bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atrial Septal Defect Occluder Device Embolization: Experience of a Tertiary Care Cardiac Center
Authors: Garre Sandeep , Gadhinglajkar Shrinivas , Sreedhar Rupa , Krishnamoorthy K.M , Pillai Vivek V. 
Published: June 2023

ABSTRACT

Background:
Percutaneous device closure of atrial septal defect (ASD) has become an increasingly popular procedure as it offers several advantages. However, it is associated with infrequent, but life-threatening complications such as device embolization.

Objective:
To analyze the risk factors, common sites of embolization, associated complications, timing of embolization, and the treatment executed.

Settings and Design:
A retrospective study was performed at a tertiary referral center for cardiac services.

Material and Methods:
Pre-procedure, intra-procedure, and post-procedure data of patients whose ASD device embolized was collected retrospectively and analyzed for risk factors, common sites of embolization, associated complications, timing of embolization, and the treatment executed.

Results:
Thirty devices were embolized, out of which 13 were retrieved percutaneously in the Catheter laboratory, whereas 17 patients underwent surgery. Fourteen patients had an unfavorable septal morphology for device closure. Ten devices were embolized in the catheter laboratory, five in the intensive care unit, and two in the ward. The devices were embolized to almost all chambers of the heart and great vessels. One patient had an inferior vena cava rim tear while attempting percutaneous retrieval. One patient required a short period of total circulatory arrest (TCA) for retrieval of the device from ascending aorta, while another required a lateral position for retrieval from descending aorta. One patient required re-exploration for bleeding, while another had an air embolism and succumbed.

Conclusions:
Once embolization occurs, the risks associated increase manifold. Most of the surgical extractions are uneventful; however, there could be certain complications that may need repair of valvular apparatus, the institution of TCA, or the need for the lateral position. Air embolization though very rare can occur which could be fatal.
Comparison of Hemodynamic Consequences of Hand Ventilation Versus Machine Ventilation for Transportation of Post-Operative Pediatric Cardiac Patients
Authors: Chauhan Ankit , Rajesh Venuthurupalli S. P. , Pujara Jigisha , Singh Guriqbal , Patel Praveen , Patel Kaushal , Pandya Himani 
Published: June 2023

ABSTRACT

Learning Objective:
Hemodynamic monitoring during in-hospital transport of intubated patients is vital; however, no prospective randomized trials have evaluated the hemodynamic consequences of hand versus machine ventilation during transport among pediatric patients’ post-cardiac surgery. The authors hypothesized that manual ventilation after pediatric cardiac surgery would alter hemodynamic and arterial blood gas (ABG) parameters during transport compared to mechanical ventilation.

Design:
A prospective randomized trial.

Setting:
Tertiary cardiac care hospital.

Participants:
Pediatric cardiac surgery patients.

Materials and Methods:
One hundred intubated pediatric patients were randomized to hand or machine ventilation immediately post-cardiac surgery during transport from the operating room to the pediatric post-operative intensive care unit (PICU). Hemodynamic variables, including end-tidal CO2 (ETCO2), oxygen saturation, heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), peak airway pressure (Ppeak), and mean airway pressure (Pmean), were measured at origin, during transport, and at the destination. ABG was measured before and upon arrival in the PICU, and adverse events were recorded. The Chi-square test and independent t-test were used for comparison of categorical and continuous parameters, respectively.

Results and Discussion:
The mean transport time was comparable between hand-ventilated (5.77 ± 1.46 min) and machine-ventilated (5.96 ± 1.19 min) groups (P = 0.47). ETCO2 consistently dropped during transport and after shifting in the hand-ventilated group, with significantly higher ETCO2 excursion than in machine-ventilated patients (P < 0.05). SBP and DBP significantly decreased during transport (at 5 and 6 min intervals) and after shifting in hand-ventilated patients than in the other group (P < 0.05). Additionally, after shifting, a significant increase in Ppeak (P < 0.001), Pmean (P < 0.001), and pH (P < 0.001), and a decrease in pCO2 (P = 0.0072) was observed in hand-ventilated patients than machine-ventilated patients. No adverse event was noted during either mode of ventilation.

