bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of repeated pronations in patients affected by COVID-19-related acute respiratory distress syndrome: think it twice!
Authors: Sica Andrea , Gobbi Luca , Bellantonio Daniele , Passero Silvia , Viola Lorenzo
Published: April 2023

Prone position is widely used to ameliorate gas exchange in severe COVID-19-related ARDS (CARDS), through its beneficial effects on shunt and dead space. However, the effectiveness of repeated pronation has never been explored in this category of patients. We then retrospectively analyzed the changes of the alveolar-arterial oxygen gradient (A-aO2grad), as shunt index, and the ratio EtCO2/paCO2 ratio, as dead space index, during repeated pronation cycles in 7 patients with CARDS admitted to our Intensive Care Unit. The A-aO2grad decreased significantly more during the first pronation than the second (-43.6% vs -12.2% - p0.008) and, similarly, the improvement was maintained only after the first supination (-26.2% vs +9% - p0.04). The EtCO2/paCO2 ratio showed similar behavior but did not achieve statistical significance. Considering our findings, with the inherent limitations of the study, since pronation entails risks for the patient, as well as requiring a lot of effort from the nursing staff, further caution appears to be necessary in indicating pronation.
Point-of-care test for tuberculosis - a boon in diagnosis
Authors: Tayal Devika , Sethi Prabhpreet , Jain Prerna
Published: April 2023

Rapid diagnosis of tuberculosis (TB) is an effective measure to eradicate this infectious disease worldwide. Traditional methods for screening TB patients do not provide immediate diagnosis and thus delay treatment. There is an urgent need for early detection of TB through point-of-care test (POCT). Several POCTs are widely available at primary health care facilities which assist in TB screening. In addition to currently used POCT, advancement in technology has led to the discovery of newer methods that provide accurate and fast information independent of access to laboratory facilities. In the present article, the authors tried to include and describe the potential point of care test for screening TB in patients. Several molecular diagnostic tests such as NAATs including GeneXpert and TB-LAMP are being currently used as point-of-care tests. Besides these methods, the pathogenic component of Mycobacterium tuberculosis can also be utilized as a biomarker for screening purposes through immunological assays. Similarly, the host immune response to infection has also been utilized as a marker for the diagnosis of TB.  These novel biomarkers might include Mtb85, IP-10, VOCs, Acute phase proteins, etc. Radiological tests have also been observed as point-of-care test in the TB screening POCT panel. Various POCTs are performed in samples other than sputum which further eases the process of screening. These POCTs should not require large-scale manpower and infrastructure. Hence, POCT should be able to identify patients with Mtb infection at the primary health care level only. There are several other advanced techniques that have been proposed as future point-of-care test and have been discussed in the present article.
The Anti-Adhesion Effect of Nisin as a Robust Lantibiotic on the Colorectal Cancer Cells
Authors: Soleimanifar Hesam , Mahmoodzadeh Hosseini Hamideh , Samavarchi Tehrani Sadra , Mirhosseini Seyed Ali
Published: April 2023

Background:

Bacteriocins are a type of antimicrobial peptide that are produced by probiotics. They have been studied as possible therapeutic drugs and have been used to suppress bacterial development in foods. Nisin is a potent bacteriocin having the anti-microbial and anti-cancer characteristics produced by Lactococcus lactis. The aim of the present paper is to evaluate the influence of Nisin on cell adhesion and its two related genes, mmp-2 and mmp-9, in the colorectal cancer cell line.

Materials and Methods:

For this purpose, HT-29 cells were treated with various concentrations of Nisin and the cell cytotoxicity, cell adhesion, and gene expression were evaluated using the MTT assay, cell adhesion assay, and real-time PCR.

Results:

Our findings showed that 32 to 1024 μg/ml of Nisin resulted in a significant reduction in cell viability (P < 0.05). Furthermore, 128 and 256 μg/ml of Nisin significantly reduced the cell adhesion, and mmp-2 and mmp-9 gene expressions (P < 0.05).

Conclusion:

Our findings suggested that Nisin could prevent metastasis and cancer progression.
Development and implementation of a simulation training program for acute respiratory-failure management in the pulmonary intensive care unit
Authors: Abdeldaim Yasmin , Khalil Magdy M. , Wagih Khaled , Galal Iman H. , Salem Hala M. , Elbeialy Marwa
Published: April 2023

Background

Many medical institutes and centers employ simulation in medical education, however, there is still limited experience regarding its use, especially in low–middle-income countries such as Egypt.

Objective

We conducted this work to investigate the effectiveness of simulation-based training (SBT) as an educational tool for teaching pulmonary-medicine postgraduate students the ICU management of acute respiratory failure (ARF).

Patients and methods

Thirty postgraduate students enrolled in the Master of Pulmonary Medicine at Ain Shams School of Medicine without previous experience in SBT were randomly categorized into two groups (1 : 1), namely SBT and lecture-based training in the period between January 2019 and January 2020. Both groups attended lectures on management of ARF in ICU patients; however, the SBT group received additional SBT. We assessed clinical knowledge after the lectures with multiple-choice written exams. The SBT group received the same exams after simulation to assess its impact in addition to a satisfaction survey. The ventilator skills of the SBT team were evaluated after a video presentation of the ventilator chart recorded in a real case using a 12-item checklist before and after simulation training.

