bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting clinical entry point for thoracic epidural catheter insertion during paramedian approach: A prospective observational study
Authors: Deshmukh Bhakti Y. , Shetmahajan Madhavi G. , Bakshi Sumitra G. , Jain Parmanand 
Published: April 2024

Abstract

Background and Aims:
Thoracic epidural insertion has high failure rates in the mid-thoracic region due to steep angulation of oblique bending of spinous processes. The preferred skin puncture point for epidural needle insertion in the paramedian sagittal plane with respect to the superior/inferior tip of spinous process or inter-spinous cleft in the mid-thoracic region (T5-8) is not standard. The primary objective of this prospective observational study was to find the skin puncture point which had the best success rate for a successful epidural catheterization. Secondary objectives were to study the number of attempts and passes required to locate epidural space, incidence of failed epidural, and its relationship with patient characteristics and demographics.

Material and Methods:
After informed consent, 155 patients planned for general anesthesia with epidural analgesia in the mid-thoracic region were included in the trial. Patient demographics, the details of epidural attempts with respect to anatomical landmarks, distance from the midline, and number of passes in each attempt were noted. Epidural catheterization was considered successful after demonstrating dermatomal band of sensory blockade.

Results:
The success rate at different skin puncture sites was not statistically significant (P = 0.58). We found a failure rate of 12.9%. Failed epidural catheterization was significantly high in the age group >56 years (n = 62 and P = 0.007).

Conclusion:
In our study, none of the skin puncture points had a significant association with successful epidural insertion in mid-thoracic segments using a para-median approach.
Testicular Regression Syndrome: Histopathological Evaluation of 20 cases from Rural India with Review of Literature
Authors: Pol Jaydeep N. , Deshmukh Sayali , Bhosale Anand , Hombalkar Priya , Dugad Vivek , Chaudhari Pallavi S. , Bindu Rajan S. , Awake Praneet , Patrike Sneha 
Published: April 2024

ABSTRACT

Context:
Testicular regression syndrome (TRS), clinically termed “vanishing testes,” is a condition with atrophy of testes in late fetal or early neonatal life. The spermatic cord ends blindly or into a small fibrovascular nubbin. Histopathology reveals a fibrovascular nodule with associated hemosiderin-laden macrophages and dystrophic calcification. Few cases show the presence of seminiferous tubules and germ cells. The presence of germ cells is associated with the risk of developing a testicular germ cell tumor.

Aims:
To study the histopathological features of testicular nubbins and to determine the presence of germ cells and associated neoplasm.

Settings and Design:
It is a retro-prospective observational study carried out on patients referred to a pediatric surgical pathology center in Miraj, who were clinically diagnosed with undescended testis, over a period of 1 year. Data were collected after the study was approved by the IEC-MGCH on December 19, 2022.

Materials and Methods:
Twenty patients diagnosed with cryptorchidism, undescended testis, or atrophic testis were included. Findings of hematoxylin and eosin-stained slides of each case were noted, and Prussian Blue (special staining) was performed in four cases.

Statistical analysis used:
As this is a descriptive observational study, simple arithmetic calculations were performed. No unique statistical analysis was performed.

Results:
Among twenty cases of vanishing testes syndrome, 20 cases showed fibrovascular tissue only, and 1 case showed the presence of seminiferous tubules with Sertoli cells.

Conclusions:
Vanishing testes syndrome is a rare condition that is difficult to diagnose on clinical examination, and a definitive diagnosis may be missed if the pathologist is unaware of the condition. Also, there is a risk of germ cell tumor if there are residual germ cells in the testicular nubbin.
Renal Doppler Velocimetric Indices among Adult Seropositive Viral Hepatitis Patients Attending Tertiary Care Facility in Kano State, Nigeria
Authors: Yau Zubaida S. , Sidi Muhammad , Garba Idris , Lawal Yusuf , Suwaid Mohammad A. 
Published: April 2024

Context:
Viral hepatitis is associated with an increased risk of renal disease leading to hepato-renal syndrome. Currently, urine and blood tests are the primary tools used to detect and monitor kidney disease among seropositive viral hepatitis patients. However, these biomarkers are affected by co-existing liver disease, age, and BMI, making their use unreliable in some patients with renal impairments. Renal Doppler sonography has been explored as a viable non-invasive alternative for the diagnosis of subclinical renal changes among asymptomatic patients with viral hepatitis.