Conclusion:
Hand ventilation leads to more significant variation in ABG and hemodynamic parameters than machine ventilation in pediatric patients during transport post-cardiac surgery. Therefore, using a mechanical ventilator is the preferred method for transporting post-operative pediatric cardiac patients.
The Effect of Postoperative Hepatic Fibrosis Factors on Morbidity in Mitral Valve Replacement Surgery: A Single Center Ten Years’ Experience
Authors: Yesiltas Mehmet Ali , AK Hulya Yilmaz , Ozsahin Yasemin , Sandal Baris , Salihoglu Ziya , Erkalp Kerem 
Published: June 2023

ABSTRACT

Background:
Previous studies have shown that hepatic fibrosis indices and rates can be used to predict cardiovascular mortality and morbidity. Our aim with this study was to investigate the effect of aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio and fibrosis-4 (FIB-4) index calculated with ALT, AST, and platelet biomarkers, which are simple, fast, and relatively inexpensive and were used in previous studies to predict cardiovascular disease prognosis, on the prediction of postoperative morbidity and early mortality after mitral valve replacement (MVR) surgery.

Methods:
By scanning the hospital electronic health record system, 116 patients who underwent isolated MVR or MVR + tricuspid valve intervention were identified from 178 patients who underwent MVR with the standard sternotomy procedure between 2011 and 2021. The study was completed with 81 of these patients. Patients were divided into AST/ALT <2 (Group 1) and >2 (Group 2). In addition, the same patients were divided into FIB-4 index <3.25 (Group 3) and >3.25 (Group 4), and a total of four groups were formed.

Results:
The mean age of Group 2 was significantly higher than Group 1 (P = 0.049). In addition, the mean age of Group 4 was significantly higher than Group 3 (P = 0.003). Postoperative complications did not differ between Groups 1 and 2 (P > 0.05). While noninvasive mechanincal ventilation (NIMV) requirements did not differ between Groups 3 and 4 (P > 0.05), MV duration and intensive care unit stay were significantly longer in Group 4 (P < 0.05).

Conclusion:
The AST/ALT ratio, which has been shown to be a predictor of cardiovascular mortality in various studies, was not useful in predicting mortality and morbidity in our study. However, a high FIB-4 index, another hepatic fibrosis index, was found to be associated with increased perioperative bleeding, duration of mechanical ventilation, and cardiac intensive care unit stay, which are important criteria in the prediction of morbidity in cardiovascular surgery.
Effectiveness of Multimodal Care Interventions on Enhanced Recovery among the Patients Undergoing Abdominal Surgery
Authors: Barboza Hezil Reema , Dsilva Fatima , Moosaba MS , Lobo Amar Sunil 
Published: June 2023

Background:
The perioperative phase includes a variety of procedures that aim to prepare the patient, physically and psychologically and prevent postoperative complications, thereby reducing the length of hospital stay.

Objectives:
This study includes the application of various measures to encourage active involvement and prompt participation of the patients in the enhanced recovery.

Materials and Methods:
A quasi-experimental design was used to evaluate the effectiveness of interventions on enhanced recovery among patients undergoing abdominal surgery at a tertiary care hospital, Mangaluru. Patients undergoing abdominal surgery between 20 to 60 years were selected as participants.

Results:
The majority of the participants (40%) belonged to the category of normal Body Mass Index (BMI) of 18.5-24.9 Kg/m2 in the experimental group and control group as per BMI categories for Asian populations. There was a significant difference in vital capacity scores between the experimental and control groups (P<0.05) on postoperative days 2 and 3. Thus it proved that deep breathing exercises are effective in improving pulmonary functions. In the experimental group, 60% received oral feed within 6 hours of surgery. The comparison of length of postoperative hospital stays in the experimental and control groups showed a significant difference between the groups (p<0.05) and the average postoperative hospital stay was 4 days in the experimental group.

Conclusion:
The enhanced surgery recovery protocol provides a faster recovery rate and fewer postoperative complications. These multimodal interventions are useful in routine practice for the optimal perioperative care for patients undergoing open abdominal surgery.
An Efficacy of Intermittent Subglottic Irrigation with 3% NaCl on Prevention of Ventilator-Associated Pneumonia
Authors: Jadhav Prerana Prakash , Mohite Vaishali Rajsinh 
Published: June 2023

Background:
ventilator-associated pneumonia (VAP) is the leading cause of death associated with healthcare-associated infections, an important cause of morbidity and mortality despite advances in antimicrobial therapy and advanced supportive measures. The accumulation of subglottic secretions above the endotracheal tube (ETT) cuff, as these secretions may leak around the cuff of the ETT resulting in aspiration and an increased risk for infection of VAP.

