bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of fascial plane blocks (ESPB vs. TPVB) for pain relief following modified radical mastectomy
Authors: Jayakrishnan S , Dua Amit , Kumar Alok 
Published: October 2023

Abstract

Background and Aims:
The erector spinae plane block (ESPB) is a novel regional anesthesia technique compared to the thoracic paravertebral block (TPVB) in providing postoperative pain relief in breast surgeries. Modified radical mastectomy (MRM) is a commonly performed surgery for breast cancer. The objective of the study is to compare the efficacy of ESPB and TPVB in providing postoperative pain relief after MRM.

Material and Methods:
This is a prospective randomized study conducted in a tertiary care teaching hospital. Sixty ASA I–III adult patients (age >18 years) scheduled to undergo elective unilateral MRM for breast cancer were enrolled in the study. Ultrasound-guided ESPB or TPVB with 0.25% bupivacaine was performed preoperatively on the patients randomized into two groups, namely, the ESPB and TPVB groups. All patients received patient-controlled analgesia for postoperative pain relief. Morphine consumption and Visual Analog Score (VAS) for pain were recorded at 3, 6, 12, and 24 h postoperatively.

Results:
Primarily, the mean postoperative VAS scores between the two groups at 3, 6, 12, and 24 h showed no statistical significance and were comparable when matched at different time points. However, 24-h morphine consumption was significantly more in the ESPB group (P = 0.035). Duration of block performance also showed a significant difference, with ESPB taking less time to perform (P < 0.001). The mean age and body mass index (BMI) of patients and length of hospital stay in both the groups were similar.

Conclusions:
Both ESPB and TPVB provided adequate analgesia in patients undergoing MRM; however, TPVB had better efficacy and opioid-sparing effect when compared to ESPB.
Electronic health record interoperability using FHIR and blockchain: A bibliometric analysis and future perspective
Authors: Anand Gaurav , Sadhna Divya 
Published: October 2023

Abstract
Electronic health records (EHRs) constitute vital statistics, current health condition, ongoing therapies, and patient data; hence, their interoperability could be useful for epidemiologic and clinical research. Fast Healthcare Interoperability Resources (FHIR) and blockchain are currently “in-use” and tested for exchange of such data. The annual scientific production of publications for both FHIR and blockchain shows steady growth. The data interoperability and electronic data interchange have been introduced in the field of EHR in 2020, hence inferring that data interoperability is relatively a new domain. The thematic mapping suggested “interoperability” of EHR is well-developed and important for the structure of the research field.
Investigator knowledge, awareness, and registrations of academic clinical trials with the Clinical Trial Registry of India: An observational study
Authors: Bhide Shruti , Patil Saurabh , Sohal Amitoj , Kadhe Neha , Munshi Renuka , Phirke Chetan , Ambre Snehal , Pawar Sudhir , Patil Ruchita 
Published: October 2023

Abstract

Introduction:
In 2019, the Central Drugs Standard Control Organization (CDSCO) introduced the New Drugs and Clinical Trials Rules 2019 (NDCTR), which separated the research guidelines for “Clinical Trials” and “Biomedical and Health Research.” As a result, guidelines issued by Indian Council of Medical Research were stated to apply to academic clinical trials (ACTs). This change is important because academic studies are crucial for scientific advancement and repurposing of approved drugs in health-care industry. However, conducting an ACT can pose challenges. We assessed the level of awareness, knowledge, and challenges faced by investigators. Our aim is to overcome some of these challenges and encourage more academic studies for the betterment of healthcare and scientific knowledge in India.

Methodology:
The study was conducted in two phases after obtaining approval from the Institutional Ethics Committee (EC) of three tertiary care hospitals in Mumbai. In the first phase, the number of ACTs was assessed from the clinical trial registry India website, while the number of registered and re-registered ECs were assessed from the CDSCO website. The second phase involved assessing investigator awareness and knowledge about ACTs using a prevalidated questionnaire with a content validity index score of 0.93.

