bluuebunny/crossref_metadata_2025 huggingface dataset:
Santé, art et spiritualité : l’installation du mètre cube d’infini de Michelangelo Pistoletto au centre de lutte contre le cancer de Marseille
Authors: Maraninchi Dominique
Published: May 2023

Les séjours à l’hôpital sont des moments de questionnements intenses autour du devenir, de la vie et de la mort. Dans ces moments intenses, lieu de soin et d’hospitalité, l’hôpital peut et devrait offrir aux patients et à leurs proches un ou des espaces de paix, de méditation où émotions et spiritualité peuvent s’exprimer de façon naturelle et intime. Ceci a guidé la démarche d’installation du « mètre cube d’infini » du maître italien Michangelo Pistoletto à l’ Institut Paoli Calmettes , le Centre régional de lutte contre le cancer de Marseille-France . Inauguré en 2000, ce lieu de rencontre entre santé et spiritualité, centré autour l’œuvre de Pistoletto, est un espace multiconfessionnel dédié à la méditation et à la prière. Présenté à travers des alcôves ouvertes et contiguës, l’espace accueille les patients de toutes les confessions, y compris les agnostiques, leur permettant de méditer face aux questions douloureuses soulevées par la rencontre avec la maladie dans un environnement radicalement nouveau, dont la beauté invite à une réflexion spirituelle au-delà d’une pratique stricte des cultes religieux.
Études cliniques réalisées en milieu thermal dans le cadre des prescriptions légales “critères 2016 - révision 2020”
Authors: Falissard Bruno , Roques-Latrille Christian-François
Published: May 2023

Les personnes pétitionnant pour l’ouverture d’un établissement thermal, l’obtention d’une nouvelle orientation thérapeutique, l’utilisation d’une nouvelle source, nouvelle eau, nouveau soin doivent recueillir l’avis de l’Académie nationale de médecine. Ils devront à l’avenir produire les types d’étude ci-après mentionnés. Les études par analogie établissent l’utilisation d’eaux minérales similaires pour des objectifs et des résultats comparables. L’étude qualitative établira la manière dont les soins sont délivrés par les personnels et reçus par les patients. Quant à l’étude clinique elle devra apporter la preuve d’une efficacité thérapeutique cliniquement probante. Dans tous les cas cette dernière étude devra aboutir à une comparaison valide du traitement traité. Cette comparaison pourra se faire avec des données existantes, en particulier d’essais contrôlés randomisés considérés comme une référence robuste. La comparaison devra se faire sur les données individuelles et non sur des agrégats de données. Les techniques de “Match Adjusted Individual Comparison” (MAIC) sont appropriées. Quant les données permettant ce type de comparaison ne sont pas disponibles, l’essai contrôlé randomisé est la règle cependant les techniques bayésiennes d’essai clinique, qui apportent des données valables à partir d’un nombre limité de patients peuvent être envisagées. Par ailleurs toutes les règles scientifiques et éthiques de l’investigation clinique doivent être respectées.
Mise en évidence d’un effet désinfectant urinaire de l’eau thermale de La Preste
Authors: Benoit Jean-Michel
Published: May 2023

L’évolution avant et durant leur cure à La Preste de 534 cas d’infection urinaire récidivante a été étudiée systématiquement. Ce travail met en évidence une rupture évolutive entre ces deux périodes pourtant en continuité. Le nombre de crises urinaires baisse nettement durant la première cure, quelle que soit la forme clinique de l’infection: 78 % en cas de cystite, 83 % lors de pyélonéphrites, 64 % pour les prostatites. Ce phénomène se reproduit lors de chaque cure suivante pour les curistes souffrant de cystite, mais non en cas de prostatites ou de pyélonéphrites, peut-être en raison d’un effectif de curistes insuffisant. L’examen des résultats d’analyses cytobactériologiques urinaires ou des contrôles par bandelettes confirme cette diminution, avec prudence, les données recueillies étant imparfaites. Cependant l’incontestable diminution des crises urinaires, et la diminution des infections urinaires qui s’ensuit, obligent à conclure à un effet désinfectant propre de l’eau thermale. La seule explication possible d’un tel effet réside dans l’existence d’une interaction entre cette eau thermale et le processus d’adhérence bactéries-urothélium, responsable premier des infections sur des systèmes urinaires normaux.
Maladies des institutions spécialisées. Petite nosographie à consommer sur place
Authors: Decourchelle Denis
Published: May 2023

Les institutions spécialisées se doivent de répondre à des attentes anciennes de la société et leur mandat est désormais reconnu, permettant de rapprocher les personnes vulnérables ou relevant de l’assistance des courants vifs, main-stream , de la vie sociale. Pour autant, elles peuvent engendrer elles-mêmes des comportements collectifs venant freiner ou même endommager leur mission. Une typologie de ces dysfonctionnements est proposée, sur la base de constats opérés par l’auteur en tant que formateur et anthropologue.
Mobile Technology for Learning Assessment: Design Process for the NursE-Quiz Mobile Application
Authors: Lajane Halima , Gouifrane Rachid , Arai Mounir , Qaisar Rabia , Chemsi Ghizlane , Radid Mohamed
Published: May 2023

