bluuebunny/crossref_metadata_2025 huggingface dataset:
L’administration de la preuve scientifique et l’appréciation de sa force probante dans le procès pénal
Authors: Sénéchal Carole , Léger-Riopel Nicholas
Published: September 2024

Dans la majorité des cas, l’admissibilité des techniques neuroscientifiques et neuropsychiatriques – utilisées comme outils de diagnostic ou utilisées par les experts au soutien de leur témoignage – ne pose pas problème. Au plan individuel, l’impact des preuves neuroscientifiques varie au cas par cas, au gré des aléas du procès et toujours pondéré au regard d’autres éléments de preuve disponibles. Lorsqu’elles mettent en évidence l’existence de certaines lésions ou anomalies de fonctionnement cérébral, les preuves neuroscientifiques sont le plus souvent considérées en tant qu’une circonstance atténuante militant pour une responsabilité criminelle moindre ou encore comme un facteur neutre ne faisant pencher la balance d’aucun côté. Elles pourraient préjudicier à l’accusé dans certaines circonstances lorsque la cause de lésions serait imputable à l’accusé, comme une intoxication volontaire. Au reste, l’admissibilité des preuves neuroscientifiques en tant qu’outils de diagnostic n’est pas contestée.
Le contentieux constitutionnel au Gabon
Authors: Ondo Télesphore
Published: September 2024

Le contentieux constitutionnel au Gabon est structurellement organisé autour de la Cour constitutionnelle. Il se présente sous deux catégories : un contentieux des textes juridiques et un contentieux du pouvoir. Son objectif est non seulement la garantie de l’État de droit, mais aussi la consolidation de la démocratie pluraliste. Toutefois, ce rôle de la Cour constitutionnelle dans le contentieux constitutionnel ne doit pas être surévalué et sa portée surestimée. En effet, l’opérationnalité de cette « machine juridictionnelle » s’avère manifestement contingente au regard de ses effets mitigés, lesquels mettent en exergue le verrouillage l’alternance démocratique et la fragilisation de l’État de droit.
Émergence de la justice para-constitutionnelle en Afrique subsaharienne
Authors: Sobze Serge François
Published: September 2024

Tout comme le principe de laïcité qui progressivement sent de l’encens, l’État en Afrique dégage la fumée des coups d’État, propulsant résolument son destin entre le charybde et le scylla. Il se crée en effet, un mouvement balancier faisant de l’ordre étatique un véritable champ de guerre où les sirènes des putschistes ont remplacé les gyrophares des campagnes électorales et les motivations savantes des juges constitutionnels, substituées par les déclarations des généraux d’armées. Cette révolution à rebours ou mieux cette catastrophe constitutionnelle oblige à repenser l’état de l’État de droit en Afrique ou à donner un contenu démocratique à la justice para-constitutionnelle qui progressivement fait sa mue ; cette justice qui bien que n’ayant pas un ancrage constitutionnel, se déploie dans l’environnement de la Constitution avec pour objet d’assurer l’organisation des pouvoirs publics en période de crise.
Les algorithmes rêvent-ils d’un droit factualisé ?
Authors: Bordere Camille
Published: September 2024

Le discours doctrinal portant sur les bases de données jurisprudentielles à vocation exhaustive et les outils de justice prédictive développe, au renfort de son argumentaire de rejet, un argument très particulier : celui selon lequel ces outils contribueraient à une « factualisation » du droit. À l’étude, cependant, le « droit » qui serait factualisé est bien moins le droit qu’il s’applique et bien plus le droit tel qu’il est pensé . Cette « factualisation » de la compréhension du droit est alors un argument à rebours par lequel le discours doctrinal s’inquiète bien plus pour lui-même que pour son droit et cherche à se prémunir des effets potentiels que ces outils pourraient avoir sur son office, sa production, sa structuration et sa raison d’être. Cet axe discursif apparaît donc à l’analyse comme un démarche d’auto-défense d’un discours doctrinal face à une menace perçue , à défaut d’être, à ce stade, démontrée .
Maât au Plateau de Kirchberg
Authors: Guiot François-Vivien
Published: September 2024

La distinction du fait et du droit peut être comprise comme une clef d’explication totale de la juridiction de la Cour de justice de l’Union européenne. Malgré l’absence de tout fondement ontologique vérifiable, la distinction du fait et du droit est utilisée comme un argument pour délimiter les pouvoirs du juge. La pratique contentieuse témoigne de la dimension en réalité déontologique de la distinction, à laquelle le juge de la légalité adhère.
Le Semestre européen sauvera-t-il l’État de droit ?
Authors: Fromont Louise , Van Waeyenberge Arnaud
Published: September 2024

En raison de l’insuffisance de l’Article 7 TUE et de la voie judiciaire pour enrayer le recul de l’État de droit au sein de plusieurs États membre de l’Union européenne, la Commission européenne développe, depuis plusieurs années, une nouvelle stratégie qui repose sur la création de nouveaux instruments d’action publique de type techno-managérial. La présente contribution tend à analyser, au moyen d’une approche pragmatique du droit couplée à une approche par les instruments, l’un de ces outils techno-managériaux : le Semestre européen. Cette analyse entend démontrer la place de plus en plus centrale qu’occupe le Semestre afin de lutter contre les violations de l’État de droit mais également identifier les conséquences qu’emporte l’utilisation de cet instrument pour l’ordre juridique européen.
Réflexions sur la perturbation de l’égalité par la responsabilité
Authors: Lefebvre Jean
Published: September 2024