Results:
In 2020, the highest numbers of studies were registered, with the highest numbers of registered and re-registered ECs from Maharashtra. All participants completed the questionnaire and were aware of the need to follow guidelines for clinical trials. Sixty-seven percent of participants knew that the guidelines for ACTs differed from those of sponsored clinical trials, but only 58% were aware of the exact definition of an ACT as per NDCTR, 2019. Eighty-five percent of participants knew who could initiate an ACT, but only 27% knew about the applicability of results of an ACT and 33% had in-depth knowledge about the required approvals, while only 10% knew the archival period. Although 71% of participants had knowledge about serious adverse event reporting, few answered in-depth questions correctly. Only 31 participants reported facing varied challenges.

Conclusion:
To conduct ACTs effectively and contribute to healthcare and scientific advancement, it is crucial to enhance investigators’ existing knowledge about ACTs.
Humoral immune response to an mRNA-1273 booster after chAdOx1-nCoV-19-priming among patients undergoing hemodialysis
Authors: Cheng Bo-Yu , Lin Ting-Yun , Hung Szu-Chun 
Published: October 2023

ABSTRACT

Objectives:
Patients who are undergoing dialysis due to end-stage kidney disease are susceptible to greater coronavirus disease 2019 (COVID-19) complications. While vaccination is seen as the most effective tactic against COVID-19, the dialysis population usually has impaired immune responses to vaccination. Owing to the global vaccine supply shortage in the early phase of the COVID-19 pandemic, hemodialysis patients in Taiwan were administered homologous ChAdOx1 nCoV-19/ChAdOx1 nCoV-19 at 12-week intervals, with a third booster shot of mRNA-1273 given 12 weeks after the second dose. We assessed the antibody responses of these patients to this extended-interval dosing protocol.

Materials and Methods:
A total of 168 hemodialysis patients (mean age: 67 ± 13 years) without prior COVID-19 infection were vaccinated between June 16, 2021, and January 5, 2022, and followed until February 10, 2022. The primary outcome was seroconversion with an antispike immunoglobulin G (IgG) antibody level ≥50 arbitrary units (AU)/mL at 4 weeks after the administration of an mRNA-1273 booster shot. The secondary outcome was the level of antispike IgG antibodies. Multivariable linear regression models were used to evaluate the associations between the baseline characteristics and the antispike IgG level.

Results:
A total of 163 (97.0%) patients reached the primary endpoint, with antibody levels after the third booster dose of mRNA-1273 being significantly higher than those after the second dose of ChAdOx1 nCoV-19 (median IgG titer 12,007 [4394–23,860] vs. 846 [interquartile range 295–2114] AU/mL; P < 0.001). Patients who were male, older, had a higher body mass index, had a lower total lymphocyte count, and used immunosuppressants had lower antibody levels.

Conclusion:
A third booster dose of mRNA-1273 after two consecutive priming doses of ChAdOx1 nCoV-19 with extended intervals resulted in adequate humoral immune responses among hemodialysis patients.
An assessment of the legal and policy framework for participatory forest governance in Bangladesh
Authors: Begum Najnin , Alam Shawkat 
Published: October 2023

A robust and well-designed legal and policy framework is vital for ensuring successful public participation in forest management and engaging local governments and communities in conservation efforts. However, despite the presence of various policies and laws aimed at protecting environmental and biological resources, Bangladesh continues to experience significant depletion of its forest resources. This can be largely attributed to inadequate implementation of forest laws, a weak institutional structure, and a bureaucratic approach to forest management.
This article undertakes an analysis of Bangladesh's policy and legal framework concerning participatory forest governance. It specifically examines the incorporation of participatory elements within the country's legal and policy framework for forest management. The assessment encompasses forest tenure, land use, and the practice of participatory forest management (PFM). Furthermore, the effectiveness of social forestry and co-management, the two primary approaches to achieving participatory forest governance in Bangladesh, is evaluated. Additionally, the article identifies the challenges hindering the successful implementation of these approaches.
The argument put forth is that despite the apparent support for participatory forest management within Bangladesh’s policy and legal framework, the actual implementation of PFM and sustainable forest management (SFM) remains ineffective. This ineffectiveness can be attributed to poor policy execution, prioritization of profit-generation over sustainable management practices, lack of coherence within the legal framework, and the centralized decision-making process regarding state-owned forests.
Effectiveness of E-Learning on Students’ Learning Process at Catholic University of Eastern Africa
Authors: Ochoo Olivia Susan , Mwalw’a Shem , Nduku Elizabeth 
Published: October 2023

