bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can Ultrasound-Guided Erector Spinae Plane Block Replace Thoracic Epidural Analgesia for Postoperative Analgesia in Pediatric Patients Undergoing Thoracotomy? A Prospective Randomized Controlled Trial
Authors: Singh Swati , Andaleeb Roshan , Lalin Dusu 
Published: October 2022

ABSTRACT

Background:
Many analgesic modalities have been investigated in pediatrics for thoracotomy. We studied the analgesic efficacy of unilateral continuous ultrasound-guided erector spinae plane block (ESPB) compared to a thoracic epidural in pediatric patients undergoing thoracotomy.

Materials and Methods:
A prospective, randomized, observer-blinded, controlled study. Pediatric patients (2–7 years) scheduled for right or left thoracotomy under general anesthesia (GA) were enrolled in the study. We randomly assigned patients into two groups: The thoracic epidural analgesia (TEA) group received GA with an epidural catheter. The ESPB group received GA with a unilateral ultrasound-guided erector spinae plane catheter. The primary outcome was postoperative cumulative opioid consumption for 24 h.

Results:
The total intraoperative fentanyl requirement was 35.4 ± 11.44 μg in the TEA group and 30.4 ± 9.08 μg in the ESPB group (t-value − 1.53013, P value: 0.134). The total postoperative fentanyl requirement was comparable in both the groups and clinically nonsignificant (44 ± 2.82 in the TEA group vs. 44.25 ± 13.72 in the ESPB group, t-value = −0.02412, P = 0.981). The median (IQR) Face, Legs, Activity, Cry, and Consolability (FLACC) score at 0, 2, 4, 8, 12, and 24 h time points in the ESPB was equivalent to the TEA group. At 6 h time point, the TEA group had a significantly lower FLACC score than the ESPB group (1[1.75, 1] in the TEA group and 2 [2, 1] in the ESPB group, P value = .02, U = 117.5, z-score = −2.218). The complications were higher in the TEA group (urine retention 20% and hypotension 40%) than in the ESPB group (0 and 0%).

Conclusions:
This study shows that the ESPB provides similar postoperative analgesia to the TEA in pediatric patients undergoing thoracotomy. The ESPB is simpler, faster, and has a lower complication rate.
Intraoperative Blood Collection Without Fluid Replacement for Cardiac Surgery – A Retrospective Analysis
Authors: Vance Jennifer L. , Irwin Lisa , Jewell Elizabeth S. , Engoren Milo 
Published: October 2022

ABSTRACT

Background:
Transfusion rates in cardiac surgery are high.

Aim:
To determine if intraoperative autologous blood removal without volume replacement is associated with fewer homologous blood transfusions without increasing acute kidney injury.

Setting and Design:
Retrospective, comparative study.

Materials and Methods:
Adult patients undergoing cardiac surgery, excluding those who underwent ventricular assist device surgery, heart transplants, or cardiac surgery without cardiopulmonary bypass were excluded, who had 1–3 units of intraoperative autologous blood removal were compared to patients without blood removal for determination of volume replacement, vasopressor support, acute kidney injury, and transfusions.

Results:
Autologous blood removal was associated with fewer patients receiving homologous transfusions: intraoperative red cell transfusions fell from 75% (Control) to 48% (1 unit removed), 40% (2 units), and 30% (3 units), P < 0.001. Total intraoperative and postoperative homologous RBC units transfused were lower in the blood removal groups: median (interquartile range) 3 (1, 6) in Control patients and 0 (0, 2), 0 (0, 2) and 0 (0, 1) in the 1, 2, and 3 units removed groups, P < 0.001. Similarly, plasma, platelet, and cryoprecipitate transfusions decreased. After adjustment for confounders, increased amounts of autologous blood removal were associated with increased intravenous fluids, only when 2 units were removed, and trivially increased vasopressor use. However, it was not associated with acidosis or acute kidney injury.

Conclusions:
Intraoperative autologous blood removal without volume replacement of 1–3 units for later autologous transfusion is associated with decreased homologous transfusions without acidosis or acute kidney injury.
Hypothyroidism-associated rhabdomyolysis
Authors: Khan Fahmi Yousef , Sulaiman Theeb Osama , Akbar Raza Ali 
Published: October 2022

Background:
Hypothyroidism alone or in combination with other factors has the risk of triggering rhabdomyolysis. In this article, we aim to describe hypothyroidism-associated rhabdomyolysis and its outcomes.

