospace Information Report (AIR) is intended to provide guidelines to tightening methods and torque values as applied to electrical connectors, related hardware and switches, relays, circuit breakers, and A-A-59125 type terminal boards. The connectors and associated hardware discussed herein are typically manufactured from aluminum alloy, high-grade engineering thermoplastics, or corrosion-resistant steel, and typically plated with a protective/conductive coating. These guidelines may be used where no rules have been mandated either contractually or otherwise.
Aluminum Alloy, Alclad, Sheet 5.7Zn - 2.2Mg - 1.6Cu - 0.22Cr (Alclad 7475-T761) Solution and Precipitation Heat Treated
Authors:   AMS D Nonferrous Alloys Committee
Published: January 2024

This specification covers an aluminum alloy in the form of alclad sheet 0.040 to 0.249 inch (1.02 to 6.32 mm), inclusive, in nominal thickness (see 8.5).
Unveiling the silent link: Normal-tension glaucoma's enigmatic bond with cardiac blood flow
Authors: Ramesh Prasanna Venkatesh , Morya Arvind Kumar , Aradhya Ajanya K , Pannerselvam Pavithra , Gopalakrishnan Sai Thaejesvi , Ramesh Shruthy Vaishali , Devadas Aji Kunnath , Krishna Navaneeth
Published: January 2024

This comprehensive review embarks on a captivating journey into the complex relationship between cardiology and normal-tension glaucoma (NTG), a condition that continues to baffle clinicians and researchers alike. NTG, characterized by optic nerve damage and visual field loss despite normal intraocular pressure, has long puzzled clinicians. One emerging perspective suggests that alterations in ocular blood flow, particularly within the optic nerve head, may play a pivotal role in its pathogenesis. While NTG shares commonalities with its high-tension counterpart, its unique pathogenesis and potential ties to cardiovascular health make it a fascinating subject of exploration. It navigates through the complex web of vascular dysregulation, blood pressure and perfusion pressure, neurovascular coupling, and oxidative stress, seeking to uncover the hidden threads that tie the heart and eyes together in NTG. This review explores into the intricate mechanisms connecting cardiovascular factors to NTG, shedding light on how cardiac dynamics can influence ocular health, particularly in cases where intraocular pressure remains within the normal range. NTG's enigmatic nature, often characterized by seemingly contradictory risk factors and clinical profiles, underscores the need for a holistic approach to patient care. Drawing parallels to cardiac health, we examine into the shared vascular terrain connecting the heart and the eyes. Cardiovascular factors, including systemic blood flow, endothelial dysfunction, and microcirculatory anomalies, may exert a profound influence on ocular perfusion, impacting the delicate balance within the optic nerve head. By elucidating the subtle clues and potential associations between cardiology and NTG, this review invites clinicians to consider a broader perspective in their evaluation and management of this elusive condition. As the understanding of these connections evolves, so too may the prospects for early diagnosis and tailored interventions, ultimately enhancing the quality of life for those living with NTG.
Venous Doppler flow patterns, venous congestion, heart disease and renal dysfunction: A complex liaison
Authors: Di Maria Alessio , Siligato Rossella , Bondanelli Marta , Fabbian Fabio
Published: January 2024

The World Journal of Cardiology published an article written by Kuwahara et al that we take the pleasure to comment on. We focused our attention on venous congestion. In intensive care settings, it is now widely accepted that venous congestion is an important clinical feature worthy of investigation. Evaluating venous Doppler profile abnormalities at multiple sites could suggest adequate treatment and monitor its efficacy. Renal dysfunction could trigger or worsen fluid overload in heart disease, and cardio-renal syndrome is a well-characterized spectrum of disorders describing the complex interactions between heart and kidney diseases. Fluid overload and venous congestion, including renal venous hypertension, are major determinants of acute and chronic renal dysfunction arising in heart disease. Organ congestion from venous hypertension could be involved in the development of organ injury in several clinical situations, such as critical diseases, congestive heart failure, and chronic kidney disease. Ultrasonography and abnormal Doppler flow patterns diagnose clinically significant systemic venous congestion. Cardiologists and nephrologists might use this valuable, non-invasive, bedside diagnostic tool to establish fluid status and guide clinical choices.
Remesas e impacto económico en la Zona 7 de Ecuador, periodo 2010-2021
Authors: Sotomayor-Pereira Jorge Guido , Macías Sares Bernard César , Alexandra Belduma Nathaly , Jadán Sánchez Víctor Manuel
Published: January 2024

Este artículo presenta un estudio sobre las tendencias migratorias y el impacto económico de las remesas en la Zona 7 de Ecuador. Se utilizó una metodología de investigación documental y descriptiva para recopilar y analizar datos de diversas fuentes escritas, y se representaron visualmente las tendencias a través de tablas y gráficos de líneas. Los resultados muestran que la migración y las remesas han tenido un impacto significativo en la economía local y nacional, y se discuten las implicaciones de estos hallazgos para la política pública y la sociedad en general.
ZOOMORPHIC SYMBOL OF THE YASE
Authors: Туаллагов А.А.
Published: January 2024

Статья посвящена продолжению исследования по проблемам геральдических сим- волов алан раннего средневековья. В ней обращается внимание на исключительные сведе- ния славянских источников о таком символе алан-асов как олень. Учитывая возможные сложности в верификации данных сведений, предлагается обращение к дополнительным археологическим и фольклорно-этнографическим данным. Установлено, что образ оленя в этнокультурной традиции ираноязычного «скифо-сакского мира» был связан с тотеми- ческими культами, служил символом солнца и плодородия, соотносился с царскими куль- тами. Культ оленя как тотемного животного представлен и в аланских материалах, где со временем он сочетается с христианской традицией. Образ оленя занимает особое место в фольклорно-этнографической традиции осетин, в которой следует особо выделить его связь с солярным представлениями и воинскими традициями. В аланском мире также ве- роятна его связь с солярным культом, божественным началом и с идеей обновления, пред- ставленная в материалах памятников социальных верхов общества. Не исключено, что в данном случае наблюдается непосредственная связь с соответствующими социальными традициями азиатского региона.