Purpose: The main aim of this study was to investigate the effectiveness of eLearning on the student’s learning process at the Catholic University of Eastern Africa. The research questions addressed the following areas: how students access educational learning resources on e-learning platforms, how eLearning has been integrated into the process of learning, how eLearning integrations affect students’ learning process, how computer-based learning influences students'’ completion rate at the CUEA, how e-learning and traditional learning environments significantly relate to students’ learning process, the challenges that are associated with e-learning, and the mitigation measures the university is taking to resolve the eLearning challenges.
Methodology: The researcher used an integrated mixed-method approach involving qualitative and quantitative paradigms. Probability and non-probability sampling techniques were used. The target population for the research was 816 out of which, 260 respondents were sampled. From the sampled population, 218 participated in the research making an 85% return rate. The hypothesis was tested using chi-square, while internal consistency was used to ensure the internal reliability of the research instruments. Cronbach validity was used to validate the Likert scale items. Besides, correlation was used to find out the relationships between the dependent and independent variables. The researcher obtained approval from the faculty of education and permission from NARCOSTI to collect data from the respondents.
Findings: The research findings revealed that independent variables, eLearning benefits, eLearning resources, eLearning incentives, and eLearning integration contribute to students’ learning process. The research further revealed that the introduction of a favorable and supportive eLearning environment positively influences Students’ Learning Processes. The researcher concluded that eLearning contributes to the effective learning process of students, therefore, is imperative to be embraced.
Unique Contribution to Theory, Policy and Practice: The researcher recommended that the government, curriculum developers and IHL focus on Instructional design, build a strong Learning management system, guidelines and policy, comparative analysis, leverage Cultural and Global perspectives, eLearning accessibility, engagement, Assessment and evaluation of the eLearning platform. Besides, the students subscribing to the eLearning platform should be given proper orientation in order to navigate the platform easily.
Enseñanza de la Física en la modalidad virtual. Experiencias en el Instituto Tecnológico de Santo Domingo
Authors: Aceituno Mederos Jose Antonio , Córdoba María , Reyes Guzmán Manuel , Morales de Jesús Ricardo , Maisonet Rodríguez Aurea 
Published: October 2023

En este trabajo se presentan los resultados de una investigación llevada a cabo en el Instituto Tecnológico de Santo Domingo en colaboración con la Universidad de Puerto Rico, a partir de la implementación de un curso Virtual de Física Mecánica. Se incluyen resultados de pruebas estandarizadas realizadas antes y después de que los estudiantes aborden los diferentes temas en la modalidad virtual y se comparan con resultados de la modalidad presencial. Se tienen en consideración criterios de los usuarios del curso virtual, y propuestas de cambios que deben hacerse para mejorar las versiones posteriores. Una propuesta que surgió a partir de los señalamientos realizados, fue la de incorporar objetos virtuales de aprendizaje, como detonadores de la motivación prácticamente nula, que se detectó en los estudiantes. Un equipo de investigación transdisciplinaria diseñó y puso a prueba un objeto de aprendizaje virtual transdisciplinario (OVAt) para evaluar si lograba superar algunas de las dificultades detectadas en estudiantes de ciencias físicas. Para ello se construyó un primer OVAt con el tema de movimiento de proyectiles. Se presentan los resultados de la aplicación del OVAt diseñado. Se construyeron instrumentos de evaluación auténtica para ponderar la ejecución disciplinar, así como medir aspectos cualitativos.
NGHIÊN CỨU MỘT SỐ ĐẶC ĐIỂM CỦA BỆNH NHÂN LOÉT TỲ ĐÈ TÁI PHÁT TẠI BỆNH VIỆN BỎNG QUỐC GIA
Authors: Nguyễn Tiến Dũng , Bùi Thị Dung , Phạm Thị Hải Yến 
Published: October 2023