Results

Total knowledge scores of all scenarios were almost similar between the two groups at baseline (SBT: 56.6 vs. 55.2, P=0.581). Simulation training significantly improved the total knowledge score of the SBT group, compared with the presimulation score (56.6 vs. 69.4, P≤0.001) and the lecture-based training group (69.4 vs. 55.2, P≤0.001). Compared with baseline, the SBT group’s skill score significantly increased after simulation (46.9 vs. 65.6, P≤0.001). The improvement in knowledge and skills scores was independent of baseline-knowledge score, age, and years of experience, except for the acute-asthma scenario. All SBT participants were either very satisfied (86.7%) or satisfied (13.3%). It should be noted that satisfaction with this type of training was not correlated with the sociodemographic characteristics of the participants. Most of the candidates (80.7%) believe that such training has successfully improved their communication skills.

Conclusion

The current study indicates a positive impact of a simulation-based program regarding team training on ARF in an ICU.
The ability of different biological therapies to reduce the use of systemic steroids and the rate of asthma exacerbations in severe asthma
Authors: Eldaabossi Safwat , Awad Amgad
Published: April 2023

Objective

Biological therapies are used to treat patients with severe asthma (SA) with type 2 inflammation. These biologics have been shown to reduce oral corticosteroids and asthma exacerbations and improve patients’ quality of life. This study will examine the extent to which biological therapies can reduce the frequency of asthma exacerbations and the use of systemic corticosteroids in a cohort of patients with SA.

Participants and methods

The frequency of exacerbations, use of systemic corticosteroids before and after biological therapy [anti-interleukin (IL)5, anti-IL-4, and anti-immunoglobulin E therapies], and symptom control were studied in 47 adult patients with SA whose asthma was uncontrolled on high-dose inhaled corticosteroids/long-acting beta-2 agonists plus another control group. These patients received biologics therapy, mepolizumab, dupilumab, or omalizumab, for at least 4 months.

Results

Of 47 patients, 28 were treated with anti-IL-5 (mepolizumab), 11 were treated with anti-IL-4 (dupilumab), and eight were treated with anti-immunoglobulin E (omalizumab). No significant differences in age, sex, BMI, concomitant diseases, oral steroids, duration of biological treatment, and prognosis were observed among patients receiving the three (before the biologics). However, exacerbations/year were significantly higher in patients receiving dupilumab. Before biological therapy, 28 patients had mixed asthma phenotypes and received systemic corticosteroid therapy. Five patients received daily OCSs (5 mg daily), and 23 patients received courses of OCSs before biological therapy. After biological therapy, almost all patients were discontinued from systemic steroid treatment, except one patient. The rate of exacerbations was 68.1% (32/47) and decreased to 10.6% (5/47) after biological therapy. In addition, patients treated with biologics showed a decrease in symptoms, an increase in forced expiratory volume in the first second (FEV1%), and a decrease in peripheral eosinophils.

Conclusions

In this study, biological therapy reduced asthma exacerbations, the dosage of glucocorticoids used, and SA symptoms.
Red blood cell distribution width
Authors: Algharbawy Manal M.R. , El-Gamal Mohamed M. , Mansour Mostafa M. , Elshaer Mohammed Y.S.
Published: April 2023

Importance

Coronavirus disease 2019 (COVID-19) is the main global health problem nowadays. It is the primary cause of many deaths all over the world, as well as associated with many morbidities and consumption of medical resources.

Objective

To assess the relation between red blood cell distribution width (RDW) level in the blood of COVID-19-infected patients on one side and various criteria of disease severity and mortality risk on the other side, to help answer the question, ‘can we use RDW as a predictor of COVID-19 disease severity?’

Patients and methods

This study included 184 adult patients (98 males and 86 females) with positive nasopharyngeal swab for acute respiratory syndrome coronavirus 2 infection diagnosed at Mansoura University Hospitals. Patients underwent clinical, laboratory, and radiological evaluation of COVID-19 cases with close follow-up till complete cure or death. Cases were divided according to the disease severity into four groups (six mild cases, 45 moderate cases, 48 severe cases, and 85 critical cases). We compared RDW level at the time of hospitalization in the four groups.

Results

A highly significant difference (P≤0.001) was found between mean RDW in mild and moderate groups compared with severe and critical groups. Moreover, there was a positive linear correlation between RDW level and disease severity (P≤0.001). RDW level more than 13.65 could predict severe disease with 79.2% sensitivity and 66.7% specificity. RDW level more than 13.85 could predict critical disease with 78.8% sensitivity and 66.7% specificity. Mean RDW was significantly lower in cured cases compared with those died owing to COVID-19 complications (P=0.004). RDW level more than 13.95 could predict increased mortality risk, with 73.5% sensitivity and 52.5% specificity.

