bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance Management in the Public Sector and Evaluation in Public Administration
Authors: Enaifoghe Andrew
Published: October 2024

The chapter investigates the intricacies of performance Management and Evaluation in Public Administration. The purpose of performance management is to improve performance, foster effective communication and feedback, foster employee growth and development, and create goals that align with departmental and college strategic plans. Performance management is a collaborative effort between an employee and their supervisor. Evaluators have been attempting to place their jobs in connection with the development of performance management for a while now. While some have categorically dismissed performance management as conceptually inadequate and oversimplified, others have sought to identify similarities between the two methods of knowledge generation. In response to these worries, the authors note that complementarity has emerged beneath the broad definitions of performance management and assessment. Rather, they regard complementarity as inherent in the methods of measuring and monitoring used by practitioners in these fields. The six essential components of performance management—managers, leaders, accountability systems, performance budgeting, measuring, monitoring, and evaluation—are explained in this chapter. It also highlights some of the main issues that assessors have brought up about the reliability of the knowledge generated within performance-management approaches that do not rely on evaluations. The theoretical study was derived from a review of the literature. The public sector has not yet seen the anticipated gains in performance, accountability, transparency, quality of service, and value for money. In the public sector, performance management issues fall into three categories: technical, systemic, and involvement. Reorganizations and restructurings that are imposed from the outside hinder the effective use of performance management.
Interwoven Realities
Authors: Alam Mumtaz , Gounder Kunal Avishek
Published: October 2024

This chapter aims to narrow the existing information gap between climate change and human rights. This chapter serves as proof that climate change is a significant anthropogenic catastrophe and ecological calamity. To prioritise the interests of the most vulnerable individuals, it argues that decisions on climate change should consider human rights. This chapter emphasises the need for researchers, activists, and political leaders to have a broader perspective on climate change that extends beyond the apparent economic and environmental risks. Moreover, it is imperative to identify a feasible, equitable, and enduring resolution, as this issue poses a threat to fundamental human rights.
Cells to Society
Authors: Verma Vidhi
Published: October 2024

In a world full of technology and modernization, we still live in a society where menstruation and periods are a dirty and negative thing that we hesitate to talk about. Where females are still burdened under the myths and taboos. This research is aimed towards breaking the walls of period related myths and taboos and Introducing the IT involvement in the ground level of this field. We can use technology and create huge machines and algorithms that can detect period related diseases within a second. But what is the use of all these if females will yet not be comfortable in coming out and ask for the technology to test them. It's necessary to start working from the ground level so that females can get everything they need to know about periods without feeling uncomfortable or ashamed. This research is aimed towards understanding and looking at the social and technical aspects of menstruation. This project is a combination of society and technology.
Women as Environmental Change-Makers in Civil Society
Authors: Roy Shyamashree
Published: October 2024

Women have played vital roles as environmental leaders within civil society across the globe. Women's participation in environmental decision-making promotes gender equality and environmental action. Involving women in political decision-making leads to more aggressive climate objectives and policies. Women in civic society form formidable networks to resist environmental degradation and address climate-related injustices.Women's environmental leadership offers a myriad of benefits, contributing to both environmental sustainability and societal progress. By occupying leadership roles, women inspire others, particularly young women, to pursue careers and activism in environmental fields, thereby fostering greater diversity and inclusivity within these sectors. Women leaders are increasingly influential in shaping environmental policies and agendas at local, national, and international levels. This chapter will aim to look into the various roles of women as vital change makers and leaders in the domain of environmental protection and sustainable development in the civil society.
Climate Change, Women's Rights, and the Way Forward
Authors: Kamboj Mayank , Verma Shilpy
Published: October 2024

The particular focus of this study is on bringing to light the differential nature of climate change effects across the population, as seen through the lens of Amartya Sen's crucial thesis on ‘missing women.' We argue that there is a need for economists to map how climate change makes invisible women, particularly in the labour force. The precarious accessibility women have, and the freedom women enjoy by virtue of gaining access to education, housing, credit and so on, is doubly at risk from the effects of climate change. It is essential to bring to light the susceptibility of the labor market at large, and the susceptibility of women workers in particular, to the vagaries of nature. Be it in the form of heat stress, or global warming disrupting large scale supply chains, or even wiping out small industries, the impact of climate change on the labor market is substantially large and deserving of closer study, especially through a fruitful application of Sen's essential ideas on human development and gender parity.
The Consideration of Children's Rights in Corporate Action
Authors: Bohlens Christopher
Published: October 2024

