bluuebunny/crossref_metadata_2025 huggingface dataset:
Operation method for the air purifier and ventilation systems of old school classrooms considering noise
Authors: Haseong Kim , Hooseung Na , Taeyeon Kim
Published: June 2023

Old schools with low airtightness performance are vulnerable to outdoor fine dust. Air purifier and ventilation systems are typically used to improve indoor air quality. However, due to the noise that these systems generate, some classrooms do not operate these mechanical facilities despite the deterioration of indoor air quality. This study aimed to propose a ventilation operation method for appropriate improvement of indoor air quality through CONTAMW simulation while minimizing students' disturbance from noise from air purifier and ventilation systems. By controlling the volume of air in the air purifier and ventilation system, it is possible to minimize this disturbance in an old school and effectively improve indoor air quality.
Impact of carpets on perceived indoor air quality
Authors: Noorian Najafabadi Seyyed Abbas , Sugano Soma , Bluyssen Philomena M.
Published: June 2023

Indoor air quality (IAQ) plays an important role in human health and well-being as people spend most of their time indoors. Among building materials, carpets covering high surface areas and having dense fibres have the potential to impact perceived IAQ. To explore the impact of carpets on perceived IAQ, it was studied whether low-emitting wool carpets can ‘clean’ the air. To assess the sorption effect of emissions of hardboard (as a permanent source) on carpet, untrained subjects were asked to assess a combination of low-odour emitting carpet and hardboard in one sample container and only hardboard in another sample container of test chamber. The results showed a slight (although not statistically relevant) difference in favour of the combination, indicating a slight adsorption effect.
Indoor environmental quality evaluation of smart/artificial intelligence techniques in buildings – a review
Authors: Aldakheel Joud , Bahrar Myriam , El Mankibi Mohamed
Published: June 2023

The built environment sector is responsible for around one-third of the world's final energy consumption. Smart technologies play an essential role in strengthening existing regulations and facilitating energy efficiency targets. Smart Buildings allow the response to the external conditions of buildings including grid and climatic conditions, and internal building needs such as user requirements achieved through real-time monitoring and real-time interaction which are resembled the smart buildings concept. The optimal management of occupant comfort plays a crucial role in the built environment since the occupant's productivity and health are highly influenced by Indoor Environmental Quality. This work explores the application of real-time monitoring and interaction to achieve optimal Indoor Environmental Quality, occupant comfort and energy savings in relation to smart buildings and smart technologies. To better address and indoor air quality issues, ventilation needs to become smarter. It is crucial to understand first the Key Performance Indicators of evaluating smart ventilation. In parallel, Artificial Intelligence techniques such as machine and deep learning have been increasingly and successfully applied to develop solutions for the built environment. Thus, this paper provides a review on the existing Key Performance Indicators that allows smart ventilation in smart buildings. Then, it reviews the existing literature on the machine and deep learning methods and software for assessing the smart ventilation. Finally, it shows the most recent technologies for performing experimental evaluation on the main indicators for smart ventilation. This work is expected to highlight the selection of the most optimal ventilation metrics, proper indicators, machine learning and deep learning models and measurement technologies to achieve excellent Indoor Environmental Quality and energy efficiency levels.
Thermal comfort prediction considering thermal adaptation based on facial temperature using thermal images and subjective indexes
Authors: Kim Sung-Kyung , Ryu Ji-Hye , Hong Won-Hwa
Published: June 2023

The aim of this study is to predict thermal comfort based on a subjective evaluation index of occupants and thermal imaging data, which are physiological signals, while considering thermal adaptation. This study was conducted in an office in the winter, and three subjective evaluation indexes were used. Air temperature data was obtained using a specific equipment, and the facial temperature was recorded using a thermal imaging camera. Based on analysis, thermal adaptation yielded different results at the same facial temperature. In previous studies, a facial temperature of 33 °C before thermal adaptation signified discomfort. However, the same facial temperature of 33 °C after thermal adaptation signified comfort. This implies that simple indexes and physiological signals based on thermal imaging are insufficient to predict the subjective thermal sensation of occupants. Therefore, accuracy of thermal comfort prediction can be improved significantly by considering thermal adaptation using the existing subjective evaluation indexes as well as by considering the results of studies pertaining to facial temperature.
Transformative Service Research and impact of indoor environmental quality on workers’ productivity: Potentialities of neuroscience in its assessment
Authors: Caratù Myriam , Pigliautile Ilaria
Published: June 2023