Une analyse croisée du droit de la responsabilité et de l’approche économique de la contrepartie montre que la responsabilité, loin d’être neutre, peut perturber le principe d’égalité. La responsabilité peut se dérégler et échouer à fournir dans tous les cas une contrepartie parfaite, qui viendrait compenser intégralement le dommage subi. Cette perturbation, et la rupture d’égalité qu’elle induit, est révélée par une modulation de la contrepartie à rebours de toute justice corrective ou distributive et incohérente à l’égard de l’exposition au risque. D’une part, la responsabilité affecte la réparation dévolue à la victime en restant, dans certains cas, indifférente à son exposition involontaire au risque. D’autre part, la responsabilité prend en compte la « préférence » de certains responsables ou de certaines victimes pour sanctionner leur décision de s’exposer volontairement au risque.
Le droit et les besoins
Authors: Mella Élisabeth
Published: September 2024

Le droit public des affaires peut être l’occasion d’identifier des mouvements de transformation radicale de l’action publique mais aussi leurs limites. L’étude des besoins de la personne publique en ce domaine en est une illustration. L’identification des besoins de la personne publique en droit public des affaires a montré sur le terrain des faits, et au-delà de leur diversité la possibilité, d’en dresser une typologie. Sur le terrain du droit, cette identification met en lumière un mouvement d’objectivisation et de rationalisation. De son côté, la satisfaction des besoins de la personne publique en droit public des affaires renvoie à une multitude de contraintes de coût et de qualité. Cependant, ces contraintes s’appliquent d’abord aux moyens de satisfaction des besoins et non aux modèles de satisfaction de ces besoins. Ces derniers renvoient au contraire à la liberté de la personne publique. Surtout, et dans tous les cas, un besoin fondamental de la personne publique est ici en jeu : celui d’agir librement.
L’attribution de l’indemnité d’assurance aux créanciers hypothécaires et privilégiés dans l’espace CIMA
Authors: Silienou Herline Idèle
Published: September 2024

Le droit des assurances et le droit des sûretés sont deux moyens qui permettent de garantir la sécurité du créancier. Toutefois, l’incertitude du paiement due aux mécanismes de l’assurance est une épine qui relativise les avantages que pourraient procurer cette association. Tout dépendra de l’étendue de la couverture des risques et davantage, de la diligence du créancier. La situation n’est pas pour autant désespérée. Le contrat d’assurance renforce la protection du créancier privilégié ou hypothécaire, grâce à la subrogation réelle. L’indemnité d’assurance remplace le bien dégradé ou perdu, à tel point qu’une procédure collective contre le débiteur ne saurait lui porter préjudice. Cette combinaison se déploie de façon harmonieuse, de telle sorte que le créancier ait plus d’intérêt à voir le bien détruit, plutôt que de mettre en œuvre les procédures de réalisation de la sûreté.
La tolérance dans le constitutionnalisme des États d’Afrique
Authors: Sandio Kamga Armel Habib
Published: September 2024

L’avènement du nouveau constitutionnalisme en Afrique a nécessité la prise en compte d’un certain nombre de principes et valeurs devant permettre la construction de véritables sociétés démocratiques où règnent la paix et la cohésion sociale. La tolérance fait partie de ces valeurs. Il a donc été question de voir comment elle est appréhendée dans le constitutionnalisme des États d’Afrique. Il est possible de constater qu’elle a deux visages qui entretiennent des rapports différents avec les normes constitutionnelles. Celles-ci sont à la fois actrices et victimes de la tolérance. D’une part, la tolérance est une qualité promue par les normes constitutionnelles qui prescrivent l’esprit de tolérance et affirment les valeurs empreintes de tolérance. D’autre part, la tolérance est un procédé présentant des risques, car elle vise à évincer, par omission ou renonciation à la sanction, les normes constitutionnelles.
Input-to-state stability of nonlinear systems with delayed impulse based on event-triggered impulse control
Authors: Li Linni , Zhang Jin-E
Published: September 2024

This paper investigates input-to-state stability (ISS) of nonlinear systems with delayed impulse under event-triggered impulse control, where external inputs are different in continuous and impulse dynamics. First, an event-triggered mechanism (ETM) is proposed to avoid Zeno behavior. In order to ensure ISS of the considered system, the relationship among event triggering parameters, impulse intensity, and impulse delay is constructed. Then, as an application, ETM and impulse control gain for a specific kind of nonlinear systems are presented based on linear matrix inequalities (LMI). Finally, two examples confirm the feasibility and usefulness of the proposed strategy.
Neutrosophic Analysis of Rejection Sampling in Post Quantum Cryptography (PQC)
Authors: Pandey Shashi Kant
Published: September 2024

Digital authentication and key encapsulation mechanisms (KEM) are two basic primitives for the security level of all robotic and IoT systems. Dilithium and Kyber are two post-quantum algorithms to establish secure communication. The use of uniform random sampling in these algorithms is very important. The finalists Dilithium and Kyber use SHAKE and AES to generate the random sequence at multiple stages of the algorithm. Here, the authors characterize one of the sampling techniques available in Dilithium with the help of the neutrosophic Boolean function. The idea of the neutrosophic Boolean function came from the theory of neutrosophy, and it is useful to study any ternary distributions. The authors present the non-existence of neutrobalanced bent functions specifically with respect to the sampling named SampleInBall in Dilithium.
The Legal Framework for Renewable Energy and Water Management in the UAE
Authors: Aljahoori Sumaya Abdul Rahim
Published: September 2024

