bluuebunny/crossref_metadata_2025_split huggingface dataset:
Posterior Cloaca
Authors: Kapoor Rohit , Gupta Amit , Yadav Partap Singh , Mandelia Ankur 
Published: November 2022

Aim:
Posterior cloacal malformations (PCMs) are distinguished from classical cloacal malformations by the posterior location of the common opening in the perineum. We aim to describe our experience of management of these rare and complex malformations.

Methods:
This study was a retrospective chart review of all patients with PCM who underwent treatment at Kalawati Saran Children's Hospital (KSCH), New Delhi, and Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, between 2013 and 2021. Individual anatomical variations and their impact on the clinical presentation, management, and final outcome (cosmesis and function) were recorded and analyzed.

Results:
During the study period, four girls with a median age of 2 (range: 0–5) years presented to us with PCM. Three patients were referred to KSCH as ambiguous genitalia whereas one patient was born at SGPGIMS with an antenatal diagnosis of “urorectal septal defect.” On examination, three patients had the urogenital sinus (UGS) opening immediately anterior to the normally located anal opening (2 orifices), whereas one had a single orifice at the normal location of the anus with the UGS opening in the anterior rectal wall. Associated anomalies included: (a) hydrocolpos (n = 3), which was managed by a tube vaginostomy; (b) urethral duplication with dorsal atretic urethra (n = 3); (c) uterine didelphys (n = 1); (d) bilateral grade 5 vesicoureteric reflux (n = 1); and (e) vaginal calculus (n = 1). Total urogenital mobilization (anterior sagittal approach) with feminizing genitoplasty was performed for patients with UGS and normal anus (n = 3). In the patient with a single opening at the normal location of the anus, posterior sagittal ano-recto-urethro-vaginoplasty was performed. At a median follow-up of 24 months, three patients are continent for urine and stool, whereas one patient is yet to be toilet trained.

Conclusions:
PCMs are unusual complex malformations that necessitate meticulous clinical examination, detailed diagnostic workup, and multistaged surgical management. Management should be tailored as per each individual patient's anatomy and clinical presentation for an optimal outcome.
Technical Innovations to Reduce Complication Rates in Esophageal Atresia with Particular Reference to Long-term Outcomes
Authors: Morsi Ahmed , Misra Devesh 
Published: November 2022

Background:
Following esophageal atresia/tracheoesophageal fistula (EA/TEF) repair, the standard leak rate reported in the literature is 5%–10%, and stricture rate is 40%–72%. There is a global quest for surgical innovations to drive down these complication rates which can cause considerable morbidity.

Methods:
A prospectively maintained database of the senior author's patients who had esophageal atresia repair from 1995 to 2016 was reviewed. Two distinct innovations were implemented: (1) adequate or generous mobilization of the lower esophageal pouch and (2) a 2–5 mm slit in distal esophagus to widen its circumference.

Results:
Forty-three patients with EA/TEF were reviewed. Of those, 40 underwent primary repair. The median follow-up was 12.5 years (range 4–26 years). There were no anastomotic leaks and only 8 (20%) patients developed anastomotic strictures requiring dilations (1–5 dilations/patients). One patient (2.5%) had a recurrent fistula. One early mortality was recorded. At the latest follow-up, 35 (87.5%) patients had normal oral feeding, while 1 (2.5%) patient had occasional food sticking episodes. Four syndromic patients (10%) were on jejunal or gastrostomy feeding.

