bluuebunny/crossref_metadata_2025 huggingface dataset:
Hyperopic SMILE Versus FS-LASIK: A Biomechanical Comparison in Human Fellow Corneas
Authors: Spiru Bogdan , Torres-Netto Emilio A. , Kling Sabine , Hafezi Farhad , Sekundo Walter
Published: December 2021

PURPOSE:

To investigate the biomechanical properties of ex vivo human paired corneas after hyperopic correction via cap-based versus flap-based laser-assisted refractive surgery.

METHODS:

In this prospective experimental study, 13 pairs of human corneas unsuitable for transplantation were equally divided into two groups. The pachymetry was performed in each eye just before the laser procedure. Corneas from the right eye were treated with small incision lenticule extraction (SMILE), whereas corneas from the left eye of the same donor were treated with femtosecond laser–assisted laser in situ keratomileusis (FS-LASIK). All corneas were subjected to a refractive correction of +6.00 diopters (D) sphere with a 6.5-mm zone under a 120-µm cap (SMILE) or a 7-mm zone under a 110-µm flap (FS-LASIK). For two-dimensional biomechanical measurements, the corneoscleral buttons underwent two testing cycles (preconditioning stress-strain curve from 0.03 to 9.0 N and stress-relaxation at 9.0 N during 120 seconds) to analyze the elastic and viscoelastic material properties. The effective elastic modulus was calculated. Statistical analysis was performed with a confidence interval of 95%.

RESULTS:

In stress-strain measurements, the effective elastic modulus was not significantly different (
P
> .311) between SMILE (13.5 ± 12.8 MPa) and FS-LASIK (7.56 ± 17.9 MPa). In stress-relaxation measurements, the remaining stress was not significantly different (
P
= .841) between SMILE (124 ± 20 kPa) and FS-LASIK (126 ± 21 kPa).

CONCLUSIONS:

Unlike myopic correction, after hyperopic correction the cap-based procedure (SMILE) and the flap-based technique (FS-LASIK) may be considered equivalent in terms of biomechanical stability when measured experimentally in ex vivo human fellow eye corneas.

[
J Refract Surg
. 2021;37(12):810–815.]
Visual and Refractive Outcomes of Toric Implantable Collamer Lens Implantation in Stable Keratoconus After Combined Topography-Guided PRK and CXL
Authors: Sakla Hani F. , Altroudi Wasim , Sakla Yousef F.R. , Muñoz Gonzalo , Pineza Catia
Published: December 2021

PURPOSE:

To evaluate the safety and efficacy of toric implantable Collamer lens (ICL) (STAAR Surgical) implanted at least 6 months after combined topography-guided photorefractive keratotomy (TG-PRK) and corneal cross-linking (CXL) in keratoconus.

METHODS:

This retrospective study included 46 eyes with keratoconus of 31 patients who underwent toric ICL implantation after previous TG-PRK+CXL. Patients were examined for uncorrected (UDVA) and corrected (CDVA) distance visual acuity, flat and steep keratometry, and manifest refraction spherical equivalent preoperatively and 12 months postoperatively.

RESULTS:

At 12 months postoperatively, there was a statistically significant improvement in visual and refractive outcomes (all
P
< .001). Mean UDVA improved to 0.17 ± 0.14 logMAR (vs 1.00 ± 0.38 logMAR preoperatively) and mean manifest refraction spherical equivalent improved to −0.32 ± 1.42 diopters (D) (vs −7.35 ± 5.20 D preoperatively). At 12 months, 63% of eyes achieved UDVA of 20/32 or better and 60.9% of eyes were within ±0.50 D of manifest refraction spherical equivalent. Mean refractive astigmatism improved from −2.90 ± 2.21 D preoperatively to −1.47 ± 1.46 D at postoperative 12 months (
P
< .001), with 30.4% and 45.7% of eyes having a postoperative astigmatic error within ±0.50 and ±1.00 D, respectively. No complications were observed.

CONCLUSIONS:

Toric ICL implantation was found to be safe and effective for the correction of myopia and myopic astigmatism in patients with stable keratoconus who had undergone TG-PRK+CXL, as revealed by the statistically significant improvement in visual and refractive outcomes at 12 months after toric ICL implantation.

[
J Refract Surg
. 2021;37(12):824–829.]
Mitigation strategies for communication networks induced impairments in autonomous microgrids control: A review
Authors: Akinwale Olayanju Sunday ,   Electrical and Electronics Engineering Department, University of Ilorin, Ilorin, PMB 1515, Kwara State, Nigeria, Mojisola Dahunsi Folasade , Adediran Ponnle Akinlolu ,   Computer Engineering Department, The Federal University of Technology, Akure, PMB 704, Akure, Ondo State, Nigeria,   Department of Electrical and Electronics Engineering, The Federal University of Technology, Akure, PMB 704, Akure, Ondo State, Nigeria
Published: December 2021