Objective:
(1) To assess the efficacy of intermittent subglottic irrigation with 3% NaCl for the prevention of VAP. (2) To assess the association between VAP in the experimental and control group with demographic variables.

Materials and Methods:
A quantitative research approach and an experimental research design were used for the present study. Simple random sampling technique using a lottery method was used for the selection of the sample.

Results:
The study revealed that on comparison of VAP for the experimental and control group on days 2nd and 3rd, there is a significant association found. Second day P = 0.003 Significant (S), 3rd day P < 0.0001(S). On 1st day, the experimental group revealed that there is a significant association (P = 0.003) between the duration of the mechanical ventilator and VAP, on the 2nd day, the control group shows the duration of the mechanical ventilator was associated with VAP (P < 0.0001).

Conclusion:
The conclusion drawn from the present study is intermittent subglottic irrigation with 3% NaCl was effective on the prevention of VAP.
Efficacy of Nesting on Physiological Parameters among Preterm Babies Admitted at Tertiary Care Hospital Karad
Authors: Nikam Priyanka Nivas , Naregal Prakash Mallikarjun , Mohite Vaishali Rajsinh , Karale Rajashri Bhagwat 
Published: June 2023

Background:
Preterm babies have immature physical growth and unstable physiology. Inability to cope up to external stress. They frequently have improper muscular tone due to infancy, which puts them at risk of having abnormal posture. Nesting provides physiological, cognitive and postural stability, comfort and helps preterm infants maintain their posture.

Objective:
To assess physiological parameters among control group and experimental group, to evaluate the effectiveness of nesting on physiological parameters in preterm babies and to find an association between physiological parameters with selected sociodemographic variables.

Materials and Methods:
An evaluative research approach with a systematic random sampling technique, 60 preterm babies were selected (30 experimental group and 30 control group) from Krishna Hospital and Medical Research Center, Karad. Experimental pretest–posttest control group design was used. Data were collected by using observational checklist.

Results:
Unpaired t-test results revealed that the calculated t value of physiological parameters in posttest comparing between the experimental and control group shows that 5 days of nesting has stabilized the physiological parameters and was found statistically significant at P < 0.05, i.e., temperature t = 4.917, heart rate t = 2.283, respiration t = 2.676 and SpO2 saturation t = 10.940. In weight, the calculated t = 0.8653 and found no statistically significant at P = 0. 3904.

Conclusion:
Study concluded that nesting was effectively stabilizing the physiological parameters of preterm babies (temperature, heart rate, respiration rate, SpO2, and weight).
Eastern Equine Encephalitis Virus Diversity in Massachusetts Patients, 1938–2020
Authors: Langsjoen Rose M. , Key Autum , Shariatzadeh Nima , Jackson Christopher R. , Mahmood Faisal , Arkun Knarik , Alexandrescu Sanda , Solomon Isaac H. , Piantadosi Anne 
Published: June 2023

ABSTRACT.
Eastern equine encephalitis virus (EEEV) is a relatively little-studied alphavirus that can cause devastating viral encephalitis, potentially leading to severe neurological sequelae or death. Although case numbers have historically been low, outbreaks have been increasing in frequency and scale since the 2000 s. It is critical to investigate EEEV evolutionary patterns, especially within human hosts, to understand patterns of emergence, host adaptation, and within-host evolution. To this end, we obtained formalin-fixed paraffin-embedded tissue blocks from discrete brain regions from five contemporary (2004–2020) patients from Massachusetts, confirmed the presence of EEEV RNA by in situ hybridization (ISH) staining, and sequenced viral genomes. We additionally sequenced RNA from scrapings of historical slides made from brain sections of a patient in the first documented EEE outbreak in humans in 1938. ISH staining revealed the presence of RNA in all contemporary samples, and quantification loosely correlated with the proportion of EEEV reads in samples. Consensus EEEV sequences were generated for all six patients, including the sample from 1938; phylogenetic analysis using additional publicly available sequences revealed clustering of each study sample with like sequences from a similar region, whereas an intrahost comparison of consensus sequences between discrete brain regions revealed minimal changes. Intrahost single nucleotide variant (iSNV) analysis of four samples from two patients revealed the presence of tightly compartmentalized, mostly nonsynonymous iSNVs. This study contributes critical primary human EEEV sequences, including a historic sequence as well as novel intrahost evolution findings, contributing substantially to our understanding of the natural history of EEEV infection in humans.
Mardin İli Kiraz Üreticilerinin Bitki Koruma Uygulamalarında Bilinç Düzeylerinin Belirlenmesi
Authors: KAPLAN Mehmet , AYAZ Tarkan 
Published: June 2023