Previous research demonstrated that there is a link between workers’ productivity and their overall comfort in the workspaces. Nowadays, the energy crisis is highlighting the need for energy saving measures also in workplaces to reduce expenses, thus posing threats to the overall comfort of workers: how to deal with this trade-off? In such a frame, this paper is a traditional literature review of the research, conducted so far, useful to understand the optimal point of energy needed to secure human wellbeing in workspaces (and thus, acceptable productivity). Moving from an overview of the most common adopted methodologies and related findings, this work focuses on applications and opportunities associated with merging methods from neuroscience. Neuroeconomics, in fact, uses some indexes (cognitive interests, mental fatigue) and techniques (EEG, heart rate) that allow to understand whether a person is focused on his/her work or not: this can represent a double-check of the optimal level of environmental comfort in offices. Environmental comfort studies concerning the adoption of physiological monitoring are compared here to business management studies lying on physiological indexes to assess employees’ interest and cognitive effort, which influence their productivity. This comparison showed up new perspectives in the investigation of occupants’ productivity and environmental comfort, which can be pursued in the coming years to understand how to achieve the optimum between energy consumption and workers’ productivity.
Thermal performance evaluation of a cool roof model in hot – dry climate
Authors: Basher Tayseer
Published: June 2023

Roof is an essential component of the building envelope which is exposed direct solar radiation and contributes to the maximum load of the total cooling load of the building; and is an essential interface between the indoor and outdoor environments and to be strong enough to withstand all weather conditions; and it covered nearly 20–25% of overall urban surface areas. In the hot and summer seasons, the components of the building envelope must be designed to minimize the discomfort. Recently, many studies were revealed and showed that there can be different solutions to the excessive heat problem through the roof. But in Sudan, no significant research was conducted for cool roofs scenario, so more comprehensive experimental and simulation analyses need to be performed for different climatic zones to establish cool roof standards specific to the Sudan context in the future. The requirement of thermal comfort is a primary need in residential buildings located on hot-dry climates. The thermal performance of cool roof model will be analysed in terms of indoor temperature compared to Flat roof configuration of Reinforced Concrete (R.C), plaster, and cool paint roof for hot –dry climate, Indore, Khartoum state, Sudan. The study aims to assess the impact of the cool roof on the indoor temperature of buildings, on the other hand indicates that a cool roof performed better for indoor temperature profile and maintains a thermal comfort in buildings. Thermal performance modelling was undertaken for analysed in term of thermal performance of the cool roof. The cool roof technology is more useful and easy to implement in all residential buildings, both old or under construction to reduce indoor temperature.
A Preliminary Study on Improving Thermal Comfort of Traditional Factories via Forced Ventilation in Taiwan
Authors: Tsay Yaw-Shyan , Shih Ya-Wen , Yeh Yu-Chun
Published: June 2023

In Taiwan, the indoor environment of factories can be classified into precisely controlled environments, austere environments, and eclectic environments. Compared with the precisely controlled environments of the electronics/medicine industries, eclectic environments of such traditional industries as footwear, textiles, or light metal processing generally use forced ventilation instead of HVAC systems to improve indoor thermal comfort. In this study, the design strategies of negative pressure fans in a large-span factory were studied, and 0.6-3.0 m/s was defined as the effective wind speed range via thermal comfort index for evaluating improvement. We first carried out an experimental study to determine an effective distance of fans, and the results were used to validate simulation via computational fluid dynamics. A simulation study was then carried out to study the design strategies of fan installation in factories with 30 m spans. The results showed that the simulation model fit the experimental data well in the first stage and that 15 m was the best distance for installing an auxiliary fan in all cases with various inlet wind velocities. In the simulation studies, the results demonstrated that the effective wind percentage can be improved 40%~60% through proper design, which provides significant potential for energy-saving and thermal comfort in traditional factories.
Numerical investigation on kitchen environment in cooking under three types of natural make-up airflow with a Chinese-style residential kitchen
Authors: Liu Yu , Li Chong , Ma Hongqiang , Dong Jiankai , Luo Xinmei
Published: June 2023

Kitchen indoor environment is not always satisfied due to unfavourable thermal condition and poor air quality in domestic cooking especially for Chinese-style residential kitchen (CRK). Traditional CRKs are only equipped with a range hood with natural make-up air from window openings or cracks. Thus, this paper made numerical simulation to study kitchen indoor environment under three natural air make-ups. Three kinds of natural make-up conditions were selected in this simulation. Computational fluid dynamics (CFD) method was conducted. Results show that there was a uniform temperature distribution in working zone of occupant under window open condition but was up to 34.4°C. In breathing zone, air temperature exceeded the accepted thermal comfort. Velocity magnitude was up to 0.9 m/s among three conditions, and was the highest in the vicinity of the stove under window open condition. Under insufficient air make-up, maximum velocity was observed in the central line of the kitchen. Through sufficient controlled well-organized air make-up in kitchen, particle mean and maximum concentration could be reduced by 77% and 68%, respectively.
Air Change and Transfer Efficiencies within a Cross-Ventilated Room Model Sheltered by Urban-Like Block Arrays using RANS simulations
Authors: Itokazu Ryu , Bryan Fernandez Ken , Ito Kazuhide
Published: June 2023