Methods:
We reported a new case of hypothyroidism-associated rhabdomyolysis and reviewed similar reported cases from the literature for in-depth knowledge.

Results:
Eighty-one cases, including the one reported in this article, met the inclusion criteria for this review. The mean age of the patients was 45.6 ± 15.8 years. Out of these, 57 (70.4%) patients were males and 24 (29.6%) were females. The precipitating factor was absent in 45 (55.6%) cases. A total of 8 (9.9%) cases had chronic renal failure at time of presentation, while 25 (30.9%) had hypertension, 11 (13.6%) had diabetes mellitus, and 32 (39.5%) had dyslipidemia. The median creatine kinase (CK) level was 5885 U/L (Interquartile range: 3280.5–11550.5 U/L). Electromyography was performed in 12 patients with 10 (12.3%) cases showing myopathic changes including polyphasic potential and fiber necrosis. Muscle biopsy was performed in 7 (8.4%) cases, with Type II fiber atrophy observed in 4 (4.9%) biopsies. Sixty-two cases developed acute kidney injury, of which 14 (17.3%) required hemodialysis. All patients were treated with levothyroxine and most patients (67, 82.7%) were treated by hydration. All the reported patients made good recovery. A statistically nonsignificant correlation was found between CK and thyroid-stimulating hormone (r = 0.218; P = 0.052).

Conclusions:
Rhabdomyolysis is a recognized complication of hypothyroidism even in the absence of additional risk factors. Clinicians should be aware of the impact of rhabdomyolysis and hypothyroidism on renal function and promptly initiate hormone replacement therapy and vigorous hydration to preserve the renal function.
Third-line chemotherapy after resistance to Etoposide, Cisplatin-Etoposide, Methotrexate, Actinomycin (EP-EMA) in high risk gestational trophoblastic neoplasia
Authors: Bolastig-Canson Julie Ann B. , Soriano-Estrella Agnes L. 
Published: October 2022

OBJECTIVE:
To describe the experience of the Division of Trophoblastic Diseases of the Philippine General Hospital with the various third-line chemotherapeutic regimens among high-risk gestational trophoblastic neoplasia (GTN) patients who experienced resistance after receiving the etoposide, cisplatin–etoposide, methotrexate, actinomycin (EP-EMA) regimen.

MATERIALS AND METHODS:
This was a 17-year descriptive study that included all patients who used various salvage chemotherapy after resistance to EP-EMA as treatment for metastatic, high-risk GTN at the Philippine General Hospital from January 2002 to December 2018. The medical records of eligible patients were retrieved and assessed. All abstracted data were analyzed retrospectively. Descriptive statistics were used to compute for percentages for the various demographic characteristics of the sample population.

RESULTS:
From January 2002 to December 2018, a total of 291 patients with metastatic, high-risk gestational GTN were treated at the Philippine General Hospital. Of these, only seven patients received various third-line chemotherapy regimens after resistance to EP-EMA. One patient was excluded due to incomplete data. Among the third-line chemotherapeutic regimens used, 3 patients received paclitaxel/carboplatin, two of whom went into remission while one expired. One patient had vincristine, bleomycin, and cisplatin (VBP) with two adjunctive surgeries in the form of hysterectomy and thoracotomy. She also went into remission. Two patients received paclitaxel–cisplatin/paclitaxel–etoposide (TP/TE) as third line of treatment. The first was shifted back to EP-EMA and eventually developed chemoresistance to EP-EMA and had multiple toxicities. After multidisciplinary conference with the patient and family, they decided to go home and refused further chemotherapy. The other patient had TP/TE followed by bleomycin–etoposide–cisplatin, with adjunctive hysterectomy. Despite multiple cycles of chemotherapy, the disease persisted. She was offered palliative care and the family decided to bring her home. Both patients eventually expired at home.