This chapter provides a concise overview of the integration of children's rights into corporate operations, highlighting the growing importance of this issue in the globalized business environment. As companies become more interconnected with global supply chains, they must address the direct and indirect impacts of their activities on children, particularly in areas like child labor prevention, fair wages, education, and healthcare. By embedding children's rights into their strategies, businesses not only fulfill legal and ethical obligations but also enhance their reputations and contribute positively to society, facing both challenges and opportunities in this endeavor.
Feminism and Honor Killing With Special Reference to the 21st Century
Authors: Dhamija Somesh , Singh Narendra
Published: October 2024

The chapter explores the evolution of feminism and its impact on addressing gender discrimination and promoting women's rights and equality particularly in the 21st century. The aim of the chapter is to explore the role of feminism in advocating for women's rights and dismantling patriarchal norms, with a specific focus on addressing issues such as gender pay gaps, workplace discrimination and representation in leadership roles. The chapter involves a historical analysis of the four phases of feminism. Participants include women and girls impacted by gender discrimination, as well as advocates and activists involved in promoting women's rights. The context of the study encompasses global awareness, legal reforms, educational initiatives, women's empowerment, social media, and cultural exchange. The dismantling of patriarchal norms has helped lower crimes such as honor killings and contributed to a more just and equal society.
Veils of Silence
Authors: Kumar Sudhir , Arora Aarya
Published: October 2024

Honor killings persist as a significant societal issue in Pakistan, reflecting complex intersections of culture, religion, law, and socio-economic factors. This chapter explores the diverse range of influences that contribute to the prevalence of honor killings within Pakistani society. By analyzing these factors, the chapter aims to provide a nuanced understanding of why and how honor killings occur, shedding light on both the structural and cultural dynamics that perpetuate this form of violence. The chapter examines the cultural and historical roots of honor killings in Pakistan. This chapter provides a comprehensive analysis of the factors influencing honor killings in Pakistan, offering a nuanced perspective on the cultural, religious, socio-economic, and legal dynamics that contribute to this form of violence. By elucidating these factors, the chapter contributes to broader discussions on gender-based violence, human rights, and the complexities of societal change in addressing harmful practices.
Honorless Honor Killings in Jordan
Authors: Kumar Abhishek , Arora Aishna
Published: October 2024

This study examines Jordan's socio-political stance of honor in order to understand how Jordanian culture, which is both sophisticated and based on traditional values, constructs meanings around honor killings. The majority of current research on honor crimes in Jordan suggests that not much has been learned or figured out about the relationship between the law in Jordan, honor crimes, and the perceptions of these offences among Jordanians. In order to better explore prospects for legislation and policy that would diminish these crimes, this chapter thoroughly examines the aspects that potentially explain the frequency, reasons, and persistence of honor killings in Jordan. It highlights the disparity between the nation's social and legal laws on the penalty of honor crimes, as well as the gender inequality that exists in the nation. It also sheds light on the relationship between Middle Eastern civilizations and ways of life and the prevalence of crimes done in a badge of honor. The study is predicated on a detailed analysis of court proceedings from 1993 to 2010.
Legacy of Silence
Authors: Kumar Pradeep , Bhaskar Anushka
Published: October 2024

In “Legacy of Silence,” we embark on a profound exploration of the grim phenomenon of honour killings, particularly as it intertwines with the intricate historical fabrics of Jewish and Medieval European societies. This chapter seeks to shed light on a topic often shrouded in obscurity and misunderstanding, drawing connections between past traditions and the remnants of these practices in contemporary societies. By delving into the historical contexts of Jewish and Medieval European cultures, we aim to uncover the roots, manifestations, and enduring impacts of honour killings in these societies. This exploration is not only a journey through time but also a critical examination of the cultural, religious, and social underpinnings that have perpetuated such acts of violence.
Shattered Honor
Authors: Singh Pratibha , Gupta Sahil
Published: October 2024