Natural and cross ventilation is recognized as an important measure for introducing outdoor fresh air to indoor without the use of mechanical equipment. Plenty of fruitful studies for elucidating natural and cross ventilation mechanisms have been reported adopting experimental and computational methods. Field and wind tunnel experiments could provide substantial flow information on indoor-outdoor interaction in actual or reduced model conditions. However, these approaches were relatively costly and time-consuming and limited in terms of spatial and temporal resolutions. Computational fluid dynamics approaches are promising complementary technique to these methods. In this study, we performed isothermal CFD simulations for both airflow and concentration fields for cross-ventilation conditions sheltered by surrounding buildings with two different opening conditions. ANSYS/Fluent was utilized to perform CFD using RANS simulation. Heterogeneity of ventilation efficiencies determined by concentration distributions in cross-ventilated room model were quantitatively analyzed using ventilation efficiencies, e.g., age of air. The results showed that the location of the openings had a significant impact on the cross-ventilation rate, creating completely different concentration fields, and ventilation efficiencies indices could quantitatively demonstrate the formation mechanisms of scalar concentration distributions in an indoor space.
Experimental study on vertical void for improving natural ventilation in midrise double-loaded apartments
Authors: Kumar Nikhil , Kitagawa Haruka , Alfata Muhammad Nur Fajri , Maeda Tasuku , Nakahara Daiki , Kubota Tetsu , Asawa Takashi , Hirayama Yukari , Trihamdani Andhang Rakhmat
Published: June 2023

Affordable apartments in tropical developing countries generally have double-loaded corridors to maximise the total floor areas. Building designs with double-loaded corridors often suffer from poor environmental conditions. Passive design using a vertical void can help improve the natural ventilation in the such building design. This study investigates the effectiveness of vertical voids in enhancing the wind speed in the building. An experimental building with a vertical void, open pilotis, penthouse at rooftop and wind fin on the ground floor to help direct air to the void was constructed in Tegal, Indonesia. Five cases were considered by controlling the window openings, louver openings on the roof and change in fin size at pilotis. Wind speed and direction were recorded at one-second intervals. High wind speed was experienced in the pilotis and void when the wind direction is from the north and the wind speed in the void improved due to the wind fin being placed on the south corridor of the building. The results show the average wind speed in the void is twice as high as compared to the corridors. The building design performed best with high wind speeds in the void and corridores when all windows were kept open.
Design and analysis of a window-integrated passive system (WIPS) with the use of solar heat gains
Authors: Eftekhar Fatemeh , Yoon Nari , Heo Yeonsook
Published: June 2023

As one of the passive building design strategies to decrease ventilation energy consumption, several window-integrated passive systems (WIPS) have been developed and implemented into buildings. This study proposed a new WIPS inspired by a double skin façade (DSF) design that provides pre-heating and ventilation by utilizing solar heat gains collected in the air cavities. The performance of the proposed WIPS was analyzed and developed based on different design parameters such as material, width, height, shape, depth, and opening area, for the wintertime in Seoul, Korea. Furthermore, the computational fluid dynamics model, Fluent 2021 R2 with the RNG k-epsilon turbulence model, was used for the simulation. To focus on the buoyancy effect occurring in the air cavities, the influence of wind was excluded from the CFD modelling and analysis. Therefore, 0 Pa pressure differences between the inlet and outlet of the room were applied. The results showed that the buoyancy effect increased in the WIPS with a wider and higher inflow cavity than a case with narrower and shorter cavity, also utilizing glass material for the cavity surfaces exposed to the outside resulted in absorbing more solar radiation and more buoyancy effect. Moreover, the converged shape cavity increased the volume flow rate of the cavity due to the increased air velocity from the Venturi effect. Overall, all design parameters can impact the performance of WIPS either by hindering or assisting the airflow of the WIPS.
A smart zero-energy building having bidirectional interaction with electricity/heating networks: An attempt to achieve a higher renewable penetration
Authors: Behzadi Amirmohammad , Nourozi Behrouz , Harsem Trond Thorgeir , Sadrizadeh Sasan
Published: June 2023

The present research introduces an innovative zero-energy building complex equipped with a rule-based control approach for higher integration of renewable resources in the local energy network while bringing down energy costs. The idea centers on establishing several smart controllers to achieve a bidirectional interaction with the heating/electricity network for peak demand shaving and mitigate energy costs. The proposed system comprises Alkaline fuel cells integrated with a hydrogen storage tank driven by either a vanadium chloride cycle or an electrolyzer unit. The system also has an absorption chiller and smart thermal energy storage to supply the heating and cooling demands. TRNSYS-MATLAB developed code is applied to assess the system's indicators from techno-economic standpoints for a residential building complex in the Scandinavian climate. Also, the parametric investigation and time-dependent analysis are carried out to examine the impact of decision parameters and the ambient condition. According to the results, the solar system's physical appearance is very important since it significantly affects performance efficiency and total cost. The results further reveal that picking up the cells' current from 300 A to 500 A improves the performance efficiency by around 12% while lowering the total cost, illustrating the importance of optimization. The results highlight the importance of smart controllers by showing that over 70% of the year's net energy values are positive, indicating that the proposed system may meet demand and sell excess electricity+heating productions to regional networks. The results further demonstrate that since the net energy values are positive for the majority of days in the spring and summer, the system might operate more independently from the local energy networks on warmer days. Eventually, the higher share of solar in summer and wind energy in colder days for hydrogen production shows that the renewable resources combination results in a secure energy supply to obtain the highest independence from the local grid throughout the year.
A new contribution ratio for indoor climate (CRISE) for the contribution evaluation of each heat and moisture source to the specific enthalpy in a closed space
Authors: Suda Hana , Kobayashi Hikaru , Mori Gaito
Published: June 2023

