bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic Difficulty Adjustment (DDA) on a Serious Game Used for Hand Rehabilitation
Authors: Vargas-Bustos Juan Ignacio , Rechy-Ramirez Ericka Janet
Published: August 2023

Serious games have been used for assisting people in physical rehabilitation for hands. People might have different degrees of mobility in their hands; consequently, it would be convenient that the game could be adapted according to the range-of-motion in performing hand movements. This study implemented a serious game for hand rehabilitation with two play modes. Mode one does not adjust the game difficulty; whereas mode two adjusts the game difficulty according to the player's range-of-motion in performing flexion, extension, ulnar, and radial deviations. The game difficulty was adjusted using fuzzy logic to compute positions at which the rewards will be displayed at the game scene (easy, medium, and difficult positions to collect the rewards). Four participants played both modes. Two-tailed t-tests revealed that there were no significant differences between both modes in terms of rewards collected (p = 0.6621), play time (p = 0.8178), and “game engagement questionnaire” score (p = 0.1383).
Mind of a Portfolio Investor
Authors: Gupta Chabi
Published: August 2023

It is smart for investors to plan for a drop that may be accompanied by a recession in the late stages of a bull market. The authors examine a variety of passive and active strategies, as well as their success in different crises. However, while choosing the best of strategies in the worst of circumstances, investors must be cautious in defining 'best.' It's critical to comprehend not only the long-term performance but also the whole cost of putting various preventive measures in place. The authors analyse popular strategies like technical analysis, fundamental analysis, relying on financial news, seeking professional advice, tips from trade experts, and self-intuition while making portfolios. Our findings indicate that every investment is unique. Some defensive methods will be more effective than others in each case. As a result, diversification across several viable strategies may be the wisest course of action.
The Theory and Applications of the Software-Based PSK Method for Solving Intuitionistic Fuzzy Solid Transportation Problems
Authors: Kumar P. Senthil
Published: August 2023

It proposes the PSK (P. Senthil Kumar) method for solving intuitionistic fuzzy solid transportation problems (IFSTPs). In our daily life, uncertainty comes in many ways, e.g., the transportation cost (TC) is not a fixed one, it varies from time to time due to market conditions (i.e., the price of diesel is depending on the cost of crude oil), mode of the transportation, etc. So, to deal with the TP having uncertainty and hesitation in TC, in this chapter, the author divided IFSTP into 4 categories and solved type II- IFSTP by using TIFNs. The model of type II- IFSTP and its relevant CSTP both are presented. The PSK method is presented clearly with the proof of some theorems and corollary. To illustrate the PSK method with proposed models, the numerical experiment and its related graphs are presented. Real-life problems are identified and solved by the PSK method with MATLAB and LINGO software. Analysis, discussion, merits, and demerits of the PSK method are all presented. A valid conclusion and recommendations are given. Finally, some of the future research areas are also suggested.
Detecting Phishing URLs With Word Embedding and Deep Learning
Authors: Selamat Ali , Quang Do Nguyet , Krejcar Ondrej
Published: August 2023

The past decade has witnessed the rapid development of natural language processing and machine learning in the phishing detection domain. However, there needs to be more research on word embedding and deep learning for malicious URL classification. Inspired to solve this problem, this chapter aims to examine the application of word embedding and deep learning in extracting features from website URLs. To achieve this, several word embedding techniques, such as Keras, Word2Vec, GloVe, and FastText, were used to learn feature representations of webpage URLs. The obtained feature vectors were fed into a deep-learning model based on CNN-BiGRU for extraction and classification. Two different datasets were used to conduct numerous experiments, while various metrics were utilized to evaluate the phishing detection model's performance. The obtained findings indicated that when combined with deep learning, Keras outperformed other text embedding methods and achieved the best results across all evaluation metrics on both datasets.
Study on Healthcare Security System-Integrated Internet of Things (IoT)
Authors: Karthik S. A. , Hemalatha R. , Aruna R. , Deivakani M. , Reddy R. Vijaya Kumar , Boopathi Sampath
Published: August 2023

The internet of things (IoT) has the potential to transform healthcare by fusing the most significant technological and scientific advances in the fields of automation, mobility, and data analytics to improve patient care. IoT links sensors, actuators, and other devices to a network in order to collect and disseminate communication messages that an organization may then evaluate. To track health parameters, the suggested paradigm focuses on sensors, communications protocols, and cloud technologies. The study looks at the crucial elements of a healthcare IoT system. For the control, security, and protection of IoT networks, data confidentiality and authentication are crucial. For the purpose of resolving security challenges, flexible infrastructure is necessary. The goal of the chapter is to discuss IoT security concerns in healthcare devices and offer recommendations for future research to enhance the use of IoT devices.
The Role of Internet of Behaviors (IoB) in Digital Marketing
Authors: Huseynov Farid
Published: August 2023