Honor killings motivated by false ideas of communal honor remain a tragically pervasive social problem in a variety of cultural contexts. This chapter examines honor killings in India and the Netherlands, two countries that have different legal systems, social structures, and cultural backgrounds yet are united in their opposition to this horrible behavior. The research employs a multifaceted method to investigate the historical and contemporary elements that have shaped honor killings in each nation. It investigates how cultural norms, gender inequality, and patriarchy contribute to this violence. This chapter examines the existing legislative frameworks and enforcement measures aimed at curbing honor killings, emphasizing the advantages and disadvantages of each in the given situations. In the end, the goal of this comparative research is to pinpoint possible best practices and practical approaches to stop and end honor killings.
Ensuring STEM Teacher Quality to Meet the Demands of the Caribbean Labor Market Beyond the 21st Century
Authors: Devonish Debbie , Bennett Sadpha , Hylton Kavelle , King Juanita , Barrett Donna
Published: October 2024

This chapter examines the evolving STEM (Science, Technology, Engineering, and Mathematics) landscape in the Caribbean, focusing on opportunities, challenges, and strategies for improving teacher quality. It proposes a robust framework for effective STEM teacher training, drawing on case studies from Jamaica, St. Vincent and the Grenadines, and the state of Georgia in the US. It addresses critical areas like future-oriented education, professional development, regional planning, recruitment and retention, diversity, peer teaching, collaboration with Higher Education Institutions (HEIs), and government policy support. The analysis highlights pockets of excellence and innovations but emphasizes the need for a robust framework for effective STEM teacher training. It calls for investment in capital, collaboration with Higher Education Institutions (HEIs), and a unified understanding of STEM. This approach aims to benefit Caribbean students, teachers, and the region while contributing to the achievement of Sustainable Development Goals (SDGs).
Powers of Higher Education Leadership
Authors: Yadav Urmila , Pitchai R. , Gopal V. , Kumar K. R. Senthil , Talukdar Mitali , Boopathi Sampath
Published: October 2024

Higher education leadership requires adept navigation of intricate policy and management landscapes to ensure institutional success and sustainability. Academic leaders must balance internal governance with compliance to external regulations while fostering environments conducive to academic excellence, innovation, and inclusivity. This paper explores the pivotal roles and responsibilities of higher education leaders, emphasizing strategic planning, stakeholder engagement, financial management, and policy implementation. Through examining case studies and current trends, the paper provides insights into effective leadership practices that drive institutional growth. It addresses challenges such as funding, regulatory compliance, and evolving educational demands, offering strategies for leaders to manage these complexities. The findings highlight the importance of adaptive leadership, collaborative decision-making, and proactive policy management in navigating the dynamic higher education sector.
Empowering Educational Excellence
Authors: Tsarkos Athanasios
Published: October 2024

This chapter delves into the transformative potential of Servant Leadership in advancing school effectiveness, exploring its theoretical underpinnings and practical implications within educational settings. By prioritizing empathy, inclusivity, and ethical governance, Servant Leadership fosters environments conducive to the holistic development of students and educators alike. Through a nuanced analysis of relational dynamics, professional development, and organizational health, the text offers insights into overcoming implementation challenges and underscores the model's capacity to navigate the complexities of contemporary education. Looking ahead, it posits a future where Servant Leadership principles guide institutions towards societal contributions, highlighting its role in cultivating a generation of ethical, engaged citizens.
Practicing Model of Relationship Between Caring Leadership and Attitude Towards Teaching Profession
Authors: Azmi Ahmad Najmuddin
Published: October 2024

Based on the research that has been employed in Malaysia, caring leadership has proven a significant relationship with attitudes towards the teaching profession. As a result, a model of relationship between caring leadership and attitude towards the teaching profession in higher education settings suggests the implementation of this model for future caring leaders. This chapter has proposed eleven steps taken to enhance the caring leadership capacity of existing and future caring leaders in caring leadership practices. Grounded from the implementation of caring using examples, networking, professional development, measurement, research, practicing, and continuous improvement,, this chapter offers insight into improving caring leadership among existing the development of future generations of leaders. All of these steps are taken to solve the issue of caring leadership and teacher retention. Therefore, this chapter is not only to improve leadership but also to cultivate caring future leaders in facing the challenging educational world.
Security Considerations of SDN Networks During DDoS Attacks in Load Balancing
Authors: Das Adrija , Nanda Pratyasha , Jain Ritika , Saini Tanisha , Bhaskar Sneha , Mohapatra Hitesh
Published: October 2024