The indoor thermal environment comprises temperature, humidity, wind velocity, and radiant temperature. The spatial distribution of these elements is a combination of the individual responses of the heat and water vapor transported into the space from each source. The contribution ratio for indoor climate (CRI) proposed by Kato, Kobayashi, and Murakami is a single index that evaluates the effect of each heat source on the temperature by breaking down the temperature increase at position x in a room into the effect of each heat source. We extended the CRI concept to three single indices to improve its applicability. Previously, thermal environment evaluation was often performed using a composite index rather than a single index. To evaluate the combined effects of heat and moisture sources, decomposing multiple elements individually and then combining them is desirable. In this study, we propose CRISE to evaluate the contribution of a heat or moisture source to the specific enthalpy at a given point in a closed space. The index was calculated by combining a single index of dry-bulb temperature and absolute humidity. The CRISE is a useful index for evaluating the indoor thermal environment and HVAC load.
Subject experiment on personal air-conditioning airflow using a vortex ring
Authors: Chikamoto Tomoyuki , Ueda Keisuke
Published: June 2023

A personal air conditioning system using vortex rings, which are characterized by their linearity and low diffusivity, is developed in this study. The authors have clarified the characteristics of the vortex ring airflow by LES (unsteady CFD) and full‐scale experiments. However, the airflow type and worker's comfort using vortex rings as an air conditioning system has not been clarified yet. As a result of the subject experiments, it became clear that air conditioning with vortex rings cooled the subjects better than conventional air conditioning and improved their sense of comfort with respect to the airflow. In addition, it was found that airflow to the neck was more effective since the subjects were less likely to feel the airflow at the top of the head due to the resistance of the hair on the head. The effectiveness of the vortex ring as a personal air conditioning system was clarified, enabling relaxation of the room temperature setting. The comfortability of the airflow sensation provided by the vortex ring was also examined when further airflow was given.
Experimental study on insulation performance of structured-core transparent vacuum insulation panels for different core materials
Authors: Hirvonen Erkki , Miyata Takato , Katsura Takao , Nagano Katsunori
Published: June 2023

The conversion of existing buildings to ZEH and ZEB requires increased thermal insulation, in which the insulation of window surfaces is particularly important. This study focused on measuring and comparing the changes in thermal conductivity of transparent vacuum insulation panels (TVIP), which could be used as simple and easy to install insulation to building windows. These changes were later compared with the results obtained from previous studies conducted by other research group members. The measured thermal conductivity values ranged between 0.017 W/(m*K) of the best performing frame-type with the thickness of 5.1 mm, and 0.011 W/(m*K) of the best performing double-layered peak-type core with the thickness of 7.8 mm. The calculated U-values of the samples ranged between 4.1 W/(m2*K) and 1.4 W/(m2*K). From the experimental results it could be seen that changing the core composition had a larger effect on the overall thermal conductivity of the sample than the added parameters of coating, getter agent, and heating had. These parameters, however, have had a substantial effect on the longevity of the vacuum inside the sample envelopes, and will thus be experimented further.
Experimental study on the wind-driven rain absorption of different exterior finishing stone materials
Authors: Hu Xing , Zhang Huibo , Qian Tianda
Published: June 2023

Wind-driven rain (WDR) is one of the sources of moisture in building facades and poses a major threat to the insulation performance and longevity of walls. Studies have been conducted to include WDR in the moisture boundary of building facades, but exactly how much rainwater can be absorbed by the wall is not yet clear. To understand the absorption of WDR by building exterior materials, nine types of exterior finishing stone materials were selected for the study and the absorption of WDR by different materials was measured. The results show that the factors affecting the absorption of WDR include not only physical parameters such as porosity, but also depend on whether the material surface is waterproof, on the amount of WDR during rainfall and on the water saturation of the material. Based on the multiple regression fitting, the WDR absorption ratio calculation model was defined with water content saturation, porosity and cumulative WDR amount as the influencing factors. The model provides a reference for the setting of building simulation parameters for exterior moisture boundary conditions of building facades.
Smart-Energy-Sharing Scenarios Based on Actual Usage in the Community
Authors: Seong Namchul , Shim Chan-Hyung , Hong Goopyo , Choi Gyeong-Seok
Published: June 2023