Bu çalışma 2021 yılında kiraz üretiminin yoğun olarak yapıldığı Mardin ili Ömerli ilçesi kiraz üreticilerinin bitki koruma uygulamalarında bilinç düzeylerini belirlemek amacıyla ele alınmıştır. Örnekleme tesadüfi olarak yapılmıştır. İki ilçede tesadüfi olarak seçilen toplam 10 köyde, 87 adet üreticiyle yüz yüze yapılan 20 soruluk anket metoduyla alınan bilgiler ve sonuçların değerlendirilmesi yüzde oran üzerinde hesaplanmıştır. Kiraz çiftçilerin, eğitim düzeylerinin yüksek ve çoğunluğunun tarımla birlikte başka gelirinin olduğu belirlenmiştir. Kiraz üreticilerinin zirai ilaç seçiminde ve dozunu karar vermede ilaç bayiliklerinden ve Tarım ve Orman İl/İlçe Müdürlüklerinden bilgi almaktadır. İlacın seçiminde marka ve etkili maddenin önemli olduğu, sürekli karşılaştıkları zararlı ve hastalık etmenlerle mücadelede devamlı aynı zirai ilacı uygulamadıkları, kendilerince önceden tedbir amaçlı olarak zararlı ve hastalıklar görülmeden ilaçlamaya başladıkları, ilaçların uygulamasında tavsiye edilen dozda kullandıkları, zirai ilaçların ürünlerde kalıntı bıraktığını, son ilaçlama ile hasat zamanı arasındaki bekleme sürelerine uyduklarını, ilaçların uygulamaları zamanında koruyucu kıyafet ve maske kullandıklarını, boş ilaç kutularını gelişigüzel etrafa atmadıkları, ilaçlama aletlerini yıkadıkları fakat ilaçlama makinalarını kalibrasyon yapmadan kullandıkları, zirai ilaçları karıştırarak uyguladıklarını, zarlı ve hastalık etmenleriyle mücadelede kimyasal savaş yanında kültürel önlemleri de uyguladıklarını fakat Biyopestisit hakkında bilgiye sahip olmadıkları saptanıştır.
Üreticilerin tarımsal üretimde bitki zararlı ve hastalıklarla mücadelede sorunlarının çözümünde genellikle kimyasal mücadeleye yönelmekte, böylece bilinçsizce yapılan kimyasal uygulamaları insan sağlığı ve ekolojik çevre olumsuz etkilenmektedir.
Sacerdocio radicalmente nuevo. Cristo y su sacerdocio "profético" y misericordioso en la Carta a los Hebreos
Authors: De Burgos Núñez Miguel 
Published: June 2023

