bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of intra-articular tranexamic acid in reducing blood loss in total knee arthroplasty
Authors: Bayomy El-Sayed Mahmoud , Abd Elgawad Samy Mohamed Khairy , El-Begawy Hossam Abd El-Naby 
Published: January 2024

Abstract

Background
Total knee arthroplasty (TKA) is associated with postoperative blood loss. Tranexamic acid (TXA) administration is an effective strategy used to reduce the blood loss.
This study aimed to evaluate the effect of intra-articular injection of TXA on blood loss and transfusion rate after an elective TKA.

Patients and methods
This was a randomized controlled clinical trial adopted to fulfill the purpose of this study. The study was conducted at Benha Health Insurance Hospital and Benha University Hospitals. It was conducted on 42 adult patients who underwent an elective primary unilateral total knee arthroplasty (TKA) through midline incision with medial parapatellar approach after tourniquet application. Patients were categorized into two groups: control group (without TXA), and intra-articular (IA) group who received 1.5 gm of TXA in 10 ml of normal saline injected into the joint after packing, lavage, hemostasis and closure of the muscle layer just before the deflation of the tourniquet to guarantee maintenance of the injected fluid inside the joint. Demographic data and age, sex, comorbidities, and preoperative hemoglobin levels were collected. The maximum hemoglobin decline was the primary outcome, while the drain’s blood amount (cc/day), the rate of blood transfusion, and the duration of hospital stay were secondary outcomes.

Results
Patients who received Intra-articular TXA had statistically significant lower drop in hemoglobin level (0.99 + 0.45 mg/dl) compared to their control group (2.14 + 1.07 mg/dl) (P<0.001).

Conclusion
TXA is a safe and efficient way to reduce overall blood loss in TKA patients, according to data from this study and the literature. Administration intraarticular seems to be significantly effective in reducing postoperative blood loss without increasing the risk of thrombotic events.
Hip abductor dysfunction following total hip arthroplasty by modified direct lateral approach: Assessment by quantitative electromyography
Authors: Khalifa Yaser E , Hamed Mohamed , Abdelhameed Mohammed Anter , El-Hamed Mohamed A A , Bakr Hatem , Rageh Tarek , Abdelnasser Mohammad Kamal 
Published: January 2024

Abstract

Background
The use of the direct lateral approach and its modifications for total hip arthroplasty (THA) may lead to postoperative abductor weakness. Assessment of abductor muscle function by the use of quantitative electromyography (EMG) aims to investigate the nature of abductor muscle dysfunction.

Methods
We conducted a study on 40 patients who had hip replacement through the modified direct lateral approach. EMG was performed before surgery on the affected and normal sides and repeated on the operated side after surgery by 6 and 12 weeks. Analysis of EMG of the three abductor muscles was done in all patients.

Results
EMG evidence of acute denervation of hip abductors was present in 15 hips (37.5%) after 6 weeks. Improvement of EMG findings occurred in 8 out of 15 patients. Quantitative electromyography (QEMG) showed early significant increase in amplitude in all muscles and decrease in duration in gluteus medius (G. Med) with a pattern of acute nerve injury. At 12 weeks, the values of duration, amplitude, and phase were insignificantly different from the preoperative values signifying the return of near normal muscle activity.

Conclusion
The use of modified direct lateral approach can cause denervation of hip abductors. It is common in the early postoperative weeks. However, it tends to improve and the residual weakness in some patients is not marked. Quantitative electromyography showed that partial denervation is related to superior gluteal nerve stretching and not to direct injury of the terminal branches of the nerve through the incision.
Investigation into the clinical performance of rectus sheath block in reducing postoperative pain following surgical intervention: A systematic review and meta-analysis of randomised controlled trials
Authors: Jeffries Sean D. , Harutyunyan Robert , Morse Joshua , Hemmerling Thomas M. 
Published: January 2024

Background and Aims:
Rectus sheath block (RSB) is an effective postoperative pain control technique in abdominal surgical procedures. This systematic review evaluated the efficacy and outcome data of patients undergoing RSB compared to the standard of care in both laparoscopic and open surgical procedures.