This paper traces the development of a mobile application  designed to simplify and support learning in nursing education. This application is based on the principles of dynamic formative evaluation, a method that encourages student involvement in the formative assessment process and supports student learning through formative feedback. A formative assessment model was derived from these principles and informed the application’s design. This mobile application project, which ran from February to September 2020, aimed to contribute to the improvement of formative assessment practices through the development of a learner-centered assessment tool and the identification of key formative processes within the application. The application’s functionality was based on the needs of the actors, which were analyzed according to Black and William’s theoretical perspectives on formative assessment and Keller’s motivational model; both were used to inform the pedagogical design of the application. This application is intended for nursing teachers working in ISPITS in Morocco and student nurses enrolled in the professional license cycle in these training institutes
Effectiveness of Seamless Mobile Assisted Real Training for Parents (SMART-P) Usage to Improve Parenting Knowledge and Children’s Cognitive Development
Authors: Yafie Evania , Mohamad Ashari Zakiah , Abu Samah Norazrena , Widiyawati Riyana , Setyaningsih Diana , Alfian Haqqi Yudha
Published: May 2023

This study aims to develop and identify the effect of SMART-P training on parenting knowledge and children's cognitive development. This research is included as Mix Method research with an ADDIE development model and experimental quantitative research approach. The research method used is explanatory research with a non-equivalent control group design research involving the control and experimental classes. This research is carried out for three weeks, with the stages covering: analysis, design, development, research instrument development, implementation, and evaluation. The population in this study are 714 parents with children aged four years from posyandu/KB in five sub-districts of Malang City, with a research sample of 150 parents with children aged four years and six experts. Data collection techniques in this study used questionnaires and observation checklists. Data analysis in this study used descriptive percentage analysis and SPSS analysis. The results show that 1) SMART-P application is declared valid and acceptable to be implemented as a training medium, 2) a significant effect of parenting knowledge in parents before and after being given parenting training using SMART-P is identified, 3) a significant effect on the development cognitive development of children before and after parents re given care using SMART-P application is identified, 4) a significant difference in the effect of parenting knowledge on parents between the control group and the experimental group is shown, and 5) a significant difference in the effect on children's cognitive development between the control group and the experimental group is slightly identified. Therefore, parenting research using SMART-P needs to be carried out continuously so that parenting knowledge and children's cognitive development can be maximized
Chasing Biodiversity Off the Scientific and Conservation Tracks
Authors: Maier Donald S.
Published: May 2023

The idea of conserving biodiversity has become central to the very meaning of biological conservation---in the public imagination and for conservation organizations worldwide. Identification of conservation with biodiversity conservation owes extensively to the idea that warrant for biodiversity's conservation is anchored in the empirical thesis that biodiversity causally determines ecosystem functioning, and thereby, somehow, important ecosystem services. This idea has fueled an enormous research program dedicated to producing the requisite causal evidence. This essay first reviews the data that are supposed to constitute direct evidence for biodiversity's causal influence. It proceeds by answering a heretofore unasked, yet foundational, question for causal hypotheses: Do these data meet basic requirements for credibility as causal evidence? By virtue of mistakenly reading causal significance into (i) massive numbers of causally irrelevant data points, (ii) an equation that simply equates a stipulated definition to an algebraically equivalent expression, and (iii) correlations produced by arbitrary computations over previously collected data sets, these data fall well short of meeting these requirements. Mistakes also suffuse the notion that biodiversity's supposed causal influence gives reasons to conserve it. These mistakes are exposed when the conservation argument that was supposed to proceed from the premise of biodiversity's causal influence is clearly spelled out. Once made explicit, each step is seen to rely on a questionable assumption, invalid logic, or both. The essay concludes with implications for conservation, biodiversity research, and scientific inquiry more generally.
Introduction to Graph Neural Network
Authors: S. V. S. Ganga Devi
Published: May 2023

Deep learning on graphs is an upcoming area of study. This chapter provides an introduction to graph neural networks (GNNs), a type of neural network that is designed to process data represented in the form of graphs. First, it summarizes the explanation of deep learning on graphs. The fundamental concepts of graph neural networks, as well as GNN theories, are then explained. In this chapter, different types of graph neural network (GNN) are also explained. At the end, the applications of graph neural network where GNN is used and for what purpose it is going to be used are explained. This also explores the various applications of GNNs in fields such as social network analysis, recommendation systems, drug discovery, computer vision, and natural language processing. With the increasing prevalence of graph data, GNNs are becoming increasingly important and will likely continue to play a significant role in many fields in the future.
Graph Classification of Graph Neural Networks
Authors: Lalotra Gotam Singh , Sharma Ashok , Bhatti Barun Kumar , Singh Suresh
Published: May 2023

Graph neural networks have recently come to the fore as the top machine learning architecture for supervised learning using graph and relational data. An overview of GNNs for graph classification (i.e., GNNs that learn a graph level output) is provided in this chapter as pooling layers, or layers that learn graph-level representations from node-level representations, are essential elements for successful graph classification because GNNs compute node-level representations. Hence, the authors give a thorough overview of pooling layers. The constraints of GNNs for graph categorization are further discussed, along with developments made in overcoming them. Finally, they review some GNN applications for graph classification and give an overview of benchmark datasets for empirical analysis.
Performance Appraisal and Performance Management
Authors: Onyeaku John
Published: May 2023