The internet of behaviors (IoB) refers to the technology that combines the internet of things (IoT), big data analytics, artificial intelligence (AI), along with behavioral science, to collect and analyze data from interconnected physical objects, with the goal of gaining insights into human behavior, needs, interests, and preferences. By analyzing purchasing patterns, consumption behaviors, and demographic interests, IoB uncovers hidden patterns in consumer behaviors. In essence, IoB endeavors to interpret the information gathered from users' online behaviors through the lens of behavioral psychology. This chapter explores the IoB technology and its impact on the digital marketing industry. This chapter discusses several sub-topics, including how businesses are currently implementing IoB in digital marketing and in other fields, the ways IoB can improve the customer experience, ethical and social concerns related to IoB, and the future of IoB in digital marketing. The chapter offers valuable insights for both digital marketing practitioners and researchers.
Long-Range and Low-Power Automated Soil Irrigation System Using Internet of Things
Authors: Gnanaprakasam C. , Vankara Jayavani , Sastry Anitha S. , Prajval V. , Gireesh N. , Boopathi Sampath
Published: August 2023

In this chapter, the Internet of Things (IoT) system is required for automating irrigation systems and monitoring real-time data from sensors. IoT systems may easily and affordably integrate the long-range wide-area network (LoRaWAN). Four irrigation strategies, including ET (ETc), MP60 (watermark 200SS-5 soil matric potential sensors, (-70 kPa), MP50 (at -50 kPa)), and GesCoN (a decision support system), were developed and put to the test. According to the findings, treatment MP70 had a marketable yield that was greater by 16 percent and 24 percent than that of ET and MP50. Due to improper installation and positioning of the soil moisture sensors, MP40 received relatively little water during irrigation. The GesCoN and ET results were not significantly different from the MP70 results. It has been demonstrated that using sensors and precision irrigation can help farmers conserve water when growing crops. The LoRaWAN-based IoT system nevertheless performed admirably in terms of power usage, connectivity, sensor reading, and valve management.
Analysis of Drone Applications in Precision Agriculture
Authors: Vanitha N. , Rakshun Selvaa S. K.
Published: August 2023

Unmanned Aerial Vehicles (UAV) or drones are a growing technological boon to major fields which possess high complexity in logistics such as defense systems, cargo transportation, mapping geographic locations and terrain, border surveillance, medical emergency shipments, and many other areas where humans find it inaccessible or inefficient to work. Drones can cope with tasks that demand precisive services and tasks that are inefficient under human intervention. Precision agriculture deals with efficiency as a key factor and it uses information technology to keep track of optimum health of the crops and productivity of a particular crop field using precisive approach which can be done with the help of purposely modified drones for precision agriculture. This chapter analyses and evaluates the significance of drones in precision agriculture, challenges possessed in scaling them, and solutions to implement them in large-scale environments. In the future, cognitive analysis and sensory evaluation can be used to further reduce the complexity of accessing drones in various environments.
The Forgotten Factors of Disciplinary Writing Assessments
Authors: Brice Lacy D.
Published: August 2023

Three powerful affective factors often forgotten in today's writing assessments are students' general perceptions of writing, how they perceive themselves as writers, and their self-efficacy for completing specific writing tasks. The purpose of this chapter is to establish an argument for the inclusion of self-perceptions and self-efficacy measures in disciplinary writing assessment protocols. This chapter shares research on middle and high school students' perceptions of and self-efficacy for the writing they do in disciplinary subjects and provides an overview of current measures used in research that examine student perceptions of and self-efficacy for writing. Practical ways to adapt those measures for middle and high school classroom use are provided. The chapter concludes with some practical guidance for educators who teach adolescent students and are interested in including process-focused assessments that evaluate the forgotten, albeit important, affective factors known to influence writing outcomes.
Young Children's Explanations
Authors: Donovan Carol A. , Kerch Cailin J.
Published: August 2023

The purpose of this chapter is to provide information teachers need to assess young children's science compositions for explanation genre features and content knowledge. The authors begin with an overview of the language specific to the genres of science in general and to explanation specifically. They provide an overview of reasoning and genre features used in explanation and describe how trade books on science topics written for children can be used to scaffold children's explanatory science thinking and writing. Examples of children's texts are then considered for how assessment of each provides insight into the disciplinary thinking of the authors, how the composition includes linguistic features of the explanation genre, and how teachers might scaffold the children's emerging explanation compositions of scientific phenomena while supporting disciplinary thinking and knowledge building.
The Rubric for Scientific Writing
Authors: Wright Katherine Landau , Hodges Tracey S. , Wenner Julianne A. , McTigue Erin M.
Published: August 2023

A major challenge of assessing students' science writing derives from the need to simultaneously consider two criteria – scientific argumentation and rhetorical form. This challenge is confounded by a lack of standardized measures for scientific writing. Therefore, this study aimed to create and validate the rubric for scientific writing (RSW), which can be used to provide both formative and summative evaluations of students' scientific writing. Three science teachers and three English/language arts teachers independently used the rubric to score 75 authentic science writing samples from middle and high school classes. The teachers also participated in a focus group to provide in-depth feedback on the strengths, weaknesses, and practical classroom applications of the rubric. Overall, the findings demonstrate that the RSW produces valid and reliable scores of proper scientific argumentation and English rhetoric, which would allow future researchers and teachers to examine how instruction and interventions impact these two aspects of scientific writing.
Formative Assessments to Promote Equitable Practices and Support Learners' and Instructors' Goal Setting for Life-Long Growth
Authors: Traga Philippakos Zoi A. , MacArthur Charles A.
Published: August 2023