The purpose of this study is to develop an energy sharing scenario for buildings within the community. This work developed an energy sharing scenario for buildings in a community consisting of several types of buildings. The community are mainly composed of low-rise building, including offices. Six buildings with energy usage measurement equipment installed in the community were selected and the energy use status of the building was measured. The electric energy consumption and electric energy production of buildings were predicted using a simulation program. Electrical energy was produced using photovoltaic panels installed in buildings. Energy consumption patterns of buildings were analysed. There are four scenarios in which the energy produced is shared with each building. The first scenario uses photovoltaic as much power as it generates, and does not use surplus power. The second scenario is to reverse transmission the surplus power to the source. The third scenario is to store surplus power in the ESS and use it for the next day's peak load. The fourth scenario is to collect surplus power into the Community's ESS and share it with the most energy-intensive buildings. After comparing the four developed scenarios, it was found the most efficient and optimal sharing scenario based on buildings in the community. Results can be used as a method for sharing electrical energy produced using photovoltaic system in a small-scale community.
Verification of Applicability Positioning Systems with Thermopile Human Sensor in Office
Authors: Oura Masamichi , Yokota Takefumi , Hayashi Tatsuya
Published: June 2023

The purpose of this study is a discussion on the multifaceted utilization of indoor positioning systems such as building facility control, use situation grasping, and operational analysis in offices. Thermopile human sensors have been come into practical use by MEMS (Micro Electro Mechanical Systems) technology and are becoming widespread. In this report, the accuracy of presence / absence and human count detection for a thermopile human sensor was verified and discussed possibility of use according to the purpose in the office.
Mammakarzinom beim Mann
Authors: Preuss Caroline , Wunderle Marius , Hack Carolin C. , Beckmann Matthias W. , Wenkel Evelyn , Jud Sebastian Michael , Heindl Felix
Published: June 2023

Männlicher Brustkrebs ist für viele Ärzte ein unbekanntes Gebiet. Die Patienten gehen oft zu verschiedenen Ärzten, bevor die richtige Diagnose gestellt wird – meist zu spät. Dieser Artikel soll Risikofaktoren sowie die Einleitung von Diagnostik und Therapie aufzeigen. Im anbrechenden Zeitalter der molekularen Medizin werden wir auch einen Blick auf die Genetik werfen.
The Effect of COVID-19 on the Efferent Auditory System in Adults
Authors: Çelikgün Bahtiyar , Sarlık Esra , Yurdakul Çınar Fatma
Published: June 2023

Abstract Background This study evaluated the effects of coronavirus disease 2019 (COVID-19) on the cochlea and auditory efferent system with transient evoked otoacoustic emissions (TEOAE) and contralateral suppression (CS). Objective We aimed
to evaluate the pre- and post-COVID-19 TEOAE and CS results in the same participants to reveal the effect of COVID-19 on the efferent auditory system. Study Design The CS measurement was performed twice for each participant before a diagnosis of COVID-19 and after treatment
for COVID-19 as a within-subjects study design. All participants exhibited hearing thresholds below 25 dB HL at all frequencies and all participants demonstrated bilateral Type A tympanograms. The tests were performed in the linear mode using a double probe on the Otodynamics ILO292-II device.
The CS of the otoacoustic emissions was measured at 65 dB peSPL TEOAE stimulus and 65 dB SPL broadband noise. All parameters including reproducibility, noise, and stability were considered during the measurements. Study Samples The study included 11 patients (eight
females and three males) aged between 20 and 35 years (mean age, 26 ± 3.66). Data Collection and Analysis Wilcoxon signed rank test and Spearman's correlation test were used for statistical analysis using the Statistical Package for the Social Sciences
version 23.0. Results The Wilcoxon signed rank test showed that there was no significant difference between the pre-and post-COVID-19 TEOAE CS results in all tested frequencies and measurement parameters, 1000 to 4000 Hz, Z = −0.356, −0.089,
−0.533, −0.533, −1.156, and p < 0.05. Although not statistically significant, the CS results obtained post-COVID-19 at all frequencies, except 4000 Hz, were lower than those before COVID-19. According to the overall TEOAE results after COVID-19,
a statistically significant decrease was observed at 3000 Hz (Z = −2.847, p < 0.01) and 4000 Hz (Z = −2.401, p < 0.05) compared with the premeasurement. Conclusion The
study findings show that severe acute respiratory syndrome coronavirus 2 can affect the cochlea and the auditory efferent system in adults. Post-COVID-19 audiological evaluation can also be considered part of a general medical examination.
Assessment of the Degree of Clinical Suspicion of 21-Hydroxylase
Deficiency Prior to the Newborn Screening Result
Authors: Sanz Fernández María , Mora Sitja Marina , Carrascón González-Pinto Lucía , López Herce Arteta Estíbaliz , Rodríguez Sánchez Amparo
Published: June 2023