One of the biggest management challenges is how to deploy the most effective appraisal system that employees trust. Performance appraisal is critically important because it determines an employee's career path within the organization such as rewards, promotions, and ultimately, retention. Performance management can both achieve the goals of providing useful information for efficient administration and a tool for employee development. Integrating the social context into performance management is equally important. But adopting a “One size fits all” approach can be risky. How can an engineer and a janitor be measured with the same metrics? Should performance appraisals occur more frequently? What is the role of the rater? Are performance appraisals still needed today? Using a literature review, this chapter explores the intricacies involving performance appraisal within the performance management system in organizations.
Why Do People Still Buy Apple Products?
Authors: Kim Connor K. , Stark Ian
Published: May 2023

Since its inception in 1976, Apple has quickly separated itself as one of the industry leaders by continuing to push the needle forward in all aspects from innovation to marketing. From the iPhone to the iPad, Apple has a long resume of successful products raising the question, “How does Apple continue to successfully shift culture and facilitate technology acceptance?” This chapter uncovers the psychological strategies used by Apple to market its products through various media including commercials and brand image. By focusing on AirPods as a case study for Apple's marketing strategies, the chapter dives deeper into the psychological strategies used by Apple to change public perception and the technology industry as a whole. Moreover, the chapter analyzes the strategies used to make technology accepted among all demographics. Last, this chapter synthesizes the information to conclude whether the success of Apple's company marketing, brand, and image is attributed to genius or plain luck.
Analyzing Risks Qualitatively in the Sustainable Noisy Environment Impacting Worker Mental Stress in the Manufacturing Sector
Authors: Mahapatra Tushar K. , Suchismita Satapathy  , Panda Subrat K.
Published: May 2023

One of the key objectives of any modern organizations is to concentrate on risks and uncertain events. Risks within the project life cycle may be serious if they are not considered at the planning stage. As a result, risk assessment is crucial and has been thoroughly studied in recent years by numerous scholars. The weighted aggregated sum product assessment (WASPAS) technique, which was used to evaluate the adverse consequences of risks on projects, was suggested by this research. The risks that a worker faced while working in the noisy environment of Bhubaneswar were identified and assessed in this study; the results indicated these risks were inaccessible or inappropriate throughout the life cycle. Additionally, this chapter recommends the WASPAS method as one of the MCDM techniques that would be most accurate for assessing risks in a practical setting.
Strategic Survival Analysis of Gastric Cancer Patients for Augmented Reality
Authors: Pandey Digvijay , Lelisho Mesfin Esayas , Kotti Jayasri , Gowwrii Gadee , Shahul Aakifa , George A. S. Hovan , Dadheech Pankaj
Published: May 2023

Gastric cancer (GC) is the fifth most common type of cancer worldwide and the third leading cause of cancer-related death. The Cox model and accelerated failure time models are widely used in the modeling of survival data for various diseases. The goal of this study was to compare the performance of the Cox proportional hazard (PH) model and accelerated failure time (AFT) models in determining the factors that influence gastric cancer death. The data for this study was obtained from gastric cancer patients admitted to the Tikur Anbesa specialized hospital, between January 1, 2015, and February 29, 2020. A total of 409 gastric cancer patients were studied retrospectively. Cox proportional hazard and accelerated-failure-time (AFT) models were compared to identify an appropriate survival model that determines factors that affect the time to death of gastric cancer patients. To compare the performance of all models, the AIC, BIC, and Likelihood criteria were used. The analysis was carried out using the R statistical software.
Metaverse Is the Future of Influencer Marketing
Authors: Tyagi Shenki , Srivastava Ashish Kumar , Dubey Anjali , Sharma Divya
Published: May 2023

Influencer marketing is expected to undergo a transformation due to the rise of the metaverse. The metaverse is a virtual world where users can interact with each other and digital content in a fully immersive environment. Influencer marketing is predicted to become more important for firms as the metaverse's popularity rises. This new platform offers opportunities for businesses to work with influencers and develop campaigns that benefit from metaverse's immersive qualities. The influencer marketing has advantage to create 3D environments. Interactive experiences to capture the attention of interested audience and connection with global audience to be successful in the metaverse, influencers will need to adapt their strategies that are immersive, engaging, interactive, and building strong communities within the metaverse for loyal following. In conclusion, the metaverse is the future of influencer marketing. As more people spend time in virtual space, influencers need to create immersive and engaging content and building strong communities for their success.
Influencer Marketing in the Digital Ecosystem
Authors: Rosário Albérico Travassos , Lopes Paula Rosa , Rosário Filipe Sales
Published: May 2023

Influencer marketing is a marketing strategy used in the digital ecosystem to promote products or services through influencers or influential people in the digital environment. These influencers can be celebrities, experts on a particular subject, or simply people with a large follower base on social media. Thus, influencing followers can help promote a brand or product more effectively than traditional marketing. Although influencer marketing is a central concept in current trends in marketing strategies, most marketing managers have yet to incorporate it into their agenda. As a result, more research is needed to provide reliable and accurate data on influencer marketing to empower marketing managers and their teams with the necessary knowledge. Based on this research gap, a systematic bibliometric literature review was conducted. This research essay aims to assess the challenges and opportunities, thus building a reference framework for influencer marketing in the digital ecosystem.
A Lead or a Dread?
Authors: Devi Saloni , Kohli Garima
Published: May 2023