Methods:
This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO ID: CRD42022372596). The search was restricted to randomised controlled trials (RCTs) comparing RSB effectiveness on postoperative pain to any standard general anaesthesia technique (control). We systematically explored PubMed, Medline, Central, Scopus and Web of Science for RCTs from inception to September 2023. The primary outcome was the evaluation of pain scores at rest 0-2, 10-12 and 12-24 h postoperatively. The secondary outcome was the analysis of postoperative intravenous (IV) morphine equivalent consumption at 24-h. A risk-of-bias tool for randomised trials (ROB 2.0, Cochrane, Copenhagen, Denmark) assessment and Grades of Recommendation, Assessment, Development and Evaluation (GRADE, Cochrane, Copenhagen, Denmark) analysis was conducted to evaluate the quality of the RCTs.

Results:
Twenty RCTs involving 708 participants who received RSB intervention and 713 who received alternative analgesic care were included. RSB pain scores were significantly lower than control at 0-2 h (P < 0.001) and 10-12 h (P < 0.001) postoperatively. No significant effect was observed at 24 h (P = 0.11). RSB performance compared to control in 24-h IV morphine equivalency in milligrams was significantly lower (P < 0.001).

Conclusion:
RSB implementation was associated with reduced postoperative pain scores and decreased opioid consumption in IV morphine equivalency up to 24 h following surgical intervention.
Comparison of airway collapsibility following single induction dose ketamine with propofol versus propofol sedation in children undergoing magnetic resonance imaging: A randomised controlled study
Authors: Bhardwaj Pooja , Panneerselvam Sakthirajan , Rudingwa Priya , Govindaraj Kirthiha , Prakash M.V.S. Satya , Badhe Ashok S. , Nagarajan Krishnan 
Published: January 2024

Background and Aims:
Adequate sedation is essential for children undergoing magnetic resonance imaging (MRI) console. Propofol is commonly used for sedation, but it has the drawback of upper airway collapse at higher doses, which may be overcome by ketamine. This study was designed to evaluate the beneficial effect of ketamine on propofol in preventing airway collapse.

Methods:
Fifty-eight children undergoing MRI were randomised to Group P (propofol bolus dose followed by infusion or Group KP (bolus dose of ketamine and propofol followed by propofol infusion). The primary aim is to compare the upper airway cross-sectional area (CSA) and diameters (transverse diameter [TD] and anteroposterior diameter [APD]) obtained from MRI during inspiration and expiration.

Results:
Upper airway collapse as measured by delta CSA in mean (SD) [95% confidence interval] was statistically more significant between the two groups [at the soft palate level, 16.9 mm2 (19.8) [9.3–24.4] versus 9.0 mm2 (5.50) [6.9–11.1] (P = 0.043); at the base of the tongue level, 15.4 mm2 (11.03) [11.2–19.6] versus 7.48 mm2 (4.83) [5.64–9.32] (P < 0.001); at the epiglottis level, 23.9 (26.05) [14.0–33.8] versus 10.9 mm2 (9.47) [7.35–14.5] (P = 0.014)]. A significant difference was obtained for TD at all levels and for APD at the soft palate and base of tongue level.

Conclusion:
Adding a single dose of ketamine to propofol reduced the upper airway collapse significantly, as evidenced by the MRI-based measurements of upper airway dimensions, compared to propofol alone.
Incidence, risk factors, and outcomes of acute kidney injury in patients undergoing emergency laparotomy – A prospective observational exploratory study
Authors: Walikar Beeraling Ningappa , Singla Deepak , Tripathi Debendra Kumar , Agrawal Sanjay , Talawar Praveen , Mangla Mishu 
Published: January 2024

Background and Aims:Acute kidney injury (AKI) can occur in post-laparotomy patients, with a variable incidence. This study aimed to determine the incidence of AKI in patients undergoing emergency laparotomy under general anaesthesia, the effect of preoperative variables on the development of AKI, and the association of post-operative AKI with patient outcomes.Methods:This prospective exploratory study in patients undergoing emergency laparotomy was followed up for 7 days to determine the incidence of post-operative AKI. We determined the patients developing different severity of AKI based on kidney disease improving global outcome staging. Fisher's exact test or Chi-squared test was used to study the association of demographic variables, and various periopertaive variables on the development of postoperative AKI. The association of AKI with the duration of hospital stay was estimated using the Wilcoxon–Mann–Whitney U Test, and Fisher's exact test was used to study the association between AKI and mortality.Results:No patient had AKI in the pre-operative period. On day 3, 18 patients; on day 5, 28 patients; and on day 7, 24 patients developed AKI. Overall, a maximum of 33 patients (out of 100) developed AKI at any time. Our study found that the American Society of Anesthesiologists (ASA) IV and sepsis were independent risk factors for post-operative AKI. Our results also show a moderate-to-high independent association between AKI and duration of hospital stay and mortality (within 30 days).Conclusion:Incidence of post-operative AKI following emergency laparotomy was 33%. Higher preoperative ASA physical status and sepsis were significantly associated with postoperative AKI development.
Career opportunities and guidance among early-career anaesthesiologists – A questionnaire-based cross-sectional survey
Authors: Naik Vibhavari Milind , Dongare Pradeep A. , Balavenkatasubramanian J 
Published: January 2024

