bluuebunny/crossref_metadata_2025_split huggingface dataset:
Innovative in vivo rat model for global cerebral hypoxia: a new approach to investigate therapeutic and preventive drugs
Authors: Stahlke Sarah , Frai Jonas , Busse Johanna Franziska , Matschke Veronika , Theiss Carsten , Weber Thomas , Herzog-Niescery Jennifer 
Published: February 2024

Introduction: Severe acute global cerebral hypoxia can lead to significant disability in humans. Although different animal models have been described to study hypoxia, there is no endogenous model that considers hypoxia and its effect on the brain as an independent factor. Thus, we developed a minimally invasive rat model, which is based on the non-depolarizing muscle blocking agent rocuronium in anesthetized animals. This drug causes respiratory insufficiency by paralysis of the striated muscles.Methods: In this study, 14 rats underwent 12 min of hypoxemia with an oxygen saturation of approximately 60% measured by pulse oximetry; thereafter, animals obtained sugammadex to antagonize rocuronium immediately.Results: Compared to controls (14 rats, anesthesia only), hypoxic animals demonstrated significant morphological alterations in the hippocampus (cell decrease in the CA 1 region) and the cerebellum (Purkinje cell decrease), as well as significant changes in hypoxia markers in blood (Hif2α, Il1β, Tgf1β, Tnfα, S100b, cspg2, neuron-specific enolase), hippocampus (Il1β, Tnfα, S100b, cspg2, NSE), and cerebellum (Hif1α, Tnfα, S100b, cspg2, NSE). Effects were more pronounced in females than in males.Discussion: Consequently, this model is suitable to induce hypoxemia with consecutive global cerebral hypoxia. As significant morphological and biochemical changes were proven, it can be used to investigate therapeutic and preventive drugs for global cerebral hypoxia.
Measuring digital stress in Norway: translation and validation of the Digital Stressors Scale
Authors: Sevic Aleksandra , Foldnes Njål , Brønnick Kolbjørn Kallesten 
Published: February 2024

IntroductionA better understanding of the effects of the widespread use of information and communication technology (ICT) among employees is important for maintaining their wellbeing, work-life balance, health, and productivity. Thus, having robust and reliable measurement instruments is crucial for quantifying the effects of ICT use, and facilitating the development of effective strategies to promote employee wellbeing.MethodsTherefore, we translated the Digital Stressors Scale (DSS) to Norwegian and administered it to a convenience sample of 1,228 employees, using the forward-backward translation method. The DSS is a new multidimensional scale consisting of 50 items that measure 10 digital stressors (first-order factors), and a second-order factor of DSS. We assessed the scale's construct validity with confirmatory factor analysis, first by assessing the model fit of each of the sub-scales separately, to facilitate the disaggregated measurement approach, and then the model fit of the whole scale with the second-order factor.ResultsAmong the participants, 45.6% completed the whole questionnaire (n = 560). The original solution's fit was unsatisfactory in our sample, which led us to perform an exploratory factor analysis. We propose a shorter 8-factor scale with 37 of the original items, which also shows good internal consistency for all the first-order factors.DiscussionWe argue that the disaggregated approach is beneficial for the investigation of the specific creators of digital stress and that conceptually sound measurement models are needed in order to facilitate a more rigorous empirical investigation of digital stressors.
Nurses’ perspectives on workplace environment needs associated to resilience: a qualitative descriptive study
Authors: Li Meng , Zhao Runze , Wei Junfan , Zhou Linghan , Yang Shuhua , Tian Yuan , Wang Lingning , Zhang Wenling , Xiong Xiaoyun , Huang Chuzhen , Pan Zhongjie , Song Ruipeng 
Published: February 2024

ObjectiveThe purpose of this study was to explore the demands of nurses on the workplace environment related to psychological resilience.MethodsA qualitative descriptive design was employed for this study. Purposeful sampling was chosen from a tertiary hospital in Henan Province, China. Semi-structured in-depth interviews were conducted with 20 nurses. The interview data was analyzed using the Colaizzi’s method and results were reported following the COREQ standards.ResultsAnalysis of the interview data revealed three main themes: (1) Career Support and Development, (2) Practical Support &amp; Development, and (3) Personal Support and Development.ConclusionThe perspectives of nurses for a workplace environment demands needs to be appreciated, and in addition, it is worth noting that the key role of building a good workplace environment in strengthening the resilience of nurses emphasizes the need for careful consideration. Nursing administrators should formulate policies and measures from multiple perspectives based on the real needs of nurses in terms of professional, practical, and personal dimensions.
Analyzing the effect of severe weather on farmers' fertilizer usage and input investment amidst decreasing productivity in single-season agroecosystems
Authors: Atinga David , Awuni Joseph Agebase , Sakurai Takeshi 
Published: February 2024