Conclusion:
An adequate or generous mobilization of the distal esophageal pouch, together with a 2–5 mm slit in the distal esophagus, achieves a tension-free and wide anastomosis. All anastomoses eventually narrow, sometimes just a little, and starting on a higher scale with a small slit, helps. These seemingly minor innovations, when used together, contributed to a substantially lower complication rate sustained over a 22-year period – no leaks and only 20% stricture rate.
The contribution of Humboldt Glacier, northern Greenland, to sea-level rise through 2100 constrained by recent observations of speedup and retreat
Authors: Hillebrand Trevor R. , Hoffman Matthew J. , Perego Mauro , Price Stephen F. , Howat Ian M. 
Published: November 2022

Abstract. Humboldt Glacier, northern Greenland, has retreated and accelerated
through the 21st century, raising concerns that it could be a significant
contributor to future sea-level rise. We use a data-constrained ensemble of
three-dimensional higher-order ice sheet model simulations to estimate the
likely range of sea-level rise from the continued retreat of Humboldt
Glacier. We first solve for basal traction using observed ice thickness, bed
topography, and ice surface velocity from the year 2007 in a PDE-constrained (partial differential equation) optimization. Next, we impose calving
rates to match mean observed retreat rates from winter 2007–2008 to winter
2017–2018 in a transient calibration of the exponent in the power-law basal
friction relationship. We find that power-law exponents in the range of
1/7–1/5 – rather than the commonly used 1/3–1 – are necessary to
reproduce the observed speedup over this period. We then tune an iceberg
calving parameterization based on the von Mises stress yield criterion in
another transient-calibration step to approximate both observed ice
velocities and terminus position in 2017–2018. Finally, we use the range of
basal friction relationship exponents and calving parameter values to
generate the ensemble of model simulations from 2007–2100 under three
climate forcing scenarios from CMIP5 (two RCP8.5 forcings, Representative Concentration Pathway) and CMIP6 (one
SSP5-8.5 forcing, Shared Socioeconomic Pathway). Our simulations predict 5.2–8.7 mm of sea-level rise
from Humboldt Glacier, significantly higher than a previous estimate
(∼ 3.5 mm) and equivalent to a substantial fraction of the
40–140 mm predicted by ISMIP6 from the whole Greenland Ice Sheet. Our
larger future sea-level rise prediction results from the transient
calibration of our basal friction law to match the observed speedup, which
requires a semi-plastic bed rheology. In many simulations, our model
predicts the growth of a sizable ice shelf in the middle of the 21st
century. Thus, atmospheric warming could lead to more retreat than predicted
here if increased surface melt promotes hydrofracture of the ice shelf. Our
data-constrained simulations of Humboldt Glacier underscore the sensitivity
of model predictions of Greenland outlet glacier response to warming to
choices of basal shear stress and iceberg calving parameterizations.
Further, transient calibration of these parameterizations, which has not
typically been performed, is necessary to reproduce observed behavior.
Current estimates of future sea-level rise from the Greenland Ice Sheet
could, therefore, contain significant biases.
Educational Complex Geographical Practice in Student-Centered Learning
Authors: Piatkova Alla , Gyzhko Lilija , Gvozdii Svitlana 
Published: November 2022

The article presents the problem of creating an optimal list of components of educational and professional programs in geography. It is noted that the Concept of student-centered learning provides for the mandatory involvement of students in the formation of educational programs, and therefore in the formation of the content of individual disciplines - a component of educational and professional programs.
The purpose of the article is to determine the ways to optimize the process of forming students' competencies in the context of «soft skills» and «hard skills» based on the results of the study on the analysis and evaluation of the content and method of geographical practice. The study was conducted with students of the first (bachelor's) level of higher education (educational and professional program «Geography») at the Odesa I. I. Mechnikov National University. To analyze and evaluate the content of training, an educational complex geographical practice was chosen as a component of the educational and professional program «Geography». The respondents were students and graduates of 1980-2020. The survey questionnaire contained 12 questions, which were divided into 4 blocks: 1) age and sphere of employment of respondents; 2) received «hard skills»; 3) received social and life safety skills; 4) emotional assessment of the practice and recommendations for improving the practice program. The obtained results proved that the survey of applicants should serve as an additional source for monitoring and modernization of both the program of the discipline and the educational and professional program of the specialty as a whole.
Online platforms for public speaking skills development of education seekers
Authors: Konivitska Tetyana , Lytvyn Oksana , Khlypavka Halyna 
Published: November 2022