The advancement in communication technology and the availability of intelligent electronic devices (IEDs) have impacted positively on the penetration of renewable energy sources (RES) into the main electricity grid. High penetration of RES also come along with greater demand for more effective control approaches, congestion management techniques, and microgrids optimal dispatch. Most of the secondary control methods of microgrid systems in the autonomous mode require communication links between the distributed generators (DGs) for sharing power information and data for control purposes. This article gives ample review on the communication induced impairments in islanded microgrids. In the review, attention is given to communication induced delay, data packet loss, and cyber-attack that degrades optimal operations of islanded microgrids. The review also considered impairments modelling, the impact of impairments on microgrids operation and management, and the control methods employed in mitigating some of their negative impacts. The paper revealed that innovative control solutions for impairment mitigation rather than the development of new high-speed communication infrastructure should be implemented for microgrid control. It was also pointed out that a sparse communication graph is the basis for communication topology design for distributed secondary control in the microgrid.
From the Entrepreneurial University to the Civic University
Authors: Riviezzo Angelo , Napolitano Maria Rosaria , Fusco Floriana
Published: December 2021

The chapter aims to investigate the impact of the presence of the university on the perceived quality of life of the host community. To this aim, the authors focused on a specific area, that is the historical town center of Naples (as defined by the UNESCO in the World Heritage List since 1995), where five universities are located. Adopting a qualitative and explorative approach, 25 in-depth interviews have been conducted with local universities' stakeholders and content-analyzed through the software Nvivo 10. Thus, the authors identified precisely the multiplicity of activities through which the presence of the university contributes to the socio-economic and cultural well-being of the community of which it is part, thinking about the dynamics that may occur in the case of an urban-located university. Based on the findings, a conceptual model is proposed that may be further validated with new investigations.
A Model Proposal for Local Governments to Increase Citizen Involvement in the Age of Information Society and E-Government
Authors: Aldemir Ceray , Şen Eyüp
Published: December 2021

Crowdsourcing is a form of citizen participation in which an institution has a question submits to citizens via the internet in order to get citizens to think about innovative solutions to the problem. Several municipalities around the world have already used this means, but it has not yet been clear exactly how they can use it and which preconditions play a role in this. Thus, this chapter argued the concept of citizen involvement in the age of ICT by emphasizing the two related terms e-government and e-local government, then secondly the chapter underlined the importance of the necessity of citizen participation in the policymaking process. In the third section of this chapter, it has been argued the crowdsourcing concept as a tool of participation in the age of ICT. Then finally the paper outlined a model for local governments that may use the crowdsourcing approach in the decision-making process.
Transformation of Government and Citizen Trust in Government
Authors: Mahmood Mohamed
Published: December 2021

The continuing erosion of citizen trust and confidence in government has been attributed to a number of factors. This chapter examines the potential role of digital transformation of government in reversing this decline. Based on a systematic literature review, key factors that influence citizen trust and confidence in government as an institution are identified, including citizen satisfaction and expectations, government transparency and accountability, transformation of government, and government performance. The review of the literature also reveals a lack of knowledge and understanding of how transformation of government can influence the growing decline in citizen engagement with government. To address this gap, a conceptual model capturing the key constructs is proposed to support a better understanding of strategies for rebuilding trust and confidence in government administrations through transformation of government.
Foundations' Civic Engagement With Stakeholders
Authors: Maxwell Sarah , Carboni Julia
Published: December 2021

Nonprofit organizations often adopt social media such as Facebook to encourage stakeholders to engage in the organizational mission. Calls to action via social media tend to reach subscribers who “like” or follow the organization via one-way communication. Researching effective approaches to dialogic communication, which asks followers to engage rather than observe, the authors focus on relationship management theory (RMT). RMT stresses organizational-stakeholder dynamic interactions. Using a quantitative modeling approach, the authors examine Facebook posts made by three different types of foundations (community, corporate, and independent) to determine how foundations call for stakeholder engagement. To date, few studies focus directly on types of posts and the response, or lack of response, to organizational messages via social media. Civic engagement requires action on the part of the stakeholder to address social problems. Defining participation and engagement varies by field and types of interaction. This research contributes to literature examining the “digital citizen.”
Higher Education Pedagogy Revisited
Authors: McCarthy-Latimer Christopher
Published: December 2021

This chapter is an update that examines the effect of using “deliberation” as a tool for teaching at the college level. The students in this study considered the economic benefits and expenses of a box store. Deliberation provides a unique insight into what might be a better understanding of what students are thinking. The literature review contains various forms of deliberation including the process of deliberation in education; the outcomes of deliberative polling events; deliberation with technology; and whether working has an impact on students who deliberate. The use of pre- and posttest surveys shows that students who engaged in a deliberative dialogue were more likely to increase their civic learning and to change their opinions about the issues discussed. The findings demonstrate that deliberation pedagogy influences students' beliefs at both the individual and aggregate level.
Citizen as Sensors' Commitment in Urban Public Action
Authors: l'Her Gwendoline , Servières Myriam , Siret Daniel
Published: December 2021

Based on a case study in Rennes, the article presents how a group of urban public actors re-uses methods and technology from citizen sciences to raise the urban air quality issue in the public debate. The project gives a group of inhabitants the opportunity to follow air quality training and proceed PM2.5µm measurements. The authors question the impact of the ongoing hybridisation between citizen science and urban public action on participants' commitment. The authors present how the use of PM2.5-sensors during 11 weeks led to a disengagement phenomenon, even if the authors observe a strong participation to workshops. These results come from an interdisciplinary methodology using observations, interviews, and data analyses.
Civic Engagement of Students
Authors: Huda SSM Sadrul , Kabir Tanveer , Siddiq Tanvir Alam
Published: December 2021