Formative assessments are used to examine students' learning, offer feedback, and support instructional decisions. Drawing from an evidence-based instructional approach on genre-based reading and writing, the chapter provides specific recommendations for educators on the use of formative assessments on writing to support students' goal setting. The authors argue that the use of specific criteria in formative assessments can support learners' self-regulation and teachers' formation of instructional and professional goals. The circular relationship between formative assessment and instruction with goal setting is explained, and the reciprocal relationship between data and instruction is explained. Resources for school-wide application and professional development practices are shared as well as cautionary notes for effective implementation.
Achieving Sustainable Developmental Goals by Empowering Women Entrepreneurs
Authors: Arora Manpreet
Published: August 2023

Women are largely invisible in the mainstream of economic development. Therefore, the concept of sustainability to a great extent depends upon providing equal distribution of not only resources, but also the equality should be created between the various sections of society where women are vulnerable. Women's empowerment should not be associated with increasing their responsibility as a whole, but it is about respecting their role. To achieve the goals of sustainable development, the concept of women entrepreneurship gains prominence where men have always been dominating the business situations. Ventures by women not only provide them financial support but also makes them empowered. This chapter, by using qualitative research approaches of content analysis, literature review, and discourse analysis, attempts to find challenges of women entrepreneurship and suggest various policy implications to deal with these challenges. The major findings are women entrepreneurship can be a major source of women empowerment backed by a focus on entrepreneurial education.
Sustainable Tourism Opportunities in Kashmir Valley and the Role of Women
Authors: Parray Parvaiz Ahmad , Sharma Puneeta , Wani Sammer Ahmad , Wani Khursheed Ahmad
Published: August 2023

This chapter looked at sustainability through women's empowerment present at Kashmir Valley tourist attractions. On the basis of the relevant issues, conclusions are reached, and solutions are offered. Government-adopted practises, concepts, and strategies are described and their applicability for improving and promoting sustainable tourism at destinations is explained. The majority of the naturally gifted goods manufactured by women in Kashmir Valley require careful monitoring and care. Strong policies, a strategic framework, eco-friendly tourist practises, and sufficient facilities for women's empowerment are recognised as essential in this context.
Glass Ceilings and Glass Elevators as Gender Segregation in Female Employment in the Tourism Sector
Authors: Sultan Muhammad Faisal , Tunio Muhammad Nawaz , Sardar Afifa , Shamsi Aamir Firoz
Published: August 2023

There is no need to highlight the importance of women as religious and cultural history is full of roles that women have played in religious, cultural, as well as business activities. Starting from Hazrat Khadija R.A., Muslim women are always admired and well-known for their acts and responsibilities. Although due to some adopted cultural, familial, political, and social barriers, professional growth of women is always hindered. Similar is the case in the Islamic world where women have to encounter several barriers in their professional growth. However, growth in the tourism industry is a special case due to the perception attached to the industry and working practices. The situation is not getting improved not only due to cultural and religious barriers but also due to inability of the educational sector to train and groom women as employees and entrepreneurs. Therefore, this chapter has been written specifically with reference to the hurdles that Muslim women are experiencing in their professional growth with special emphasis on barriers in the tourism industry.
Social Media Influencers in Fashion
Authors: Rosário Albérico Travassos , Morais da Silva José
Published: August 2023

Social media influencers (SMIs) in the fashion industry become professional individuals who have a large following on social media platforms such as Instagram, Facebook, TikTok, and YouTube. Many SMIs in the fashion industry have become successful in their own right and have gained significant influence in the fashion world projecting their branded personas. Fashion industry SMIs can face several challenges including the need to constantly create new and rich content; develop engaged narratives; pressure to maintain a certain image, the rivalry from other influencers. However, there are also many opportunities for SMIs in the fashion industry. Some say it is fertile ground. They can also collaborate directly with brands and use their influence to promote products and services. Having said that, more research is needed to grant reliable data to empower SMIs with accurate knowledge. Based on a systematic bibliometric literature review at Scopus, this research aims to appraise challenges and opportunities in building a SMI landscape in fashion.
The Use of Social Media in the Fashion Industry During the Post-COVID-19 Period
Authors: Sklavounos Nikolaos , Papadopoulou Agapi Paraskevi
Published: August 2023

The use of social media to promote clothing and textile businesses has revealed several changes in consumer behavior during the post-COVID-19 era. In this study, the social media tools which provide useful information in regards to consumer preferences and their decision-making processes in the fashion industry are presented. Moreover, the marketing strategy used and the strong presence of social media influencers in the fashion industry both during and after the COVID-19 pandemic period are also examined. A mixed research methodology is applied through the conduction of interviews with 20 owners of small fashion businesses and a questionnaire survey of 200 consumers who use social media for their purchases from the region of Thessaly in Central Greece. Furthermore, the results are analyzed and the research findings are discussed in detail. Finally, suggestions for further research are also included.
Role of HR Analytics in Ensuring Psychological Wellbeing and Job Security
Authors: Khatri Bhanupriya , Shrimali Harshita , Khan Shad Ahmad , Naim Arshi
Published: August 2023