IntroductionIn Ghana and comparable developing countries, advancing farm investments and adopting innovative rice farming techniques encounters obstacles because of climate change. Smallholder farming households, affected by climate events, confront substantial risks that affect both agricultural returns and investment decisions.MethodsThis research evaluates the enduring impact of fluctuating weather patterns in a single-cropping agroecological region on rice yields, examining the consequent influence on the utilization of inorganic fertilizers and agricultural input investment among rain-fed households, investigating disparities, reasons, and underlying mechanisms. The research used panel data from 60 communities, employing regression analysis and probability models. It integrated monthly cropping season weather data across the study zone's grid cells for community-level time series analysis.Results and discussionThe results suggest that while weather shocks have a minimal impact on farmers abandoning inorganic fertilizers altogether, they do significantly decrease the overall amount of fertilizer used, agricultural investments, and rice crop yields. Floods and severe shocks exert a more pronounced influence compared to droughts and moderate shocks. Off-farm employment aids households in recovering from these shocks and maintaining agricultural investments. Climate shocks impact agricultural investment by reducing farm household income via altering crop yield and revenue. Consequently, this disrupts their ability to save, resulting in financial constraints. Encouraging and sustaining farm investments in vulnerable agrosystems involves diversifying income sources through combined crop and livestock farming, supplemented by off-farm activities. This strategy is fortified by climate-resilient farming practices, including resilient crop varieties supported by irrigation, weather insurance, and risk-oriented credit.
Anesthetic management of adult patients with tetralogy of Fallot: a case series
Authors: Sengottian Mano Praveen , Ajanth S. , Baliarsing Lipika A. , Deshpande Charulata 
Published: February 2024

Tetralogy of Fallot (ToF) is the most common form of cyanotic congenital heart disease, occurring predominantly in the childhood with a rare late presentation in the adults. the prognosis OF ToF remains poor, especially in those who do not undergo surgical correction. However, in the recent times, there is a significant improvement in the prognosis of congenital heart diseases and almost 85% patients are expected to survive till adulthood due to early diagnosis and appropriate medical and surgical management. These adult patients with congenital heart disease exhibit specific and complex anatomic and physiological changes, which can affect the perioperative morbidity and mortality to a great extent. We present this case series to discuss the relevant clinical and successful anaesthetic conduct of adult patients with ToF. before and after surgical repair, with good perioperative outcome.
Key words: Tetralogy of Fallot; Congenital heart disease; Anesthesia; Cyanosis; Pulmonary stenosis; Pulmonary atresia.
Citation: Sengottian MP, Ajanth S, Baliarsing LA, Deshpande C. Anesthetic management of adult patients with tetralogy of Fallot: a case series. Anaesth. pain intensive care 2023;27(3):429−433; DOI: 10.35975/apic.v27i3.2229
Received: November 27, 2022; Reviewed: March 16, 2023; Accepted: April 05, 2023
A retrospective analysis of the incidence and determinants of self-extubation in a tertiary care surgical intensive care unit
Authors: Ali Muhammad Asghar , Rashid Saima , Siddiqui Khalid Maudood , Yousuf Muhammad Saad 
Published: February 2024