The aim of the study was to analyze the clinical suspicion and where patients
were when they received the positive result of the neonatal screening for CAH
21OHD. The present data derived from a retrospective analysis of a relatively
large group of patients with classical CAH 21OHD patients nosed by newborn
screening in Madrid, Spain. During the period from 1990 to 2015 of this study 46
children were diagnosed with classical 21OHD [36 with the salt-wasting (SW) form
and 10 with simple virilizing (SV)]. In 38 patients, the disease had not been
suspected before the neonatal screening result (30 SW and 8 SV). Thirty patients
(79%) were at home without suspicion of any disease, as healthy
children, 3 patients (8%) were at home pending completion of the study
due to clinical suspicion of any disease (ambiguous genitalia, cryptorchidism)
and 5 patients (13%) were admitted to the hospital for reasons unrelated
to CAH (sepsis, jaundice, hypoglycemia). It is relevant to note that
69.4% of patients (25/36) with SW form were at home with
potential risk of adrenal crisis. Six females had been incorrectly labeled as
male at birth. The most frequent reason for clinical suspicion was genital
ambiguity in women followed by family history of the disease. Neonatal screening
provided better results than clinical suspicion. In the majority of patients
with 21OHD the diagnosis by screening was anticipated to the clinical suspicion
of the disease even in female patients with ambiguous genitalia.
Bilateral Percutaneous Transpedicular Drainage under Local Anesthesia for Thoracic Tuberculous Spondylitis
Authors: Maki Yoshinori , Takayama Motohiro , Go Kohichi
Published: June 2023

Tuberculous spondylitis is a common spinal infection. If surgical intervention is necessary, anterior debridement and anterior fixation are typically performed. However, a minimally invasive surgical strategy under local anesthesia seems rarely implemented.

A 68-year-old man presented with severe pain in the left flank. Whole spinal magnetic resonance imaging revealed abnormal intensity of vertebral bodies from T6–9. A bilateral paravertebral abscess extending from T4–10 was suspected. The T7/T8 intervertebral disc was destroyed, but severe vertebral deformity or spinal cord compression was not observed. Bilateral percutaneous transpedicular drainage under local anesthesia was planned. The patient was set in the prone position. Under the guide of a biplanar angiographic system, the bilateral drainage tubes were placed paravertebrally in the abscess cavity. The left flank pain improved after the procedure. Laboratory culture of the pus specimen confirmed a diagnosis of tuberculosis. A chemotherapy regimen for tuberculosis was soon initiated. The patient was discharged during postoperative week 2, with continuation of chemotherapy for tuberculosis.

Percutaneous transpedicular drainage under local anesthesia can be effective in the management of thoracic tuberculous spondylitis without severe vertebral deformity or compression of the spinal cord by an abscess.
Effect of Multimodal Intervention on Cancer-Related Fatigue and Quality of Life among Patients Undergoing Cancer Treatment—Pilot Study (Part 1)
Authors: Shambhavi Shambhavi , Lobo Diana
Published: June 2023

Background Cancer-related fatigue (CRF) is the most common and devastating problem in cancer patients even after successful treatment. CRF has a severe impact on daily activities, social relationships, reintegration, and overall quality of life (QOL).

Objective This study was done to evaluate the effect of multimodal intervention (MMI) on CRF and QOL among cancer patients undergoing cancer treatment.

Materials and Methods One group before-and-after study (pre-experimental design) was conducted among cancer patients undergoing cancer treatment who met inclusion criteria and were selected using a purposive sampling technique, in selected hospitals. MMI consisted of exercise program, acupressure, and home care management guide. Pre-test CRF and QOL were assessed on first day using a FACIT-F scale (Functional Assessment of Chronic Illness Therapy: Fatigue) and Functional Assessment of Cancer Therapy: Fatigue (FACT-G) Version 4, respectively. Post- test for CRF was further determined after 7 days, 21 days, and 3months and QOL was determined after 21 days and 3 months.

Statistical Analysis Demographic and clinical characteristics of the participants are presented as frequency and percentage. Comparison of pre- test and post-test means of CRF and QOL is done by repeated measures analysis of variance (ANOVA). Correlation between fatigue and QOL of cancer patients was found by using Pearson correlation test.

Results The mean pre-test fatigue score of the cancer patients (pre-test mean= 25.21) was lower than their mean post-test fatigue scores (post-test 1 =25.83, post-test 2 = 28.28, and post-test 3 = 34.72). There was a significant difference in CRF and QOL scores between before and after the MMI. In the repeated measures ANOVA, p-value is less than 0.05 (level of significance p < 0.05).