Aim:
This study aimed to evaluate renal Doppler velocimetric indices of asymptomatic adult patients with viral hepatitis and compared Doppler values between carrier serotypes with correlations with prothrombin time (PT) at Aminu Kano Teaching Hospital, Kano.

Settings and Design:
This was a hospital-based cross-sectional observational study conducted at the Radiology Department of AKTH.

Materials and Method:
This study was conducted between March 2022 and January 2023, among seropositive viral hepatitis patients grouped into acute hepatitis B (AHB), chronic hepatitis B (CHB), and chronic hepatitis C (CHC). The resistive index (RI) and pulsatility index (PI) for the different serotypes were obtained following renal Doppler sonography among study subjects. Also, PT was recorded for each serotype.

Statistical Analysis Used:
Relevant data obtained were entered and analyzed using SPSS version 23. The significance level was considered at P < 0.05.

Results:
The study had 153 patients. The resistive index (RI) was significantly higher among AHB than CHB serotypes, and PI was also higher among CHB than CHC serotypes − likewise, the PT. Positive correlations (r = 0.75, P = 0.01) and (r = 0.78, P = 0.01) were seen between RI and PT in both male and female patients, respectively.

Conclusion:
The RI, PI, and PT values were higher among acute and chronic hepatitis B serotypes than in chronic hepatitis C serotypes.
Lens Diameter, Anterior Chamber Depth, and Vitreous Depth in Adult Patients: A Nigerian Study
Authors: Abadom Gloria E. , Ominde Beryl S. , Ikubor Joyce E. , Achapu Lawrence C. , Igbigbi Patrick S. 
Published: April 2024

Context:
The awareness of the diversity of ocular biometry is vital in the management of glaucoma and pathologies of the lens.

Aim:
To establish the normal globe biometric parameters of adults in Delta State, Nigeria.

Setting and Design:
An observational retrospective cross-sectional study at the Radiology Department of Teaching Hospital in Delta State. A purposive sampling technique was adopted.

Materials and Methods:
After obtaining ethical approval, ocular biometry was conducted on 150 adult brain MRI scans (75 males and 75 females) using a digital caliper.

Statistical Analysis Used:
The data were analyzed and summarized in descriptive statistics. Inferential statistics were employed for comparison across gender, side, and age groups, as well as to determine the association between variables. A significance level of 5% was adopted.

Results:
The anterior chamber depth (ACD), vitreous depth, superoinferior (SI), and anteroposterior (AP) lens diameters were symmetrical. All the parameters lacked sexual dimorphism, while the AP and SI lens diameters significantly varied between the 10 year’s age groups (P < 0.05). Age had a significant positive correlation with the AP and SI lens diameters and a negative association with ACD and vitreous length. The vitreous length had a significant positive link with the ACD and SI lens diameter (P < 0.05). The AP lens diameter had a significant negative correlation with ACD and vitreous length (P < 0.05).

Conclusion:
The normal ocular biometry obtained can be used within the studied population to help in the diagnosis of ocular conditions, management of cataracts, and the design of intraocular lenses.
Analgesia for Infant Circumcision: Eutectic Mixture of Local Anesthetic (EMLA) Cream versus Dorsal Penile Nerve Block using Bupivacaine
Authors: Nuhu Samuel I. , Omoba Aruoture B. , Embu Henry Y. , Isamade Suckie E. , Usman Yohanna M. 
Published: April 2024

Context:
Circumcision is a painful procedure; thus, analgesia for neonatal circumcision is advocated for every male infant, and its use is considered essential by the American Academy of Pediatrics.

Aim:
This study aimed to compare the analgesic, hemodynamic effects, and complications of an eutectic mixture of a local anesthetic cream versus dorsal penile nerve block using bupivacaine for infants coming for circumcision.