This chapter aims to review the transformation witnessed by the energy sector in the United Arab Emirates, where energy sources focus on being affected by policy-related matters. The current framework of renewable energy projects is analyzed, focusing on its role in resource sustainability and investigating what damage it draws. The chapter will also shed light on issues related to the water management of resources in the Advanced Energy Technology Company. The chapter will analyze the commitment and legislation of experts and provide a comprehensive assessment of the future challenges and opportunities facing the country in this field, to achieve an effective balance between meeting energy needs and keeping track of water resources in general.
Local to Global
Authors: Abdallah Asma Khaleel
Published: September 2024

With the development of placed-based and personalized learning as the subsequent step in the transformation of the school, it is the correct time to take these mechanisms one step further by emphasizing the project and personalized learning on locally, country-wide, and internationally relevant objects. With the enhancement in student agency, the student can achieve experience regarding the implementation of knowledge, and the society achieves a significant resource in the people of willing and excited students desiring to better the long-term health and well-being of the society. Through a place-based perspective and individualized learning, we can develop an effective educational foundation. In order, to progress into more than merely learners, students must gain the knowledge, skills, abilities, and independence essential for contributing positively to the globe's and their communities' development in the years ahead which is possible only through place-based learning.
How Does Cost Leadership Strategy Suppress the Performance Benefits of Explainability of AI Applications in Organizations?
Authors: Talaei Jason , Yang Alan , Takishova Tolkyn , Masialeti Masialeti
Published: September 2024

This study examines how explainable artificial intelligence-enabled agility, encompassing operational and market agility, influences performance. We examine the potentially negative effect of a cost-leadership strategy on the performance benefits of explainable AI. Data from a survey of IT executives was analyzed. Findings suggest that the explainability of artificial intelligence applications does not directly relate to performance. Instead, its benefits are actualized through operational and market agility. However, our study finds that in organizations that prioritize cost leadership, the positive link between explainability and performance becomes negative and significant. Additionally, the mediating roles of operational and market agility become insignificant in such organizations.
Applicability of High-Entropy Alloys
Authors: Hareancz Ferenc , Juhász Gergely , Fábián Enikő Réka , Vida Ádám
Published: September 2024

In the 21st century a new chapter in materials science has been opened with the appearance of high-entropy alloys (HEA). These alloys differ from conventional alloys, they contain five or more elements in roughly equal amounts which are often based on a single main element (base metal) to which one or more other elements are added in small amounts to achieve the desired properties. High entropy alloys exhibit simple crystal structures due to high entropy, such as lattices that are body-centered cubic (BCC), face-centered cubic (FCC). In conventional alloys, diffusion inhibition is often achieved by using small amounts of alloying elements to increase the number of lattice defects or by creating secondary phases that block atomic motion. In high-entropy alloys, the large number of different elements results in high entropy, which can lead to slower diffusion due to the disorder of the atomic arrangement. This property can be beneficial in terms of corrosion resistance and suitability for use at high temperatures.. High-entropy alloys possess exceptional mechanical properties, corrosion resistance, and high-temperature behavior, making them promising alternatives to conventional alloys in fields such as aerospace and aviation, where materials must perform under extreme environmental conditions. However, the economic production and processing of HEAs remains a challenge, which limits their widespread application. Additional research and development are required to fully realize the potential of HEAs and to replace conventional alloys on a larger scale.
The Effect of Inorganic-Based Plasticizers on Clay Bodies
Authors: Hamza Alexandra , Kocserha István
Published: September 2024

In this paper, the effect of two additives on the plasticity properties and drying sensitivity of a Hungarian clay were investigated. Two different sodium tripolyphosphate-based commercially available plasticizers (Fabutit 734, Budit 8H) were applied for experiments. The amount of the additives in the clay mass was changed between 0 and 0.5wt% relative to the weight of the dry clay and the plasticity was measured with two different methods. In addition to the plasticity of the clay mixes, the effect of the additives on the drying sensitivity was also analyzed with the Macey method. Results showed that the moisture content required to shape the clay body can be reduced by 1-1.5% with the mixing 0.1 and 0.2 wt% of Budit 8H additive.
Analysis of Horizontal and Vertical Grinding Technologies
Authors: Bodzás Sándor
Published: September 2024

The grinding technologies are widely used for finishing operations of various types of parts to provide better surface roughness and accuracy for the selected surfaces. Those technologies are expensive and take a lot of time to execute them consequently they are used when it is reasoned. The goal of this research is to compare the manufacturing design processes for horizontal and vertical grinding where the arrangement distinction between them is just the position of the tool axis compared to the machined surface of the workpiece. All of the necessary manufacturing parameters are determined to ease the design process. After the manufacturing design CAM design and CNC program writing are possible if CNC controlled machine is applied. Using of the same manufacturing parameters a comparative manufacturing analysis is done to determine the differences between the two processes.
Fabrication of Metal Particles Using Differences in Standard Electrode Potentials
Authors: Kasori Reo , Yamauchi Noriko , Tada Shohei , Kobayashi Yoshio
Published: September 2024