Mục tiêu: Xác định một số đặc điểm của bệnh nhân loét tỳ đè tái phát. Đối tượng phương pháp nghiên cứu: Nghiên cứu hồi cứu bệnh án kết hợp với phỏng vấn qua điện thoại đã được thực hiện trên 108 bệnh nhân trên 18 tuổi, bị loét tỳ đè tái phát vào điều trị tại Trung tâm Liền vết thương, Bệnh viện Bỏng Quốc gia từ tháng 1 năm 2017 đến tháng 12 năm 2021. Kết quả: Bệnh nhân loét tỳ đè tái phát gặp chủ yếu ở Nam giới với tỷ lệ Nam/nữ 5,75. Độ tuổi trung bình là 48,1±15,37 tuổi. Trong đó gặp nhiều nhất ở độ tuổi từ (41-60] với 42,6%. 81,48% số bệnh nhân bị liệt, 14,81% số bệnh nhân bại yếu. 100% bệnh nhân có bệnh lý kết hợp trong đó gặp với tỷ lệ cao nhất là bệnh nhân có chấn thương cột sống/ tủy sống (63,89%). Bệnh nhân hầu hết tiểu tiện và đại tiện không tự chủ (chiếm 88,89% và 87,03). Vết loét tái phát gặp nhiều ở ụ ngồi (45,07%) và cùng cụt (41%). 66,67% số bệnh nhân không được áp dụng các biện pháp trị liệu phối hợp (áp lực âm, ô xy cao áp) trong quá trình điều trị tại Bệnh viện Bỏng Quốc gia trước đó. 31,48% số bệnh nhân không được tập phục hồi chức năng và 43,53% bệnh nhân được người nhà không có chuyên môn hỗ trợ tập phục hồi chức năng ở nhà. 87,97% số bệnh nhân được trăn trở thay đổi tư thế không đúng cách. Kết luận: Bệnh nhân loét tỳ đè tái phát có đặc điểm phong phú. Bệnh nhân Nam giới, bị liệt do chấn thương cột sống, tuỷ sống, đại tiểu tiện không tự chủ, loét vùng ụ ngồi, không được áp dụng các trị liệu phối hợp điều trị vết thương, bệnh nhân không được tập phục hồi chức năng và trăn trở, thay đổi tư thế đúng cách có tỷ lệ loét tỳ đè tái phát cao.
ĐÁNH GIÁ TÁC DỤNG CỦA PHƯƠNG PHÁP TÁC ĐỘNG CỘT SỐNG KẾT HỢP ĐIỆN CHÂM ĐIỀU TRỊ ĐAU THẮT LƯNG DO THOÁI HÓA CỘT SỐNG
Authors: Trần Thị Huyền Trang , Trần Thái Hà 
Published: October 2023

