bluuebunny/crossref_metadata_2025_split huggingface dataset:
Published- Post cervical spine surgery hyperpyrexia (108°F) in a patient with COVID-19: a case report
Authors: Cherunghattil Nimisha , Panda Chinmaya K. , Karim Habib M. R. , Dhawan Mishal 
Published: October 2024

Perioperative hyperpyrexia raises many questions and can cause permanent brain damage if left untreated. Malignant hyperthermia (MH), although uncommon, but sporadic cases continue to happen and it is potentially life-threatening. It is characterized by sudden rise of body temperatures to above 106° F or even more, and hypercapnia. It is usually associated with anesthetic exposure. However, not every hyperpyrexia is MH; a clinical examination, risk stratification, scoring, and logical approach are required to exclude MH in the postoperative patient. We present a case of rare postoperative hyperpyrexia caused by COVID-19. The patient underwent uneventful spine surgery under general anesthesia and developed hyperpyrexia on the first postoperative day. The case highlights the importance of a logical and systematic approach for excluding the causes of postoperative hyperpyrexia and aggressive management.
Abbreviations: CCU - Critical Care Unit; FiO2 - Inspired fraction of oxygen; GA - General anesthesia; MH - Malignant hyperthermia; PCR - Polymerase chain reaction
Key words: Hyperpyrexia; Malignant Hyperthermia; COVID-19; Spine Surgery
Citation: Cherunghattil N, Panda CK, Karim HMR, Dhawan M. Post cervical spine surgery hyperpyrexia (108°F) in a patient with COVID-19: a case report. Anaesth. pain intensive care 2023;27(2):276−279; DOI: 10.35975/apic.v27i2.2045
Received: October 31, 2022; Reviewed: February 06, 2023; Accepted: February 15, 2023
Impact of frailty and comorbidity index on postoperative complications and functional outcomes among elderly patients undergoing hip fracture surgeries under regional anesthesia techniques
Authors: Mathew Anita , Lukachan Gincy Ann , Varughese Deepak , Raju Nimmy , Mathai Ashu Sara , Johnson Abel Samuel 
Published: October 2024

Background & Objective: Elderly patients sustaining hip fractures often are physically very frail and have multiple co-morbidities that might significantly affect their clinical outcomes after surgery. We evaluated the effect of frailty and co-morbidities on the functional outcomes, morbidity and mortality among elderly patients undergoing hip fracture surgeries under regional anesthesia.
Methodology: Elderly patients who underwent hip fracture surgeries under regional anesthesia between 1 April 2021 to 30 April 2022 were included in this non-concurrent cohort study. Besides basic demographic and perioperative data, the Charlson Comorbidity Index (CCI), length of hospital stay, length of ICU stay and 30-day readmission rates were noted. Telephonic interviews were conducted at 3 months following surgery and a note was made of their pre-operative Clinical Frailty Score (CFS), ability to walk within 3 months of discharge, Activities of Daily Living (ADL) using Katz Index (KI) and 90-day mortality.
Results: Of the 109 patients included in the final analysis, forty belonged to the prefrail and sixty-nine to the frail group. Forty-five had moderate CCI while sixty-four belonged to severe CCI. Patients with severe co-morbidities had a significantly lower KI score (P = 0.023) and longer length of ICU stay (P = 0.005). Frail patients had significantly higher mortality rates at 30, 60 and 90 days compared to prefrail, (mortality at 30-days P = 0.029, 60-days P = 0.006, 90-days P < 0.001)
Conclusions: Presence of Frailty and multiple co-morbidities result in significantly worse outcomes (both mortality and functional outcomes) among elderly patients undergoing hip fracture surgeries. This underlines the importance of routine assessment of frailty and CCI scores during preoperative screening.
Abbreviations: ADL - Activities of daily living; CCI - Charlson Comorbidity Index; CFS - Clinical Frailty Score; ICU – Intensive Care Unit; KI - Katz Index; MI - Myocardial Infarction
Key words: Hip Fracture; Elderly; Frailty; Comorbidity; Mortality; Functional Outcome; Clinical Frailty Scale; Charlson Comorbidity Index
Citation: Mathew A, Lukachan GA, Varughese D, Raju N, Mathai AS, Johnson AS. Impact of frailty and comorbidity index on postoperative complications and functional outcomes among elderly patients undergoing hip fracture surgeries under regional anesthesia techniques. Anaesth. pain intensive care 2023;27(2):161−169; DOI: 10.35975/apic.v27i2.2132
Received: January 16, 2023; Reviewed: February 19, 2023; Accepted: February 28, 2023
Farewell to opioids
Authors: Zahid Muhammad Arslan 
Published: October 2024