Background and Aims:
The opportunities to work for early-career anaesthesiologists are in various sectors such as teaching institutes, private practice, and corporate hospitals in India or abroad. The primary aim of the survey was to determine whether early-career anaesthesiologists wanted to work in India or abroad. The secondary objectives were to determine the proportion of early-career anaesthesiologists who wished to pursue further studies and what degree they wanted to pursue.

Methods:
A validated questionnaire containing questions related to career preferences was circulated by social media among early-career anaesthesiologists via Google Forms. The survey questionnaire focussed on whether the respondents wanted to work in India or abroad or pursue further studies. The survey results were tabulated in an Excel sheet. Descriptive statistics were used to analyse the data, and the Chi-square test was applied where appropriate. Age-group preferences and gender preferences were also analysed.

Results:
A total of 684 responses were received. The mean (SD) age of the respondents was 31.4 (2.8) years. Among the respondents, 64.1% were female, and 35.9% were male. Of the respondents, 309 (72.5%) were in a job, 50 (11.7%) were pursuing Society-recognised fellowships, and the rest were pursuing super-specialisation degrees or University-recognised fellowships. Two hundred and eighty-six respondents (75.5%) wanted to study outside India. Only 155 (36.6%) had career guidance from immediate contacts or mentors.

Conclusion:
Early-career anaesthesiologists want to pursue further degrees and fellowships after their graduation in anaesthesiology. Career guidance is an important aspect of anaesthesiology training.
Prevention of post-spinal anaesthesia hypotension in caesarean delivery using delayed supine positioning – A randomised controlled trial
Authors: Elsakka Ahmed Ibrahim , Mostafa Gamal , Mohamed Mohamed Raafat Abdelaziz , Mahrous Reham , Abdelnasser Amr 
Published: January 2024

Background and Aims:
Maternal hypotension is a common and dangerous consequence after a subarachnoid block for a caesarean section. Combining pharmacological methods such as norepinephrine infusion, ondansetron and non-pharmacological methods in delayed supine positioning better impacts the maternal haemodynamic profile. The present study assessed the benefits and adverse effects of combining pharmacological and non-pharmacological methods in hypotension prophylaxis.

Methods:
This randomised controlled trial was conducted at Cairo University Hospital's obstetric theatre from January to October 2020. The study included 85 parturients who were randomised to two groups. Group Sitting was left seated for 2 min after injection, and Group Control was made to lie down in the supine position immediately after the subarachnoid block. Both groups received prophylactic intravenous norepinephrine infusion, in addition to an ondansetron bolus, before surgery. Patients' systolic blood pressure (SBP) from intrathecal injection until delivery of the foetus, was documented.

Results:
The Sitting group's SBP (122 (14) mmHg) till delivery was statistically higher than the Control group's readings (114 (10) mmHg) (P = 0.004). The Sitting group's intraoperative SBP values were often greater than the Control group values. In addition, the Sitting group had a reduced hypotension incidence and a lower rate of ephedrine use than the other group, but bradycardia incidence was comparable between both groups.

Conclusion:
In elective caesarean delivery, combining pharmacological and non-pharmacological methods achieve better results regarding maternal hypotension, vasopressor consumption, nausea and vomiting, and foetal outcomes.
Intrathecal ropivacaine versus bupivacaine in a non-obstetric population- A meta-analysis and trial sequential analysis
Authors: Khalil Rashaad S. , Mehmud Aaliya , Banerjee Rahul , Malhotra Rajiv , Banerjee Arnab 
Published: January 2024

Background and Aims:
Intrathecal bupivacaine is used for anaesthesia and analgesia but is associated with hypotension. Ropivacaine is an alternative drug that may have fewer cardiotoxic and neurotoxic events. This meta-analysis investigated whether intrathecal ropivacaine is associated with reduced hypotension as compared to bupivacaine.