Mục tiêu nghiên cứu: Đánh giá tác dụng của phương pháp tác động cột sống kết hợp điện châm điều trị đau thắt lưng do thoái hóa cột sống. Đánh giá tác dụng không mong muốn của phương pháp. Đối tượng và phương pháp nghiên cứu: can thiệp lâm sàng ngẫu nhiên, so sánh trước và sau điều trị, có nhóm chứng trên 60 bệnh nhân từ 38 tuổi trở lên được chẩn đoán xác định đau thắt lưng do thoái hóa cột sống thắt lưng tại trạm y tế phường 1 quận Tân Bình từ tháng 1/2022 đến hết tháng 8/2022. Nhóm nghiên cứu: 30 bệnh nhân điều trị bằng phương pháp TĐCS vùng thắt lưng kết hợp điện châm. Nhóm đối chứng: 30 bệnh nhân điều trị bằng phương pháp điện châm (phác đồ như nhóm nghiên cứu) kết hợp xoa bóp bấm huyệt vùng thắt lưng. Kết quả: Sau 14 ngày điều trị, giá trị trung bình của điểm VAS, tầm vận động CSTL các động tác ngửa, nghiêng phải, nghiêng trái, xoay phải, xoay trái, giá trị trung bình mức độ cải thiện chức năng sinh hoạt (ODI) ở nhóm nghiên cứu có cải thiện tốt so với trước điều trị và so với nhóm đối chứng. Sự khác biệt này có ý nghĩa thống kê với p<0,05. Giá trị trung bình của chỉ số Schober ở nhóm nghiên cứu có cải thiện hơn so với trước điều trị, tuy nhiên sự khác biệt không có ý nghĩa thống kê p>0,05. Các chứng trạng YHCT đều có sự cải thiện ở cả hai nhóm, thể hiện tốt nhất ở các chứng trạng đau vùng thắt lưng - đau tăng khi vận động, nằm nghỉ đỡ đau - sợ lạnh, thích ấm với p<0,05 khi so sánh nhóm nghiên cứu với nhóm đối chứng. Bệnh nhân đạt tỷ lệ tốt đạt 66,7% và tỷ lệ khá đạt 30,0%, sự thay đổi có hiệu quả lâm sàng về mức độ giảm đau qua thang điểm VAS và cải thiện tầm vận động CSTL. Không có trường hợp bệnh nhân nào gặp tác dụng không mong muốn. Kết luận: Phương pháp tác động cột sống kết hợp điện châm là phương pháp an toàn, có hiệu quả tốt trong điều trị đau thắt lưng do thoái hóa cột sống
La Administración Tributaria española: una reforma necesaria
Authors: Arias Velasco José 
Published: October 2023

Ponencia expuesta en el VI Congreso Nacional de Subinspectores de losTributos
Es uso de ponentes bien nacidos el de iniciar su oración con unas palabras de agradecimiento a la institución o colectivo que les da cobijo. En este caso, no se trata tan sólo de rendir tributo al tópico. En mi condición de heterodoxo tributario casi profesional, agradezco muy sinceramente a la Asociación de Subinspectores de Hacienda que haya tenido la benevolencia de albergar mi heterodoxia. El título que doy a mi ponencia es: «La Administración Tributaria Española: una reforma necesaria». Según para qué oídos, mis palabras pueden resultar incómodas. Como don Quijote, cuando arremetió contra los gigantes que Cervantes confundía con molinos de viento, me dispongo a arremeter, sin más armas que las de la palabra, contra el monstruo engendrado por el sueño de la razón llamado Agencia Tributaria.
Creo que una de las asignaturas pendientes de la Democracia española es la de edificar la Administración Tributaria que corresponde a un verdadero Estado de Derecho. Una Administración que sirva eficazmente a la equitativa distribución de las cargas públicas entre los ciudadanos y a la lucha contra el fraude; pero con sometimiento pleno a la ley y al Derecho, como predica el artículo 103 de la Constitución. Una Administración que destierre para siempre las tentaciones de apropiación de la función pública por parte de determinados cuerpos de élite. La confusión de los intereses públicos con intereses corporativos fue el vicioso rasgo característico de la Hacienda Pública española durante 55 años, entre 1923 y 1978; años marcados, con el breve paréntesis republicano, por el signo de dos dictaduras casi sucesivas.
Budesonide Extended Release for Ulcerative Colitis
Authors: Khangura Sara D. , Spry Carolyn 
Published: October 2023