Conclusion

Higher RDW levels in COVID-19-infected patients, upon hospital admission, were associated with increased disease severity and mortality risk.
Diagnostic value of pleural fluid lactate dehydrogenase/adenosine deaminase ratio in differentiating parapneumonic effusion from tuberculous pleurisy
Authors: Anar Ceyda , Yavuz Melike Yüksel , Alıcı İbrahim O. , Güldaval Filiz , Büyüksirin Melih
Published: April 2023

Objective

The purpose of this study was to determine the diagnostic value of pleural fluid lactate dehydrogenase (LDH)/pleural fluid adenosine deaminase (ADA) ratio in differentiating pleural effusions owing to tuberculous pleurisy (TBP) and parapneumonic effusion (PPE).

Patients and methods

The data of 272 patients (140 patients with TBP and 132 patients with PPE) between January 2012 and October 2018 were analyzed retrospectively. Demographic data of all patients; concurrent serum glucose, albumin, protein, and LDH values; and pleural fluid pH, glucose, albumin, protein, and ADA results have been reviewed.

Results

Pleural fluid ADA values were statistically significantly higher in the TBP group than PPE (P<0.001). The median values of pleural fluid LDH/ADA ratio between TBP and PPE groups were 16.10 (12.53) and 32.90 (34.45), respectively, which was found to be significantly lower in TBP group (P<0.001). Pleural fluid LDH/ADA ratio’s sensitivity, specificity, positive predictive value, and negative predictive value were 90, 59.85, 70.4, and 84.9%, respectively, in the diagnosis of TBP for values less than 28 (P<0.001).

Conclusion

The ratio of pleural fluid LDH/ADA determined from routine biochemical analysis predicts TBP at value of 28. Measurement of this parameter may help clinicians distinguish between TBP and PPE.
Role of pulmonary ultrasound in evaluation of respiratory manifestations of heart failure with preserved ejection fraction
Authors: Awad Taha A. , Ibrahim Abdelmonem E.M. , Elrifai Atef W. , Hesham Khalid , Rihan Muhammad S.
Published: April 2023

Background

Pulmonary congestion quantification is essential for follow-up of heart failure (HF). Most available tools are inaccurate or invasive. Hence, ultrasonographic B-line modes have been suggested as an alternative easy noninvasive diagnostic instrument for pulmonary congestion evaluation in patients with HF.

Aim

The aim was to assess the lung ultrasound role in evaluating HF in patients with preserved ejection fraction (EF).

Patients and methods

A total of 150 participants admitted to the cardiovascular department or followed in the outpatient clinic between July 2016 and May 2017 were included in this study. The participants were divided into five groups (each 30 patients): patients with HF having preserved EF (HFpEF) without comorbidities, patients with HFpEF with comorbidities, HF patients with midrange EF (HFmrEF) without comorbidities, patients with HFmrEF with comorbidities, and nondiabetic nonhypertensive individuals. All groups were subjected to New York Heart Association grading for cardiac diseases, echocardiography, and serum brain natriuretic peptide assessment.

Results

B-lines significantly increased with increased New York Heart Association class. A negative correlation was found between B-lines and the EF% (r=−0.46). The brain natriuretic peptide and B-lines showed a significant, powerful association in the first group (r=0.81), the second group (r=0.80), the third group (r=0.85), and the fourth group (r=0.098), but there was an inverse insignificant correlation in the control.

Conclusion

B-line assessment by lung ultrasound is considered a simple tool for the evaluation of pulmonary congestion resulting from diastolic HF (HFPEF). It can be used as a fast and reliable tool.
Comparison of sleep quality before and after chemotherapy in locally advanced non-small-cell lung cancer patients
Authors: Nidhal Belloumi , Sonia Maalej , Imene Bachouche , Fatma Chermiti , Soraya Fenniche
Published: April 2023

Background

Outcome of sleep disturbances in lung cancer patients before and after treatment is not much reported. Their intensity and their correlation to quality of life or to humor disturbances were not widely studied. The aim of this study was to report precisely sleep disturbances in advanced stage lung cancer patients, their outcome after chemotherapy and/or radiotherapy, and their correlation to anxiodepressive humor.

Patients and methods

It was a prospective study including 64 patients with stage 3 or 4 non-small-cell lung cancer. Patients answered the Tunisian dialectal version of the following questionnaires: Pittsburgh sleep quality index and hospital anxiety depression scale in order to evaluate, respectively, the sleep quality and anxiodepressive troubles. The questionnaires took place before chemotherapy and then were repeated after chemotherapy was over.

Results

The mean age was 62.9 years. All patients were active smokers. Before chemotherapy, there were 10 (15%) patients with poor sleep quality. Most frequent complaints were daily sleepiness (70%) and nocturnal arousals (100%). Sixteen (25%) patients had depressive humor. Depression was statistically more frequent among patients with poor sleep quality (80 vs 15%, P<0.001). After chemotherapy, the mean Pittsburgh sleep quality index score increased from 2.9 to 5.4 and 45% of all patients had poor sleep quality. Most frequent complaints were extension of sleep latency (69%), daily sleepiness (98%), and nocturnal arousals (100%). After chemotherapy, depressive humor was reported in 34.3% of all patients, with higher prevalence among patients with poor sleep quality (58 vs 14%, P<0.001). Anxious humor was reported in 17% of all patients. A higher prevalence was correlated with poor sleep quality (31 vs 6%, P<0.001). The predicting factors of sleep disturbance according to statistical univariate analysis were delayed diagnosis confirmation (P=0.05), delayed start of treatment (P<0.001), and anxious (P=0.001) or depressive humor (P=0.001). Multivariate analysis confirmed the correlation of sleep disturbance to delayed diagnosis confirmation and treatment onset.