This research is situated at the intersection of three contemporary trends: employees' influence within the internal branding and brand value co-creation process; organizations' use of social media to build their brands; and employees' roles as influencers whereby they voice their opinions, post work-related content on social media, and express their perceptions of their employer's brand and influence consumers via social media. Further, it is based on extensive review of the literature to get deep knowledge of an interaction between employee influencer and brand co-creation. This piece of research will be valuable for academicians, managers, and scholars as well as for those who are looking to have an understanding of employee as influencers of firm.
Repertórios, veredas e história impressa: a Revista del Instituto Paraguayo como síntese da reescrita nacional
Authors: Elisângela da Silva Santos
Published: May 2023

Neste artigo discutimos aspectos da trajetória da Revista del Instituto Paraguayo que tangenciaram temas sobre a discussão da recondução da nacionalidade paraguaia do final do século XIX e início do XX, momento em que diversos intelectuais se esforçavam em forjar uma nova versão do país, que sofria as consequências nefastas da Guerra da Tríplice Fronteira (1864-1870). Desde seu surgimento, esse periódico se propôs ao debate, de maneira interdisciplinar, de um conjunto de temas e questões que englobaram repertórios fundamentais para a consolidação no despertar de uma consciência nacional. Destacamos como principal condutora dessa atuação a Geração de 900, formada por autores interligados por uma comunidade intelectual interessada na reconfiguração nacional, a partir da cultura, da pátria, da história nacional e do porvir. Esperamos contribuir para o debate sobre o protagonismo desta Revista como uma das plataformas essenciais que sintetizou aspirações que projetaram o país para o século XX.
Las posturas oficiales en torno a los modos de integración de los indígenas del Territorio Nacional del Chaco durante la década del cuarenta. Reacciones ante la intervención de los misioneros no-católicos
Authors: MARI OSCAR ERNESTO
Published: May 2023

La temática de este artículo tiene como ámbito de estudio a uno de los antiguos Territorios Nacionales argentinos (Chaco), y aborda el análisis de los intercambios discursivos y epistolares expuestos respecto a la temática de la integración indígena durante los años cuarenta, enmarcados en un contexto de creciente actividad misional de pastores de origen protestante. Se exponen aquí algunos nuevos conocimientos producto de investigaciones recientes en archivos regionales del nordeste argentino. En este caso nos centramos en los puntos de vista planteados como consecuencia de la acción de algunos de estos misioneros, quienes con su labor pudieron demostrar metodologías novedosas para obtener una inusual inserción de los naturales dentro de estas sociedades nuevas y en proceso de formación. Procuramos así mismo explicar las razones de las reacciones oficiales ante este fenómeno, evaluando finalmente las innovaciones y avances que en tal sentido se esbozaron o produjeron durante la década del cuarenta.
Quando os antigos romanos entram em cena: corpos, vestimentas e masculinidades no cinema
Authors: Garraffoni Renata Senna , Bonadio Maria Claudia
Published: May 2023

Tendo como premissa o campo de estudos de recepção da Antiguidade Clássica, o presente artigo visa examinar a constituição de discursos de poder e masculinidade em três filmes: Spartacus, dirigido por Stanley Kubrick, Gladiator, de Ridley Scott e, Satyricon, de Federico Fellini. A partir de um estudo dos protagonistas dos filmes, da aparência de seus trajes e corpos, dos significados simbólicos de masculinidade e dos embates culturais contemporâneos, discutiremos como os diálogos entre passado e presente não só constroem narrativas hegemônicas de masculinidade como, também, provocam sua desconstrução em âmbito da contracultura dos anos de 1960.
Enhanced recovery after retrograde intra-renal surgery (RIRS) in comparison with mini-percutaneous nephrolithotomy (Mini-PCNL) for renal stone treatment
Authors: Vorobev Vladimir , Beloborodov Vladimir , Hovalyg Temirlan , Seminskiy Igor , Sherbatykh Andrey , Shaderkin Igor , Firsov Mikhail
Published: May 2023

Objectives. The study presents a comparative analysis of the mini-percutaneous nephrolithotripsy (mini-PCNL) and retrograde nephrolithotripsy (RIRS) with a logistic analysis of outcomes and complications. Material and methods. The prospective study included 50 patients diagnosed with urolithiasis from 2018 to 2021 in the urological hospitals in Irkutsk. Patients were divided into two groups: RIRS (group I, n = 23) and Mini-PCNL (group II, n = 27). The comparison groups are statistically homogeneous. Results. Both procedures equally lead to high stone free rates (SFR > 1 mm, 91.3% vs 85.1%; p = 0.867; SFR > 2 mm, 95.6% vs 92.5%; p = 0.936). The intergroup analysis of the total operation time (and lithotripsy) demonstrated similar times (p > 0.05). Postoperative complications of classes II-III (Clavien-Dindo) in the early and late postoperative period developed rarely and were comparable (p > 0.05). Class I complications were predominant in the PCNL group (p = 0.007). Some parameters demonstrated the superiority of RIRS over PCNL: less pronounced pain syndrome (p = 0.002), less drainage time (p < 0.001), no postoperative hematuria (p = 0.002), shorter hospitalization and total treatment period (p < 0.001). Conclusions. The study highlighted the positive effect of the one-day surgery principle on the risk of developing postoperative hematuria, urinary infection, or severe postoperative pain. RIRS and mini-PCNL have similar effectiveness, but RIRS meets the criteria of the enhanced recovery program more than PCNL.
The use of renal biopsy in the kidney tumor management: A retrospective analysis of consecutive cases in a referral center
Authors: Galosi Andrea Bendetto , Macchini Marco , Candelari Roberto , De Stefano Virgilio , Stramucci Silvia , Cammarata Vanessa , Al Ayoubi Omar , Cicconofri Andrea , Giulioni Carlo
Published: May 2023