This chapter explores the impact of job insecurity on psychological well-being in the context of the COVID-19 pandemic. This chapter is based on empirical study measuring the six elements of job insecurity on psychological wellbeing, i.e., perceived threats to job features, role insecurity, role conflict, powerfulness, meaningfulness, and perceived threats to total job. Further, this chapter the role of HR analytics in ensuring psychological wellbeing and job security, with a focus on the lessons learned during the COVID-19 pandemic. highlights the importance of HR analytics in identifying and addressing employee needs related to psychological wellbeing and job security, and explores the ways in which HR analytics can be used to improve organizational decision-making and drive business outcomes. This chapter also briefly highlights the emerging practices, and the ways modern digital technologies can be harnessed for the betterment of the employees.
Chyngyz Aitmatov as an Actor in Cultural Diplomacy of the Turkic World
Authors: Bekturgan Kyzy Tolkun , Unal Ugur
Published: August 2023

Chyngyz Aitmatov is a world-renowned Kyrgyz writer whose literary works have been translated into 186 languages, as well as a politician and diplomat. Chyngyz Aitmatov not only gained worldwide recognition for his literary works, but also carried out a diplomatic mission. He started his cultural diplomatic career as soon as he wrote his first literary work and spread it to the public. He emphasized the prominent themes of his works and promoted the ideology of peace, harmony, and unity. Each of his translations, the awards he received in other countries, the honors attributed to him were important parts of creating a picture of Aitmatov in the world. The aim of the study is to analyze Chyngyz Aitmatov as a cultural diplomacy actor of the Turkic world. Descriptive document analysis technique was used to analyze the data obtained. As a result of the research, Aitmatov confirms his role as an actor in cultural diplomacy not only through his diplomatic activities, but also through his literary works, translations, awards received around the world, and places named after him.
Gerenciamento de resultados por accruals e por decisões operacionais em fusões e aquisições no Brasil
Authors: Oliveira de Melo Antonio Maysa , Vianna Brugni Talles , Soares Monte-mor Danilo , Camargos Avelino Bruna , Nossa Valcemiro
Published: August 2023

Este artigo objetiva verificar se as empresas brasileiras listadas na Brasil, Bolsa, Balcão (B3) que passaram por processo de Fusões e Aquisições (F&A) gerenciam resultados por meio de accruals ou por gerenciamento por decisões operacionais. A amostra foi composta por empresas não financeiras listadas na B3 no período de 2009 a 2017. Para atender o objetivo proposto, foram testadas duas hipóteses: H1 - Empresas alvo e licitantes apresentam maior nível de gerenciamento de resultados por accruals durante períodos de F&A e H2 - Empresas alvo e licitantes apresentam maior nível de gerenciamento de resultados por decisões operacionais durante períodos de F&A. Mensurou-se o gerenciamento por accruals pelo modelo Jones Modificado e o gerenciamento por decisões operacionais pelo modelo de Roychowdhury. Foram empregados os métodos dos mínimos quadrados agrupados, efeitos fixos e efeitos aleatórios. Os resultados empíricos indicam que as empresas listadas na B3 que passaram por processo de F&A gerenciam resultados por meio de accruals e por decisões operacionais, que ocorre via superprodução nas empresas licitantes e por meio de manipulação das vendas nas empresas-alvo. Os achados sugerem, ainda, que para economizar no custo de aquisição da empresa-alvo, gestores de empresas licitantes que seguem a estratégia de realizar F&A utilizando ações como forma de pagamento, tendem a sobrevalorizar de forma temporária o preço de suas ações por meio de gerenciamento de resultados por accruals. Todavia, não foi possível afirmar que F&A envolvendo pagamento em ações incentiva o gerenciamento de resultados por decisões operacionais por parte das empresas licitantes. Este estudo contribui para a literatura ao validar empiricamente as evidências de gerenciamento de resultados por decisões operacionais em eventos específicos de F&A no Brasil, além de analisar o trade-off entre o gerenciamento por accruals e por decisões operacionais em um país emergente, considerando que um cenário com menor proteção ao investidor tende a oferecer incentivos à manipulação de resultados.
Idílio e opressão na relação educação e natureza
Authors: Veiga Cynthia Greive
Published: August 2023

O texto discute a presença das dimensões do idílio e da opressão nos debates sobre a relação educação e natureza. Busca suas origens na experiência europeia de colonização da América e problematiza sua permanência. Destaca a apropriação dessa contradição pela Pedagogia, numa longa duração histórica, seja na perspectiva idílica desenvolvida por Rousseau, com desdobramentos nos séculos seguintes, incluindo a escola nova; seja na perspectiva opressora, com a prescrição de trabalho no campo para educação de ‘crianças desvalidas’. Especificamente demonstra a permanência dessas abordagens, de cunho eurocêntrico, no debate educacional brasileiro em início do século XX e problematiza as consequências para a desigualdade na oferta escolar e o racismo
Safe Patient Handling and Pressure Injury Prevention for Patients With Delayed Sternal Closure
Authors: Stokes Jason , Seabrooks Jessica , Yeung Yeu-Li , Richardson Angela , Pena Heather , Kester Kelly
Published: August 2023

Background

Pressure injuries are associated with increased morbidity, mortality, and cost. Patients with delayed sternal closure after cardiac surgery are at increased risk of developing pressure injury because of their reduced mobility and inability to undergo complete skin assessment.