Up till recent times, various opioid products have been the main stay for pain management during surgeries and in the postoperative period. The clinicians had to adopt multiple ways to control the troublesome side effects associated with opioid use; especially the ileus and nausea / vomiting. Wide spread use of in-hospital and prescription use of opioids lead to an alarming rise in the addiction rates, ultimately termed as opioid epidemic. The clinicians had to think about other effective but safe methods to control pain. This invited editorial throws some light on this topic with an aim to involve clinicians in this debate.
Key words: Addiction; Opioids; Opioid epidemic; Pain
Citation: Zahid MA. Farewell to opioids (Editorial). Anaesth. pain intensive care 2023;27(1):150−153.
DOI: 10.35975/apic.v27i2.2179
Received: February 19, 2023; Reviewed: February 28, 2023; Accepted: February 28, 2023
Effect of caudal epidural adhesiolysis plus steroid injections on pain and daily activities among chronic lumbar disc herniation patients; an observational study
Authors: Budisulistyo Trianggoro , Husni Amin , Pramukarso Dodik Tugasworo , Pudjonarko Dwi 
Published: October 2024

Background & Objective: The management of lumbar disc herniation (LDH) may involve the surrounding tissues, and attract neovascularization facilitated macrophage aggregates. Epidural triamcinolone might have a half-life ranging from 10−31 days; 80 mg methylprednisolone might improve the pain up to 1 week. The higher doses of steroids will lead to adrenal cortex suppression and osteopenia. We evaluated the effect of treatment with 1500 international unit (IU) hyaluronidase followed by 20 mg triamcinolone at 2 weeks, and 3 and 6 months follow-up.
Methodology: We enrolled seven males (38.9%) and 11 females (61.1%) with mean age 44 ± 23 y in the study. Eight (44.44%) subjects were younger than 51 y old, whereas the 10 (55.56%) subjects were ≥ 51 y old. Twelve (66.7%) subjects had had a bulged disc, and 6 (33.3%) subjects had disc protrusion. We injected 1500 international unit (IU) hyaluronidase followed by 20 mg triamcinolone at the site of disc lesion. Pain scores were measured with NRS scale and Oswestry Disability Index (ODI) scores at 2 weeks, and 3- and 6-months follow-up.
Results: The NRS score improved at 2 weeks, 40% to 71.43%, at 3 months 60% to 100%, and 6 months 80% to 100%. And the Oswestry Disability Index (ODI) score was improved at 2 weeks from 23.5% to 68.18%), at 3 months from 39.13% to 100%, and at 6 months 82.35% to 100%. A significant association was observed between age older than 50 y old and ODI scores at 2 weeks followed up.
Conclusions: The intra-epidural 1500 IU hyaluronidase before triamcinolone brings better results even though using a lower dose of triamcinolone. This approach showed the lower-cost better pain scores as compared to the routine use of heavy doses of triamcinolone for managing bulged and protruding LDH.
Abbreviations: ACTH: Adrenocorticotropic hormone; CRH: Corticotropin releasing hormone; CSF: Cerebrospinal fluid; HPA: Hypothalamus-Pituitary-Adrenal; ESI: Epidural steroid injection; LDH: Lumbar disc herniation; MRI: Magnetic resonance imaging; NRS: Numerical Rating Scale; ODI: Oswestry Disability Index; TNF-α: Tumor necrosis factor-alpha; VAS: Visual analogue scale
Key words: Bulged disc; Disc protrusion; Lumbar disc herniation; NRS; ODI; Caudal epidural; Adhesiolysis
Citation: Budisulistyo T, Husni A, Pramukarso DT, Pudjonarko D. Effect of caudal epidural adhesiolysis on pain and daily activities among chronic lumbar disc herniation patients. Anaesth. pain intensive care 2022;26(6):198−203.
DOI: 10.35975/apic.v27i2.2184
Received: Sep 06, 2022; Reviewed: Oct 09, 2022; Accepted: Oct 21, 2022
Local wound infiltration with fentanyl vs ketamine after open abdominal hysterectomy: a prospective, randomized, double-blind study
Authors: Afify Noha , Mahdy Wafiya 
Published: October 2024