This article aims to figure out the impact of civic engagement of students in Bangladesh. Developed countries are well aware about the importance of civic engagement of the student community nowadays. Their educational system is already structured in a manner which encourages civic engagement in educational life. There are a lot of studies in developed countries regarding student participation in civic engagement. It is seen that the educational system and curriculum in Bangladesh does not incorporate civic engagement. However, there is some skill sharing institutions that has started engaging students in civic activities. Students are learning leadership skills, gaining practical knowledge besides academic, experiencing innovation and becoming responsible citizens of the country. This article focuses on some practical scenarios through which students were engaged with civic activities, which, in turn, positively affect the academic and non-academic achievements of the students in Bangladesh.
Political Consumerism and Social Networking Usage
Authors: Ozgen Ozlen , Sukuroglu Veysel Karani , Akar Basak
Published: December 2021

The main purpose of the study is to reveal the relations between the internet and social media usage and the basic motives behind the actions and engagements of political consumers departing from the thoughts and individual experiences of scholars. Therefore, the study first draws a framework of the political consumer, political consumerism, and the effects of political consumerism. Then it investigates the link between the internet and social media use and the aforementioned concepts. In other words, the purpose of the study is to analyze the extent to which internet and social media use and increase the likelihood of engaging in political consumerism through the method of a case study. As a method of sampling, quota sampling method was chosen. The in-depth interviews were performed in a semi-structured form to maintain the coherence and details. The results of this study and similar studies are thought to be beneficial for improving the quality of life for consumers, corporations, and governments related to agenda setting and policy making.
Centrality of Youth Engagement in Media Involvement
Authors: Iwasaki Yoshitaka
Published: December 2021

Contextualized within the popularity of new media, youth engagement is a very important concept in the practice of public involvement. Guided by the current literature on youth engagement and media studies, this chapter examines the key engagement-related notions involving youth and media usage. Being informed by a variety of case studies on youth engagement through the use of media within various contexts globally, the chapter discusses the opportunities and challenges of engaging youth through media involvement. The specific notions covered in this chapter include (1) the role of “hybrid” media in youth engagement, (2) “intersectionality” illustrating the diversity of youth populations and their media usage, (3) meaning-making through media involvement among youth, and (4) building global social relationships and social and cultural capital through youth's media usage. Importantly, the use of new media can be seen as a means of reclaiming and reshaping the ways in which youth are engaged, as key meaning-making processes, to address personal, social, and cultural issues.
Activating Activists
Authors: Smith Justin M. , Bradshaw Elizabeth A.
Published: December 2021

The purpose of this chapter is to demonstrate the pedagogical and practical importance of learning skills around political advocacy and community engagement in prison-based classes. The primary focus of the exercises described here is upon engaging students in exercises that develop their skills in advocating for social policies that affect them directly. Learning objectives include understanding the challenges of community organizing and consensus-building, developing policy proposal- and grant-writing skills, and developing skills around public messaging.
When Democratic Innovations Integrate Multiple and Diverse Channels of Social Dialogue
Authors: Spada Paolo , Allegretti Giovanni
Published: December 2021

This chapter explores the opportunities, limitations, and risks of integrating multiple channels of citizen engagement within a democratic innovation. Using examples and case studies of recent face-to-face and online multichannel democratic innovations, the authors challenge the emerging consensus that redundancy and diversification of venues of participation are always positively correlated with the success of democratic innovations. Applying their concrete experience in areas of the world in which a systemic organization of different channels of citizen participation exists, the authors provide guidelines for achieving better integration of multiple channels of social dialogue.
Student Athlete Activism in a Millennial World
Authors: Pope Myron L. , Smith Darnell , Pope Shanna
Published: December 2021

College student athletes are among the most recognized students in their communities, across the country, and in some cases around the world. Their voices hold a significant esteem, and they can impact many societal and political issues. Some have postulated that college student-athletes are hesitant to be a part of these politics, but during the past few years, many have taken stands through social media and through protests on their campuses that have been in opposition to the stances of their coaches, their university's administration, and their teammates. Many, however, challenge the role that student athletes have in these protests. This chapter will explore the history of student athlete activism and its developmental aspects, highlight the more recent instances of such activism, and finally discuss how university administration and others can support and be responsive to the concerns that are expressed by this unique set of students.
Determinants and Consequences of Citizens' E-Participation
Authors: Machado Raul , Azevedo António
Published: December 2021

This article aims to discuss the determinants of digital active citizenship behaviors such as the e-participation using reporting urban apps. The article makes a comparative analysis between two groups of citizens: a) 98 users of a reporting app (MyHomeCity) who were selected for the case study); and b) 148 non-users of reporting apps. Users of MyHomeCity revealed higher scores for the satisfaction for life in the city, self-esteem, self-efficacy, and perceived happiness, for all place attachment dimensions and all digital citizenship dimensions except for political activism (online and offline) and critical perspective. The probability of being an app user is predicted by satisfaction for living in the city, place identity (attachment), and digital citizenship dimensions. The implications for public decision makers, app developers, and citizens' organizations are discussed.
Drivers of E-Government Citizen Satisfaction and Adoption
Authors: Al-Ma'aitah Mohammad
Published: December 2021