Local Problem

Safe patient handling of patients with delayed sternal closure is challenging because of mobility restrictions, leading to increased risk for patient and staff harm.

Methods

An interprofessional team composed of bedside nurses, ergonomic specialists, a wound ostomy continence nurse, and cardiothoracic surgeons developed a patient mobility protocol for patients with delayed sternal closure consisting of levitating the patient for thorough skin assessment and care. A multimodal educational strategy was used to disseminate the new protocol. Patient information was collected on the type of surgery, results of the levitation, completion of the skin assessment, and subsequent interventions. Staff injury related to this work was monitored.

Results

After implementation of the protocol, 84 levitations were performed including 50 patients. No staff injuries were reported. Comprehensive skin assessments and care were completed for 98% of patients. Five patients were identified with pressure injury development, and appropriate interventions were applied.

Discussion

A standardized patient mobility protocol for patients with delayed sternal closure that leveraged available equipment was successful in reducing the risk for injury among staff and patients. The protocol allowed assessment and care and thus also reduced the risk for pressure injury development in these patients.

Conclusion

Development of an innovative protocol to safely mobilize patients with delayed sternal closure resulted in improved patient care and increased staff safety.
Protocolization of Analgesia and Sedation Through Smart Technology in Intensive Care: Improving Patient Safety
Authors: Ojeda Isabel Muñoz , Sánchez-Cuervo Marina , Candela-Toha Ángel , Serrano-López Dolores R. , Bermejo-Vicedo Teresa , Alcaide-López-de-Lerma Juan Miguel
Published: August 2023

Background

The risk of medication errors in intensive care units is high, primarily in the drug administration phase.

Local Problem

Management of high-alert medications within intensive care units in the study institution varied widely. The aim of this quality improvement project was to protocolize and centralize the management of high-alert medications in acute care settings and to implement smart intravenous infusion pump technology in intensive care units.

Methods

The project was conducted in 4 phases: (1) protocolization and standardization of intravenous mixtures, (2) centralization of intravenous mixture preparation in the Pharmacy Department, (3) programming of the smart pumps, and (4) dissemination and staged implementation of intravenous mixture protocols. Smart pumps (Alaris, CareFusion) were used to deliver the medicines, and the manufacturer’s software (Alaris Guardrails, CareFusion) was used to analyze data regarding adherence to the drug library and the number of programming errors detected.

Results

Morphine, remifentanil, fentanyl, midazolam, dexmedetomidine, and propofol were included. After implementation of the smart pumps, 3283 infusions were started; of these, 2198 were programmed through the drug library, indicating 67% compliance with the safety software. The pumps intercepted 398 infusion-related programming errors that led to cancellation or reprogramming of drug infusions.

Conclusions

Protocolization and centralization of the preparation of high-alert sedative and analgesic medications for critically ill patients and the administration of these drugs using smart pump technology decrease variability of clinical practice and intercept potentially serious medication errors.
Research trends over 10 years (2010-2021) in infant and toddler rearing behavior by family caregivers in South Korea: text network and topic modeling
Authors: Song In-Hye , Kang Kyung-Ah
Published: August 2023

Purpose: This study analyzed research trends in infant and toddler rearing behavior among family caregivers over a 10-year period (2010-2021). Methods: Text network analysis and topic modeling were employed on data collected from relevant papers, following the extraction and refinement of semantic morphemes. A semantic-centered network was constructed by extracting words from 2,613 English-language abstracts. Data analysis was performed using NetMiner 4.5.0.Results: Frequency analysis, degree centrality, and eigenvector centrality all revealed the terms ''scale," ''program," and ''education" among the top 10 keywords associated with infant and toddler rearing behaviors among family caregivers. The keywords extracted from the analysis were divided into two clusters through cohesion analysis. Additionally, they were classified into two topic groups using topic modeling: "program and evaluation" (64.37%) and "caregivers' role and competency in child development" (35.63%).Conclusion: The roles and competencies of family caregivers are essential for the development of infants and toddlers. Intervention programs and evaluations are necessary to improve rearing behaviors. Future research should determine the role of nurses in supporting family caregivers. Additionally, it should facilitate the development of nursing strategies and intervention programs to promote positive rearing practices.
Perception of precocious puberty among school-aged children in South Korea with the experience of treatment for precocious puberty: a Q methodological approach
Authors: Park Sun Jung , Nam Hye Ri , Choi Eun Ju
Published: August 2023