Materials and Methods:
This was a prospective randomized interventional study involving 64 infants scheduled for circumcision at the Jos University Teaching Hospital. Infants were randomized into one of two groups through allocation concealment technique. Group I received dorsal penile nerve block with plain bupivacaine 0.5 mL/kg of 0.25%, while group II received 1 g of an eutectic mixture of a local anesthetic cream (EMLA). Circumcision started 5 minutes after penile block for group I and 1 hour after EMLA cream application for group II. Pain levels using CRIES scale, hemodynamic parameters, duration of surgery, and postoperative complications were noted and documented. Data were analyzed using SPSS version 23. A P value of less the 0.05 was considered statistically significant.

Results:
The study groups were comparable in demographic characteristics (P = 0.054). Less infants had CRIES scores of >4 in the DPNB group up to 2 hours postoperative period. Hemodynamic parameters were within normal ranges but higher in the EMLA group. No complication was noted in both study groups.

Conclusion:
Dorsal penile nerve block with bupivacaine provided better analgesia in infants undergoing circumcision than EMLA.
Is the Rule of Halves Still Relevant today? A Study from a Tertiary Care Hospital in India
Authors: Shivani Sajjan , Chawla Parvinder S. , Kalra Khyati 
Published: April 2024

Introduction:
Hypertension significantly increases the risk of heart disease, stroke and kidney failure. It impacts approximately one-third of adults in Southeast Asia, yet a considerable number remain unaware or lack access to adequate treatment. Introduced by Wilber and Barrow in 1972, the ‘rule of halves’ governs the prevalence of hypertension. The study aimed to re-evaluate the rule of halves and suggest measures for early detection and treatment compliance.

Materials and Methods:
A hospital-based study was conducted from (August, 2023 to October, 2023) involving 1518 employed individuals selected through non-probability sampling, excluding those seriously ill or absent. Data were gathered through a semi-structured questionnaire.

Results:
Out of all 1518 study subjects, 206 (14%) were diagnosed with hypertension. Among them, (42) 20% were aware and within this aware group, 81% received treatment. Of those receiving treatment (25), 73% received treatment adequately.

Conclusion:
The findings suggest that, although the proportion of diagnosed hypertension was lower, the rates of treatment and adherence amongst individuals with diagnosed hypertension were higher. There is a need to revisit the rule of halves for India.
Monitoring Trends and Differences in COVID-19 Case Fatality Rates in a Union Territory of India: Inferential Data Analysis
Authors: Saleem Sheikh Mohd , Rather Rouf Hussain , Anjum Sahifa , Sood Vibhusha , Shoib Sheikh , Zaidi Ilham 
Published: April 2024

Objective:To understand the challenges posed by the second wave of COVID-19 cases in the Union Territory of Jammu and Kashmir, India.Materials and Methods:The study utilised weekly aggregated surveillance data from November 2020 to May 2021. Ethical clearance was obtained, and an exploratory trend analysis was performed using Excel 2019.Results:Distinct trends in active cases, symptomatic patients tested, case fatality rate (CFR) and rapid antigen test (RAT) positivity rates were observed across the 10 districts in the Kashmir division. Srinagar exhibited notable variations, and CFR showed district-specific differences.Conclusion:This study underscores the significance of tailored strategies, government interventions and community resilience.
Leadership as a socially and culturally informed praxis: The question of internationalisation in international school leadership
Authors: Al Haj Sleiman Nidal 
Published: April 2024