Introduction: Ultrasound-guided renal masses biopsy (RMB) is a useful and underestimated tool to evaluate suspected renal tumors. This study aimed to assess the safety and feasibility of this technique. Materials and Methods: Data of 80 patients with suspected primary or secondary kidney tumors who underwent RMB between January 2012 and December 2020 were included in this retrospective study. Twelve patients were excluded due to incomplete data. Biopsy outcomes were collected through our electronic medical records system and then compared with definitive pathology. Results: RMB was performed in 68 cases. Pathological examination reported 43 (63%) malignant cases, while RMB was negative in 15 (22%) samples. On the other hand, a benign lesion was present in 8 (12%) cases, and 2 (3%) biopsies were non diagnostic. One major and one minor post-procedure complication were reported among the patients. A total of 31 patients underwent renal surgery including 19 partial and 12 radical nephrectomies. Out of them, 4 patients had a negative biopsy, but radiological imaging strongly suggested malignancy. The concordance between biopsy and definitive pathology occurred in 22 out of 31 (71%) cases, with a higher rate among the masses greater than 4 cm, 9/11 (82%) compared to smaller ones 13/20 (65%). Pathologic examination of the 4 cases with negative biopsy showed 3 renal cell and a translocation renal cell carcinoma. Conclusions: Ultrasound-guided biopsy for renal masses is a safe and effective procedure. Its ability to identify malignancy is evident, especially for primary renal tumors. However, low concordance between biopsy and definitive pathology in cases with negative biopsies, especially for tumors < 4 cm, does not reliably guarantee the absence of tumor and, therefore, strict follow-up or repeat biopsy may be indicated.
Characteristics and decreased VASI of vitiligo patients with NB-UVB phototherapy in Yogyakarta, Indonesia
Authors: Kirtti Pradipta Nabila , Ryoto Viensa , Danarti Retno , Budiyanto Arief
Published: May 2023

Narrowband ultraviolet-B (NB-UVB) phototherapy is the mainstay of vitiligo therapy. The response can be evaluated using the vitiligo area scoring index (VASI) and repigmentation grade. However, few studies used VASI to evaluate phototherapy response and there are no definitive data on the reduction of VASI. This retrospective descriptive study aimed to determine the characteristics and decrease of VASI in patients with vitiligo after 36 and 48 sessions of NB-UVB phototherapy, conducted at Dr. Sardjito General Hospital, Yogyakarta, from December 2021-June 2022. The most common predilection was on the face (71.43%) and acral (61.90%). The most common responses after 36 and 48 phototherapy sessions were minimally improved (decrease in VASI<10%) and improved (reduction in VASI 10-25%). The mean decrease in VASI was 18% and 22% after 36 and 48 phototherapy sessions, respectively. 9.52% and 6.67% of patients experienced a reduction in VASI >50% after 36 and 48 phototherapy sessions, respectively. VASI assessment can be used to evaluate the response to phototherapy in vitiligo. However, VASI cannot show a reduction in vitiligo with slight repigmentation in slow-response patients.
Correlation between FLACC scale score and analgesic requirement in children undergoing Minimally Invasive Surgery
Authors: Turco Assunta , Cerulo Mariapina , Del Conte Fulvia , Coppola Vincenzo , Severino Giovanni , Escolino Maria , Esposito Ciro
Published: May 2023

Postoperative pain presents several challenges in pediatric Minimally Invasive Surgery. The Faces, Legs, Activity, Cry, and Consolability (FLACC) scale is a valid scale for pediatric postoperative pain. The aim of our study was to assess postoperative pain using FLACC scale and to analyze the correlation between FLACC scale score and analgesic requirement in children underwent Minimally Invasive Surgery. We retrospectively analyzed data of 153 children aged 2 months-3 years who underwent Minimally Invasive Surgery in our unit from January 2019 and December 2019. Postoperative pain assessment was established using FLACC scale. In each patient were analyzed the correlation between FLACC score and analgesic requirement. Pain evaluation was assigned immediately after surgery and at 15 and 60 minutes. 36.6% of patients (56 children) were asleep so considered pain free; 21.6% of patients (33 children) had a FLACC score more than 7 so they required analgesics and the pain assessment 15 and 60 minutes after was significantly lower. 41.8% of patients (64 children) had a postoperative FLACC score less than 3, so they didn’t require any analgesic treatment. On the basis of our results, we recommend FLACC scale for postoperative pain assessment in children underwent MIS aged 2 months-3 years. FLACC scale is an effective and precise scale in detection of postoperative analgesic requirement in children and it could be extended in different age groups with further research.
Performance of two multiplex flow cytometric assays for antibody detection in Egyptian patients
Authors: Ahmed Alshymaa A. , El Shahaway Alia A. , Kadry Heba M. , Said Nora M.
Published: May 2023