This study proposes a simple method for fabricating metal particles. Metal nanoparticles are synthesized in an aqueous solution. The synthesis method is based on the galvanic replacement of one metal with another, i.e., the deposition of a metal on the surface of another metal using difference between the standard electrode potentials of the metals under ultrasonication. An aqueous colloidal solution of metallic copper (Cu) nanoparticles is prepared using Cu acetate and a metallic zinc (Zn) plate. A similar colloidal solution of metallic Cu nanoparticles is prepared using Cu acetate and a metallic iron plate. No metallic nanoparticles are obtained using metallic aluminum and nickel (Ni) plates because of the formation of passivated layers. An aqueous colloidal solution of metallic Ni nanoparticles is prepared using Ni acetate and a metallic Zn plate; however, Ni0.7Zn0.3O is also formed. The results of the study show that the proposed method can be used to produce metallic particles in a simple manner.
Experimental Investigation of the Dynamic Compressive Behavior of Carbon-Flax Fiber Reinforced Polymer Composites at High Strain Rates
Authors: Mabrouk Osama M. , Khair-Eldeen Wael , Hassanin Ahmed H. , Hassan Mohsen A.
Published: September 2024

The present study investigates the dynamic compressive behavior of hybrid carbon/flax fiber-reinforced polymer composites in which epoxy resin is used as the matrix. The hybrid carbon/flax and non-hybrid flax polymer composite laminates were fabricated by hand lay-up followed by hot-compression molding. The Split-Hopkinson pressure bar test (SHPB) was utilized to evaluate the dynamic compressive mechanical properties of the fabricated composites. Compressive strength and failure strain were determined in the sample’s out-of-plane direction at strain rates ranging from 2638 s-1 to 6716 s-1. Macroscopic images were used to assess the progressive accumulated damage mechanisms due to the impact loading. Experimental results proved that non-hybrid flax and hybrid carbon/flax epoxy composites are high strain-rate-sensitive materials. For instance, the compressive strength of hybrid carbon/flax composites has increased from 327 MPa to 498 MPa as the strain rate increased from the lowest to the highest value in the considered range. At all impact pressures, hybrid carbon/flax composites have shown higher compressive strength than non-hybrid flax composites. The macroscopic inspection of post-tested composite specimens indicated that the accumulated damage becomes more severe with increasing the strain rate; and the main failure modes were shearing and splitting for both hybrid and non-hybrid composites. Overall, carbon/flax hybridization was found to be an effective technique for improving the load-bearing capacity of the polymer composites subjected to impact loading conditions.
Electrochemical Performance of Activated Carbon-NiCo2O4 as Candidate for Supercapacitor Electrode Materials
Authors: Wibowo Silvi Rahmawati , Putri Viona Lidya Haryati , Mufti Nandang , Aripriharta Aripriharta , Diantoro Markus , Sari Eprilia Trikusuma
Published: September 2024

Asymmetric supercapacitors have been fabricated using nanostructured AC// AC-NiCo2O4 composite electrodes. The aim was to determine the performance of a modified electrode based on AC as the anode and AC-NiCo2O4 as the cathode. NiCo2O4 has been successfully synthesized using the co-precipitation method. FTIR, XRD, and SEM characterized the material. The NiCo2O4 confirmed the crystalline structure assigned to cubic spinel with nanospheres morphologies. The electrochemical properties of the prepared composite electrodes and fabricated supercapacitor cells have been studied using charge-discharge (CD) and cyclic voltammetry (CV) in 1M Et4NBF4 as an electrolyte. The optimized composition is AC-NiCo2O4 (15%), exhibiting a superior power density of 42.56 W kg-1. These results showed that AC-NiCo2O4 material could be a great candidate as an active material for supercapacitors.
Preparation of High Specific Capacitance Material Based on Activated Carbon-Manganese Dioxide Composite Using Lemon Peel (Citrus limon) Extract for Supercapacitor Electrode
Authors: Ramadhan Muhammad Hafidz , Sumari Sumari , Nur Hadi , Nazriati Nazriati
Published: September 2024

In this study, the high specific capacitance material based on activated carbon-manganese dioxide (AC/MnO2) composite was prepared by an impregnation method. The MnO2 particle was synthesized via a redox reaction between KMnO4 and lemon peel extract as a bioreductor. The steps taken in this research were the preparation of lemon peel extract, then synthesis of MnO2 using lemon peel extract, synthesis of AC/MnO2 composites, and electrodes characterization using powder XRD, SEM, and CV. According to the results, the AC/MnO2 composite electrode had a higher specific capacitance compared to the synthesized MnO2. The powder XRD test results show that the synthesized MnO2 consisted of α, γ, and δ polymorphs. SEM data show that the average MnO2 particle size is 482.80 nm. The CV test results show that the highest AC/MnO2 capacitance is 188.17 F g-1 which was obtained at an AC/MnO2 ratio is 1:1. This suggests that the AC/MnO2 composite material has the potential to be used as a supercapacitor electrode material.
Mechanical Performance of Defective FDM Multi-Layer Material Panels
Authors: Elhassan Amged , Ahmed Waleed , Zaneldin Essam
Published: September 2024