Conclusion

This study insisted on the persistence and potential intensity worsening of sleep disturbances in advanced stage non-small-cell lung cancer patients. The authors, hereby, reported a statistical correlation between sleep quality and humor quality in patients.
Chest ultrasound findings in pulmonary tuberculosis
Authors: Abdel-Atty Hesham , EL-Habashy Mahmoud M. , EL-Esdoudy Ahmed , Abd El-Maged Ahmed Manar S.
Published: April 2023

Objective

The current observational study aims to identify the role of ultrasound (US) in detecting pleuropulmonary lesions in active pulmonary tuberculosis (TB) patients.

Background

Owing to the fact that US is the predominant criterion in determining major disorders, it provides quantitative data from which pleural effusions can be calculated, along with reporting lung consolidation. This process is found to be useful to increase the end-expiratory pressure.

Patients and methods

This research involved 30 patients with active pulmonary TB (sputum positive for acid-fast bacilli) by direct smear microscopy, clinical manifestation, and radiological abnormalities who were admitted to the Chest Department, Faculty of Medicine, Menoufia University Hospitals, from April 2018 to March 2019. Full assessment of history, and routine, physical, and bacteriologic examination and radiological examination were performed.

Results

Outcomes showed a statistically significant difference between the males and females in occupation, sputum, smoking, and dyspnea (P<0.001). Most importantly, 15 out of 30 patients (half of them) showed a massive effusion with clear fluid. The second most noteworthy finding was the presence of a minimal effusion in 5/30 patients. In terms of radiograph results, however, half the patients revealed massive effusion and almost the same number of patients (16/30) had comorbidities; five of them suffered from hypertension and diabetes. Nevertheless, there were no statistically significant differences between the males and females with respect to US findings (P=0.179) and radiograph findings (0.202).

Conclusion

TB appears to be highly prevalent among male patients than the female ones. However, the increased incidence of TB among males has been proven to be independent of other risk factors of TB. It can be concluded that US is an efficient and suitable method for the evaluation of different pleural diseases in TB patients. US is mostly sensitive and specific in diagnosing pleural effusions.
Role of antibiotics in coronavirus 2019
Authors: Elassal Gehan , Othman Noha
Published: April 2023

During the current COVID-19 pandemic, there are potential threats that could affect antimicrobial stewardship activities and drive antimicrobial resistance. For instance, many individuals presenting with mild disease without pneumonia or moderate disease with pneumonia receive antibiotics. Zhou et al. [5] showed that in the current coronavirus disease 2019 (COVID-19) pandemic, 50% of patients with COVID-19 who have died had secondary bacterial infections. Rapid characterization of coinfection is essential. It will save lives. Notably, among COVID-19 ICU cases in Zhongnan Hospital, there was a high reported frequency of secondary infections with carbapenem-resistant Acinetobacter baumannii, particularly among ICU deaths. The standard empiric antibacterial treatment should be initially prescribed for adults with clinical and radiographic evidence of CAP who test positive in the inpatient and outpatient settings. If hydroxychloroquine is being used for COVID-19 treatment, avoid antibiotics that also prolong QTc interval (e.g. levofloxacin, azithromycin).
COVID-19 in asthma and chronic obstructive pulmonary disease
Authors: Mohamed Ahmed SH.
Published: April 2023

Since December 2019, the coronavirus disease 2019 (COVID-19) Caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), outbroke in Wuhan, China, and rapidly spread to all over the World.1-3 COVID-19 is an acute respiratory disease that can lead to respiratory failure and death. About 20%-51% of COVID-19 patients reported as having at least one comorbidity. The most prevalent comorbidity was hypertension (10%–30%), followed by diabetes (10%–20%) and coronary heart disease (7%–15%), which associated with poorer clinical outcomesIt is anticipated that chronic respiratory diseases including chronic obstructive pulmonary disease (COPD) and asthma may predispose patients to SARS-CoV-2 infection. However, the reported incidences of both diseases in patients with COVID-19 were frequently lower than the prevalence of these conditions in general population.
A summary of the differences between pediatric and adult COVID-19
Authors: El Attar Mona M.
Published: April 2023

Children of all ages can get COVID-19. However, through examinations, studies have found that COVID-19 presents itself differently in children than in adults; it appears to be milder in children, but there is a higher chance of severe disease in high-risk children. The pediatric multi-system inflammatory syndrome (MIS-C) is a severe complication of COVID-19 in children with different case definitions. Breast eeding is an important issue concerning mothers infected with COVID-19 as there is a debate about whether rooming in or separation is the preferrable method for the child’s wellbeing.
Comparative study between double-row suture and modified Mason-Allen suture bridge in rotator cuff repair: a prospective clinical study
Authors: Eldeeb Sherif M , Bayomy Elsayed M
Published: April 2023

Background

Rotator cuff lesions are one of the causes of shoulder pain. Surgical treatment has been increasingly indicated.