La cristología de la carta a los Hebreos está determinada por el sacerdocio de Cristo. Esa presentación magistral viene precedida por el principio de “Cristo como kerygma del Padre” (cc. 1-2), en que se pone de manifiesto el papel profético de Jesús, lo que debe ser valorado en su justa medida. Aunque es verdad que el sacerdocio de Cristo, lo más exclusivo de todo el NT, pone de manifiesto una visión particular y original de lo que se quiere afirmar. Es un sacerdocio de solidaridad con sus hermanos; se trata de un sacerdocio misericordioso y, por ello, no estamos simplemente ante un título exótico que el autor rescata exegéticamente de Gn 14; la cristología del sacerdocio de Cristo nos hace asomarnos al papel kenótico de su sacerdocio: compasivo y semejante a sus hermanos. No es un sacerdocio de casta, sino de solidaridad fraternal para acercarnos al misterio de Dios. Se debe entender que estamos ante un sacerdocio compasivo, humano, que es lo que llevará a la exaltación de ese sacerdocio,. La comparación con el himno de Filipenses (Flp 2,5-11) es muy sugerente. Y no menos decisivo es que ese sacerdocio trae para la humanidad un “alianza nueva” que implica para los cristianos una conciencia de salvación y liberación; una nueva concepción de la santidad de Dios y de lo divino; y, en definitiva, se quiere mostrar una religión de absoluta confianza en Dios y en la obra salvífica de Cristo.
Video game experience affects performance, cognitive load, and brain activity in laparoscopic surgery training
Authors: Onur Keleş Hasan , Omurtag Ahmet 
Published: June 2023

Objective: Video games can be a valuable tool for surgery training. Individuals who interact or play video games tend to have a better visuospatial ability when compared to non-gamers. Numerous studies suggest that video game experience is associated with faster acquisition, greater sharpening, and longer retention of laparoscopic skills. Given the neurocognitive complexity of surgery skill, multimodal approaches are required to understand how video game playing enhances laparoscopy skill.
Material and Methods: Twenty-seven students with no laparoscopy experience and varying levels of video game experience performed standard laparoscopic training tasks. Their performance, subjective cognitive loading, and prefrontal cortical activity were recorded and analyzed. As a reference point to use in comparing the two novice groups, we also included data from 13 surgeons with varying levels of laparoscopy experience and no video game experience.
Results: Results indicated that video game experience was correlated with higher performance (R2 = 0.22, p< 0.01) and lower cognitive load (R2 = 0.21, p< 0.001), and the prefrontal cortical activation of students with gaming experience was relatively lower than those without gaming experience. In terms of these variables, gaming experience in novices tended to produce effects similar to those of laparoscopy experience in surgeons.
Conclusion: Our results suggest that along the dimensions of performance, cognitive load, and brain activity, the effects of video gaming experience on novice laparoscopy trainees are similar to those of real-world laparoscopy experience on surgeons. We believe that the neural underpinnings of surgery skill and its links with gaming experience need to be investigated further using wearable functional brain imaging.
Surgical outcomes of resected cystic neoplasms of pancreas: Experience from a tertiary care centre in India
Authors: Sharma Digvijoy , Bheerappa Nagari 
Published: June 2023

Objective: Cystic neoplasms of the pancreas form a rare heterogeneous group of pancreatic tumors with variable clinical and diagnostic characteristics. Its incidence has increased in recent years due to improvements in cross-sectional imaging methods and awareness amongst surgeons.
Material and Methods: This study aimed to study the demographic, clinical, imaging, and histopathologic characteristics, incidence of malignancy and outcome of surgical resection of pancreatic cystic neoplasms. Retrospective analysis of 91 patients who underwent surgical resection for cystic neoplasm of the pancreas between 2006 to 2017 at a tertiary care institute was done.
Results: There was a female preponderance in the study with a mean age of 47.2 years. Abdominal pain (46.1%) and jaundice (23.1%) were the most common symptoms. Computed tomography and endoultrasound (EUS) were the most commonly used imaging methods in the study and demonstrated good surgical correlation. Pancreaticoduodenectomy (37.1%) was the most commonly performed procedure followed by distal pancreaticosplenectomy (31.8%). Of the lesions, 9.8% were found malignant. Solid pseudopapillary epithelial neoplasm (SPEN) (37.3%) was the most common neoplasm followed by serous (21.9%), intraductal papillary mucinous neoplasm (IPMN) (15.3%) and mucinous neoplasm (14.3%). Preoperative radiological diagnostic correlation was found to be 75-100% implying the importance of imaging in cystic neoplasms of the pancreas. Morbidity and mortality in the study group were 28.5% and 2.1%, respectively.
Conclusion: Pancreatic cystic neoplasms were mostly benign with female preponderance and presented in the younger age group with prevalence of SPEN higher than IPMN in our subcontinent. These can be reliably diagnosed on preoperative cross-sectional imaging, and surgical resection is associated with favourable outcome and acceptable morbidity.