The article is devoted to the continuation of the study on the problems of the heraldic symbols of the Alans of the early Middle Ages. It draws attention to the exceptional information of Slavic sources about such a symbol of the Alans-Ases as a deer. Given the possible difficulties in verifying this information, it is proposed to refer to additional archaeological and folkloreethnographic data. It is established that the image of a deer in the ethno-cultural tradition of the Iranian-speaking «Scythian-Saka world» was associated with totemic cults, served as a symbol of the sun and fertility, correlated with royal cults. The cult of the deer as a totem animal is also represented in the Alanian materials, where over time it is combined with the Christian tradition. The image of a deer occupies a special place in the folklore and ethnographic tradition of the Ossetians, in which its connection with solar representations and military traditions should be emphasized. In the Alanian world, its connection with the solar cult, the divine principle, and with the idea of renewal, presented in the materials of the monuments of the social elites, is also probable. It is possible that in this case there is a direct connection with the corresponding social traditions of the Asian region.
ONE MORE TIME ABOUT THE CAPITAL OF ALANIA
Authors: Дзиццойты Ю.А.
Published: January 2024

Настоящая статья является продолжением работы автора о местонахождении сто- лицы Алании, опубликованной под названием «В поисках столицы Алании». Для опреде- ления местонахождения столицы Алании ученые обычно обращаются к сведениям араб- ских и китайских источников, а также к археологическим данным о средневековых алан- ских городищах. В первой части своей работы автор этих строк предпринял попытку до- полнить эти сведения данными осетинского языка и фольклора. В настоящей публикации вопрос о столице Алании решается с помощью грузинских источников, практически полностью выпавших из поля зрения исследователей. В результате этих поисков автор приходит к выводу о том, что наиболее приемлемой является гипотеза, согласно которой столица Алании находилась на территории современной Северной Осетии в местности Æрджынарæг (Дзылат).

This article is a continuation of the author’s work on the location of the capital of Alania, published under the title “In Search of the Capital of Alania”. To determine the location of the capital of Alania, scientists usually turn to information from Arab and Chinese sources, as well as archaeological data about medieval Alanian settlements. In the first part of his work, the author of the given article attempted to supplement this information with data from the Ossetian language and folklore. In this publication, the issue of the capital of Alania is resolved with the help of Georgian sources, which have almost completely fallen out of researchers’ view. As a result of these searches, the author comes to the conclusion that the most acceptable hypothesis is that the capital of Alania was located on the territory of modern North Ossetia in the area of Ærdzhynaræg (Dzylat).
Nationalism: Essence, Issues of Prevention and Counteraction in Bodies and Institutions of the Russian Penal System
Authors: Оганесян С.С.
Published: January 2024

Введение: в статье рассматриваются проблемы националистических воззрений, возникшие в последние десятилетия не только в России, но и во многих государствах, что ставит под угрозу стабильность в различных регионах. Цель: показать, что понятие «национализм», являясь порождением современной ментальной цивилизации, напрямую связано с закономерным и неизбежным переходом человечества от жизни по религиозным канонам к жизни «по собственному разумению», определить пути противостояния формированию националистических взглядов в пенитенциарных учреждениях. Результаты: автор считает, что действенным методом противодействия националистическим воззрениям в уголовно-исполнительной системе России станет основанный на конкретных примерах рассказ сотрудников о становлении семьи, рода, племен, формировании обычаев и традиций. Необходимо понять, что насильственное навязывание другому этносу или народу своих языка, культуры, традиций, обычаев, ценностного мира и норм бытия противоречит тенденциям развития человечества. Показано, что понятия «национализм» в силу ряда объективных причин, связанных с исторически обусловленной цивилизационной ментальностью этносов и народов, не существовало в религиозных эпохах. Вывод: автор, отмечая актуальность исследуемой проблемы и ее многоаспектность, предлагает разработать специальную систему профилактики и противодействия национализму в уголовно-исполнительной системе России, требующую соответствующей подготовки сотрудников.

Introduction: the article considers problems of nationalist views that have recently arisen not only in Russia, but also in many states, which threatens stability in various regions. Purpose: to show that the concept of “nationalism”, being a product of modern mental civilization, is directly related to the natural and inevitable transition of mankind from life according to religious canons to life “according to their own understanding”. Results: the author believes that to effectively counter nationalist views in the Russian penal system, its employees should familiarize convicts with the formation of a family, clan, tribes, as well as customs and traditions. It is necessary to disseminate the idea that forcible imposition of one’s own language, culture, traditions, customs, the value world and norms of being on another ethnic group or people contradicts human development trends. The article shows that the concept of “nationalism”, due to a number of objective reasons related to the historically conditioned civilization mentality of ethnic groups and peoples, did not exist in religious epochs. Conclusion: the author, noting the relevance of the problem under study, points to its multidimensional nature and proposes, taking into account the results formulated in the article, to develop a special system of prevention and counteraction to nationalism in the Russian penitentiary system, with appropriate training and retraining of its employees.