The article is devoted to the issue of the formation and development of public speaking skills during the forced transition to distance and blended learning in the system of formal, non-formal and informal education. A number of online platforms for the development of public speaking skills were analyzed, in particular online platforms in the virtual educational environment of a higher education institution, specialized international online platforms for developing public speaking skills, courses for developing public speaking skills on educational online platforms, and author's online platforms of this direction. The advantages and prospects of using online in the classroom and during independent work on rhetoric at higher education institutions, as well as self-improvement in oratory skills, are outlined.
The study of rhetoric at higher education institutions is considered and it is indicated that it is advisable to expand rhetoric training courses on university online platforms with the help of the creation and active use of online platforms of university or inter-university oratorical schools or clubs, thus forming a favorable rhetorical educational environment. On the basis of the analysis of specialized, educational and author's online platforms for the development of public speaking skills, it is concluded that the use of theoretical material or practical recommendations and cases of the above-mentioned online platforms for future specialists’ rhetorical training will ensure the diversification of the material presentation and increase interest and motivation in studying rhetoric, as well as understanding the importance of public speaking skills development. It is summarized that the combination of formal, non-formal and informal rhetorical education will facilitate the exchange of important and interesting information, views, values and will contribute to individual development and professional growth.
The Influence of Modern English Poets on Nissim Ezekiel: A Study
Authors: Chandni Rani  
Published: November 2022

In the present paper it has been attempted to study the influences on Ezekiel. In his works there is a reflection of modern English Poets’ perspective along with the style of their writing. Through references to various critics, the influences on Nissim Ezekiel and his poetic works have been shown. The modern English Poets like T.S Eliot, W.B. Yeats, Ezra Pound, Philip Larkin etc proved to be influential enough to Ezekiel and this has been shown here in the present paper through various quotes. He seems to be influenced by the great modern English Poets and ultimately emerging as a great modern poet himself left his fellow poets and readers much influenced with the power of his poetic charm.
Management of Physiotherapy In Brachial Plexus Injury Post Neurotization SAN To SSN : Case Report
Authors: Hijriansyah La Ode Abdul Haris 
Published: November 2022

Brachial plexus injury (BPI) is an injury to the brachial plexus that can cause muscle paralysis in the upper extremities. Based on the data, the proportion of brachial plexus injuries with total lesions (C5–T1) was 54%, partial lesions (C5-6) 24%, (C5-C7) 19%, and (C8-Th1) 3%. This case report aims to present the physiotherapy management of brachial plexus injury.
A 23-year-old man with a medical diagnosis of brachial plexus injury. Previously the patient fell from the bathroom and suffered a blow to the shoulder and fractures in the proximal 1/3 of the ulna & radial. The patient received the first medical treatment for fracture with ORIF (plate and screw), while the shoulder injury received medical treatment after 6 months. The medical procedure is SAN to SSN neurotization surgery.
The physiotherapy program provided include ROM exercise, strengthening, stretching, and release. The results of the evaluation for 3 times of therapy showed that there was a change in passive ROM, pain, edema and spasm in the shoulder region. there has been no change in muscle strength and sensory function. In addition, in the wrist and elbow region there is an increase in muscle strength.
The process of nerve recovery takes a long time, so there have not been many changes that have occurred in the patient. The process of nerve growth only occurs at 1 mm / day. Physiotherapy program given for 3 days postoperative conditions only aim to reduce problems such as muscle spasm, edema, postoperative pain, muscle tightness, and prevent potential problems that will occur.
The physiotherapy program given can reduce secondary problems that occur in the condition 3 days after brachial plexus injury.
COMPARISON OF OUTCOME WITH OR WITHOUT ASPIRIN IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS SURGERY
Authors: IQBAL H , KHALID W , INAM T , AAMIR M 
Published: November 2022