Background: Autoantibodies are vital biomarkers for the diagnosis, assessment and prognostic determination of various autoimmune disorders.Objective: This study aimed to evaluate the performance of the two AtheNA Multi-Lyte® systems for the detection of various autoantibodies.Methods: A total of 105 systemic lupus erythematosus patients, 35 patients with other autoimmune diseases (diseased controls), and 30 healthy volunteers (healthy controls) at Zagazig University Hospitals, Zagazig city, Al Sharqia governorate were tested for anti-double-stranded DNA (anti-dsDNA) antibodies using indirect immunofluorescence (IIF) and the AtheNA Multi-Lyte® anti-nuclear antibodies-II system between May 2020 and April 2022. Seventy-five patients with clinically suspected autoimmune vasculitis (AIV) and 25 healthy volunteers were also tested for anti-myeloperoxidase and anti-proteinase 3 antibodies using IIF, the AtheNA Multi-Lyte® AIV system, and enzyme-linked immunosorbent assay (ELISA).Results: The AtheNA anti-dsDNA test (98.5%) was more specific than IIF (96.9%) for diagnosing systemic lupus erythematosus, but both tests had the same sensitivity (38.1%). Combining both methods increased sensitivity to 47.6%, while increasing the cut-off of the AtheNA anti-dsDNA test to 134 international units/mL increased specificity to 100%. The AtheNA Multi-Lyte AIV system exhibited substantial agreement with IIF regarding anti-myeloperoxidase testing (κ = 0.65) and almost perfect agreement with ELISA (κ = 0.85). The AtheNA Multi-Lyte® AIV system exhibited perfect agreement with IIF (κ = 1) and substantial agreement with ELISA for anti-proteinase 3 testing (κ = 0.63).Conclusion: AtheNA Multi-Lyte® systems appear to be reliable for anti-dsDNA, anti-myeloperoxidase, and anti-proteinase 3 screening and may be an optimal choice for monitoring anti-dsDNA levels.What this study adds: It is necessary to evaluate various autoantibodies detection assays to increase both sensitivity and specificity of autoimmune diseases diagnostic approaches. AtheNA Multi-Lyte® systems appear to be reliable for anti-dsDNA, anti-myeloperoxidase, and anti-proteinase 3 screening and may be an optimal choice for monitoring anti-dsDNA levels.
Knowledge and Perceived Effects of Psychoactive Substances among Undergraduate Students of Achievers University, Owo, Ondo State, Nigeria
Authors: Olorunfemi Olaolorunpo , Hammed Omonike Robiat , Oyekanmi Mary
Published: May 2023

Background:

The use of drugs and other psychoactive substances by students poses a significant risk to public health that affects multiple aspects of individuals’ lives, including health, social interactions, and the economy. As a result, this research seeks to evaluate the level of understanding and the perceived consequences of psychoactive substances among undergraduate students at Achievers University in Owo, Ondo state.

Materials and Methods:

This descriptive cross-sectional research was conducted between September 2022 and November 2022. A total of 351 students from different departments were selected using a multistage sampling technique. The researchers utilized a self-structured questionnaire that was validated to gather data that aligns with the objectives of the study. The acquired data were then codified and analyzed through descriptive and Chi-square tests set with a significance level of 0.05 using SPSS version 25.

Results:

Out of 351 individuals surveyed, a majority of 88.3% were aware of the existence of illegal drugs. Among them, 22.2% were found to be currently abusing such substances, whereas 20.5% acquired them from friends. Respondents reported abusing various substances, including alcohol (20.5%), tramadol (13.4%), coffee (11.4%), cigarettes (18.2%), stimulants (2.0%), marijuana (2.0%), and tobacco (16.8%). The use of psychoactive substances was found to have negative impacts on individuals, such as low self-esteem (47.9%), despair (27.1%), psychiatric disorders (17.1%), social isolation (17.9%), increased violence (23.4%), and an increased risk of overdose and suicide (11.4%). Furthermore, there was a significant correlation between education level, religion, and knowledge of psychoactive substances (P ˂ 0.05).

Conclusion:

The study findings indicate that the misuse of psychoactive substances is prevalent among the surveyed population, with adverse effects on mental health, heightened risk of engaging in illegal activities, and increased likelihood of overdose and suicide fatalities. As a result, we recommend that the university and other religious organizations undertake a suitable drug education campaign.
Unscheduled Treatment Gaps in Head and Neck Cancer Radiotherapy
Authors: Chakrabarti Deep , Verma Mranalini , Resu Abigail Veravolu , Kukreja Divya , Bhatt Madan Lal Brahma
Published: May 2023

Unscheduled treatment gaps are a recurring problem faced by radiotherapy units worldwide. During the times of a global emergency like the coronavirus pandemic, the problem was further potentiated. This article describes the treatment breaks experienced by our radiotherapy unit during the initial nine months of the pandemic in a tertiary-care academic university hospital. Head and neck cancers are a priority for radiation oncologists and gaps in treatment lead to reduced local control. Sound knowledge of tumor repopulation and timely corrections using the biologically effective dose are essential to mitigate such effects.
Histological study of the effect of quercetin on experimentally induced ulcerative colitis in adult male albino rats
Authors: Elgalil Mohamed Ahmed Asmaa A. , Attia Mona M.A. , Abd-Elaziz Magdy A.E.-E. , Abd Ellatif Rasha A.
Published: May 2023

Background

Ulcerative colitis is a huge health problem, and its occurrence is increasing around the world. It is manifested with abdominal pain, diarrhea, bloody stool, and body weight loss.