Background & Objective: Self-extubation is reported as one of the most common adverse events in the adult intensive care units worldwide. We aimed to find out the incidence and determinants of self-extubation in surgical intensive care unit of our tertiary care hospital. Methodology: It was retrospective analysis of the data acquired from the hospital databases, about the patients who self-extubated during admission to surgical intensive care unit (SICU) of Aga Khan University Hospital, Karachi, Pakistan, during six calendar years, from January 01, 2010, through December 31, 2016. Data collection form was used to collect personal details, drugs used for sedation, sedation agitation score, pain score, nurse-patient ratio and the use of any restraint at the time of extubation. SPSS was used to analyze data applying the central limit theorem to calculate the mean and standard deviation for quantitative variables and the Chi-square test was conducted using a P < 0.05 for qualitative variables. Multivariate logistic regression analysis was performed to identify the independent risk factors for self-extubation Results: A total of 618 patients were admitted to the SICU who required mechanical ventilation during the study period. An overall 2.1% incidence of self-extubation was calculated with a documented thirteen self-extubation episodes. The mean age of patients was 38.46 ± 16.97 y with majority of them being males. Most, 9 (69.2%), of the patients were not restrained at the time of self-extubation. Nurse to patient ratio was 1:1. Majority of patients 7 (53.8%) were not on any sedative drug infusion and the mean sedation agitation score at that time was 4.46 ± 2.02 while mean pain score was 5.31 ± 2.72. Reintubation was performed in 10 (76.9%) of the patients, who had self-extubated. Conclusion: This study revealed that the incidence of self-extubation was 2.1% in SICU and there was strong correlation between absent physical restraint and self-extubation incidence during the weaning period. Key words: Mechanical ventilation; Reintubation; Self-extubation; Sedation; Surgical Intensive Care Unit; Tertiary Care Hospital Ali MA, Rashid S, Siddiqui KM, Yousuf MS. A retrospective analysis of the incidence and determinants of self-extubation in a tertiary care surgical intensive care unit. Anaesth. pain intensive care 2023;27(3):260−263; DOI: 10.35975/apic.v27i3.2231 Received: October 03, 2022; Reviewed: April 04, 2023; Accepted: April 19, 2023
Effectiveness of goal-directed fluid therapy guided by estimated continuous cardiac output (esCCO) in major gastrointestinal surgeries: a randomized controlled trial
Authors: Vu Phương Hoang , Duong Nu Diep Anh , Tran Viet Duc , Tran Thu Ha , Luu Xuan Vo , Truong Quang Trung , Nguyen Huu Tu , Ochiai Roy 
Published: February 2024

Background & Objective: This study was conducted to compare the effectiveness between goal-directed fluid therapy guided by Estimated Continuous Cardiac Output (esCCO) monitoring and liberal infusion therapy on the early perioperative and postoperative complications, as well as long-term complications in major gastrointestinal surgeries.
Methodology: A randomized controlled trial was conducted at Hanoi Medical University Hospital, Hanoi, Vietnam from October 2020 to October 2021. There were 138 patients enrolled in the study and divided randomly into two groups: Group LIF (liberal infusion therapy) and Group GD (goal-directed fluid therapy using esCCO monitors). The logistic regression (univariate and multivariate) analysis models were performed to evaluate the relationship between the complication (yes or no) and potential predictors.
Results: Mortality and length of hospital stay in the esCCO group were not different from those in the liberal infusion therapy group (P > 0.05). Postoperative respiratory complications such as pneumonia and pulmonary edema were lower in the Group GD but not statistically significant compared with the Group LIF (5.7% vs 7.4% with P > 0.05). There was a higher rate of acute kidney injury in the Group GD than in the Group LIF, but the difference was not statistically significant (5.7% vs 1.5% with P > 0.05). Other complications such as bleeding, wound infection, and tissue edema in the Group GD was almost equivalent to those in the Group LIF and the difference was not statistically significant.
Conclusion: Goal-directed fluid therapy according to esCCO guidelines reduced the amount of intraoperative fluids while maintaining hemodynamic stability during surgery, but has not shown a real effect in reducing postoperative complications. Further studies with a larger number of patients are needed, in high-risk groups of patients requiring intravenous fluids according to esCCO guidelines to better evaluate the effectiveness of reducing postoperative complications.
Abbreviations: esCCO - Estimated Continuous Cardiac Output; esSVI - Estimated Stroke Volume Index; PEEP -Positive End-Expiratory Pressure; MAC - Minimum Alveolar Concentration
Key words: esCCO; Gastrointestinal Surgeries; Goal-directed Fluid Therapy; Infusion Therapy; Randomized Controlled Trial
Citation: Hoang Vu P, Anh Duong ND, Viet Duc Tran VD, Tran TH, Luu VX, Truong QT, Nguyen HT, Ochiai R. Effectiveness of goal-directed fluid therapy guided by estimated continuous cardiac output (esCCO) in major gastrointestinal surgeries: a randomized controlled trial. Anaesth. pain intensive care 2023;27(3):371−378; DOI: 10.35975/apic.v27i3.2242
Received: November 15, 2022; Reviewed: April 29, 2023; Accepted: April 29, 2023
Sub-hypnotic dose of midazolam is effective in reducing intraoperative nausea and vomiting during cesarean sections under spinal anesthesia
Authors: Ibrahem Ibrahem Ghaleb 
Published: February 2024