This study investigated the impact of drivers of e-government, particularly social CRM, citizen trust, and quality of electronic services, on citizen satisfaction with e-government services in the Jordanian environment. In addition to measuring the impact of social CRM on citizen trust and service quality respectively and its impact on citizen satisfaction. A convenience sample was used to achieve the study purpose consisting of 386 questionnaires collected online. The resulting data was analyzed using PLS.2 software. The study findings reveal that social CRM has a significant impact on citizen trust and quality of electronic services, and furthermore that citizen trust and quality of electronic services have significant impacts on citizen satisfaction with e-government services. The study found no direct relationship between the use of social CRM and citizen-government satisfaction but showed a significant indirect impact via customer trust and service quality.
Play Is the Game
Authors: Peck Sharon
Published: December 2021

Drawing on a multimodal framework, this chapter looks at the ways engagement and embodiment of learning are mediated through play as sixth graders learn to skin or repurpose board games to represent the story of The Lightning Thief. Studying game design for the purpose of skinning, that is, applying a new theme or skin to a game, provides a literacy learning process that can foster collaborative, creative, and authentic learning. Outcomes demonstrated gains in social skills and interactions, critical thinking, reading comprehension, visual representation, graphic design, and writing for specific purposes. Analysis revealed that students were immersed in the learning process to the extent that they felt comfortable acting informally, responding in the moment, and being playful. This chapter shows a way to foster academic growth, engagement in learning, and collaboration is to engage students in skinning games based on literature and integrated a playful learning environment.
The Transformation of Literacy and Media Literacy
Authors: Dolanbay Hacer
Published: December 2021

Whether we call it the age of information, the age of digitalization, or the informatics, this century is an era in which rapid technological developments are taking place and will continue without stopping. The importance of using the media consciously and appropriately is increasing by reducing the effects of the media on individuals with many positive and negative characteristics. Having media literacy skills, which is one of the basic skills of the new century, is important in learning how tool live with the media. Becoming a conscious media consumer and producer, the way to realize the reality in the media is to have media literacy skills which is one of the basic skills of the new century. This chapter is mainly aimed at studying the dynamics that makeup media literacy and media literacy skills. How the century has transformed to meet the needs of its students will be highlighted within the context of media literacy. Then, the chapter will be completed by explaining how media literacy is reflected in pedagogy with examples suitable for different courses and levels.
The Application of AI Teachers in Facilitating Game-Based Literacy Learning
Authors: Li Yixun , Zou Lin
Published: December 2021

This chapter discusses the theoretical frameworks for artificial intelligence (AI) teachers and how AI teachers have been applied to facilitate game-based literacy learning in existing empirical studies. While the application of artificial intelligence (AI) in education is a relatively emerging research area, it has received increasing attention in the scientific community. In the future, AI teachers are likely to be able to serve as powerful supplementary tools in classroom teaching in support of human teachers. The main goal here is to provide the readers with new insights on promoting game-based literacy learning from the perspectives of AI teachers. To this end, the authors introduce the readers to the key concepts of AI teachers, the merits and demerits of AI teachers in education, scientific research on AI teachers in literacy learning, and some highlighted examples of AI teachers in literacy classrooms for practical concerns.
Spanish Teacher Attitudes Towards Digital Game-Based Learning
Authors: Huertas-Abril Cristina A. , García-Molina María
Published: December 2021

The consideration that the only goal of games is the achievement of entertainment is still commonly accepted, although there is now an outgrowing perspective that believes in the use of games to promote learning. This exploratory quantitative research examines both in-service and pre-service Spanish teacher perceptions (n = 112) about using digital games in their lessons, paying a special attention to the TPACK model, and comparing the results regarding age, gender, and professional situation. Responses show a positive attitude towards the potential use of video games in their lessons, although there are differences considering the results of the items concerning technological, pedagogical, or content knowledge. The data presented in this study is relevant to guide the design of curriculum and training programs, as well as to develop strategies to support and scaffold pre-service and in-service teachers' knowledge and practical implementation of digital game-based learning (DGBL).
Providing Validity Evidence for Ignite by Hatch
Authors: Luce Hannah E. , Lambert Richard G.
Published: December 2021

The authors of this study seek to provide practitioners with evidence to support the instructional value of Ignite by Hatch, a digital learning game designed for preschool children. Analyses were conducted using the entire population of three- and four-year-old children who used Ignite during the 2020-2021 academic year (n = 29,417) and included the use of descriptive statistics to explore patterns of growth and the Rasch measurement model to explore item difficulty. This chapter also features a preliminary crosswalk establishing the alignment between the domains, subdomains, and games presented within the Ignite game environment and the learning goals provided by the North Carolina Foundations for Early Learning and Development framework. Results suggest strong preliminary evidence in support of the instructional value of Ignite by Hatch. Further research is recommended to understand how knowledge and skill acquisition within the game environment translate to developmental growth outside of the gaming environment.
Learning Coding Through Gaming
Authors: Kellinger Janna Jackson
Published: December 2021