Purpose: This study aimed to investigate the perceptions of precocious puberty and elucidate the distinct characteristics of each type of perception related to precocious puberty among school-aged children who had undergone treatment for the condition.Methods: This study applied the Q methodology to identify and classify the perceptions of precocious puberty among school-aged children who had undergone treatment for the condition. The analysis involved 34 questions from the Q sample and data from 35 individuals in the P sample, using the PC-QUANL Program for analysis.Results: The perceptions of precocious puberty among school-aged children who had undergone precocious puberty treatment were classified into the following four types: "shyness - passive self-management," "resentment - suppression," "anxiety - fear," and "adaptation - acceptance." Conclusion: This study investigated the experiences and perceptions of children who have undergone treatment for precocious puberty. Through the identification of four types of perceptions, we can see that there is a need to develop an intervention program for nursing that is tailored to the specific type of precocious puberty.
Perceptions of fatherhood and confidence regarding neonatal care among fathers of high-risk neonates in South Korea: a descriptive study
Authors: Lee Jin Won , Lee Sunhee
Published: August 2023

Purpose: The purpose of this study was to investigate perceptions of fatherhood among fathers of high-risk neonates and their confidence regarding neonatal care.Methods: A study was conducted of 100 fathers whose neonates had been admitted to a neonatal intensive care unit (NICU) for at least 48 hours. Perceptions of fatherhood, neonatal characteristics, and fathers' confidence regarding neonatal care were measured using a self-reported questionnaire. The survey took approximately 10 minutes to complete and was completed anonymously. The factors that affected fathers' confidence regarding neonatal care were analyzed using multiple regression.Results: The scores for positive and negative perceptions of fatherhood were relatively high at 4.27 and 3.42 out of 5 points, respectively. A positive perception of fatherhood was found to influence fathers' confidence regarding neonatal care.Conclusion: NICU nurses should encourage fathers to effectively perform their parenting roles by implementing educational programs and interventions to promote positive perceptions of fatherhood and fathers' confidence regarding neonatal care after discharge.
Association between severe retinopathy of prematurity (ROP) and poor motor neurodevelopmental outcome
Authors: Godugu Swathi , Vudugula Sunil Akshara , Neupane Bandana , Esarla Kalyani , Bathina Vanaja Rani , Vajje Jaahnavi , Mohan Anmol , Raghu Kumar BR , Gowda Sohan , Gopisetti Sudeepthi
Published: August 2023

During the final (third) trimester outside of the womb, the retina develops significantly and is vulnerable to problems. Similar to how the cerebral cortex does, the cerebellum also grows quickly during this time and is susceptible to upsetting environmental influences. The only factors that show promise for lowering the incidence and retinopathy of prematurity (ROP) severity among high-risk infants are prematurity prevention, preeclampsia control, and prudent use of oxygen therapy and ventilation. The third trimester is when the cerebral cortex, cerebellum, and retina develop. These areas are vulnerable to environmental influences if their development is interrupted. Throughout childhood and adolescence, neurodevelopmental defects have been linked to impaired cortical development and smaller brain volumes. Reduced cerebellar volumes have been linked to an increased risk of autism spectrum disorder, lower motor performance, impaired executive functioning, and poorer cognitive outcomes. The complete avascular retina, as well as the peripheral retina, should be treated during retinal ablation with laser photocoagulation (using a transpupillary diode, 11 argon, and three FD-YAG) or cryoablation as failing to do so promotes disease progression and results in unfavorable anatomical and refractive outcomes.
My X-nit
Authors: Bharti Chhaya
Published: August 2023

This article explains a technique of scleral fixation of intraocular lens (SFIOL) by using a 30-gauge (g) needle.

Background:

The X-nit needle by “Aurolab” uses a 26-g needle, while in this technique, a 30-g needle is used, thus reducing the incision size and relevant complications.

Purpose:

In this technique, glue or end-gripping forceps are not used, thus making it hassle free and more economical. There is no dependency on assistant; because of using 30 g needle, bleeding is minimal and wound healing is faster.

Synopsis:

A 30-g needle is bent at 3/4–1/4 junction (from the tip) and a piece of 240 silicon band is inserted into the needle to be used as a stopper. After completing vitrectomy, a 1.5-mm marking is done perpendicular to the limbus at 3’o clock and 9’o clock positions. Another marking is done 1.5 mm away from the first mark parallel to the limbus. A 30-g needle is inserted into partial-thickness sclera from the second mark toward the first marking, thus making a tunnel. The needle is penetrated into the sclera to enter in the vitreous cavity. The needle is then progressed toward the anterior vitreous cavity and brought out through the lip of previously made scleral tunnel in the superior quadrant. The tip of leading haptic of three-piece intraocular lens (IOL) is fed into the tip of needle and gradually, the needle is withdrawn. As soon as the tip of needle is visualized, the piece of band is gradually slipped into the haptic and the needle freed from the haptic. In a similar fashion, the trailing haptic is withdrawn from the opposite side. The bands are removed and the haptics are adjusted by pulling or pushing to centralize the IOL in the pupillary axis. Haptics are trimmed and ends are cauterized to make them blunt. Tunnel and conjunctiva are sutured with one or two (8-0) absorbable Vicryl sutures. The 25-g ports are removed and no suturing of ports is done.