Conclusion Regardless of mechanism of occurrence of fatigue, most patients living with cancer suffer with persistent CRF. Yet it is often not assessed, has limited treatment options, there is a need to assess the state of fatigue in cancer patients. They do need intervention to reduce the fatigue and to improve the QOL. Nonpharmacological therapies are the best strategies to manage the fatigue among cancer patients without any safety issue.
Aortoiliac: Covered, Uncovered, CERAB as It Relates to Peripheral Arterial Disease
Authors: Bozorghadad Sayeh , Scheidt Matthew J. , Patel Parag J.
Published: June 2023

Peripheral arterial disease (PAD) affects over 200 million worldwide and is the leading cause of major limb amputation, with individuals suffering from PAD being at three times greater risk of dying compared with matched controls. TASC-II guidelines provide a consensus on the management of PAD based on the collaboration between international vascular specialties. These guidelines previously outlined open surgery as the gold standard for treatment of aortoiliac disease and PAD as it has demonstrated consistent long-term results. However, this approach is also associated with high perioperative mortality, especially when compared with endovascular techniques. With recent developments in endovascular technology, user technique, and experience, this approach has become more widely used as primary intervention for aortoiliac disease. One of these novel techniques includes covered endovascular reconstruction of the aortic bifurcation, which has demonstrated excellent technical success and improved primary and secondary patency rates with follow-up. The aim of this review is to compare the efficacy of these approaches to the treatment of aortoiliac disease and demonstrate the benefits of the shift toward an endovascular-first approach to treatment of this disease, regardless of lesion complexity or severity.
Case Report with a Review of Literature: Pancoast Syndrome—A Rare Presentation of Metastatic Hepatocellular Carcinoma
Authors: Singuluri Lakshmi Sandhya , Ganesan Prasanth , Srinivas Bheemanathi Hanuman , Dubashi Biswajit , Nisha Yadav
Published: June 2023

Superior sulcus tumors, also known as Pancoast tumors, present in a distinctive way with Horner's syndrome (ptosis, miosis, and anhidrosis), hand weakness brought on by the atrophy of the intrinsic hand muscles, and excruciating pain along the medial aspect of the arm. (1) Primary lung cancers constitute a majority of Pancoast tumors, but Pancoast syndrome can be multifactorial. (2) Here, we present a case of 62-year-old male who presented with right shoulder pain and weakness for 2 months. Clinically, he had a supraclavicular mass with atrophy of the intrinsic muscles of the hand and sensory-motor weakness. Computed tomography showed a mass lesion in the supraclavicular fossa with the erosion of the T1 vertebra and first rib, mimicking carcinoma right upper lobe. However, the biopsy from the mass was suggestive of metastasis from hepatocellular carcinoma (HCC). Our case report identifies HCC as a rare differential for Pancoast syndrome and highlights the unique metastatic presentation.
Percutaneous Snaring and Retrieval of Cephalad Migrated Double J Stents in Pediatric Patients–A Bailout Technique Urologists Should Know
Authors: Nandolia Khanak K. , Chauhan Udit
Published: June 2023

Double J (DJ) stents are placed in patients with obstructive uropathy to relieve the obstruction. Curved ends prevent slippage or migration of the stent. Antegrade migration into the urinary bladder or retrograde migration into the ureter are common complications. Mode of retrieval of migrated stents depends upon the location of the stent. We present a case series of four cases with percutaneous snaring of cephalad migrated DJ stents in pediatric patients.
Anxiety and Depression Symptoms of Family Members of Intensive Care Unit Patients: A Prospective Observational Study and the Lived Experiences of the Family Members
Authors: Gurbuz Hande , Demir Nalan
Published: June 2023

Background The aim of this study is to investigate the factors affecting symptoms of anxiety and depression in the family members of critically ill patients.

Methods This prospective cohort study was conducted in an adult tertiary care mixed medical–surgical intensive care unit (ICU) at a tertiary-level teaching hospital. The symptoms of anxiety and depression of first-degree adult relatives were evaluated with the Hospital Anxiety and Depression Scale. Four family members were interviewed and asked about their experiences during the ICU process.

Results A total of 84 patients and their family members were included in the study. The symptoms of anxiety were present in 44/84 (52.4%), and depression was present in 57/84 (67.9%) family members. A nasogastric tube was found to be related to anxiety (p = 0.005) and depressive symptoms (p = 0.002). The family members of the patients with an acute developed illness had 3.9 (95% confidence interval [CI]: 1.4–10.9) times the odds of having the symptoms of anxiety and 6.2 (95% CI: 1.7–21.7) times the odds of having the symptoms of depression than the family members of the patients with an illness developed on a chronic basis. The family members of the patients who died in the ICU had 5.0 (95% CI: 1.0–24.5) times the odds of being depressed than the patients discharged from the ICU. All interviewees stated having difficulty understanding and remembering what was told. The common feelings of all the interviewees were desperation and fear.