A pesar del crecimiento en número y tamaño de las escuelas internacionales a nivel global, la investigación que examina su liderazgo y comunidades es aún limitada. El emergente interés en la investigación de este campo aún no ha explorado cabalmente las relaciones de los líderes con los campos sociales en los cuales trabajan y las necesidades culturales y sociales de sus docentes y estudiantes. Este artículo investiga la práctica de liderazgo y el aprendizaje en las escuelas internacionales en Inglaterra y Qatar, ofreciendo un breve contexto histórico respecto del desarrollo de estas escuelas en cada país. De manera adicional, el artículo examina la respuesta de los líderes a los campos sociales multiculturales en los cuales trabajan y el capital cultural de sus docentes y estudiantes. El artículo usa la teoría social de Bourdieu como marco sociológico clave y se involucra con sus conceptos, campo, capital, habitus y práctica, destacando su interconexión y relevancia en el contexto de su investigación. El artículo analiza la praxis de liderazgo (conocimiento y práctica) construyendo sobre la investigación actual sobre liderazgo de justicia social, y liderazgo educacional culturalmente relevante y culturalmente receptivo. Este artículo está basado en un estudio más extenso que aborda las limitaciones del liderazgo y la práctica en las escuelas internacionales de Qatar e Inglaterra a través de un enfoque crítico realista y metodológico mixto. Sin embargo, este artículo presenta solamente resultados de las entrevistas en profundidad, individuales y grupales (N=24), con líderes experimentados de las escuelas internacionales (n=10), líderes intermedios (n=9), docentes (n=7), y estudiantes de educación secundaria (n=16). Los hallazgos mostraron que las escuelas internacionales se caracterizan por el multiculturalismo, movilidad y transitoriedad, lo que impacta significativamente las experiencias de trabajo y aprendizaje en estos contextos. Los hallazgos reflejan nociones de internacionalismo que son amplias y performativas, y brechas significativas en el conocimiento y práctica del liderazgo en relación con el capital cultural y las necesidades de sus docentes y estudiantes. La discusión de los hallazgos se adentra en el análisis teórico de las razones detrás de estas brechas y el impacto del neoliberalismo y la estructuralización en el campo. El artículo releva la necesidad de un cambio en la perspectiva en la teoría de liderazgo educativo que incluya una praxis social y culturalmente informada y aprendizaje de liderazgo transformativo y que requiere una mayor teorización de la internacionalización en el liderazgo educativo.
Székelyföldi turizmus-vendéglátásban tevékenykedő vállalatok munkavállalói teljesítménymérési, értékelési, és menedzsment gyakorlatának vizsgálata (Különös tekintettel Hargita megyére)
Authors: Lőrincz Annamária 
Published: April 2024

As a resource, people are one of the most important factors in the modern economy. From a subjective measurement approach, it can form the basis of business performance measurement. In this research, I am looking for answers to the question: what does business practice show, and how consistent is it with theoretical findings? The results of the research show that companies operating in the hospitality sector in Harghita County are consistently aware of the fact that employee performance contributes greatly to company performance. For this very reason, employee guidance, performance monitoring and feedback are considered significantly important. Employee performance is measured and evaluated informally, often on a monthly basis. The standardised, formal form of measurement, on the other hand, is only done annually, from time to time when necessary. However, its frequency increases significantly with the size of the company. Companies are moderately satisfied with the current employee performance measurement and evaluation. They are therefore aware that there is room for improvement. In their opinion, the introduction of a performance management system in the future would make a significant contribution to solving the problems discussed in the research. In doing so, it would also contribute to the improving of the company's business performance at the same time. Our development objective could be to provide guidance in this area for the future.
Advancements in Medical Image Analysis: A Comprehensive Method of AI-Based Classification and Segmentation Technique
Authors: Biswas Ankur , Banik Rita 
Published: April 2024

Medical imaging is an important tool in the current healthcare system for precise diagnosis and treatment of a wide variety of illnesses. The use of artificial intelligence, namely machine learning and deep learning approaches, has transformed medical picture interpretation and resulted in substantial advances in the area. This research looks at the most recent advances in artificial intelligence as they pertain to medical image processing, with a focus on the classification and segmentation of ocular problems. Given the rising frequency of eye diseases and the imperative need for early diagnosis, artificial intelligence (AI) presents a potential approach for automated, precise, and early detection of diverse ocular issues. The article discusses the most recent methodologies, challenges, and possible applications in the field of AI-driven segmentation and classification of ocular diseases utilizing medical imaging.

Received: 19 November 2023 | Revised: 7 March 2024 | Accepted: 23 April 2024

Conflicts of Interest
The authors declare that they have no conflicts of interest to this work.

Data Availability Statement
The data that support the findings of this study are openly available in public repository as cited and also available on request from the corresponding author upon reasonable request.