In 2017, the CADTH Canadian Drug Expert Committee recommended that budesonide extended release (with multi-matrix system) not be reimbursed for the induction of remission in patients with active mild to moderate ulcerative colitis based on limitations in the evidence at that time.
The limited primary clinical evidence (i.e., 1 randomized controlled trial) published since the literature searches conducted for the previous CADTH Reimbursement Review corroborates the clinical findings of that report. The evidence demonstrates that budesonide extended release is more effective for inducing remission in patients with mild to moderate ulcerative colitis compared to placebo.
No new clinical evidence was identified describing head-to-head comparisons of budesonide extended release with active therapies. Indirect comparative evidence between budesonide extended release and other active therapies suggests minimal or no difference in remission, clinical response, or adverse events.
Cost-effectiveness evidence from 1 study conducted in the Netherlands indicates that budesonide extended release is a more effective and less costly second-line therapy versus aggregated comparators for patients with mild to moderate ulcerative colitis.
Evidence-based recommendations support the use of budesonide extended release for patients with mild to moderate ulcerative colitis who have not responded to 5-ASAs.
No clinical or cost-effectiveness evidence or evidence-based recommendations were found describing the use of budesonide extended release in patients with moderate to severe ulcerative colitis.
Engaging Emotions?
Authors: Mononen Sini 
Published: October 2023

Tämä artikkeli käsittelee musiikin ja äänen roolia Elokapinan (XR Finland) muutoskommunikaatiossa. Artikkelissa kysytään, kuinka äänen ja musiikin affektiivisuus on valjastettu liikkeen artivismissa osaksi ilmastonmuutoksen muutoskommunikaatiota. Hybridietnografiaa (hybrid ethnography) (Przybylski 2021) hyödyntävä tutkimus tuo esiin kahden tapauksen avulla, kuinka ääni ja musiikki kommunikoivat liikkeessä erilaista affektiivisuutta erilaisille yleisöille instituutioista kansalaisiin ja liikkeen sisällä vaikuttaviin aktivisteihin. Artikkelissa analysoidaan keväällä 2021 järjestetyn Kirjoita Kriisistä -kampanjan sekä lokakuussa 2021 pidetyn Pitkänsillan tiesulun äänellistä ja musiikillista retoriikkaa. Näistä ensimmäinen yhdisti niin sanotun die in -aktion symbolista lamaannusta alarmistiseen äänelliseen kansalaistottelemattomuuteen (sonic disobedience). Jälkimmäinen puolestaan kommunikoi musiikin avulla liikkeen luonnetta rauhanomaisena.
Yhteenvetona todetaan, että siinä missä ilmastonmuutoksen muutos­kommunikaation ”parhaisiin käytäntöihin” on aiemmassa tutkimuksessa määritelty kuuluvan kulttuurisesti positiivisiksi koettuihin affekteihin keskittyminen (Moser 2019), Elokapinan artivisimissa ääni ja musiikki ilmentävät laajaa affektiivista skaalaa hätätilan ilmentämisestä rauhal­lisuuteen ja arvokkuuteen.
Herbivore–shrub interactions influence ecosystem respiration and biogenic volatile organic compound composition in the subarctic
Authors: Brachmann Cole G. , Vowles Tage , Rinnan Riikka , Björkman Mats P. , Ekberg Anna , Björk Robert G. 
Published: October 2023

Abstract. Arctic ecosystems are warming nearly 4 times faster than the global average, which is resulting in plant community shifts and subsequent changes
in biogeochemical processes such as gaseous fluxes. Additionally, herbivores shape plant communities and thereby may alter the magnitude and
composition of ecosystem respiration and biogenic volatile organic compound (BVOC) emissions. Here we determine the effect of large mammalian herbivores on ecosystem respiration and
BVOC emissions in two southern and two northern sites in Swedish Scandes, encompassing mountain birch (LOMB) and shrub heath (LORI) communities in
the south and low-herb meadow (RIGA) and shrub heath (RIRI) communities in the north. Herbivory significantly altered BVOC composition between sites
and decreased ecosystem respiration at RIGA. The difference in graminoid cover was found to have a large effect on ecosystem respiration between
sites as RIGA, with the highest cover, had 35 % higher emissions than the next highest-emitting site (LOMB). Additionally, LOMB had the highest
emissions of terpenes, with the northern sites having significantly lower emissions. Differences between sites were primarily due to differences in
exclosure effects and soil temperature and the prevalence of different shrub growth forms. Our results suggest that herbivory has a significant effect on
trace gas fluxes in a productive meadow community and that differences between communities may be driven by differences in shrub composition.