Purpose

The aim of this work is to compare the clinical outcome and tendon healing after arthroscopic rotator cuff repair either by modified Mason-Allen suture bridge technique or double-row suture stitch technique.

Patients and methods

During the period between August 2021 and July 2022, a prospective clinical study was conducted involving 20 patients with symptomatic rotator cuff tear, who underwent arthroscopic repair. These patients were managed by the modified Mason-Allen suture bridge technique and double-row suture. This study conducted in the Benha University Hospitals, Nasr City Insurance Hospital and the military production hospital.

Results

The current study revealed no statistically significant difference between groups according to demographic factors such as age, sex and side, with P value more than 0.05. There was statistically significant higher change in group A: modified Mason-Allen suture bridge compared with group B: double-row according to constant score, with P value less than 0.05 (significant).

Conclusion

This study proved that there is statistically significant difference between the modified Mason-Allen suture bridge technique versus double row in functional outcome and integrity of rotator cuff tendon healing with relative advantage to the modified Mason-Allen suture bridge technique.
Treatment of intra-articular phalangeal fractures of the hand by Suzuki frame external fixator
Authors: Bayoumy Elsayed M , Eltramcy Mohamed S
Published: April 2023

Purpose

This study aims to evaluate the functional, clinical, and radiological outcome of treatment of fractures of proximal interphalangeal joints of the hand by the Suzuki frame external fixator technique.

Patients and methods

A prospective study was held in Benha University Hospital that included 20 patients with intra-articular proximal interphalangeal joint (PIPJ) fractures treated with the Suzuki frame external fixator technique. All of the patients were followed up for a minimum period of 12 weeks, and the maximum period of follow-up was 36 weeks. Postoperatively, plain radiographs were used for assessing fracture reduction, congruity, and healing. The visual analog score and the Michigan Hand Outcome Questionnaire were used for functional evaluation. PIPJ range of motion and hand grip strength were also assessed.

Results

The mean age of the studied patients was 33.85 ± 8.65 years, and there was a male predominance (75%). The left hand was affected in 12 (60%) patients. The nondominant hand was involved in 13 (65%) patients. The mechanisms of injury were crushing by hard object (45%), followed by falling on the ground (35%), and sports injury (20%). The mean time from injury was 2.05 ± 1.88 days. The mean time of surgery was 17.55 ± 3.1 min. The mean time of the bony union was 11.8 ± 2.9 weeks. The mean time of the frame removal was 4.7 ± 0.57 weeks. At the final follow-up, all patients had no residual pain. The average PIPJ-range of motion was 86.25 ± 9.6°, and the average grip strength was 89.9 ± 8.19% as compared with the healthy side. The mean normalized Michigan Hand Outcome Questionnaire score was 86.1 ± 11.26 points, with seven, 10, and three patients having excellent, good, and fair results, respectively. Complications included pin-tract infection (three cases), stiffness (one case), aseptic loosening and osteolysis at head of proximal phalanx (one case), and flexion contractures (one case).

Conclusion

The pins and rubber traction frame technique is simple, reliable, available, reproducible, time saving, and cost-effective for managing complex PIPJ fractures while allowing early joint mobilization, which is proven to be effective in achieving high satisfactory functional results.
Submuscular bridge plating in the treatment of length unstable femur fracture in adolescents
Authors: Attia Ahmed E , Zayed Emad , El Ghait Hussein A
Published: April 2023

Background

The most common fractures in teenagers that need hospitalization are femoral shaft fractures.

Aim

This study aims to evaluate the role of the submuscular bridging plate in the treatment of length unstable femur fracture as a safe and alternative option in cases where use of intramedullary nails and open reduction methods is debatable regarding healing and functional outcomes.

Patients and methods

Submuscular bridge plate for femur fracture was performed on 20 patients having length unstable femoral shaft fractures through a minimally invasive technique.

Results

There was a significant positive link between age and healing time, but no such relationship existed between healing time and patient sex, level, type of fracture, or injury mechanism. The patients’ average age was 11 years (10–19 years). Overall, 12 patients were males and eight were females. There was no infection except for three cases of superficial infection. There was no significant swelling except in four cases; all patients restored full range of motion except four patients had limited knee flexion for a short period. No patient had a deformity greater than 10° in the frontal or sagittal planes, or a limb-length disparity greater than 1 cm. There has been no clinically obvious malrotation, late union, or nonunion.

Conclusion

Submuscular plating is a dependable method with excellent healing capacity and fixing mechanics. Submuscular plating is a surgical technique with a learning curve. It offers clear benefits over other operative procedures and is linked to minimization of complications.
Academic burnout among undergraduate nursing students: A quantitative survey approach
Authors: Prakash Pushpa , Sheilini Melita , Nayak Shalini G.
Published: April 2023

BACKGROUND:

Exposure of nursing students to constant work pressure, stress, and emotional turmoil during both clinical and theoretical sessions of nursing training often leads to academic burnout among them. The aim of the study was to determine the presence of academic burnout among undergraduate nursing students and the association of academic burnout with age, gender, year of nursing program, residence location, and relaxation technique practice.