This chapter begins by arguing that computational thinking and coding should be included as two more C's in the Partnership for 21st Century Learning's list of essential skills. It does so by examining how coding and computational thinking can be used to manipulate people. It argues that gaming uses all the C's, including the two new ones proposed. It then explores connections between playing video games and computer programming. It claims that game-based learning would be an optimal way to leverage these connections to teach coding and describes ways in which to do so, including specific challenges that could be included in game-based learning and a sequence of introducing them so students can “level up.” It briefly examines different coding games and describes ways in which educators can create their own coding games. It concludes by arguing that educators can make the connections between gamer thinking and computational thinking visible, use games designed to teach coding, or create their own coding games to take advantage of near transfer.
Exploring the Intellectual Structure and International Cooperation in Information Management
Authors: Zhang Huaige , Hong Xianpei , Li Qing , Gong Yeming , Liu Shan
Published: December 2021

To make a comprehensive literature review and identify the development trends, this study maps the intellectual structure of the research information management based on co-keyword analysis, the 2-tuple linguistic technique, and social network analysis. This study reveals the intellectual structure by analyzing the topological structure, conceptual structure, and strategic diagram. From the perspective of topological structure, the research of the information management field can be divided into three layers including the nucleus layer, middle layer, and marginal layer. In terms of the conceptual structure, the research of information management can be divided into four sub-fields including health information management, information systems, information technology, and information management application. The four subfields can be repartitioned into seven clusters by using a 2-tuple linguistic model, which means that the 2-tuple linguistic model can improve co-keyword analysis.
Erros e incidentes de medicaçao na atençao primaria: revisão integrativa
Authors: Soares Santos Anna Cecília , Grou Volpe Cris Renata , Moura Pinho Diana Lúcia , Roberta Silva Araújo Paula , Talita Adriano da Silva Heloiza
Published: December 2021

Objetivo: Identificar, na literatura científica, publicações acerca dos erros de medicação e os incidentes relacionados, na atenção primária à saúde.
Método: Realizou-se uma revisão integrativa da literatura nas bases de dados Medical Literature Analysis and Retrieval System on Line, Cumulative Index to Nursing and Allied Health Literature, Scientific Eletronic Library Online e Web of Science. Analisaram-se 17 artigos que atenderam aos critérios de inclusão.  Para extração dos dados, fez-se a leitura, na íntegra, dos artigos selecionados.
Resultados: dos 17 estudos analisados, sete (41,17%) foram indexados, tanto no PubMed, quanto no Medline; nove (52,94%) na Web of Science; um (5,9%) na base Scielo; e nenhum na Cinahl. Os estudos apontam fortes evidências na aplicação clínica, sendo que a maioria desses mostra que prescrições com medicamento incorreto, dose incorreta, interações medicamentosas e alergias medicamentosas foram as principais causas de erros com potencial para danos graves.
Conclusão: Ainda é crescente o desenvolvimento de pesquisas que visem identificar estratégias e intervenções voltadas aos erros de medicação. Sabe-se que esses estudos fornecem subsídios para o aprimoramento das práticas, além de propiciar maior segurança no processo de medicação, a fim de reduzir os eventos adversos evitáveis.
Vídeo educativo sobre a quimioterapia oncológica: tecnologia na educação em saúde
Authors: Amaral Mortola Luana , Manfrin Muniz Rosani , Habekost Cardoso Daniela , Alves Azevedo Norlai , Da Costa Viegas Aline , De Medeiros Carniere Clarice
Published: December 2021

Objetivo: Descrever as etapas de construção de um vídeo educativo para pacientes em tratamento quimioterápico. Método: Estudo do tipo desenvolvimento de tecnologia educativa realizado em um serviço de oncologia de um hospital de ensino no sul do Rio Grande Sul. A construção do material ocorreu no período de março de 2016 a abril de 2017, e contou com a participação de profissionais especializados do serviço de oncologia considerados no estudo como juízes especialistas. Foi desenvolvido por meio de quatro etapas: revisão da literatura, análise dos dados coletados e construção do roteiro, avaliação do roteiro pelos juízes e edição audiovisual. Resultados: Os resultados compreendem a descrição do roteiro e o conteúdo do vídeo como uma proposta de educação em saúde para os pacientes em tratamento quimioterápico. Conclusão: O Vídeo Educativo constitui-se em uma importante ferramenta de educação em saúde para as pessoas em quimioterapia, podendo ser utilizado principalmente na consulta de enfermagem, momento no qual se deve priorizar o acolhimento com intuito de minimizar os efeitos colaterais e favorecer a adesão ao tratamento.
Positividade ao HIV e fatores associados em um centro de testagem e aconselhamento
Authors: Rossi Angélica da Mata , Albanese Silvia Paulino Ribeiro , Kuriaki Aparecida Tioko , Birolim Marcela Maria , Monroe Aline Aparecida , Arcêncio Ricardo Alexandre , Dessunti Elma Mathias
Published: December 2021