Background & Objectives: Intra and postoperative nausea and vomiting under regional anesthesia is a common problem in cesarean sections. Globally, the incidence has been documented to be from 40−80%, and various drugs have been used to control it. We aimed to determine if a subhypnotic dose of midazolam will be effective to reduce intraoperative nausea and vomiting during an elective cesarean section under spinal anesthesia.
Methodology: A randomized interventional study was done through a period of 6 months from March 11, 2019 to September 11, 2019 and included 100 full term pregnant women undergoing elective cesarean sections (CS) under spinal anesthesia. The participants were allocated to one of two groups: Midazolam group (received midazolam 1 mg bolus then 1.0 mg/h infusion after umbilical cord clamping), and placebo group (received normal saline). Bellville score was used to evaluate nausea and vomiting (N/V). The hemodynamic parameters were monitored at three-minute intervals.
Results: No statistically significant differences were noted between study groups regarding mean arterial pressure, heart rate and total ephedrine used in the two groups. Intraoperative nausea and vomiting were recorded midazolam (81.6%) with a significant association between prevention of intraoperative N/V and receiving midazolam. Insignificant association was noticed between the level of sedation and receiving midazolam.
Conclusion: Administration of low dose of midazolam during cesarean sections under spinal anesthesia can lessen intraoperative nausea/vomiting without significantly effect on blood pressure or heart rate and without any negative side effects.
Abbreviations: BMI – Body Mass Index; CS - Cesarean Section; LA – Local Anesthesia; N/V - Nausea/Vomiting; RASS - Richmond Agitation Sedation Score SA - Spinal Anesthesia
Key words: Nausea; Vomiting; Anesthesia, Spinal; Midazolam; Cesarean Section
Citation: Ibrahem IG. Sub-hypnotic dose of midazolam is effective in reducing intraoperative nausea and vomiting during cesarean sections under spinal anesthesia. Anaesth. pain intensive care 2023;27(4):485−489; DOI: 10.35975/apic.v27i4.2087
Received: October 12, 2022; Reviewed: May 16, 2023; Accepted: June 23. 2023
Accuracy of preoperative evaluation of inferior vena cava collapsibility index and caval aorta index for prediction of hypotension after induction of general anesthesia: a prospective observational study
Authors: Omar Heba , Moamen Ahmed , Abdelhamid Bassant Mohamed , Rady Ashraf , Farouk Inas 
Published: February 2024

Background & Objective: Post general anesthesia induction hypotension (PGAH) is not a rare event. Almost every induction agent has been incriminated to a variable extent. Preoperative ultrasound assessment of Inferior Vena Cava Collapsibility Index (IVCCI) has been investigated for predicting hypotension with mixed results. Inferior vena cava to aorta diameter index (IVC/Ao) hasn’t been studied before as a predictor for PGAH. We studied the comparative accuracy of preoperative IVCC and IVC/Ao index for PGAH prediction.
Methodology: This observational prospective blinded study involved 102 participants undergoing different surgeries under general anesthesia. Preoperative ultrasound assessment of IVCCI and IVC/Ao index was done. Mean arterial pressure (MAP) was assessed 6 times; before induction, 1 min and 3 min after induction and 1, 5 and 10 min after endotracheal intubation. The area under the receiver operating characteristic curve (AUROC) was calculated for the ability of IVCC and IVC/Ao index to predict PGAH. Stepwise, backward logistic regression model was constructed to detect and quantify the predictive factors of PGAH.
Results: A total of 80 (78.43%) patients developed PGAH. ROC curve analysis for PGAH prediction demonstrated better diagnostic accuracy for IVC/Ao index than IVCCI, as the AUC of both were 0.666 (P < 0.017) and 0.487 (P = 0.852) respectively. IVC/Ao index cutoff value was 0.852
Conclusions: Inferior vena cava collapsibility index and inferior vena cava to aorta diameter ratio (IVC/Ao) index are both reliable indicators of post general anesthesia induction hypotension. IVC/Ao index is a more accurate and reliable indicator than inferior vena cava collapsibility index.
Abbreviations: CVP: Central Venous Pressure; IVCCI: Inferior Vena Cava Collapsibility Index; IVC/Ao: Inferior Vena Cava to Aorta Diameter Index; IVCD: Inferior Vena Cava Diameter; PAOP: Pulmonary Artery Occlusion Pressure; PGAH: Post General Anesthesia Induction Hypotension
Key words: Hypotension; General Anesthesia; Ultrasound; IVCCI; Aorta
Citation: Omar H, Moamen A, Abdelhamid BM, Rady A, Farouk I. Accuracy of preoperative evaluation of inferior vena cava collapsibility index and caval aorta index for prediction of hypotension after induction of general anesthesia: a prospective observational study. Anaesth. pain intensive care 2023;27(4):449−455; DOI: 10.35975/apic.v27i4.2255
Received: October 12, 2022; Reviewed: March 03, 2023; Accepted: May 20, 2023
Intrathecal bupivacaine with fentanyl compared to levobupivacaine with fentanyl for painless labor: a double-blind, randomized clinical trial
Authors: Ali Wesam Nashat , Youssef Hamdy Abbas , Abbas Ahmed Mohammed , Roshdy Peter Eleshaa , Imbaby Ahmed Said Saad , Abdelrady Marwa Mahmoud 
Published: February 2024