Aim

This work aimed to evaluate the possible effects of quercetin on a rat model of ulcerative colitis that was induced by acetic acid.

Materials and methods

A total of 40 adult male albino rats were used in this study. Rats were divided into controls, that is, group I, which included 10 rats that received intrarectal injection of a single dose of 2 ml of physiological saline, and experimental cases, that is, group II. The experimental group contained 30 rats and were divided into three equal subgroups. Subgroup IIA received 50 mg/kg/day of quercetin orally for three consecutive days, subgroup IIB received intrarectal injection of a single dose of 2 ml of 4% acetic acid solution for ulcerative colitis induction, and subgroup IIC received 50 mg/kg/day of quercetin orally for 3 consecutive days before induction of ulcerative colitis by a single dose of acetic acid that was received by intrarectal injection on the fourth day. Colonic specimens were subjected to histological and immunohistochemical examinations. The data were analyzed statistically.

Results

The current study of subgroup IIB showed disturbed normal histological architecture of colonic structure, but in subgroup IIC, quercetin resulted in preservation of normal histological architecture of the colon.

Conclusion

There is a correlation between quercetin and reduction of the severity of acute attacks of ulcerative colitis induced by acetic acid in adult male albino rats. Quercetin leads to protection of colon.
Conventional versus accelerated corneal collagen cross-linking in cases of progressive keratoconus
Authors: Elbatawy Amira L.A. , Sharaf Amr F. , Allam Waleed A. , Selima Adel A.
Published: May 2023

Background

Keratoconus is mainly a noninflammatory, bilateral corneal disease, which changes stability and refractive intensity.

Aim

Studying the visual acuity, refraction, and keratometric data of keratoconic patients who underwent either standard or accelerated cross-linking at 6-month duration.

Patients and methods

A randomized, comparative study with 60 eyes of 30 keratoconus patients. The study participants were categorized into two groups: A and B. Patients in group A underwent epi off conventional corneal crosslinking according to The Dresden’s protocol (3 mW/cm2 for 30 min), while patients in group B underwent epi off accelerated corneal crosslinking (30 mW/cm2 for only 3 min). Preoperative and postoperative outcomes were evaluated and then compared.

Results

The conventional corneal crosslinking group showed more improvement than the accelerated corneal crosslinking group in postoperative uncorrected distant visual acuity and corrected distant visual acuity at 6 months of follow-up. The two groups were similar in terms of spherical equivalent and manifest refraction. No significant change in K1 and K2 in the both groups from preoperative at 6 months. The same results were found for 6 months of f/up of corneal topography as well as central corneal thickness (CCT) and thinnest location of cornea thickness.

Conclusions

The study has increased the proof on the power of conventional corneal crosslinking in comparison with accelerated corneal crosslinking at 6 months of follow up.
Serum growth differentiation factor 15 levels as a marker for liver cirrhosis and hepatocellular carcinoma on top of liver cirrhosis
Authors: Anis Zainab M.A. , Ahmed Amira Y. , Soliman Hanan H. , Nagy Hala M.
Published: May 2023

Background

Cirrhosis is the 14th leading cause of mortality globally. Additionally, it is subclassified by clinical stage. Hepatocellular carcinoma (HCC) was reported to account for ~4.7% of patients with chronic liver disease in Egypt. Early detection and treatment are highly beneficial. Growth differentiation factor 15 (GDF-15) proteins are implicated in the infection, fibrosis, and apoptotic processes of the liver. GDF-15 mRNA is mostly found in the heart, kidney, and lungs, as well as in the liver. The adult liver expresses the greatest amounts of GDF-15 following surgical and pharmacological therapies that produce acute liver damage.

Aim

This study’s objective was to assess serum GDF-15 levels in individuals with cirrhosis of the liver and HCC on top of cirrhosis of the liver.

Patients and methods

We have recruited 90 people in three groups: group 1 comprised 35 patients with HCC, group 2 comprised 35 individuals having cirrhosis of the liver, and group 3 comprised 20 nonhepatic individuals who acted as controls.

Results

In the HCC group, alpha-fetoprotein (AFP) was significantly higher than in the cirrhosis group, and the cirrhosis group has significantly higher AFP than in the control group. In comparison with the cirrhosis group, and in comparison with the control group, the HCC group had a significant increase in GDF-15 level.

Conclusions

GDF-15 levels were substantially greater in individuals with HCC compared with patients with cirrhosis and healthy controls. It is more sensitive, specific, and accurate than AFP. Thus, we may regard GDF-15 as a new marker for the diagnosis of HCC.
Optical coherence tomography angiography of macular area in diabetic patients and healthy subjects
Authors: Ebidw Eman E.F. , El-Emam Sharif Y. , El-Touky Hesham M. , El-Koumy Hamdy A. El-Azim
Published: May 2023

Background

Diabetic retinopathy is a complication of the microvessels related to diabetes that most commonly leads to blindness. Optical coherence tomography angiography (OCTA) is an innovative noninvasive procedure that allows depth-resolved imaging of the microvessels of the retina and choroid.