Objetivo: Analisar os fatores sociodemográficos e comportamentais associados à positividade ao Vírus da Imunodeficiência Humana (HIV) em usuários de um Centro de Testagem e Aconselhamento (CTA). Método: Estudo transversal com 5.229 usuários que realizaram o teste rápido para HIV, registrados no Sistema de Informação do CTA. As análises bivariadas e multivariadas foram realizadas utilizando-se a regressão logística binária, com apresentação do OddsRatio, intervalo de confiança de 95% e p-valor <0,05. Resultados: A prevalência de infecção pelo HIV foi de 5,0% (259), com maior acometimento da população mais jovem (p=0,010). Observou-se maior positividade entre as pessoas vivendo com HIV/Aids (91,3%; p<0,001) e homens que fazem sexo com homens (HSH) (20%; p<0,001). Nas análises multivariadas verificou-se maior associação à infecção pelo HIV no modelo 2 que inclui, as variáveis sociodemográficas e comportamentais, como: o recorte populacional de HSH,o compartilhamento de seringas, a orientação sexual HSH, ter infecções sexualmente transmissíveis (IST) nos últimos 12 meses, parceiro soropositivo para HIV e uso irregular ou não uso do preservativo nos últimos 12 meses com parceiro fixo. Conclusão: A vulnerabilidade ao HIV foi mais associada aos fatores relacionados ao compartilhamento de seringas e ao comportamento sexual, especialmente os HSH e as parcerias fixas.
A repercussão do diagnóstico de câncer colorretal para pessoa e sua família
Authors: Nachtigall Barboza Michele Cristiene , Manfrin Muniz Rosani , Cagliari Raquel , Viegas Aline da Costa , Duarte do Amaral Débora Eduarda , Habekost Cardoso Daniela
Published: December 2021

Objetivo: compreender a repercussão do diagnóstico de câncer colorretal na experiência de adoecimento da pessoa e sua família. Método: pesquisa qualitativa desenvolvida de maio a julho de 2017, com pessoas com câncer colorretal e seus familiares, totalizando 23 participantes, mediante a entrevista em profundidade. Os dados foram organizados e codificados no software webQDA e realizado análise temática. Resultados: Organizou-se três temas: Câncer colorretal: repercussão do diagnóstico na perspectiva da pessoa e da família, na qual o familiar mais expressou sofrimento diante do diagnóstico; Experiência pregressa e conhecimento como forma de enfrentar a repercussão do diagnóstico de CCR, destacando a capacidade de resiliência colaborando no enfrentamento; O câncer colorretal marcado no corpo e na mente, o corpo marcado pela estomia e mente pelo medo da recidiva. Conclusão: foi possível compreender que o diagnóstico de câncer repercute é compartilhado entre os membros da família, caracterizando a experiência como um evento coletivo.
Subacute combined degeneration of spinal cord, optic atrophy and thrombocytopenia without anemia secondary to B12 deficiency
Authors: Perera Charith , Sivagnanam F. G. , Ranaweera Y. , Wijesooriya S.
Published: December 2021

Long-standing vitamin B12 deficiency can lead to neurological manifestations such as optic atrophy and subacute combined degeneration of the cord without causing significant anemia. In addition, folic acid supplementation could mask the hematological manifestations of vitamin B12 deficiency and delay the presentation of neurological manifestations We present a case of a 32-year-old vegan woman on long-term sodium valproate and folic acid treatment presenting with progressive weakness of bilateral lower limbs for three months and reduced vision in both eyes for two weeks duration. Further evaluation revealed optic atrophy, combined degeneration of the spinal cord, macrocytosis, thrombocytopenia, and severely deficient serum B12 levels. With B12 replacement therapy, the patient’s overall wellbeing improved.
Young man presenting with clubbing - A case-based evaluation
Authors: Herath Y. B. , Indrakumar J. , Matthias A. T.
Published: December 2021

Clubbing is the bulbous enlargement of the distal segment of digits. It is known to be associated with several cardiological, gastrointestinal, pulmonary, neoplastic, infectious, and endocrinological disorders. Rarely clubbing may not associate with any underlying pathology despite presenting in a later stage. Here we report a case of a 26- year- old man who presented with a history of recent onset of clubbing. Following extensive evaluation we were unable to find a possible etiology.
Sex Differences of Visceral Fat Area and Visceral-to-Subcutaneous Fat Ratio for the Risk of Incident Type 2 Diabetes Mellitus
Authors: Kim Eun Hee , Kim Hong-Kyu , Lee Min Jung , Bae Sung-Jin , Choe Jaewon , Jung Chang Hee , Kim Chul-Hee , Park Joong-Yeol , Lee Woo Je
Published: December 2021