A finite element model was developed in this research to investigate the impact of defects on the mechanical properties of a 3D-printed composite sandwich panel that could occur during the layer alteration period between the dissimilar materials, affecting the interfacial strength between the layers and causing the 3D-printed panel to fail. Numerous parameters, such as interfacial position, size, material properties, and location of defects along the panel, have been examined that might affect the failure mechanism. This finite element study adopted linear elastic behavior by utilizing ANSYS simulation program. The outcomes showed that the midsection of the composite is under a lot of stress, and as we approach the edges of the composite, the tension concentration falls outward until it reaches zero. In the intact scenario, the deformation was zero at either end of the panel and highest in the composite middle. The shear stress was most significant in the center, and it decreased as we moved closer to the extremities of both sides, it gradually decreased until it was lowest there. The endpoints where we have support responses have significant maximum shear stresses, which could degrade the material overall mechanical properties. This rise in the maximum principle stress at the end support could be due to the reaction of the fixed support, which tries to counteract the applied flexural load and raise the maximum principle stress.
Efficiency of the Carbide Machining Process with WEDM Technology
Authors: Straka Ľuboslav
Published: September 2024

Carbide machining process brings a whole range of problems in practice. This mainly concerns problems associated with their machinability and the economy of the applied machining technology. Because of these problems, it is often not possible to use traditional production technologies when machining them. However, progressive machining technologies achieve relatively good results. However, even with progressive technologies, the problem with the overall efficiency of the machining process remains. Therefore, experimental research was carried out, the aim of which was to obtain relevant data regarding the quantification of qualitative indicators of the machined surface during the machining of hard metals through progressive electrical discharge technology in relation to the overall economic efficiency of the machining process. As part of the conducted experimental research, partial data of individual elements were obtained on the basis of which complex conclusions were drawn in mutual contexts. Subsequently, complex data regarding the effectiveness of the applied electrical discharge process in the machining of hard metals were summarized.
A Challenging Case Of A Severe Ectopic Cushing Syndrome Due To Recurrent Thymic Carcinoid Tumour
Authors: Gnanathayalan S. W. , Subasinghe C. J. , Bulugahapitiya U.
Published: September 2024

Introduction: Cushing syndrome due to thymic carcinoids is rarely seen. Severe Cushing syndrome is an endocrine emergency requiring prompt treatment initiation. Here, we report a case of severe Cushing syndrome due to a thymic neuroendocrine tumour.Case Description: A 60-year-old female presented with symptomatic severe hypokalaemia. She didn’t have the typical cushingoid appearance, but dark pigmentation was evident over the knuckles and nails. She had severe hypokalaemia (2.2 mmol/L). Further assessment confirmed the diagnosis of ACTH-dependent Cushing syndrome. Ten years back, she underwent surgery for thymic atypical carcinoid tumour followed by chemoradiation. History revealed probable Cushing syndrome during that period, but medical record was not available. Considering this, CECT Chest, Abdomen and Pelvis was arranged, and it showed recurrence of invasive thymic neoplasm. Histology was atypical thymic carcinoid with synaptophysin positivity. Diagnosis of severe ectopic Cushing syndrome was made with cortisol burden of up to 1500 nmol/L with refractory hypokalaemia worsening glycaemic control and high blood pressure. The multidisciplinary team decision was to do urgent bilateral adrenalectomy. She underwent bilateral adrenalectomy after preoperative reduction of cortisol with etomidate infusion. Unfortunately, her post-operative course was complicated with severe COVID pneumonia with secondary bacterial sepsis, and she succumbed to death after 3 weeks of surgery.Conclusion: Ectopic Cushing syndrome is well-known to cause severe hypercortisolism with catastrophic complications. Emergency bilateral adrenalectomy is a safe option in this situation, especially when the primary tumour is not identified or can’t be resected completely within a short time. Increased risk of infection persists even after cortisol reduction with surgery and appropriate infection control measures and surveillance are of paramount importance.
Chemokine Receptor CCR2 Is Protective toward Outer Hair Cells in Chronic Suppurative Otitis Media
Authors: Gupta Ankur , Schiel Viktoria , Bhattacharya Ritwija , Eftekharian Kourosh , Xia Anping , Santa Maria Peter L
Published: September 2024

Chronic suppurative otitis media (CSOM) is a neglected disease that afflicts 330 million people worldwide and is the most common cause of permanent hearing loss among children in the developing world. Previously, we discovered that outer hair cell (OHC) loss occurred in the basal turn of the cochlea and that macrophages are the major immune cells associated with OHC loss in CSOM. Macrophage-associated cytokines are upregulated. Specifically, CCL-2, an important member of the MCP family, is elevated over time following middle ear infection. CCR2 is a common receptor of the MCP family and the unique receptor of CCL2. CCR2 knockout mice (CCR2−/−) have been used extensively in studies of monocyte activation in neurodegenerative diseases. In the present study, we investigated the effect of CCR2 deletion on the cochlear immune response and OHC survival in CSOM. The OHC survival rate was 84 ± 12.5% in the basal turn of CCR2+/+ CSOM cochleae, compared with was 63 ± 19.9% in the basal turn of CCR2−/− CSOM cochleae (p ≤ 0.05). Macrophage numbers were significantly reduced in CCR2−/− CSOM cochleae compared with CCR2+/+ CSOM cochleae (p ≤ 0.001). In addition, CCL7 was upregulated, whereas IL-33 was downregulated, in CCR2−/− CSOM cochleae. Finally, the permeability of the blood–labyrinth barrier in the stria vascularis remained unchanged in CCR2−/− CSOM compared with CCR2+/+ CSOM. Taken together, the data suggest that CCR2 plays a protective role through cochlear macrophages in the CSOM cochlea.
Impact of New-Onset Diabetes after Transplantation on Cardiovascular Risk and Mortality in Korea: A Nationwide Population-Based Study
Authors: Park Seung Shin , Koo Bo Kyung , Park Sanghyun , Han Kyungdo , Moon Min Kyong
Published: September 2024