CONCLUSION:
No conclusion can be made about the most effective third line chemotherapy for resistant high-risk GTN because of the limited cases included in this study. An individualized approach is still recommended. Physicians and centers for patients caring for such patients are encouraged to report their experience to improve the management of future patients.
Antenatal corticosteroids in Singapore: a clinical and scientific assessment
Authors: Gosavi Arundhati , Amin Zubair , Carter Sean William David , Choolani Mahesh Arjandas , Fee Erin Lesley , Milad Mark Amir , Jobe Alan Hall , Kemp Matthew Warren 
Published: October 2022

Abstract
Preterm birth (PTB; delivery prior to 37 weeks’ gestation) is the leading cause of early childhood death in Singapore today. Approximately 9% of Singaporean babies are born preterm; the PTB rate is likely to increase given the increased use of assisted reproduction technologies, changes in the incidence of gestational diabetes/high body mass index and the ageing maternal population. Antenatal administration of dexamethasone phosphate is a key component of the obstetric management of Singaporean women who are at risk of imminent preterm labour. Dexamethasone improves preterm outcomes by crossing the placenta to functionally mature the fetal lung. The dexamethasone regimen used in Singapore today affords a very high maternofetal drug exposure over a brief period of time. Drawing on clinical and experimental data, we reviewed the pharmacokinetic profile and pharmacodynamic effects of dexamethasone treatment regimen in Singapore, with a view to creating a development pipeline for optimising this critically important antenatal therapy.
Effect of Teachers’ Welfare on Job Effectiveness among Secondary Schools in Mbarara City, Uganda
Authors: Ashaba Monica , Twebaze Richard , Novatus Nyemara 
Published: October 2022

This study sought to establish the effect of teachers’ welfare on teachers’ job effectiveness among the secondary schools in Mbarara City in Uganda using a descriptive cross sectional survey design. The study was conducted in Mbarara City which had 25 secondary schools. The 25 schools had 750 teachers and 25 Head teachers. According to Galvan (2013), a sample of 50% is desirous. Therefore, 50% of 25 schools brought 12 schools which were sampled. The twelve schools had 360 teachers from whom systematic random sampling was used to select 260 teachers. Out of the 260 teachers selected, 256 responded and out of 12 head teachers selected, 10 responded. Furthermore, one Education Office and one City Inspector of schools were included in the sample. Descriptive statistics and Pearson correlations were used in analyzing the data. The study established a moderate quality of welfare of secondary school teachers in terms of housing, performance allowances, medical care services, school environment, meals, transport allowances, training and development opportunities, classroom environment and government policy on teachers. The level of teachers’ job effectiveness was also perceived to be moderate. Furthermore, the study established a moderate positive relationship between teachers’ welfare and job effectiveness. It is recommended that teachers’ salaries and allowances be regularly provided in time. Meals, housing and other facilities should be given to teachers to encourage them to work hard.
Effect of Broken Families on School Attendance among Private Secondary School Students in Iringa Municipality, Tanzania
Authors: Ebele Ezeufondu Raechal 
Published: October 2022

This study sought to establish the effect of broken families on school attendance among private secondary school students in Iringa Municipality, Tanzania. The study adopted the case study design which helped the researcher to study a smaller unit in terms of two schools with students from broken families. The methods of data collection involved a questionnaire, a semi-structured interview, a focus group discussion and documentary review. Quantitative data was analyzed through descriptive statistics while the qualitative data was analyzed through the thematic approach. The study concluded that students form broken families faced unique challenges that affected their school attendance. They did not commence to school on resume days and they regularly missed classes because some were required to take parental responsibilities like taking care of their younger ones and others engaged in such activities like farming and casual works to enable their families to get necessities and school fees. Some students had missed school with reasons like financial problems including lack of school fees, inability to obtain school requirements and poor parental care. Furthermore, family structures in terms of broken families led to school dropout since students from those families were involved in illegal businesses like theft, robbery and prostitution as the means to meet their daily needs. Based on the conclusions, it is recommended that broken family parents should try as much as possible to provide basic needs that support school attendance and encourage their children to attend school regularly in order to avoid absenteeism which may hinder the intended academic achievement.
Pengembangan E- Comic Education pada Mata Pelajaran Ilmu Pengetahuan Alam Materi Gaya dan Manfaatnya
Authors: Hanifah Hindun , Maslikhah Maslikhah 
Published: October 2022