MATERIALS AND METHODS:

A descriptive survey design was used, and data were collected from 266 undergraduate nursing students from Udupi Taluka, South India. Baseline information was collected through a demographic proforma, and Oldenburg Burnout Inventory for Students was used for assessing academic burnout. A stratified proportionate sampling technique was used to select the study sample. The data were collected from April 2021 to May 2021. Descriptive and inferential statistics were used for the analysis by using Statistical Package for the Social Sciences (SPSS) version 16.

RESULTS:

The study revealed that most of the participants had high levels of academic burnout (163, 61.7%), emotional exhaustion (165, 62%), and disengagement (173, 65%). Moreover, academic burnout was significantly associated with age (χ2 = 8.669, P = 0.012) and relaxation technique practice (χ2 = 9.263, P = 0.002). Additionally, disengagement was significantly associated with gender (χ2 = 9.956, P = 0.002), residence location (χ2 = 7.032, P = 0.027), and relaxation technique practice (χ2 = 8.729, P = 0.003).

CONCLUSIONS:

Based on the findings of the study, we recommend that the faculty and administrators of nursing institutes must incorporate strategies for the prevention or reduction of academic burnout in the nursing curriculum.
Evaluation of strategies against vaccine hesitancy in the COVID-19 and Indian context—A systematic review
Authors: Suhail Mohammed K. , Moinuddin Arsalan
Published: April 2023

The world has been severely affected by the COVID-19 pandemic in terms of loss of lives, health, and its socioeconomic consequences; however, the true magnitude and extent of the damage from COVID-19 is still elusive till date. With the advent of many efficacious vaccines, one of the most effective ways to get to grips with the pandemic is mass vaccination. However, due to vaccine hesitancy (VH), it remains a colossal challenge globally thereby causing serious threat to the pandemic response efforts. This review intends to identify evaluated interventions and evidence to support recommendation of specific strategies to address VH from an Indian context. A systematic review was conducted to synthesize relevant literature around the evaluation of strategies to tackle VH for effectiveness or impact in India. Electronic databases were searched using specific keywords and predefined inclusion–exclusion criteria. A total of 133 articles were screened, 15 were assessed for eligibility, and two were included in the final review. There is a paucity of research on evaluation of vaccine hesitancy interventions in India. Evidence is not strong enough to recommend one specific strategy or intervention. Together, a permutation of multicomponent and tailored interventions has been found most effective in repressingVH in India.
Therapeutic and medicinal effects of snowdrop (Galanthus spp.) in Alzheimer's disease: A review
Authors: Babashpour-Asl Marzieh , kaboudi Parvin Sajadi , Barez Shekufe Rezghi
Published: April 2023

Genus Galanthus (Amaryllidaceae) is an early spring flowering bulbous plant. Galanthus species contain alkaloids that have shown pharmacological activity. Galanthamine is an alkaloid that was extracted from Galanthus and other Amaryllidaceae. Owing to its acetylcholinesterase (AChE) inhibitory activity, galanthamine is used and marketed to treat Alzheimer's disease (AD). The aim of the present study, while introducing the botanical and pharmacological characteristics and various aspects of the medicinal plant Galanthus, is to emphasize the effect of this plant in the treatment of AD. In this web-based study in 2021, articles indexed in scientific databases in English language, including ISI Web of Knowledge, PubMed, Scopus, MedLib, Medknow, SID, ISC, and also articles and e-books published in Springer, Elsevier, John Wiley and Sons, and Taylor and Francis were evaluated from 1990 to 2021, using the following keywords: “Galanthus” “galanthamine,” “Alzheimer's disease.” Amaryllidaceae-type alkaloids possess an anticholinesterase activity. The most studied Galanthus alkaloid, galanthamine, is a long-acting, selective, reversible, competitive inhibitor of AChE and an allosteric modulator of the neuronal nicotinic receptor for acetylcholine (ACh). Owing to its AChE inhibitory activity, galanthamine is used to treat certain stages of AD. Galantamine can act as a parasympathomimetic agent, especially as a reversible cholinesterase inhibitor. Galantamine is not structurally associated with other AChE inhibitors. Hence, its proposed mechanism of action involves the reversible inhibition of AChE, preventing hydrolysis of ACh that results in an increased concentration of ACh at cholinergic synapses.
Comparison of the clinical efficacy of surgical versus medical method for first trimester pregnancy termination in Iran: A quasi-experimental research
Authors: Barghazan Saeed Husseini , Hadian Mohamad , Rezapour Aziz , Nassiri Setare
Published: April 2023

BACKGROUND:

The surgical and medical options for management of pregnancy termination procedures are acceptable in practice but differ in clinical efficacy, costs, and patient experiences, and deciding what the best method is not clear always. This study aimed to compare clinical efficacy, outcomes, and patient acceptance of dilatation and curettage (D and C) versus medical abortion using misoprostol for first trimester of gestation in Iranian context.

MATERIALS AND METHODS:

A prospective, multicenter, quasi-experimental research conducted from July 2021 to January 2022. The primary outcomes were the rate of composite complications or complete abortion. Data were analyzed with SPSS 18 using descriptive statistics, independent t-test, analysis of variance and non-parametric tests. Secondary outcomes were quality of life using EQ5D questionnaire, estimated blood loss, pelvic infection, pain level, hospital stay, and acceptability of intervention and relative risk as the effect size.