Preoperative use of aspirin in coronary artery bypass graft surgery (CABG) might rely more on surgeon’s preference rather than on evidence-based approach. Conflicting guidelines and lack of reliable recommendations make ambiguous the preoperative aspirin administration before elective CABG. This study was conducted to compare the outcome with or without aspirin in patients undergoing coronary artery bypass surgery. The aim of the study was to compare the outcome with or without aspirin in patients undergoing coronary artery bypass surgery. This Randomized controlled trial was conducted at the Department of Cardiac Surgery, AFIC/ NIHD, Rawalpindi from 11th Dec 2018 to 10th June 2019. One hundred and fifty patients fulfilling inclusion criteria underwent through CABG were divided into two groups. In group A, 75 patients continued aspirin, while in group B, aspirin was stopped 5 days before surgery. Patient’s demographic features, comorbid conditions, Postoperative bleeding, perioperative MI and need for blood transfusion were noted. The mean age and BMI of patients were 61.41 ± 3.09 and 63.96 ± 7.64 years and 28.98 ± 2.46 and 32.61 ± 1.98 Kg/m2 in group A and B, respectively. Male to female ratios were 3.41:1 and 4.35:1 in group A and B, respectively. Diabetes and hypertension were seen in 67(89.34%) and 59(78.67%) patients and 69(90.67%) and 70(93.34%) patients in group A and B, respectively. Perioperative MI and blood transfusion were statistically significant among both groups (5.34% vs. 9.34% patients; p=0.0001 and 5.34% vs. 1.34%; p=0.0003). Mean postoperative bleeding was 401.39 ± 121.04 and 389.21 ± 101.13 ml/24 hr. in group A and B, respectively. The continuation of aspirin therapy in patients undergoing elective CABG reduces perioperative MI, increases quantity of postoperative bleeding and need for blood transfusion. There is a significant difference in outcome with or without aspirin in patients undergoing coronary artery bypass surgery.
Anticoagulant Usage After Anterior Cruciate Ligament Reconstruction Is Associated With Increased Rate of Manipulation Under Anesthesia
Authors: Gu Alex , Agarwal Amil R. , Malahias Michael-Alexander , Wessel Lauren E. , Richardson Shawn S. , McDaniel Lea , Knapp Brock , Mathur Abhay , Doerre Teresa , Sculco Peter K. , Rodeo Scott A. , Kaar Scott G. 
Published: November 2022

Background:
Arthrofibrosis after anterior cruciate ligament reconstruction (ACLR) is a notable but uncommon complication of ACLR. To improve range of motion after ACLR, aggressive physical therapy, arthroscopic/open lysis of adhesions, and revision surgery are currently used. Manipulation under anesthesia (MUA) is also a reasonable choice for an appropriate subset of patients with inadequate range of motion after ACLR. Recently, the correlation between anticoagulant usage and arthrofibrosis after total knee arthroplasty has become an area of interest. The purpose of this study was to determine whether anticoagulant use has a similar effect on the incidence of MUA after ACLR.

Methods:
The Mariner data set of the PearlDiver database was used to conduct this retrospective cohort study. Patients with an isolated ACLR were identified by using Current Procedural Terminology codes. Patients were then stratified by MUA within 2 years of ACLR, and the use of postoperative anticoagulation was identified. In addition, patient demographics, medical comorbidities, and timing of ACLR were recorded. Univariate and multivariable analyses were used to model independent risk factors for MUA.

Results:
We identified 216,147 patients who underwent isolated ACLR. Of these patients, 3,494 (1.62%) underwent MUA within 2 years. Patients who were on anticoagulants after ACLR were more likely to require an MUA (odds ratio [OR]: 2.181; P < 0.001), specifically low-molecular-weight heparin (OR: 2.651; P < 0.001), warfarin (OR: 1.529; P < 0.001), and direct factor Xa inhibitors (OR: 1.957; P < 0.001).