The purpose of the study was to determine the need for developing e- comic education learning media to improve cognitive learning outcomes for fourth grade students of MI NU Tsamrotul Wathon. The type of this research is Research and Development with ADDIE model. Data collection techniques used questionnaires, and tests. The limited scale test was carried out with 10 students and the broad scale test was carried out with 30 students. The results showed that: the results of the validation of the eligibility criteria were based on the validation media experts, material experts and practitioners. Eligibility criteria for displaying writing are 62.5% (fair enough), image eligibility 72.5% (fair enough), e-comic education media function is 91.6% (very feasible), e-comic education media benefits are 87.5%. The eligibility criteria for the content aspect are 83.92% (very feasible), the feasibility on the construction aspect is 68.75% (adequate) and the feasibility of the language aspect is 60% (fair enough). The results of the development of e-comic education media are very effective in influencing students cognitive learning outcomes as indicated by the increase in cognitive learning outcomes with α < 0,05 its mean 0.00 < 0.05. The gain test of 0.467 is in the medium category.
Conflitos ambientais na microrregião de Barbacena (Minas Gerais, Brasil): o que as fontes permitem ver?
Authors: Pinto Lucas , Jurandir Carneiro Eder 
Published: October 2022

Resumo.O trabalho apresenta os resultados finais do projeto de pesquisa “Mapa dos conflitos ambientais do estado de Minas gerais na microrregião de Barbacena”, desenvolvido pelo Núcleo de Investigações em Justiça Ambiental (NINJA) da Universidade Federal de São João Del Rei (UFSJ), no âmbito do PIBIC-FAPEMIG-USFJ. O trabalho tem como objetivo analisar a situações-problema e casos de conflito ambiental envolvendo o uso de forma assimétrica dos territórios e seus recursos naturais na microrregião de Barbacena, Minas Gerais, brasil. O mesmo se inscreve de forma mais ampla no projeto “Mapa dos conflitos ambientais no Estado de Minas Gerais”, desenvolvido em parceria entre UFSJ, Universidade Federal de Minas Gerais (UFMG), Universidade Federal de Viçosa (UFV) Universidade Estadual de Montes Claros (UNIMONTES). Abstract Mapping environmental conflicts in Minas Gerais, Brazil: survey and critical analysis of sources related to the micro region of Barbacena. This study presents the final results of the research project “Map of environmental conflicts in the state of Minas Gerais” in the micro region of Barbacena”, carried out by the Núcleo de Investigações em Justiça Ambiental (NINJA) of Universidade Federal de São João Del Rei (UFSJ), within the framework of PIBIC-FAPEMIG-USFJ. The study’s objective is to analyze problem occurrences and environmental conflict situations related to the asymmetrical territorial uses as well as of its natural resources exploration in the micro region of Barbacena, Minas Gerais, Brazil. The present study is part of the larger project “Map of environmental conflicts in the State of Minas Gerais”, carried out jointly by UFSJ, Universidade Federal de Minas Gerais (UFMG), Universidade Federal de Viçosa (UFV) and Universidade Estadual de Montes Claros (UNIMONTES).
Work Experience of Rehabilitation Centers at Correctional Institutions: Organizational and Psychological Aspects
Authors: Дебольский Михаил Георгиевич , Кирильчук Сюзанна Геннадьевна , Москвитина Мария Михайловна 
Published: October 2022