Background: Limited data are available on the adverse effects of new-onset diabetes after transplantation (NODAT) in solid organ transplantation (TPL) other than kidney. This study aimed to identify the risk of complications associated with NODAT in recipients of kidney, liver, or heart TPL.Methods: Using the Korean National Health Insurance Service database, recipients of kidney, liver, or heart TPL between 2009 and 2015 were identified. The incidence of coronary artery disease (CAD), cerebrovascular accident (CVA), and malignancy was compared across groups with NODAT, pretransplant diabetes mellitus (DM), and without DM using Cox regression analysis.Results: A total of 9,632 kidney, liver, or heart TPL recipients were included. During the median follow-up of 5.9 years, NODAT independently increased the incidence of CAD (hazard ratio [HR], 2.46; 95% confidence interval [CI], 1.39 to 4.30) and overall mortality (HR, 1.48; 95% CI, 1.14 to 1.95) compared to the reference group even after adjustment for confounders; this was more prominent in kidney TPL than in liver TPL. The risk of CVA was significantly increased by pretransplant DM but not by NODAT in both kidney and liver TPL (HR, 2.47; 95% CI, 1.68 to 3.65; and HR, 3.18; 95% CI, 1.07 to 9.48, respectively). NODAT increased the risk of malignancy in the crude model, which lost its statistical significance after confounder adjustment.Conclusion: NODAT independently increases the risk of CAD and mortality after TPL, which is more evident in kidney recipients. There was no additional increased risk of CVA or malignancy with NODAT in solid organ TPL.
The current era of AyurGenomics and AyurProteomics
Authors: Saini Heena , Tripathi Richa
Published: September 2024

Background:

Ayurveda, traditionally known as “The Science of Life,” has been practiced in India for centuries, focusing on holistic well-being. Despite its longstanding application, Ayurveda has faced challenges in gaining scientific acceptance globally, primarily due to the absence of standardized drug testing and certification.

Objective:

This study explores the recent initiatives by the Indian government to globalize Ayurveda by integrating modern molecular biology techniques and high-throughput technologies to provide a scientific foundation for Ayurvedic practices.

Methods:

The research examines the integration of genomics and proteomics with Ayurveda, giving rise to Ayurgenomics and Ayurproteomics. These emerging fields aim to elucidate the molecular mechanisms underlying Ayurvedic practices, leveraging contemporary scientific tools.

Results:

The interdisciplinary approach seeks to generate evidence-based data for Ayurvedic diagnostics and therapeutics, explore pharmacokinetics and pharmacodynamics, and ensure the safety and efficacy of Ayurvedic medicines. Additionally, the study highlights the need for scientific validation, ethical guidelines, and collaboration between traditional practitioners and modern scientists.

Conclusion:

Integrating Ayurveda with modern scientific fields like genomics and proteomics has the potential to validate traditional practices and lead to the development of personalized medicine. Overcoming the challenges of scientific validation and promoting collaborative research are key to the success of Ayurgenomics and Ayurproteomics in modern healthcare.
Navigation-assisted occipitocervical fixation and decompression in a patient with polyostotic fibrous dysplasia
Authors: Nagashima Yoshitaka , Nishimura Yusuke , Abe Takashi , Saito Ryuta
Published: September 2024

Fibrous dysplasia (FD) is a rare skeletal disorder characterized by the replacement of normal bone with fibrous connective tissue, leading to abnormal bone formation. This case report details the successful treatment of a 61-year-old woman with FD at the craniovertebral junction (CVJ). The patient, who had a history of intracranial meningioma and had already been diagnosed with FD, experienced worsening gait disturbance and muscle weakness following a fall. Imaging studies revealed extensive polyostotic FD lesions in the skull and cervical spine, along with a C2 odontoid fracture causing spinal cord compression. The patient underwent occipitocervical fixation and decompression surgery. Intraoperative O-arm navigation was used to ensure accurate screw placement and effective decompression. This procedure allowed for proper positioning of the C2 and C3 pedicle screws, resection of the hyperplastic occipital bone and C1 posterior arch, and placement of the occipital plate with avoiding the cyst components. At a 2-year follow-up, there were no signs of screw loosening, and the patient showed marked clinical improvement. This case emphasizes the importance of tailored surgical strategies and the use of advanced navigational technologies in managing complex FD cases, particularly those involving the CVJ. It also highlights the challenges of treating polyostotic FD, where complete resection is often unfeasible. The successful outcome in this case supports the use of decompressive surgery combined with stabilization to relieve symptoms and prevent further complications.
Impact of physical exercise (strength and stretching) on repairing craniovertebral and reducing neck pain: A systematic review and meta-analysis
Authors: Nazwar Tommy Alfandy , Bal’afif Farhad , Wardhana Donny Wisnu , Mustofa Mustofa
Published: September 2024

Background:

The craniovertebral (CV) junction is crucial for head support, mobility, and protecting the upper spinal cord and vital nerve structures. Disorders in this area can cause severe symptoms such as neck pain, restricted movement, and neurological issues such as headaches and balance problems. Exercise and physical activity improves muscle strength, flexibility, joint stability, reducing pain, and enhancing joint function, while specifically for the CV junction, exercise can relieve muscle tension, boost blood flow, and improve posture, although the specific impact on CV junction health remains underexplored.