RESULTS:

Finally, 168 patients were included in this study. The composite complication rate among medical abortion patients is significantly more than that of surgical abortion patients (39.3% vs. 4.76%). The relative risk calculated 8.25 (3.05–22.26 CI). Medical abortion patients have experienced higher levels of ongoing bleeding, pain, and symptoms of pelvic infection. The higher level of acceptance has been reported by surgical group patients in comparison to the medical group patients (85.7% vs. 59.5%). Quality of life scores for surgical and medical group estimated 0.6605 and 0.5419, respectively.

CONCLUSION:

Surgical method of abortion using D and C is a very safe and highly successful option in comparison to the medical method using misoprostol alone and is associated with better clinical outcomes, acceptance, and quality of life in first trimester of pregnancy among Iranian women.
Design, implementation, and validation of an application for childbirth preparation classes to improve the performance of midwifery students: Study protocol
Authors: Kiani Zahra , Moghasemi Mobina , Elyasi Forouzan , Shirvani Marjan Ahmadi , Hamzehgardeshi Zeinab , Tayebi Tahereh , Tabari Narges Sadat Motahari , Azarfar Hamidreza , Moosazadeh Mahmood , Khani Soghra
Published: April 2023

BACKGROUND:

Childbirth preparation classes are incredibly useful for midwifery students as future medical personnel. Nowadays, given the outbreak of Covid-19 pandemic and as mobile applications are extensively welcomed, virtual space can be used for education in the area of childbirth preparation classes. Given the lack of an application for childbirth preparation classes, this study will be conducted to design, implement and validate such an application to improve the performance of midwifery students in the areas of pregnancy and safe delivery.

MATERIALS AND METHODS:

The present study will be conducted in three phases. In the first phase, content will be provided to Information Technology experts based on the content of the national guidelines for physiological delivery in Iran, and the application will be designed and validated for the use of midwifery students, then develop app for other medical students, midwives and physicians. In the second phase, the assessment will be based on Kirkpatrick's model. In the third stage, develop app for other medical students, midwives and physicians based on the results of the first and second phase. SPSS version 17 will be used in this phase for analysis of data through descriptive and analytical tests.

CONCLUSION:

Owing to the expansion of virtual space and the outbreak of Covid-19 pandemic, design, validation, and evaluation of an application for childbirth preparation classes is an exceptionally significant necessity which contributes to the process of educating midwifery students.
Child-to-child approach in disseminating the importance of health among children –A modified systematic review
Authors: Johnsunderraj Sheeba E. , Francis Frincy , Prabhakaran Harshita
Published: April 2023

Health is a paramount issue in every society. Children's lives are more dominated by two main environments, which are the home and the school. Children's health is most affected when they encounter disease-laden environments; hence, schools have high influence in their health. Schools also serve as health promoting agencies and have a strong bidirectional relationship between a child's holistic wellbeing and education. Children are the best teachers who have the charisma to be influential change agents in reciprocating what is taught to them as healthy behavior. This paper is focused on the child-to-child approach in disseminating the importance of health among school-age children and the importance of molding them into change agents. The objective is to systematically review all literature works answering the question “Is Child-to-Child approach effective in disseminating health information's among school children?”. Using critical appraisal skills program (CASP) framework and a data extraction form, articles were retrieved from different databases, including Scopus, CINAHL, PubMed, ProQuest, and EBSCOHost. These articles were published between 2003 and 2020. After critically appraising 85 articles based on the inclusion criteria, only 16 were found appropriate for addressing the purpose of this review. Major results of the review were that each of the studies had tested the effectiveness of the child to child approach using different health education topics such as prevention of worm infestation, eating behaviors, first aid measures, hand hygiene practices, importance of Vitamin A, and eye care. Studies reported that this approach empowered children with better health related knowledge and practice. This paper concludes that child-to-child approach plays an important role in disseminating health to children either as siblings, peer groups, and to parents.
Prosthetic Rehabilitation of Post-COVID Mucormycosis
Authors: Shalimon Ayana , Ravichandran R. , Kumar K. Harsha , Aneesh S.
Published: April 2023

Mucormycosis is one of the most rapidly fulminating fatal mycotic infections in human beings leading to necrosis and destruction of the involved structures. Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2, has been associated with a wide range of opportunistic bacterial and fungal infections. Increasing case of mucormycosis has been seen in patients affected by COVID-19. This article includes a case report on diagnosis, pharmacological, surgical management, and prosthetic rehabilitation of post-COVID mucormycosis.
Computing fusion products of MV cycles using the Mirković–Vybornov isomorphism
Authors: Bai Roger , Dranowski Anne , Kamnitzer Joel
Published: April 2023

The fusion of two Mirković–Vilonen cycles is a degeneration of their product, defined using the Beilinson–Drinfeld Grassmannian. In this paper, we put in place a conceptually elementary approach to computing this product in type

A

. We do so by transferring the problem to a fusion of generalized orbital varieties using the Mirković–Vybornov isomorphism. As an application, we explicitly compute all cluster exchange relations in the coordinate ring of the upper-triangular subgroup of