В статье раскрыты научные основы и описан опыт создания реабилитационных центров при исправительных учреждениях. Обобщены основные направления их деятельности, рассмотрены наиболее уязвимые категории осужденных, которые нуждаются в социальной реабилитации. Показана роль Межрегионального благотворительного фонда помощи заключенным в создании и научно-методическом обеспечении реабилитационных центров при исправительных учреждениях. Раскрыты психологические механизмы реабилитации осужденных. Предметом научной статьи стала практика реабилитации и ресоциализации осужденных в реабилитационных центрах при исправительных учреждениях. Цель работы - ознакомить читателей с опытом работы реабилитационных центров при исправительных учреждениях. Методологическую основу работы составили позитивизм, редукционизм, критический рационализм. В качестве теоретических методов использовались анализ, синтез, индукция. В результате проведенной работы достигнуты поставленные цели: изучен опыт работы реабилитационных центров, а также проведены теоретические изыскания в вопросе реабилитации и ресоциализации осужденных. Полученные выводы могут использоваться при совершенствовании системы подготовки осужденных к освобождению.
In the article the authors reveal the scientific foundations and describe the experience of creating rehabilitation centers at correctional institutions. They summarize the main directions of their activity and underline the most vulnerable categories of convicts who need social rehabilitation. The role of the Interregional Charitable Fund for Assistance to Prisoners in the creation and scientific and methodological support of rehabilitation centers at correctional institutions is shown. The psychological mechanisms of the rehabilitation of convicts are revealed. The subject of the scientific article is the practice of rehabilitation and resocialization of convicts in rehabilitation centers at correctional institutions. The purpose of the work is to acquaint readers with the experience of rehabilitation centers at correctional institutions. The methodological basis of the work was positivism, reductionism, critical rationalism. The authors used analysis, synthesis, and induction as theoretical methods. As a result of the work carried out, the goals set were achieved: the experience of the work of rehabilitation centers was studied, and theoretical research was carried out on the issue of rehabilitation and resocialization of convicts. The findings can be used to improve the system of preparing convicts for release.
Grain size of fluvial gravel bars from close-range UAV imagery – uncertainty in segmentation-based data
Authors: Mair David , Do Prado Ariel Henrique , Garefalakis Philippos , Lechmann Alessandro , Whittaker Alexander , Schlunegger Fritz 
Published: October 2022

Abstract. Data on grain sizes of pebbles in gravel-bed rivers are of key importance for the understanding of river systems. To gather these data efficiently, low-cost UAV (uncrewed aerial vehicle) platforms have been used to collect images along rivers. Several methods to extract pebble size data from such UAV imagery have been proposed. Yet, despite the availability of information on the precision and accuracy of UAV surveys as well as knowledge of errors from image-based grain size measurements, open questions on how uncertainties influence the resulting grain size distributions still persist. Here we present the results of three close-range UAV surveys conducted along Swiss gravel-bed rivers with a consumer-grade UAV. We measure grain sizes on these images by segmenting grains, and we assess the dependency of the results and their uncertainties on the photogrammetric models. We employ a combined bootstrapping and Monte Carlo (MC) modeling approach to model percentile uncertainties while including uncertainty quantities from the photogrammetric model. Our results show that uncertainty in the grain size dataset is controlled by counting statistics, the selected processed image format, and the way the images are segmented. Therefore, our results highlight that grain size data are more precise and accurate, and largely independent of the quality of the photogrammetric model, if the data are extracted from single, undistorted nadir images in opposition to orthophoto mosaics. In addition, they reveal that environmental conditions (e.g., exposure to light), which control the quality of the photogrammetric model, also influence the detection of grains during image segmentation, which can lead to a higher uncertainty in the grain size dataset. Generally, these results indicate that even relatively imprecise and inaccurate UAV imagery can yield acceptable grain size data, under the conditions that the photogrammetric alignment was successful and that suitable image formats were selected (preferentially single, undistorted nadir images).
Обнаружение сигналов на фоне шумов в сверхширокополосных радиолокационных системах при субполосной обработке информации
Authors: Орищук Сергей Григорьевич , Олейник Иван Иванович , Прохоренко Екатерина Ивановна , Головко Марина Викторовна 
Published: October 2022

Разработано параметрическое решающее правило обнаружения сигналов на фоне шумов в сверхширокополосных радиолокационных системах при субполосной обработке информации. Решающее правило основано на вычислении отношения правдоподобия и сравнении его с порогом. В качестве оценок используются оценки вектора математического ожидания и ковариационной матрицы. В качестве критерия принятия решения о наличии сигнала на фоне собственных шумов, был выбран критерий Неймана-Пирсона, который обеспечивает максимальную вероятность правильного обнаружения сигнала, при заданной вероятности ошибки первого рода. В качестве обучающей выборки используется выборка, получаемая при априорном отсутствии сигнала, полученная по собственным шумам. В силу независимости частотных каналов, при субполосной обработке, оценка ковариационной матрицы, получаемая на этапе обучения, имеет диагональный вид с оценкой дисперсий уровня шумов в каналах. Разработана процедура оценки уровня порога принятия решения, которая проводится на этапе обучения. Для этого необходимо получить оценки отношения правдоподобия при априорном отсутствии сигнала и выбрать квантиль нормального распределения для заданной вероятности ошибки первого рода.