Background & Objective: Local wound infiltration with local anesthetics is known to be an efficacious analgesic modality with minimal side effect. We evaluated the comparative analgesic effect of fentanyl with ketamine as an additive to 0.25% bupivacaine for local wound infiltration during open abdominal hysterectomy.
Methodology: Ninety female patients with ASA class I or II, aged 20–60 y, who underwent elective open abdominal hysterectomy under spinal anesthesia, were allocated randomly to one of the three groups. Patients of Group C received 30 ml of 0.25% bupivacaine, Group F received 30 ml of 0.25% bupivacaine plus 2 ml of fentanyl (100 µg), and Group K received 30 ml of 0.25% bupivacaine plus 2 mg/kg ketamine. The time to first analgesic demand and the total analgesic consumption in the first 24 h postoperatively were noted. Postoperative sedation score was also noted in all patients.
Results: Total analgesic consumption in the first 24 h postoperatively was significantly less in both Group K and F, in comparison to Group C (P = 0.001); however, there was no statistically significant difference between Group K and Group F (P = 0.706). The first call for analgesia was significantly earlier in the Group K in comparison to Groups C and F (P = 0.001). The sedation score was higher in Group K than the other two groups (P > 0.001).
Conclusion: Local wound infiltration with ketamine as an adjuvant to bupivacaine appears to be a promising analgesic modality in open abdominal hysterectomy surgery. It has comparable analgesic effect to fentanyl when added to bupivacaine in local wound infiltration with longer duration of analgesia and minimal sedative effects.
Key words: Analgesia; Fentanyl; Hysterectomy Ketamine
Citation: Afify N, Mahdy W. Local wound infiltration with fentanyl vs ketamine after open abdominal hysterectomy: a prospective, randomized, double-blind study. Anaesth. pain intensive care 2023;27(2):250−255; DOI: 10.35975/apic.v27i2.2196
Received: February 05, 2023; Reviewed: February 20, 2023; Accepted: March 31, 2023
SISTEM PENGELOLAAN REKAM MEDIS DI PUSKESMAS BAURENO
Authors: Amelia Rahmawati Mitha , El-syafa'ah Sukma Lathifa , Mae Vannesa 
Published: October 2024