Methods:
The meta-analysis is registered in the International Prospective Register of Systematic Reviews (PROSPERO). The databases PubMed, Cinahl Plus, Google Scholar, and Scopus were searched, and papers from January 1980 to January 2023 were deemed eligible and filtered using predetermined inclusion and exclusion criteria. The primary outcome was the incidence of hypotension. Secondary outcomes were the duration of sensory block, duration of motor block, incidence of bradycardia, ephedrine usage, and duration of analgesia. Jadad scores were used to evaluate the quality of the papers. RevMan statistical software® utilised inverse variance and a random effect model to calculate the standardised mean difference with 95% confidence intervals for continuous variables and the Mantel–Haenszel test and the random effect model to calculate the odds ratio for dichotomous variables.

Results:
Thirty-three papers, including 2475 patients in total, were included. The Jadad score was between 1 and 5. The incidence of hypotension was significantly higher with intrathecal bupivacaine than with ropivacaine (P = 0.02). The duration of sensory block (P < 0.001) and motor block (P < 0.001) was prolonged with intrathecal bupivacaine. The duration of analgesia favoured intrathecal bupivacaine (P = 0.003).

Conclusion:
Intrathecal ropivacaine has a reduced incidence of hypotension and a reduced duration of sensory block compared to bupivacaine.
O vilão, a vítima e o herói
Authors: Silva Matheus Henrique da , Fulaneti Oriana De Nadai 
Published: January 2024

O presente artigo consiste em uma análise semiótica do debate na CCJ a respeito da PEC da reforma da Previdência em abril de 2019. O objetivo é demonstrar como o conflito é gerado mais pelo choque de esquemas subjacentes ao discurso do que pela confrontação de percepções individuais. Demonstrou-se como o teor passional da discussão é gerado na interação desses esquemas, muito mais do que por artifícios ou provocações pessoais. A teoria utilizada é a Semiótica Discursiva greimasiana; o corpus para análise consiste em dois trechos de discurso: um da deputada Talíria Petrone (PSOL), e outro do deputado Marcel Van Hattem (NOVO). A análise parte de um esquema narrativo subjacente ao discurso, e a partir dele explica os temas e figuras que aparecem em cada um e como esses temas se relacionam de forma conflitiva.
"Todo ponto de vista é a vista de um ponto"
Authors: Xavier Glayci Kelli Reis da Silva , Pontes Isabella Da Rocha 
Published: January 2024

A argumentação é uma prática social determinada pela situação e pelo contrato comunicativo inerente a cada ato de linguagem (CHARAUDEAU, 2001; 2008), o que dá características específicas aos textos de diferentes gêneros discursivos. Além disso, todo texto expressa, de alguma maneira, um ponto de vista daquele que enuncia. Nesse sentido, o projeto em tela tem por objetivo refletir sobre a argumentatividade intrínseca ao discurso, sob um viés linguístico-discursivo, considerando a intencionalidade do ato comunicativo e os diferentes níveis (AMOSSY, 2011; 2018) em que tal argumentatividade se manifesta. Para isso, como corpus de análise, foram selecionadas diferentes capas de revista publicadas no Brasil, entre 2020 e 2023, que tematizassem o cenário após pandemia de covid-19. Como resultados, verificou-se que as capas em evidência direcionam o olhar do público para determinadas conclusões, ora levantando expectativas para o cenário futuro, ora analisando as consequências geradas por esse momento tão marcante na sociedade mundial.
An investigation of thermal patterns in guitarists performing a musician-specific exercise program
Authors: Farrugia Robert , Falzon Owen , Pace Josef 
Published: January 2024