Aim

The aim of this work was to study OCTA of macular area in diabetic patients having no diabetic macular edema and in healthy persons.

Patients and methods

This cross-sectional, prospective research included 55 participants who were divided into two groups: group I included 30 eyes of 30 cases with type 2 diabetes mellitus [having no diabetic macular edema on fluorescein angiography (FA), clinical assessment, and optical coherence tomography (OCT) macular B-scan], and group II included 25 eyes of 25 healthy persons not having any ocular or systemic diseases. Both groups underwent FA, OCTA, and OCT. Two metrics from OCTA images were quantified: foveal avascular zone area and vessel area density at two levels, that is, superficial capillary plexus and deep capillary plexus. Moreover, diabetic changes such as microaneurysms, capillary nonperfusion, and vessel tortuosity were estimated in the two groups.

Results

Between cases and controls, a statistically significant variance in vessel area density values and foveal avascular zone area was observed in superficial capillary plexus and deep capillary plexus utilizing OCTA. No significant differences were detected between diabetic cases and normal participants regarding central foveal thickness.

Conclusions

OCTA was capable of detecting microvascular alterations in diabetic eyes before visualization through clinical evaluation or FA. OCTA may be able to rapidly and noninvasively test for diabetic maculopathy.
Different modalities for management of peripheral corneal ulcer
Authors: Elshahawy Sarah I.I. , Nasef Mohamed H. , Shaheen Mohamed A.E. , Elshorbagy Mohamed S.
Published: May 2023

Background

The peripheral cornea has unique features, which make it more vulnerable to inflammatory reactions and necrosis. Peripheral corneal ulcer is caused by various infectious and noninfectious ocular and systemic diseases. It may impair vision by inducing astigmatism and ulcer progression to the center or threaten the eyeball integrity by spontaneous perforation. So, early diagnosis and proper treatment prevent blindness.

Aim

To evaluate different modalities for management of peripheral corneal ulcer.

Patients and methods

In this prospective study, 30 eyes of 29 patients having peripheral corneal ulcer were evaluated and treated with medical treatment and surgical intervention as adjunctive therapy in resistant cases. The duration of the study was 6 months with a follow-up period of 3 months.

Results

Of 30 eyes, 14 responded to medical treatment, with complete epithelial healing ranging from 2 to 6 weeks, with a mean of 3.36 ± 1.34 weeks. On the contrary, 16 of 30 eyes were resistant within 2 weeks and underwent surgical interference. A total of seven eyes were managed by amniotic membrane transplantation, and nine eyes were treated with tectonic keratoplasty. Time of healing ranged from 4 to 14 weeks, with a mean of 9.38 ± 3.91. All eyes showed anatomically successful outcomes.

Conclusion

Mild infectious peripheral keratitis heals on medical treatment. Cases of moderate infectious peripheral keratitis with history of diabetes mellitus or exposure keratitis need amniotic membrane transplantation as adjunctive therapy. Severe noninfectious cases with history of rheumatoid arthritis or Mooren’s ulcer need systemic treatment and tectonic keratoplasty.
Assessment of level of care of diabetic patients with nephropathy in predialysis stage 4 in Tanta
Authors: Elmoghany Ahmed A.A. , El-Naggar Mohammed H. , El-Sherbiny Ali , Ibrahim Ingy A.W.
Published: May 2023

Background

Stage 4 chronic kidney disease (CKD) in comparison with earlier stages of CKD is associated with higher morbidity, mortality, and costs, and current guidelines recommend greater intensity of care for patients with stage 4 disease.

Aim

Our study assessed the level of care of patients with diabetic nephropathy (DN) in predialysis stage (CKD stage 4) in Tanta.

Patients and methods

A total of 257 patients experiencing DN stage 4 from Tanta were subjected to a questionnaire sheet that included age; duration of diabetes; time of diagnosis of DN; treatment of hypertension; patient diet; antidiabetic drugs; level of serum creatinine; estimated glomerular filtration rate; hemoglobin level; serum levels of Ca, Ph, parathyroid hormone, Na, K, and HCO3; lipid profile; statin therapy; and hemoglobin A1c. The data collected were compared with Kidney Disease: Improving Global Outcomes clinical practice guideline for the evaluation and management of CKD.

Results

Of the 257 patients, 27.6% were type 1 diabetics and 72.4% were type 2. The mean duration of diabetes was 12.43 years (±6.388). Overall, 29.9% had uncontrolled elevated blood pressure, of whom 27.2% were on no antihypertensive drugs. Renin-angiotensin-aldosterone system blockage agents were used in 52.1% of patients. Overall, 57.2% had good control of diabetes. Dyslipidemia was found in 49.4% patients of them 62.2% patients were on no statin therapy. Hypocalcemia was found in 5.4% patients, hyperphosphatemia was found in 12.4% patients, 4.7% had secondary hyperparathyroidism, 79.8% had bicarbonate level below normal range, 9.7% had mild elevate potassium level, and 20.4% had anemia.

Conclusion

Our patients reached stage 4 early after few years of diabetes, and parameters that need more level of care include hypertension, diabetes, treatment used for diabetes, dyslipidemia, and acidosis.