Background & Objective: Labor pain relief has been a challenge for the clinicians for centuries. A lot many regimes and therapeutic interventions, including spinal and epidural injections, have been tried with variable effect. We aimed to compare the duration of analgesia and potency of bupivacaine plus fentanyl vs. levobupivacaine plus fentanyl for painless labor.
Methodology: We enrolled 70 parturients who requested spinal analgesia in active labor, and randomly divided them into two groups; Group B (35 women) received 2.5 ml of bupivacaine 0.5% plus fentanyl 25 µg, and Group L (35 women) received 2.5 ml of levobupivacaine 0.5% plus fentanyl 25 µg. We assessed motor and sensory block, the efficacy of analgesia, pain scores, adverse effects, and obstetric and neonatal outcomes of both groups.
Results: Time to reach maximum sensory block was significantly longer in Group L than in Group B (P = 0.002*). There was a statistically significant increase in the duration of motor blocks in Group B than in Group L (P < 0.05). The median VAS scores were significantly lower in Group L than in Group B after 2 and 3 h after injection. The duration of analgesia was significantly longer in Group L than in Group B (P < 0.05). The two study groups had no differences in the measured obstetric and neonatal outcomes.
Conclusion: Levobupivacaine with fentanyl was superior to bupivacaine with fentanyl regarding the duration and potency of analgesia with lower pain scores, high maternal satisfaction, and no adverse obstetric or neonatal outcomes. Therefore, spinal levobupivacaine plus fentanyl was a reasonable choice for labor analgesia and can be used without jeopardizing the safety of the mother and fetus.
Key words: Bupivacaine; Fentanyl; Levobupivacaine; Labor pain; Spinal Analgesia
Citation: Ali WN, Youssef HA, Abbas AM, Roshdy PE, ImbabyASS. Intrathecal bupivacaine with fentanyl compared to levobupivacaine with fentanyl for painless labor: a double-blind, randomized clinical trial. Anaesth. pain intensive care 2023;27(4):478−484; DOI: 10.35975/apic.v27i4.2256
Received: July 29, 2022; Reviewed: April 19, 2023; Accepted: April 21, 2023
The perception of obstetric healthcare workers to the partners’ presence in the operating room-a phenomenological study
Authors: Ventour Dale , Gardiner Kadija 
Published: February 2024

Objective: It is current practice in our setting to not admit a partner in theatre during cesarean section (CS) even though this is becoming commonplace in various countries. This study is designed to determine the views of healthcare workers, postpartum mothers and their accompanying partners on having a partner present in the operating roon (OR) during an elective CS at Port of Spain General Hospital, Trinidad, West Indies.
Materials and Methods: The study’s theoretical model was based on a constructionist, interpretivist framework as well as phenomenological research. A semi-structured interview was conducted and a thematic approach was used to develop codes. This was analyzed by Qualitative Data Analysis (QDA miner) software and the following themes emerged: ‘Maternal support’; ‘Fathers’ marginalization’; ‘Nurses’ perception of fathers’ role’; ‘Healthcare workers’ perception of litigation and ‘Limiting factors’.
Results: 70% of respondents were in favor of a partner being present in the operating room for an elective CS and thought it would help to keep the mother at ease by allowing her to hold hands with the partner, talk to them and be accompanied by them to the recovery room. Healthcare workers did think that male partners might not have much of an impact in the operating room as they would not know what to do and may actually pose a security threat if things did not go exactly as planned.
Conclusions: Healthcare professionals were neutral about partners being present in the operating room but had concerns regarding partner’s presence in the operating room.
Key words: Anesthesia; Cesarean section; Health personnel; Parturients; Obstetric; Perception
Citation: Ventour D, Gardiner K. The perception of obstetric healthcare workers to the partners’ presence in the operating room-a phenomenological study. Anaesth. pain intensive care 2023;27(4):528−534; DOI: 10.35975/apic.v27i4.2276
Received: May 08, 2023; Reviewed: June 22, 2023; Accepted: June 28, 2023