Several musicians suffer from musculoskeletal problems during their career. These injuries are referred to as performance-related musculoskeletal disorders (PRMDs). Through the use of exercise programs, PRMDs can be prevented. Exercise programs aim to strengthen musicians' upper limbs and supporting muscles, which can correct and improve postural control during performance and thereby prevent PRMDs. In this study, a musician-specific exercise program was carried out by guitarists. Thermal imaging was used to observe and monitor the effect of the program. Thermal data was collected from 14 guitarists who played their instrument for at least 7 hours a week. Data was gathered from the trapezius, shoulder, upper arm, forearm, wrist, and digits for a period of 20 minutes whilst the guitarists were playing. The participants followed the exercise program throughout a period of 6 weeks, after which the process of thermal data collection was performed again. While existing studies that evaluate musicians through thermal imaging mostly observe thermal asymmetries, in this work we also looked at absolute and relative temperature changes over time, both before and after the exercise program. The results show that one of the main and most consistent effects of the musician-specific exercise program was the reduction of thermal asymmetries within the shoulder region. This is indicative that the musician-specific exercise might be beneficial to avoid or reduce the effect of PRMDs in guitarists.

Keywords: infrared thermography, musculoskeletal, instrumentalist, guitarists, thermal patterns, exercise program
The impact of job satisfaction on employee productivity at work
Authors: Cima Mihaela-Gabriela , Gîgă Maria , Călin Mariana Floricica 
Published: January 2024

Job satisfaction plays an essential role in determining organizational climate and employee performance within an organization. Given that people spend a significant part of theirlives at work satisfaction levels must be high for them to perform. Thus, in this paper we set out to explore the complex relationship between job satisfaction and productivity to highlight how employee satisfaction impacts employee performance at the organizational level. The study sample consisted of 20 women and 16 men between the ages of 20 and 65. The study investigated 3 hypotheses that established a positive correlation between employee satisfaction and employee productivity at work.
Play Way Method and Academic Achievement of Students with Deafness in Social Studies in Special Education Schools in Uyo Nigeria
Authors: Nwachukwu Dr. Kingsley Ezechinyere , Anyanwu Dr. Chikodi Joy 
Published: January 2024

Purpose: This work examined the Influence of Play Way Method on the Academic Achievement of Students with Deafness in Social Studies in Special schools in Uyo Nigeria. The objectives of the work were to examine the difference in the achievement of students with deafness taught social studies using play way method and those taught without in Special schools in uyo Nigeria ; determine the difference in achievement of male and female students with deafness taught social studies using play way method in Uyo, Special schools in uyo Nigeria and assess the difference in achievement of students with deafness in rural and urban areas taught social studies using play way method and those taught without in Special schools in uyo Nigeria .
Materials and Methods: The research adopted the quasi experimental research design of the pre test post test control group methodology. Independent t-test was used to test the hypotheses. A researcher-designed questionnaire titled "Playway Method Instrument" and a Social Studies Achievement Test were the instruments used for data collection.
Findings: Findings of the study indicated that there is a significant influence of play way method on the academic achievement of students with deafness in social studies in Special education schools in Uyo Nigeria.
Implications to Theory, Practice and Policy: The study recommended that Teacher should create play activities to engage the students during every lesson. This will engage students into more activities which will enable them use their hands, develop their eye-hand coordination as they usually concentrate carefully on what they are doing.
Sectoral Utilization of Foreign Exchange and the Policy Implications for Economic Growth in Nigeria (1997 – 2022)
Authors: Uchendu Winifred Chinyere , Anyanwu Sarah .O. 
Published: January 2024

Purpose: The purpose of this study is to investigate the effect of sectoral utilization of foreign exchange and the policy implications for economic growth in Nigeria.
Methodology: The methodology involved the use of annual time series data covering 1997 to 2022 for pre-diagnostic tests for unit roots which showed that the variables used in the study: economic growth (proxied by real gross domestic product), visible transactions, invisible transactions, treasury bill rate, and exchange rate, were stationary in the first difference. Hence, after first differencing the data, the Ordinary Least Squares (OLS) estimation method was used to estimate the model.
Findings: The findings of the study showed that visible and invisible foreign exchange utilization valid for foreign exchange transactions, in addition to exchange rate and Treasury bill rate impacted positively and significantly on economic growth in Nigeria during the study period. The results of the study strengthened the theoretical basis for the use of relevant policies to grow economies generally, and that of Nigeria in particular.
Unique contributor to theory, policy and practice: By implication, the governments at all tiers should endeavor to provide the enabling environment for greater availability and utilization of foreign exchange to further improve economic growth and sustainable development in Nigeria.