Discussion:
In conclusion, arthrofibrosis after ACLR is associated with the use of preoperative or postoperative thromboprophylaxis. Healthcare providers should be aware of increased stiffness among these patients and treat them aggressively.
Çiğneme Kası Ağrısının Yaşam Kalitesi ve Anksiyete Seviyesine Etkisi
Authors: EREL Nilsu , YAPALAK Ebru , ERDENOL Ezgi , ARİFAĞAOĞLU Özge , YÜZÜGÜLLÜ Bulem 
Published: November 2022

ÖZET
Amaç: Bu çalışmanın amacı, yalnızca çiğneme kası ağrısına sahip TMD hastalarının ağız sağlığını değerlendiren OHIP-14 anketi ile GAD-7 anket puanlanma sonuçlarını cinsiyet, eğitim durumu ve mesleki duruma göre karşılaştırmak ve yaş ile arasındaki korelasyonu incelemektir.
Gereç ve Yöntem: Yaşları 18 ile 68 arasında değişen, yalnızca çiğneme kası ağrısına sahip ve şikayeti olan 80 hasta, kinisyen tarafından DC/TMD Eksen I formunun Türkçe versiyonuna göre muayene edilmiş ve teşhis konmuştur. Ardından, hastalardan sırasıyla GAD-7 ve OHIP-14 anketlerinin Türkçe versiyonunu doldurmaları istenmiştir.
Bulgular: Erkeklerin OHIP-14(7+8) ve OHIP-14(13+14) puanları kadınların puanlarından istatistiksel olarak daha yüksek bulunmuştur. Yaş, eğitim ve meslek gruplarına göre GAD-7 toplam, OHIP-14 toplam ve alt skorları arasında istatistiksel olarak anlamlı fark bulunamamıştır. GAD-7 Toplam skoru ile OHIP-14 toplam skoru ve OHIP-14‘ün psikolojik değerlendirmesi için alt skorları arasında yapılan korelasyon analizinde pozitif yönlü orta düzeyde anlamlı korelasyon bulunmuştur
Sonuç: Erkek hastaların fiziksel açıdan ağız sağlığı ile ilgili yaşam kalitesinin, çiğneme kas ağrısından daha çok etkilendiği belirlenmiştir. Ayrıca, yaş, meslek ve eğitim durumu farklılıkları; çiğneme kası ağrısı olan hastalarda ağız sağlığı ile ilgili yaşam kalitesi ve anksiyete açısından herhangi bir değişim göstermemiştir.

Anahtar Kelimeler: Çiğneme kası ağrısı; GAD-7; OHIP-14
Panoramik Radyografik Parametreler ile Üst Gömülü Kanin Dişlerin Konumları ve Komşu Dişlerde Meydana Getirdiği Rezorpsiyonların Değerlendirilmesi
Authors: ÇOLAKOĞLU Gizem , YİĞİT Müge 
Published: November 2022

Amaç:
Panoramik radyografide (OPG) belirlenen parametrelerle, üst gömülü kaninlerin labio-palatal konumlarının ve komşuluğundaki dişlerdeki rezorpsiyonların tespit edilip edilemeyeceğini değerlendirmek, gömülü kanine ait lokal faktörlerin rezorpsiyonlarla ilişkisini belirlemektir.
Gereç ve Yöntem:
Bu retrospektif çalışmada 65 adet üst gömülü kanin diş, OPG ve konik ışınlı bilgisayarlı tomografi (KIBT) görüntüleriyle değerlendirilmiştir. OPG’de gömülü kaninlerin transversal ve vertikal konumları belirlenmiş, alfa ile beta açıları ölçülmüştür. Sonrasında KIBT’ta bu dişlerin labio-palatal konumlarıyla komşu dişlerdeki rezorpsiyon varlığı, derecesi tespit edilmiştir. Ayrıca üst gömülü kaninlerin dental folikül durumu (şekli, genişliği) ile komşu dişlerle teması kaydedilmiştir. Veriler istatistiksel olarak değerlendirilmiştir (p
ANALISIS USABILITY APLIKASI RSI WONOSOBO MENGGUNAKAN METODE SUS (SYSTEM USABILITY SCALLE)
Authors: Nur Azhari Wulandari  , Saifu Rohman  , Nulngafan  , Hermawan  
Published: November 2022