Conclusions Awareness of the emotional stress of family members can help develop interventions and attitudes to alleviate symptom burden.
Effects of Recombinant SARS-CoV-2 Spike Protein Variants on Platelet Morphology and Activation
Authors: Vettori Marco , Carpenè Giovanni , Salvagno Gian Luca , Gelati Matteo , Dima Francesco , Celegon Giovanni , Favaloro Emmanuel J. , Lippi Giuseppe
Published: June 2023

Platelets are central elements of hemostasis and also play a pivotal role in the pathogenesis of thrombosis in coronavirus disease 2019. This study was planned to investigate the effects of different severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) recombinant spike protein variants on platelet morphology and activation. Citrated whole blood collected from ostensibly healthy subjects was challenged with saline (control sample) and with 2 and 20 ng/mL final concentration of SARS-CoV-2 recombinant spike protein of Ancestral, Alpha, Delta, and Omicron variants. Platelet count was found to be decreased with all SARS-CoV-2 recombinant spike protein variants and concentrations tested, achieving the lowest values with 20 ng/mL Delta recombinant spike protein. The mean platelet volume increased in all samples irrespective of SARS-CoV-2 recombinant spike protein variants and concentrations tested, but especially using Delta and Alpha recombinant spike proteins. The values of both platelet function analyzer-200 collagen-adenosine diphosphate and collagen-epinephrine increased in all samples irrespective of SARS-CoV-2 recombinant spike protein variants and concentrations tested, and thus reflecting platelet exhaustion, and displaying again higher increases with Delta and Alpha recombinant spike proteins. Most samples where SARS-CoV-2 recombinant spike proteins were added were flagged as containing platelet clumps. Morphological analysis revealed the presence of a considerable number of activated platelets, platelet clumps, platelet-monocyte, and platelet-neutrophils aggregates, especially in samples spiked with Alpha and Delta recombinant spike proteins at 20 ng/mL. These results provide support to the evidence that SARS-CoV-2 is capable of activating platelets through its spike protein, though such effect varies depending on different spike protein variants.
The Frequency of SMN1, SMN2 Copy Numbers in 246 Turkish Cases Analyzed with MLPA Method
Authors: Yalcintepe Sinem , Karal Yasemin , Demir Selma , Atli Emine Ikbal , Atli Engin , Eker Damla , Mail Cisem , Zhuri Drenushe , Guler Hazal Sezginer , Gurkan Hakan
Published: June 2023

This study aimed to define the copy numbers of SMN1 and SMN2 genes and the diagnosis rate and carrier frequency of spinal muscular atrophy (SMA) in the Thrace region of Turkey. In this study, the frequency of deletions in exons 7 and 8 in the SMN1 gene and SMN2 copy numbers were investigated. A total of 133 cases with the preliminary diagnosis of SMA and 113 cases with the suspicion of being an SMA carrier from independent families were analyzed by multiplex ligation-dependent probe amplification method for SMN1 and SMN2 gene copy numbers.

SMN1 homozygous deletions were detected in 34 patients (25.5%) of 133 cases with the suspicion of SMA. Cases diagnosed with SMA type I was 41.17% (14/34), 29.4% (10/34) with type II, 26.4% (9/34) with type III, and 2.94% (1/34) with type IV. The SMA carrier rate was 46.01% in 113 cases. In 34 SMA cases, SMN2 copy numbers were: two copies – 28 cases (82.3%), three copies – 6 cases (17.6%). SMN2 homozygous deletions were detected in 15% (17/113) of carrier analysis cases. The consanguinity rate of the parents was 23.5% in SMA diagnosed cases. In this study, we had a 25.5% of SMA diagnosis rate and 46% SMA carrier frequency. The current study also showed the relatively low consanguinity rate of the Thrace region, with 23.5% according to the east of Turkey.
Below-the-Knee Stents and Scaffolds: A Comprehensive Review
Authors: Dadrass Farnaz , Raja Sahitya C. , Lookstein Robert
Published: June 2023

Below-the-knee intervention of chronic limb-threatening ischemia is an area of increasing interest. Due to lower morbidity and possibly better clinical outcomes, endovascular techniques have become increasingly important in this patient population many of who have limited surgical options. This article serves as a review of existing stent and scaffolding devices utilized for infrapopliteal disease. The authors will additionally discuss current indications and review studies that are investigating novel materials used in treating infrapopliteal arterial disease.
Peripheral Arterial Disease Treatment in the Non-Hospital Setting
Authors: Wiechmann Bret N.
Published: June 2023

Treatment of peripheral artery disease (PAD) has undergone a progressive shift toward less invasive, endovascular options within the last three decades. For PAD patients, the benefits of this shift are numerous and include less periprocedural pain, decreased blood loss, shorter recovery times, and fewer missed workdays. Commonly, patient-reported outcomes are very positive with this “endovascular first” strategy and the number of open surgical procedures for various stages of PAD has declined steadily over the last 20 years. Coincident with this trend is the move toward “ambulatory” lower extremity arterial intervention (LEAI) in the hospital outpatient “same-day” department. The next logical extension was then performing LEAI in a true physician office-based lab (OBL), ambulatory surgical center (ASC), or “non-hospital setting.” This article examines these trends and the concept that the OBL/ASC provides a safe, alternative site of service for PAD patients requiring LEAI.