Highlights:

It is a minimally invasive and glueless technique in which end-gripping forceps is not used. So, it is very economical with faster wound healing and minimal bleeding and no post-op hypotony. Since the temporal scleral flaps are not made and 30 g needle is used so minimal invasive. Astigmatiam induced by scleral tunnel is seen i;e about 0.75- 1.15 D of cylinder.

Video Link:
https://youtu.be/1msuS5KySOk

Key words: 30 gauge, intraocular lens, scleral fixation of IOL
Gonioscopy-assisted transluminal trabeculotomy in patients with advanced glaucoma
Authors: Dar Nimrod , Naftali Ben Haim Liron , Yehezkeli Veronika , Sharon Tal , Belkin Avner
Published: August 2023

Purpose:

To evaluate the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with advanced glaucoma.

Methods:

Records of 46 patients with advanced glaucoma were reviewed retrospectively in this single-center chart review. The main outcome measure was surgical success; intra-ocular pressure (IOP) and IOP lowering medication use were secondary outcome measures. Success was defined as an IOP of 18 mmHg or lower (criterion A) or 14 mmHg or lower (criterion B) and one of the following: IOP reduction >30% from baseline on the same or fewer medications or IOP ≤ of baseline on fewer medications as compared to baseline.

Results:

Forty-seven eyes were included in the analysis. The average mean deviation was -17.5 ± 7.2 dB (range −8.0 to -33.0). The average follow-up was 6.8 months (range 3.2–22.3). Success at 6 months was 91% for criterion A and 75% for criterion B (n = 33). Mean IOP was reduced from 19.3 ± 6 mmHg (12–40) on 3.7 ± 1.4 medications to 13.2 ± 5.8 mmHg on 1.6 ± 1.4 medications at the 6th post-operative month (P < 0.001 for both IOP and medications). At the last follow-up visit, 37 patients (78%) had an IOP of 14 mmHg or lower, and ten of these patients were unmedicated. Transient hyphema and IOP spikes were the most prevalent adverse events following surgery. Three eyes required further surgery for IOP control. None of the patients lost vision because of surgery.

Conclusions:

GATT is a viable surgical option in cases of advanced glaucoma. Careful patient selection and attentive post-operative management are imperative.
Extralesional triamcinolone acetonide injection in the treatment of small chalazion
Authors: Gan Lu , Liu Yi , Zhou Xiaoting , Xue Kang , Guo Jie , Qian Jiang , Ren Hui
Published: August 2023

Purpose:

To evaluate the effect of extralesional triamcinolone acetonide (TA) injection in the treatment of small chalazion (diameter ≤ 5 mm).

Methods:

Prospective interventional clinal study that included patients diagnosed as chalazion of small size not responding to conservative management for at least 2 weeks. All patients were treated with extralesional TA injection (4 mg). Successful resolution of a chalazion was defined as a decrease in size to 1 mm or smaller.

Results:

Thirty-eight patients were included in the study. The resolution was achieved in 33 (87%) patients. Nineteen (50%) patients had complete resolution after the first injection, and 13 (34.2%) patients had complete resolution after the second injection. Chalazion near the lower punctum needed more times of injections than those elsewhere (P = 0.02).

Conclusions:

Extralesional TA injection is effective in the treatment of both primary and recurred small chalazia. It is a simple and cost-saving procedure and can be considered an alternative first-line treatment for small chalazion.
Comparative Clinical and Histopathological Evaluation of Mature and Nonmature Arteriovenous Fistula
Authors: Mahapatra Himansu Sekhar , Kushal D P , Kaur Navjot , Bhardwaj Minakshi , Pursnani Lalit , Muthukumar B , Singh Anamika , Krishnan Chandra , Kumar Adarsh , Binoy Renju
Published: August 2023

Introduction:

Nonmaturation of arteriovenous fistula (AVF) is a common obstacle due to neointimal hyperplasia (NIH). The present study evaluated the clinical and histopathological factors predicting AVF nonmaturation.

Methodology:

This prospective observational study was conducted over 18 months in 100 patients. AVF site venous tissue samples of 55 4/5 chronic kidney disease stages patients were collected. Histopathological analysis was done to detect four immunohistochemistry (IHC) markers, namely cluster of differentiation (CD68), CD31, α-SMA, and Ki67. IIntimal composition, hyperplasia, and calcification were also assessed. Fistulae were followed up at the 2nd, 6th, and 12th weeks and classified into mature and nonmature groups at 12 weeks based on clinical and Doppler examination. A comparison between the two groups was done and an association of radiological, histopathological, and IHC parameters of nonmature AVF was also carried out.

Results:

Among 55 patients, 35 (63.6%) had mature AVF and 26 (47%) had preexisting NIH. Preexisting NIH had no significant association with maturation (odds ratio: 0.44). Subjects without preexisting NIH had a significantly higher luminal diameter in 2nd week (P ≤ 0.05). There was a significant increase in blood flow both between the 2nd and 6th and between the 6th and 12th week (P < 0.05). Of the four IHC markers, three markers viz., CD68 (r = 0.525), CD31 (r = 0.420), and α-smooth muscle actin (r = 0.718) correlated significantly (P < 0.05) with the NIH. The mean AVF diameter and blood flow in the matured arm were more than that in the nonmatured arm at all the follow-ups (P < 0.09).