Pengelolaan Rekam Medis di Puskesmas adalah untuk menunjang tercapainya tertib administrasi dalam rangka upaya mencapai tujuan puskesmas yaitu peningkatan mutu pelayanan kesehatan . Berdasarkan hasil dari studi pendahuluan, ditemukan beberapa permasalahan di Puskesmas Baureno yang kurang efektif yaitu pengelolaan rekam medis belum sesuai dengan tatakerja dan organisasi sarana pelayanan kesehatan. Hal ini terlihat dari kurangnya jumlah SDM rekam medis, sering terjadi duplikasi nomor rekam medis, penggunaan tracer yang tidak maksimal, sering terlambat dalam pelaporan rekam medis, kurang efektifnya komunikasi yang terjadi antara petugas rekam medis dengan petugas lainnya di Puskesmas tersebut. Tujuan penelitian ini untuk mengetahui sistem pengelolaan rekam medis di Puskesmas Baureno. Hasil penelitian didapatkan bahwa sistem pengeloaan rekam medis Puskesmas Baureno antara lain untuk SP2TP masih belum sesuai karena kurangnya koordinasi pada setiap bagian puskesmas sehingga sering terjadi keterlambatan, sistem pelayanan rekam medis sudah sesuai dengan SPM yaitu mulai dari pendaftaran sampai dengan pasien pulang rekam medis pasien selalu lengkap serta tepat waktu. Sistem pengolahan rekam medis yang terdiri dari TPP, assembling, indexing, coding, dan filling sudah berjalan sesuai dengan SOP. Proses pengelolaan rekam medis pada puskesmas harus tetap meningkatkan dan mempertahankan sistem pengelolaan rekam medis yang sesuai guna untuk menunjang tercapainya tertib administrasi rekam medis yang efektif dan efisien.
Hubungan Fasilitas Belajar dan Dukungan Keluarga dengan Motivasi Belajar Online pada Siswa Asisten Keperawatan
Authors: Yuliani Indah , Gunardi Saiful , Susaldi  
Published: October 2024

Setiap orang memiliki tingkat kemauan atau motivasi yang berbeda, memiliki alasan yang berkaitan langsung dengan suatu kebutuhan orang tersebut untuk memenuhi kebutuhannya. Artinya, makin besar suatu kebutuhan seseorang maka akan semakin besar pula dorongan/kemauan dari dalam diri seseorang guna melakukan apa yang di inginkannya. Motivasi belajar sangatlah penting untuk mengukur ketertarikan para siswa dalam memilih suatu tempat belajar yang diharapkan sesuai dengan minatnya. Berdasarkan studi pendahuluan bahwa terdapat 6 dari 10 siswa yang mengungkapkan bahwa kurang termotivasi dalam belajar karena fasilitas belajar dan dukungan keluarga yang kurang mendukung. Penelitian ini bertujuan untuk mengetahui hubungan antara fasilitas dan dukungan keluarga dengan motivasi belajar online siswa Asisten Keperawatan SMK Mitra Bakti Husada Bekasi, dengan populasi berjumlah 113 siswa dan sampel berjumlah 54 siswa yang dihitung menggunakan rumus slovin. Penelitian dilakukan dengan pendekatan analitik kuantitatif dengan desain studi crosssectional. Hasil penelitian ini menunjukkan bahwa adanya hubungan antara fasilitas belajar dengan motivasi belajar online siswa dengan p value 0,035 dan adanya hubungan antara dukungan keluarga dengan motivasi belajar online siswa dengan p value 0,003. Penelitian ini membuktikan bahwa ada hubungan antara fasilitas belajar dan dukungan keluarga dengan motivasi belajar online siswa.
Eye-tracking analysis of attentional disengagement in phobic and non-phobic individuals
Authors: Saalwirth Christina , Stefani Maximilian , Sauter Marian , Mack Wolfgang 
Published: October 2024

AbstractThis study investigated threat-related attention biases using a new visual search paradigm with eye tracking, which allows for measuring attentional disengagement in isolation. This is crucial as previous studies have been unable to distinguish between engagement, disengagement, and behavioral freezing. Thirty-three participants (Mage = 28.75 years, SD = 8.98; 21 women) with self-reported specific phobia (spiders, snakes, and pointed objects) and their matched controls (Mage = 28.38 years, SD = 8.66; 21 women) took part in the experiment. The participants were instructed to initially focus on a picture in the center of the screen, then search for a target picture in an outer circle consisting of six images, and respond via a button press whether the object in the target picture was oriented to the left or right. We found that phobic individuals show delayed disengagement and slower decision times compared with non-phobic individuals, regardless of whether the stimulus was threat-related or neutral. These results indicate that phobic individuals tend to exhibit poorer attentional control mechanisms and problems inhibiting irrelevant information. We also confirmed a threat-unrelated shared feature effect with complex stimuli (delayed disengagement when an attended stimulus and an unattended target share common stimulus features). This process might play a role in various experimental setups investigating attentional disengagement that has not yet been considered. These findings are important, as good attentional control may serve as a protective mechanism against anxiety disorders.
Detection of High-frequency Pulsation in WR 135: Investigation of Stellar Wind Dynamics
Authors: Kar Subhajit , Das Ramkrishna , Mathew Blesson , Baug Tapas , Mandal Avijit 
Published: October 2024