Aplikasi pendaftaran online dirancang untuk mempermudah dan mempercepat pelayanan pendaftaran pasien yang akan memanfaatkan layanan Rumah Sakit. Aplikasi dapat dikatakan memiliki tingkat usability yang tinggi apabila pengguna mengerti dan dapat menggunakan dengan mudah aplikasi tersebut tersebut. Aplikasi RSI Wonosobo hadir untuk memberikan layanan secara online, diharapkan dapat memberikan kemudahan mengkases dan memperoleh layanan kesehatan. Masih terdapat beberapa hal yang kurang memadai dan bermasalah pada aplikasi RSI Wonosobo, pasien masih memiliki kendala dalam penggunaan aplikasi tersebut. Oleh karena itu, penelitian ini bertujuan untuk mengetahui tingkat usability dan menghasilkan hasil analisis usability aplikasi RSI Wonosobo menggunakan SUS (System Usability Scalle). Penelitian ini menggunakan metode SUS (System Usability Scalle). Hasil yang diperoleh adalah aplikasi RSI Wonosobo memiliki skor rata-rata SUS sebesar 70,8. Menempati level Marginal High pada sisi Acceptability Ranges, dari sisi Grade Scales sistem menempati Grade C. Sedangkan dari sisi Adjective Rating, hasil analisis sistem berada posisi GOOD. Aplikasi RSI Wonosobo tidak memiliki nilai usability yang sangat baik atau luar biasa, namun dapat diterima oleh para pengguna. Oleh karena itu diberikan beberapa rekomendasi perbaikan yang diharapkan dapat dijadikan sebagai rujukan bagi pengembang aplikasi dalam melakukan perbaikan usability aplikasi RSI Wonosobo sehingga memiliki tingkat usability yang tinggi dan memiliki kemudahan dalam penggunaan.
TOXICO-PATHOLOGICAL ASSESSEMENT OF Nerium oleander ROOTS AND LEAVES ON WISTAR RAT
Authors: MAAROUF TOUNES , OTMANI INES , TALBI AMINA , HAMAMDIA ZAHRA , BENDALI-SAOUDI FATIHA , ABDENNOUR CHERIF 
Published: November 2022

The aim of the study was to evaluate the toxic effects of Nerium oleander roots (R) and leaves (L) aqueous extract on Wistar rat. Serum chemistry, epididymal sperm parameters and histological examination of liver, kidney and brain were assessed after twelve consecutive day’s oral administration of N. oleander. The extracts of R1, R2, L1 and L2 induced no treatment-related adverse effects with regard to general behaviors, hematological, serum chemistry, epididymal sperm parameters and histological profiles of liver, kidney and brain. However, the higher doses (R3, L3) led to, diarrhea, weakness, anorexia, frequent urination, and nasal hemorrhage, with no mortality. The hematological data revealed a significant increase in the levels of hematocrit and platelets in both L3 and R3 compared to the control. However, these two extracts have not affected the level of RBC, hemoglobin, WBC, and lymphocytes, while the L3 has reduced the concentration of glucose and increased that of urea. However, triglycerides, total cholesterol, alanine aminotransferease, albumin, conjugated bilirubin, potassium and calcium levels of L3 and R3 were not statistically significant compared to the control. Simultaneously bilirubin concentration was increased significantly in L3 and R3. There were no significant differences in epididymal sperm analysis when compared to the control. Adverse histological changes were observed in both liver and kidney as well as in the brain. To conclude, N. oleander extracts have disturbed the levels of certain vital variables in rats at higher dose, in which caution should be taken during the use of this plant.