Methods:

A comprehensive literature search was conducted using databases MEDLINE, Cochrane, Lilacs, and ScienceDirect, alongside manual searches through reference lists. The review focuses on exercise and CV junction issues and includes randomized controlled trials, cohort or case–control studies, and systematic reviews. Primary outcomes include pain levels, joint mobility, function, and quality of life.

Results:

Results yield four meta-analyses with corrective exercise and conventional exercise in improving forward head posture risk difference 0.00 (−0.09, 0.09) 95% confidence interval (CI), between cervical and thoracic exercises odds ratio 1.04 (0.59, 1.84) 95% CI. Comparing exercise treatment and physiotherapy showed risk difference 0.11 (−0.10, 0.32) 95% CI and the comparative analysis between training and no treatment showed risk difference 0.09 (−0.01, 0.20) 95% CI.

Conclusion:

Exercise-based rehabilitation programs tailored to patients with CV junction problems offer robust evidence, benefiting clinical management, and prevention efforts.
Do low-density screws influence pelvic incidence in adolescent idiopathic scoliosis correction?
Authors: Sultan Ahmed Maher , El Nawawy Walid , Dawood Mohammed Ahmad , Koptan Wael Tawfik , Elmiligui Yasser , Barakat Ahmed Samir , Fawaz Khaled Ahmed
Published: September 2024

Background:

Low-density screw constructs yield significant radiographic and clinical improvements with reduced risk of neurological complications. This study aimed to investigate the relationship between coronal Cobb angle and pelvic incidence (PI) in the correction of adolescent idiopathic scoliosis (AIS) using a low-density construct, as well as the association between PI and functional outcomes.

Patients and Methods:

This prospective cohort study involved 60 posteriorly instrumented AIS patients, aged 10–16 years, with Cobb angles ranging from 45° to 90° of various Lenke types. Radiological assessments were conducted pre- and postsurgery at 1, 3, 6, 12, and 24 months. Functional evaluation utilized the Scoliosis Research Society score form (SRS-30).

Results:

A positive correlation was observed between screw density and operation time, blood loss, and degree of correction with SRS change (P = 0.004). No correlation was found between screw density and hospital stay, loss of correction, correction rate, SRS change, change in PI, or Cobb angle.

Conclusions:

Correction of AIS through a posterior approach using a low-density construct can lead to satisfactory curve correction, impacting spinopelvic parameters. However, PI alone does not directly influence patient functional outcomes assessed by SRS-30. Low-density implant constructs reduce operative time, blood loss, costs, and complication risks.
Unprecedented journey to 650 transpedicular screws using freehand technique and intraoperative C-arm imaging with technical nuances
Authors: Fayaz Mohsin , Chibber Sarabjit Singh , Singh Kaushal Deep , Tyngkam Lamkordor , Hela Amir , Chaurasia Bipin
Published: September 2024

Introduction:

Pedicle screw placement plays a crucial role in treating various cases such as fractures, scoliosis, degenerative spine issues, and kyphosis, reinforcing all three spinal columns simultaneously. While three-dimensional navigation-assisted pedicle screw placement is considered superior, the freehand technique relies on anatomical landmarks and tactile feedback, with observed low complication rates.

Materials and Methods:

This was a prospective single-center study conducted over a period of 3 years. It included all patients of dorsal, lumbar, and sacral spinal instability of myriad etiology. Previously operated patients and sick obtunded patients were excluded from the study.

Results:

In our study, we included 102 patients including 62 (60.7%) males and 40 (39.2%) females. More than half of patients were young in the age group of 20–50 years. Our study population had a varied etiology with 43.1% of patients having vertebral column instability due to trauma. The other etiologies were spondylolisthesis and lumbar canal stenosis (39.2%), Pott’s spine (11.7%), tumors (2.9%), and osteoporotic fractures (2.9%). Majority of patients (44.1%) presented with lower backache with radiculopathy. All the transpedicular screws inserted were evaluated by C-arm to assess for screw fixation. In the first year of our study, an average of 4 anteroposterior (AP) and 4 lateral C-arm X-ray shots were taken per screw placement. In the next year, an average of 3 AP and 3 lateral shots and finally in the last year of our study only 2 AP and 2 lateral C-arm X-ray shots were taken per screw placement. Out of 650 screws placed, 4 screws were identified to cause breach with maximum breaches in the lumbar spine fixation. In dorsal spine fixation, there was 1 lateral breach at D10. In lumbar spine fixation, there were 3 breaches: two medial one each at L4 and L5 and one anterior at L2 level. The various complications include wound infection, temporary and permanent neurological deficit, screw breakage, screw misplacement, cerebrospinal fluid leaks, nonunion, and spinal epidural hematoma.