Background: This study aimed to determine the optimal cut-off values of visceral fat area (VFA) and visceral-to-subcutaneous fat ratio (VSR) for predicting incident type 2 diabetes mellitus (T2DM).Methods: A total of 10,882 individuals (6,835 men; 4,047 women) free of T2DM at baseline aged between 30 and 79 years who underwent abdominal computed tomography scan between 2012 and 2013 as a part of routine health check-ups were included and followed. VFA, subcutaneous fat area, and VSR on L3 vertebral level were measured at baseline.Results: During a median follow-up of 4.8 years, 730 (8.1% for men; 4.3% for women) incident cases of T2DM were identified. Receiver operating characteristic curve analysis showed that the optimal cut-off values of VFA and VSR for predicting incident T2DM were 130.03 cm2 and 1.08 in men, respectively, and 85.7 cm2 and 0.48 in women, respectively. Regardless of sex, higher VFA and VSR were significantly associated with a higher risk of incident T2DM. Compared with the lowest quartiles of VFA and VSR, the highest quartiles had adjusted odds ratios of 2.62 (95% confidence interval [CI], 1.73 to 3.97) and 1.55 (95% CI, 1.14 to 2.11) in men, respectively, and 32.49 (95% CI, 7.42 to 142.02) and 11.07 (95% CI, 3.89 to 31.50) in women, respectively.Conclusion: Higher VFA and VSR at baseline were independent risk factors for the development of T2DM. Sex-specific reference values for visceral fat obesity (VFA ≥130 cm2 or VSR ≥1.0 in men; VFA ≥85 cm2 or VSR ≥0.5 in women) are proposed for the prediction of incident T2DM.
Comparison between Intravenous Dexmedetomidine and Spray as you Go with 4% Lignocaine Versus Intravenous Fentanyl and Transtracheal Injection of 4% Lignocaine for Awake Nasotracheal Intubation with Flexible Vedioscope – A Randomized Single-Blind Prospective Study
Authors: Kumar Miriyala Pavan , Patro Madhusmita , Panigrahy Sasmita , Samal Soumya , Kartheek B. Sai
Published: December 2021

Background:

Awake fiber-optic bronchoscopy-guided intubation is the method of choice in difficult airway which requires effective airway anesthesia to ensure patient comfort and acceptance.

Aims:

This study was conducted to assess the quality of airway anesthesia, patient comfort during intubation, and postoperative satisfaction of patients.

Settings:

Patients posted for surgeries under general anesthesia with Mallampati Grade I and II in a medical college. Patients were followed in the operation theater and postoperative ward.

Study Design:

This was a prospective randomized single-blind study.

Materials and Methods:

Group D received intravenous (i.v.) dexmedetomidine 1 μg.kg−1 i.v. over 10 min and 3 ml of 4% lignocaine spray as you go (SAYGo). Group F received i.v. fentanyl 2 μg.kg−1 over 10 min and transtracheal injection 3 ml of 4% lignocaine. Parameters assessed were endoscopic time, intubating condition, vocal cord position, cough severity, comfort during intubation, postoperative patient satisfaction, and any adverse effects such as sore throat, hoarseness, unpleasant memories, and hemodynamic response during intubation.

Statistical Analysis:

Independent Student's t-test, Mann–Whitney, Chi-squared test, or Fisher's exact test were used. P ≤ 0.05 was considered statistically significant.

Results:

Intubating conditions, vocal cord position, cough severity, comfort during intubation, and postoperative patient satisfaction were statistically significant (P ≤ 0.05) in favor of Group D though endoscopic time was longer.

Conclusion:

IV dexmedetomidine with SAYGo is effective than IV fentanyl with transtracheal block for awake fiber-optic videoscopic intubation in terms of intubating conditions, vocal cord position, cough severity, comfort during intubation, and postoperative satisfaction of patients with significant attenuation of postintubation hemodynamic response and better preservation of respiration though endoscopic time is more.
Analyses of serum 25-hydroxyvitamin D levels and single nucleotide polymorphisms in the vitamin D receptor gene for acne vulgaris
Authors: Hassan M Mohammed , Shaker Olfat G. , Abd el-Raheem Talal A. , Yasen Sara M.
Published: December 2021

Background

Acne vulgaris (AV) is one of the diseases that are widespread in Egypt. It is a disease that mainly affects the pilosebaceous units of the face, neck, and others.

Aim

To analyze and assess the role of 25-hydroxyvitamin D levels in serum as well as different vitamin D receptor (VDR) genes (Taq-1, Apa-1, Fok-1, and Cdx-2 polymorphisms) among Egyptian patients having AV.

Patients and methods

A total of 300 patients with acne and another 300 healthy controls were included in the study. Patients were subdivided into four different groups: group 1 received cholecalciferol 8000 IU/day for 3 months; group 2 applied 1–2 g of topical vitamin D analog for 3 months, group 3 had no treatment, and lastly, group 4 included healthy controls. For all patients, skin manifestations were assessed. Serum 25(OH)3 D was measured in all participants before and after treatment. Different VDR gene polymorphisms were measured.

Results

Patients with acne showed a statistically significant decrease in serum 25(OH) D3 concentration than controls, with P value of 0.001. Regarding VDR polymorphisms (rs731236 for Taq-1, rs7975232 for Apa-1, rs2228570 for Fok-1, and rs11568820 Cdx-2 polymorphisms), the results revealed that there was a statistically significant difference between patients with acne and controls regarding Taq-1 and Apa-1 genotypes, with P values of 0.001 and 0.026, respectively, whereas regarding Fok-1 and Cdx-2 genotypes, the results revealed that there were no statistically significant differences between the studied patients and the controls (P=0.690 and 0.113, respectively).