Abstract
We report the detection of high-frequency pulsations in WR 135 from short-cadence (10 minute) optical photometric and spectroscopic time series surveys. The harmonics up to the sixth order are detected from the integrated photometric flux variations, while the comparatively weaker eighth harmonic is detected from the strengths of the emission lines. We investigate the driving source of the stratified winds of WR 135 using the radiative transfer modeling code, CMFGEN, and find the physical conditions that can explain the propagation of such pulsations. From our study, we find that the optically thick subsonic layers of the atmosphere are close to the Eddington limit and are launched by the Fe opacity. The outer optically thin supersonic winds (τ
ross = 0.1–0.01) are launched by the He II and C iv opacities. The stratified winds above the sonic point undergo velocity perturbation that can lead to clumps. In the optically thin supersonic winds, dense clumps of smaller size (f

VFF
= 0.27–0.3, where
f

VFF
is the volume filling factor) pulsate with higher-order harmonics. The larger clumps (
f

VFF
= 0.2) oscillate with lower-order harmonics of the pulsation and affect the overall wind variability.
Bayesian Black Hole Photogrammetry
Authors: Chang Dominic O. , Johnson Michael D. , Tiede Paul , Palumbo Daniel C. M. 
Published: October 2024

Abstract
We propose an analytic dual-cone accretion model for horizon-scale images of the cores of low-luminosity active galactic nuclei, including those observed by the Event Horizon Telescope (EHT). Our model is of synchrotron emission from an axisymmetric, magnetized plasma, constrained to flow within two oppositely oriented cones that are aligned with the black hole’s spin axis. We show this model can accurately reproduce images of a variety of time-averaged general relativistic magnetohydrodynamic simulations and that it accurately recovers the black hole spin, orientation, emission scale height, peak emission radius, and fluid flow direction from these simulations within a Bayesian inference framework using radio interferometric data. We show that nontrivial topologies in the images of relativistic accretion flows around black holes can result in nontrivial multimodal solutions when applied to observations with a sparse array, such as the EHT 2017 observations of M87*. The presence of these degeneracies underscores the importance of employing Bayesian techniques to adequately sample the posterior space for the interpretation of EHT measurements. We fit our model to the EHT observations of M87* and find a 95% highest posterior density interval for the mass-to-distance ratio of θ

g
∈ (2.84, 3.75) μas, and give an inclination of θ
o ∈ (11°, 24°). These new measurements are consistent with mass measurements from the EHT and stellar dynamical estimates and with the spin axis inclination inferred from properties of the M87* jet.
Searching for Bumps in the Cosmological Road: Do Type Ia Supernovae with Early Excesses Have Biased Hubble Residuals?
Authors: Ye Christine , Jones David O. , Hoogendam Willem B. , Shappee Benjamin J. , Dhawan Suhail , Sharief Sammy N. 
Published: October 2024