Conclusions:

Our study has provided strong encouragement to persist with the freehand technique in transpedicular fixation surgeries after a certain number of cases given the minimal breaches and complications observed. There are subtle technical nuances as we increase the number of cases with less exposure of anatomical landmarks and X-rays. Success hinges on experience, adherence to technique, and thorough preoperative planning. Further research and extended follow-up periods are necessary to firmly establish this technique as the gold standard.
Demographics in the context of health-care delivery for C1 and C2 fractures
Authors: Ladehoff Lauren C , Root Kevin T. , Foreman Marco , Brown Jeffrey B. , Webb Paul Bryce , Diaz Michael J , Taneja Kamil , Patel Karan , Lucke-Wold Brandon , Wessel Robert P.
Published: September 2024

Introduction:

Atlas and axis fractures are the most severe cervical fractures which may result in complete paralysis or death. The purpose of the current study is to identify disparities regarding length of stay (LOS), mortality, and demographic factors in patients with the most serious cervical spine fractures utilizing a nationally representative database.

Materials and Methods:

The Nationwide Emergency Department Sample was utilized to provide a representative sample for patients with a primary diagnosis of C1 or C2 fracture presenting to emergency departments in years from October 2015 to December 2019. A multivariable logistic regression model was used to estimate LOS for different patient demographics, including gender, race, and age.

Results:

A weighted sample of 7,262,791 patients presented to emergency rooms in the United States between 2015 and 2019. The mean age at admission was 76 years old, 52.6% of patients were female, and 83.0% identified as white. Patients between 45 and 65 and patients over 65 were significantly more likely to have an increased LOS. Women were less likely to have an increased LOS than men. Patients identifying as Black were significantly more likely to have increased LOS over white patients. In addition, patients who had an increased LOS were more likely to die in the hospital than patients with a shorter LOS.

Conclusion:

This study provides patient characteristics that help providers determine patient risk factors for increased hospital LOS and in-hospital mortality for those suffering from C1 and C2 fractures. Clinicians should be made aware of these disparities to allow equitable delivery of care.
Dysplasia Epiphysealis Hemimelica (Trevor’s Disease) of Talus Treated with Excision, Periosteal Flap, and Open Wedge Osteotomy: A Case Report and Review of Literature
Authors: Meena Devi Sahai , Saini Sanjay , Sehrawat Manisha , Yadav Vipul , Kumar Praveen
Published: September 2024

Dysplasia epiphysealis hemimelica (DEH), also known as Trevor’s disease, is a rare disease which is skeletal developmental disorder characterized by asymmetrical growth of epiphyseal cartilage. It most frequently affects the ankle joint. Surgical treatment with complete resection is recommended before irreversible joint damage and deformity occurs. Multiple surgeries may be required if resected at an early age because recurrences are common until skeletal maturity. We present a case of DEH at the anteromedial aspect of a left ankle joint and a review of the literature.
Conical Washers Technique Tip
Authors: Iobst Christopher , Fragomen Austin , Rozbruch S. Robert
Published: September 2024

Circular external fixators often use fine transfixion wires as part of the construct. When a wire needs to be placed obliquely, standard methods of attaching the wire to the ring can cause tension in the surrounding soft tissues and the underlying bone. One method to avoid this issue is to use a long wire fixation bolt with conical washers above and below the ring. This technique is described in the following article.
Etiological Evaluation of Infantile Epileptic Spasms Syndrome (West Syndrome) Based on the New 2017 International League Against Epilepsy Seizure Classification from Southern India
Authors: Gowda Vykuntaraju K. , Mohanty Shanti Bhusan , Sugumar Kiruthiga , Srinivasan Varunvenkat M.
Published: September 2024

Abstract

Objectives:

Infantile epileptic spasms syndrome (IESS) is a term proposed to encompass both West syndrome as well as infants presenting with epileptic spasms who do not fulfill all the criteria for West syndrome. Children with epileptic spasms (ES) typically exhibit ES along with the electroencephalographic pattern known as hypsarrhythmia. Despite advancement, the etiology of ES remains obscure in many cases. To estimate the etiological profile of children, with IESS, and to classify etiologically as per the new International League Against Epilepsy (ILAE)-2017 classification.

Materials and Methods:

This is a retrospective study in a tertiary care hospital in southern India. All patients diagnosed with IESS were included between January 2014 and December 2019. The clinical and laboratory data were collected from the case records and classified according to the 2017-ILAE classifications.

Results and Conclusions:

Of 605 children, 411 (67.93%) were boys, with a male:female ratio of 2.1:1. The mean age presentation was 10 months (1–84 months). We have identified the cause in 509 (84.13%) cases. Various causes identified according to new ILAE classifications were structural 390 (64.46%), genetic 35 (5.78%), infectious 28 (4.62%), metabolic 56 (9.25%), and unknown in 96 (15.86%) cases. Hypoxic-ischemic encephalopathy was the single most cause (226/605 [37.35%]). Genetic and inborn errors of metabolism account for 91 (15.04%) of cases, probably due to the high degree of consanguineous marriages in this part of the world, many of them were treated with specific treatment. The cause for IESS was identified in 84% of cases, and in the remaining, the cause was not found despite extensive investigations. The most common cause is symptomatic etiology, and hypoxic-ischemic encephalopathy was the leading cause. Inborn errors of metabolism, genetic causes, and neuroinfections contributed to the rest.