Author Contribution Statement
Ankur Biswas: Conceptualization, Methodology, Software, Formal analysis, Investigation, Resources, Data curation, Writing - original draft, Visualization, Supervision, Project administration, Funding acquisition. Rita Banik: Methodology, Investigation, Visualization, Supervision, Project administration, Funding acquisition.
FORMULASI DAN EVALUASI FISIK EDIBLE FILM EKSTRAK ETANOL BUNGA ROSELLA (Hibiscus sabdariffa L.) SEBAGAI PENYEGAR MULUT
Authors: Putri Asharzya , Sulistyawati Rini , Widiastuti Rina 
Published: April 2024

Bunga Rosela (Hisbiscus sabdariffa L) mengandung flavonoid yang terbukti berkhasiat menghambat pertumbuhan mikroorganisme terutama bakteri Streptococcus mutans. Ekstrak etanol bunga rosella dapat dimanfaatkan sebagai antibakteri dalam bentuk sediaan edible film yang memiliki bentuk tipis sehingga lebih nyaman digunakan. Tujuan penelitian ini adalah untuk mendapatkan formulasi dan karakteristik fisik sediaan edible film ekstrak etanol bunga rosela dengan variasi konsentrasi matriks HPMC. Ekstrak etanol bunga rosella konsentrasi 5% diformulasikan menjadi sediaan edible film dengan variasi konsentrasi matriks HPMC 1%, 1,5% dan 2%. Sediaan edible film yang telah dihasilkan di uji karakteristik fisiknya yang meliputi organoleptis, pH, ketebalan, keseragaman bobot, ketahanan lipatan, waktu melarut dan kerapuhan. Hasil uji organoleptis, edible film memiliki bentuk tipis, berwarna merah kecoklatan, asam dan mint, memiliki pH 5, ketahanan lipatan >100, kelarutan tidak larut hanya menjadi lunak, uji kerapuhan < 1%. Keseragaman bobot dianalisis menggunakan One way Anova dan diketahui terdapat perbedaan yang signifikan pada bobot edible film pada tiap formula. Ketebalan edible film dianalisis dengan One way Anova dan diketahui tidak terdapat perbedaan yang signifikan terhadap ketebalan edible film. Sediaan edible film yang lebih disukai panelis adalah formula I.
Validation of the coupled physical–biogeochemical ocean model NEMO–SCOBI for the North Sea–Baltic Sea system
Authors: Ruvalcaba Baroni Itzel , Almroth-Rosell Elin , Axell Lars , Fredriksson Sam T. , Hieronymus Jenny , Hieronymus Magnus , Brunnabend Sandra-Esther , Gröger Matthias , Kuznetsov Ivan , Fransner Filippa , Hordoir Robinson , Falahat Saeed , Arneborg Lars 
Published: April 2024

Abstract. The North Sea and the Baltic Sea still experience eutrophication and deoxygenation despite large international efforts to mitigate such environmental problems. Due to the highly different oceanographic frameworks of the two seas, existing modelling efforts have mainly focused on only one of the respective seas, making it difficult to study interbasin exchange of mass and energy. Here, we present NEMO–SCOBI, an ocean model (NEMO-Nordic) coupled to the Swedish Coastal and Ocean Biogeochemical model (SCOBI), that covers the North Sea, the Skagerrak–Kattegat transition zone and the Baltic Sea. We address its validity to further investigate biogeochemical changes in the North Sea–Baltic Sea system. The model reproduces the long-term temporal trends, the temporal variability, the yearly averages and the general spatial distribution of all of the assessed biogeochemical parameters. It is particularly suitable for use in future multi-stressor studies, such as the evaluation of combined climate and nutrient forcing scenarios. In particular, the model performance is best for oxygen and phosphate concentrations. However, there are important differences between model results and observations with respect to chlorophyll a and nitrate in coastal areas of the southeastern North Sea, the Skagerrak–Kattegat transition zone, the Gulf of Riga, the Gulf of Finland and the Gulf of Bothnia. These are partially linked to different local processes and biogeochemical forcing that lead to a general overestimation of nitrate. Our model results are validated for individual areas that are in agreement with policy management assessment areas, thereby providing added value with respect to better contributing to international programmes aiming to reduce eutrophication in the North Sea–Baltic Sea system.