Conclusion

Vitamin D and VDR polymorphisms (Taq-1, Apa-1, Fok-1, and Cdx-2) play important roles in AV.
Oxidant and antioxidant status in patients with female pattern hair loss with varying severity
Authors: Khattab Fathia M. , Al-Karamany Amira S.
Published: December 2021

Background

Female pattern hair loss (FPHL), also known as female androgenic alopecia, is a common dermatological disorder with a multifactorial pathogenesis. Oxidative status has been implicated in the pathogenesis of several skin diseases, including FPHL.

Aim

This study was aimed to investigate the levels of oxidative stress biomarkers in patients with FPHL with varying severities.

Patients and methods

The study involved 56 patients with FPHL and 46 healthy controls. Diagnosis was based on clinical examination and trichoscopic evaluation. Patients were grouped into three subgroups as follows: mild, moderate, and extensive. Oxidative stress was examined by measuring plasma levels of catalase (CAT), superoxide dismutase, total antioxidant capacity, and malondialdehyde (MDA).

Results

Plasma levels of MDA in FPHL were significantly higher as compared with that of the controls, whereas activities of the antioxidant enzymes superoxide dismutase and CAT were lower. Moreover, total antioxidant capacity was also low in patients with FPHL as compared with that of the controls. Higher MDA levels in the extensive FPHL subgroup as compared with that of the mild and moderate subgroups were also observed. Furthermore, in the extensive FPHL subgroup, a significant negative correlation was observed between MDA and CAT levels.

Conclusion

The data suggest that oxidative stress plays a key role in FPHL progress, which accelerates hair loss by causing microinflammation and fibrosis. The recognition of the effect of androgens and associated factors on the hair follicle cycle is essential for the development of new and effective treatment methods and may be employed as a biomarker index to assess the disease’s activity and to monitor its treatment.
Therapeutic efficacy of three systemic antifungals in onychomycosis
Authors: Taha Emad A. , Moharam Ahmed Mohamed , Ladeed Amany Morgan , Tawfik Yasmin M. , Bakr Radwa M.
Published: December 2021

Background

Onychomycosis is a nail fungal infection that significantly affects the patient’s quality of life. It represents a treatment challenge for dermatologists.

Aim

The aim was to compare the efficacy of pulse therapy of itraconazole, fluconazole, and terbinafine in the treatment of onychomycosis.

Patients and methods

Sixty patients clinically and mycologically diagnosed with onychomycosis were included in this study. Patients were randomly divided into three groups: group A received itraconazole (400 mg/day for 1 week/month); group B received fluconazole (300 mg/week); and group C received terbinafine (500 mg/day for 1 week/month). All patients received the treatment for 3 months and were followed up for another 3 months. They were evaluated clinically by photography, mycologically (microscopy and culture), and by the ‘Naildex score questionnaire’.

Results

The clinical, mycological, and complete cure rates were the highest among group A (80, 70, and 70%, respectively), followed by group C (60, 55, and 55%, respectively) and finally group B (50, 35, and 35%, respectively), with no statistical difference between them. Also, group A showed greater improvement in the nail function index compared with the other two groups.

Conclusion

Pulse therapy of itraconazole, terbinafine, or fluconazole was effective in the treatment of onychomycosis with increasing patient compliance. The best response was achieved with itraconazole, followed by terbinafine and finally fluconazole.
Viral stimulation modulates endotype-related ACE2 expression in eosinophilic chronic rhinosinusitis
Authors: Hong S.-N. , Kim J.K. , Kim J.-A. , Cha H. , Kim J.Y. , Lim H.-S. , Eun K.M. , Kim D.W.
Published: December 2021

Background: Angiotensin-converting enzyme 2 (ACE2), a receptor targeted by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is highly expressed in the nasal mucosa. Chronic rhinosinusitis (CRS) shows diverse endotypes and is aggravated by viral infection. Whether viral stimulation and CRS endotype influence ACE2 expression remains unclear. We investigated the expression of ACE2 and the transmembrane protease, serine 2 (TMPRSS2), which mediate the entry of SARS-CoV-2 into cells, and assessed polyinosinic:polycytidylic acid (poly[I:C])-induced changes based on CRS endotype. Methodology: ACE2 and TMPRSS2 expression was evaluated based on CRS phenotype, endotype, and tissue type. Correlations between ACE2/TMPRSS2 expression and inflammatory mediators in nasal polyps (NP) were examined. Air-liquid interface culture experiments were performed to assess the effects of major cytokines or poly(I:C) stimulation on ACE2/TMPRSS2 expression in primary epithelial cells from healthy nasal mucosa, eosinophilic NP (ENP), and non-eosinophilic NP (NENP). Results: In primary nasal epithelial cells, interleukin (IL)-13 decreased ACE2 expression but increased TMPRSS2. Eosinophilic CRS showed lower ACE2 expression than non-eosinophilic CRS, regardless of CRS phenotype. CRS endotype was an independent factor associated with ACE2/TMPRSS2 expression in NP. Serum and tissue eosinophilic marker levels were inversely correlated with ACE2 expression, whereas tissue neutrophilic marker levels and ACE2 expression were positively correlated in NP. ACE2 expression was suppressed in ENP tissues; however, a combination of poly(I:C) and IL-13 induced ACE2/TMPRSS2 upregulation in ENP. Conclusions: ENP tissues have lower ACE2 expression than NENP; however, viral stimulation promotes ACE2/TMPRSS2 upregulation in ENP.