Abstract
Flux excesses in the early-time light curves of Type Ia supernovae (SNe Ia) are predicted by multiple theoretical models and have been observed in a number of nearby SNe Ia over the last decade. However, the astrophysical processes that cause these excesses may affect their use as standardizable candles for cosmological parameter measurements. We perform a systematic search for early-time excesses in SNe Ia observed by the Zwicky Transient Facility (ZTF) to study whether SNe Ia with these excesses yield systematically different Hubble residuals. We analyze two compilations of SN Ia light curves from ZTF’s first year of operations: 127 high-cadence light curves from Y. Yao et al. and 305 light curves from the ZTF cosmology data release of S. Dhawan et al. We detect significant early-time excesses for 17 SNe Ia in these samples and find that the excesses have a median g − r color of 0.10 ± 0.11 mag; we do not find a clear preference for blue excesses as predicted by several models. Using the SALT3 model, we measure Hubble residuals for these two samples, finding that excess-having SNe Ia may have lower Hubble residuals (HR) after correcting for shape, color, and host-galaxy mass, at ∼2–3σ significance; our baseline result is ΔHR = −0.056 ± 0.026 mag (2.2σ). We compare the host-galaxy masses of excess-having and no-excess SNe Ia and find they are consistent, though at marginal significance excess-having SNe Ia may prefer lower-mass hosts. Additional discoveries of early excess SNe Ia will be a powerful way to understand potential biases in SN Ia cosmology and probe the physics of SN Ia progenitors.
Thermodynamic Evolution of Plumes
Authors: Malaker Biswanath , Upendran Vishal , Tripathi Durgesh 
Published: October 2024

Abstract
Plumes are considered to play an important role in the origin of the solar wind. However, an understanding of their thermodynamic evolution is not complete. Here, we perform a detailed study of a plume inside a coronal hole throughout its lifetime, using the observations from the Atmospheric Imaging Assembly and the Helioseismic and Magnetic Imager. We find that the plume’s formation is preceded by frequent occurrences of small-scale jets and jetlets at its base, leading to the gradual development of plume haze. The plume rapidly developed within the first 6 hr into its well-known morphology. Light curves from all extreme ultraviolet channels exhibit a similar profile, suggesting its multithermal nature and intensity modulation over its lifespan. Moreover, the photospheric magnetic field dynamics at the plume’s base are highly correlated with its light curve in 171 Å. We calculate outflow velocities, observed prominently in the 171 Å passband and mildly in the 193 and 211 Å passbands, with median speeds lower in higher temperature bands but occasionally comparable to the respective sound speeds. When data are averaged over larger spatial scales, the plume appears isothermal along its length, with constant temperature throughout its lifetime. However, an analysis of the differential emission measure at full resolution reveals the presence of higher-temperature plasma, indicating internal temperature structures within the plume. These results provide new insights into the formation, dynamics, and thermal properties of coronal plumes, placing tighter constraints on models to understand their thermodynamic evolution and potential role in the solar wind.
Large-scale Structure of the Heliospheric Current Sheets within the Heliosheath Inferred from Voyager 2 Observations
Authors: Choi Dooyoung , Lee Dae-Young , Choi Kyung-Eun , Noh Sung Jun , Kim Kyung-Chan 
Published: October 2024

Abstract
In this paper, we conducted an analysis of the heliospheric current sheets (HCSs) in the heliosheath (HS), utilizing observations by Voyager 2 between 2008 and 2018. Employing rigorous criteria, we identified a total of 34 HCSs that indicate significant changes in magnetic polarity. These occurrences were more prevalent during solar maximum periods when the HCS expanded to higher latitudes, coinciding with the spacecraft positioned at an average latitude of −31° from the solar equator. We determined certain features of the large-scale structures of the identified HCSs. Most importantly, employing two distinct methods indicates that the thickness of the HCSs within the HS ranges from ∼0.003 to ∼0.4 au with an average thickness of ∼0.03 to ∼0.1 au, depending on methods of event selection and fitting techniques. This thickness surpasses that known near 1 au or other heliospheric distances. It is also notably thicker than the typical proton inertial length, implying unfavorable conditions for magnetic reconnection. Additionally, our analysis reveals a frequent tilt of HCS planes relative to the solar equatorial plane by a varying angle up to several tens of degrees, likely implying a common occurrence of a warped structure of the HCS within the HS. Longitudinally, the HCS planes closely align with the Parker spiral field direction expected in the HS. Finally, for a large fraction of the identified HCS events, the HCS planes are likely characterized by a rotational discontinuity. These findings are valid within the limits of the 1 hr resolution data used in this study.