\mathbf{GL}_4

, confirming that all the cluster variables are contained in the Mirković–Vilonen basis.
Квазилинейная параболическая задача Вентцеля с разрывными старшими коэффициентами
Authors: Apushkinskaya Darya Evgen'evna , Nazarov Alexander Il'ich , Palagachev Dian K , Softova L G
Published: April 2023

Получены новые результаты о сильной разрешимости в пространствах Соболева квазилинейной задачи Вентцеля для параболических уравнений с разрывными старшими коэффициентами.
Центр Бернштейна в натуральной характеристике
Authors: Ardakov Konstantin , Schneider Peter
Published: April 2023

Пусть $G$ - локально проконечная группа и $k$ - поле положительной характеристики $p$. Пусть $Z(G)$ - центр группы $G$, а $\mathfrak Z(G)$ - ее центр Бернштейна, т.е. $k$-алгебра естественных эндоморфизмов тождественного функтора на категории гладких $k$-линейных представлений группы $G$. В работе показано, что если $G$ содержит открытую про-$p$-подгруппу, но не содержит собственных открытых централизаторов, то существует естественный изоморфизм $k$-алгебр $\mathfrak Z(Z(G)) \xrightarrow {\cong } \mathfrak Z(G)$. Кроме того, центр Бернштейна $\mathfrak Z(Z(G))$ описан явно как некоторое пополнение абстрактного группового кольца $k[Z(G)]$. Оба условия на $G$ выполнены, если $G$ является группой точек произвольной связной гладкой алгебраической группы, определенной над локальным полем с полем вычетов характеристики $p$. В частности, показано, что если алгебраическая группа полупроста, то $\mathfrak Z(G) = k[Z(G)]$.
Проалгебраическая фундаментальная группа для топологических пространств
Authors: Deninger Christopher
Published: April 2023

Пусть $X$ - связное топологическое пространство с точкой $x\in X$, и пусть $K$ - поле с дискретной топологией. Изучаются категория Таннаки конечномерных (плоских) векторных расслоений на $X$ и ее двойственная по Таннаке групповая схема $\pi (X,x)$ относительно функтора слоя в точке $x$. Максимальная проэтальная групповая фактор-схема групповой схемы $\pi (X,x)$ является этальной фундаментальной группой пространства $X$, которая изучалась Кухарчиком и Шольце. Для хороших топологических пространств групповая схема $\pi (X,x)$ является проалгебраическим пополнением обычной фундаментальной группы. Получены некоторые структурные результаты о групповой схеме $\pi (X,x)$ для очень общих топологических пространств при помощи изучения (псевдо)торсоров, связанных с ее фактор-группами. Этот подход использует идеи Нори из алгебраической геометрии и результат Делиня о категориях Таннаки. Также вычисляется групповая схема $\pi (X,x)$ для некоторых обобщенных соленоидов.
Пример многообразия модулей $D$-точных лагранжевых подмногообразий: сферы в многообразии флагов в $\mathbb C^3$
Authors: Tyurin Nikolai Andreevich
Published: April 2023

В предыдущих работах автора была предложена конструкция многообразия модулей $D$-точных лагранжевых подмногообразий в алгебраических многообразиях относительно очень обильного дивизора. Точками таких многообразий являются классы гамильтоновой эквивалентности лагранжевых подмногообразий дополнений $X\setminus D$, где $D$ - дивизор из полной линейной системы; по самому своему определению многообразие модулей оказывается накрытием открытого подмножества в проективном пространстве $|D|$. Было показано, что такие многообразия являются гладкими и кэлеровыми, а также был предложен способ выделения стабильных компонент таких многообразий модулей, главное предполагаемое свойство которых - алгебраичность. В настоящей работе найдена стабильная компонента многообразия модулей лагранжевых сфер в многообразии флагов с обильным дивизором, равным половине антиканонического класса, и показано, что эта компонента является алгебраическим многообразием.
Автоколебательные процессы в дискретной $RCL$-линии с туннельным диодом
Authors: Glyzin Sergey Dmitrievich , Kolesov Andrei Yurevich
Published: April 2023

Рассматривается цепочка последовательно связанных $RCL$-контуров, к одному из концов которой подсоединен источник постоянного напряжения $E$, а к другому - туннельный диод и постоянная емкость $C_0$. Показано, что математической моделью данного генератора служит некоторая нелинейная система обыкновенных дифференциальных уравнений, в которой, в свою очередь, реализуется известное явление буферности. А именно, с помощью сочетания аналитических и численных методов устанавливается неограниченный рост числа сосуществующих аттракторов этой системы при увеличении количества $RCL$-контуров и при надлежащем изменении остальных параметров. Проводится также сравнительный анализ локальной динамики в дискретной и непрерывной $RCL$-линиях.
Функция напряжений Эри для двумерной неупорядоченной упаковки
Authors: Grinev Dmitry Vasil'evich
Published: April 2023

Упаковка абсолютно твердых частиц, находящихся в контакте друг с другом в состоянии механического равновесия, предлагает статически разрешимую задачу. Использование метода вероятностного функционала позволяет провести аналитический вывод полной системы уравнений для компонент тензора напряжений системы. Для случая двумерной изотропной и однородной упаковки получены уравнения Эйлера-Коши и Навье, последнее из которых позволяет выразить тензор напряжений системы через функцию напряжений Эри.