Conclusion:

The presence of CD68, CD31, and α-smooth muscle actin in the venous tissue suggests preexisting NIH which postoperative luminal diameter and blood flow may have long-term consequences in AVF functioning.
An Observational Study on Transposed Brachial Artery ‒ Basilic Vein AV Fistula in Vascular Access for Hemodialysis
Authors: Jha Manvendu , Vembu Anand , Dhillan Rishi
Published: August 2023

Background:

Dialysis access in patients of chronic kidney disease (CKD) on long-term hemodialysis is a problem area. Patients with poor caliber veins distally on initial evaluation or with multiple fistula failures, basilic vein transposition is a good alternative. We present our experience with basilic vein transposition at our center.

Methods:

This study was a single-center observational study. A retrospective review of prospectively collected data from December 2013 to June 2019 was done. Qualitative variables were expressed as frequencies/percentages and compared between groups using the Chi-square test. Quantitative variables were expressed as mean ± standard deviation and compared between groups using unpaired t-test between groups and paired t-test within groups across follow-ups. Multiple linear regression analysis using a stepwise model selection tool was used to assess factors affecting the first cannulation. The best model was arrived in four steps where explanatory power (R
2) increased from 66.6% to 79.3% (P < 0.001).

Results:

One hundred and eighty-eight patients formed a part of the study. One hundred and sixty-four patients underwent single stage, whereas 24 underwent two-stage transposition. Ninety-four each were male and female. The mean age was 51.38 ± 14.74 years. About 96.27% of fistulas underwent successful cannulation. The overall mean maturation time was 44.46 ± 7.21 days. It was 42.28 ± 3.71 for single and 60.27 ± 6.66 days for two-stage procedures. Primary patency at 6 months and 1 year were 92.82% and 85.67%, whereas primary-assisted patency rates were 94.6% and 91%. The secondary patency rate at 1 year was 60.77%. Salvage procedures included thrombolysis in 2, thrombectomy in 18, and thrombectomy with venoplasty in four cases. There were 28 failures. Fistula thrombosis was the most common cause. Complications included transient arm edema in 36.7%, late thrombosis in 7.7%, wound infection in 4.4%, and lymphorrhea in 6.9% of patients.

Conclusion:

The smallest basilic vein diameter for successful transposition is 2.5 mm. Factors used to predict successful maturation are initial vein diameter ≥2.5 mm, preoperative Peak systolic velocity (PSV) in brachial artery >70 cm/s, fistula flow rate of >400 ml/min at 6 weeks, and fistula diameter >4.5 mm at 06 weeks.
Hemoperfusion in patients with severe COVID-19 respiratory failure, lifesaving or not?
Authors: Abbasi Saeed , Naderi Zohre , Amra Babak , Atapour Abdolamir , Dadkhahi Seyed Amir , Eslami Mohammad Javad , Hajian Mohammad Reza , Hashemi Marzieh , Hashemi Seyed Taghi , Iraj Bijan , Khorvash Farzin , Madadi Samane , Pour Hossein Mahjoubi , Mansourian Marjan , Rezvani Majid , Sami Ramin , Soltaninejad Forough , Shahidi Shahrzad , Vahdat Sahar , Zamani Zahra , Moeinzadeh Firouzeh
Published: August 2023

Background:

The new coronavirus outbreak quickly filled hospital beds and stunned the world. Intensive care is required for 5% of patients, and the mortality rate for critically ill patients is 49%. The “cytokine storm” is considered as the main cause of pathogenesis for coronavirus disease-19 (COVID-19)-related respiratory failure, hemoperfusion may be a modality for treatment of disease.

Materials and Methods:

Thirty-seven an patients with positive real-time polymerase chain reaction for SARStions2 in an upper respiratory tract sample or typical chest computed tomography lesion were eligible for this case–control study. Patients meeting the criteria for hemoperfusion including clinical and laboratory indices, were evaluated for outcomes such as hospitalization length and mortality. Patients were divided into three groups, i.e., patients who received hemoperfusion without a need for mechanical ventilation (MV), patients who received hemoperfusion before MV, and patients who received hemoperfusion after MV.

Results:

Among 37 patients with COVID-19 respiratory failure, 32% were female with a mean age of 55.54 (standard deviation 14.1) years. There was no statistically significant difference between the three groups in terms of length of hospital stay and intensive care unit (ICU) stay (P-tayns: 0.593 and 0.243, respectively, confidence interval [CI]: 95%). Heart rate, respiratory rate, PaO2/FIO2, high-sensitivity C-reactive protein, and ferritin significantly improved after the application of hemoperfusion in all groups (P < 0.05, CI: 95%).

Conclusion:

It seems that applying hemoperfusion in the inflammatory phase of the disease, especially before the intubation, reduce the need for MV. However, hemoperfusion does not have any impacts on the duration of hospital and ICU stay.