Cloud computing deals with the dynamic allocation of resources on demand from any location. Load balancing is the phenomenon of ensuring the distribution of traffic and the operation of loads on multiple servers. There are security considerations where the load balancers are potential targets for Distributed Denial of Service (DDoS) attacks. This occurs when the attacker overwhelms the system with a flood of traffic, causing it to become unresponsive. The paper discusses the security challenges and attacks that affect workload distribution across servers dealing with access control mechanisms and concerns about multi-tenancy risks. The analysis involves identifying attacks in load-balancing systems from pre-existing frameworks by utilizing tools like Snort, Wireshark, and MATLAB for DDoS attacks. Furthermore, the paper does a comparative study on the established works. It addresses the best mitigation strategies for different types of DDoS attacks, such as Smurfing and TCP-SYN attacks, thus enhancing resilience with SDN architecture and multi-layered defense mechanisms.
Improving the Quality of the Face Recognition Using LBPH in Machine Learning
Authors: Shukla Ratnesh Kumar , Tiwari Arvind Kumar , Mishra Vinay Kumar
Published: October 2024

The objective of this article is to recognize facial features from images using face recognition approaches. For preprocessed face images with equalized histograms, the suggested solution employs a local binary pattern histogram (LBPH). One of the long-standing issues with computer vision is accurate face detection and recognition. The Local Binary Pattern (LBP) is a better facial descriptor in face recognition, in recent study. A person's identity, sentiments, and ideas may be more easily discernible from their face. Everyone wants to feel safe from unauthorized authentication in the current world. To improve security, face detection and recognition have joined the scene and are tackling the most challenging challenge of effectively recognizing faces without creating any false identities. The histogram values are extracted and joined into a single vector. After applying these methods, the training loss decreases and the validation of accuracy rise by over 96.5%. This vector compares the facial likenesses and produces the most advantageous outcome.
Social Media Revolution
Authors: Afaq Syed Adnan , Dwivedi Shweta , Srivastava Saurabh , Izhar Syed Khalida , Faisal Mohammad , Yasmeen Gausiya , Shahab Qudsia
Published: October 2024

The chapter explores the transformative journey of social media and its impact on contemporary society, highlighting both challenges and opportunities. From its origins to its global ubiquity, social media has redefined communication, transcending geographical and cultural barriers. While it empowers global sharing and creativity, it also raises issues like privacy breaches, data security, and misinformation. Despite these challenges, social media drives social movements, political engagement, and revolutionizes marketing. It influences agriculture by spreading innovative techniques and bioinformatics by enhancing research collaboration. Emerging technologies like AR, VR, and AI will further shape its future. Integrating bioinformatics and agricultural analytics into social media can address global challenges, fostering positive societal change and connectivity.
Psychological Analysis and Psychological Training of Piano Teaching Based on the Analysis of Emotional Characteristics
Authors: Lan Xinjun , Zhou Yanzhi
Published: October 2024

Modern piano teaching theory attempts to explore the basic laws of modern piano teaching by using emotional feature recognition algorithm from the emotional level and in the analysis of emotional characteristics, deeply reveal the important value of emotion in piano teaching, and effectively improve the quality of piano teaching, which is also what this paper tries to clarify. This paper studies the psychology of piano teaching based on the emotional feature recognition method. In the proportion of piano teaching, when the number of experiments is 6, the average proportion of machine learning algorithm is 56.5%, the average proportion of decision tree algorithm is 55.1%, the average proportion of data mining algorithm is 58.7%, and the average proportion of this method is 61.8%. It can be seen that the proportion of this method in piano teaching is the highest. This method is used to cultivate students' learning enthusiasm, constantly overcome all kinds of difficulties, change restlessness, irritability and other bad mentality, so as to achieve better learning effect.
The Construction of Localized Teaching Model of Orff Music Teaching Method Based on Big Data Analysis
Authors: Tian Ping , Pu Jing
Published: October 2024

This paper discusses how Orff's music education system is combined with the localized teaching mode under the background of globalization, especially with the support of big data analysis to realize the innovation of music education. Orff's music education has attracted worldwide attention for its openness, diversity and innovation. In China, its localization practice aims to balance the international educational concept with the local cultural needs. The innovations of this paper are as follows: firstly, the big data analysis technology is integrated into the localized teaching mode, and the new mode of music teaching is analyzed; Secondly, advocate students' active participation, get rid of the shackles of traditional teaching and make music learning lively and interesting; Thirdly, from a new discipline perspective, combined with the frontier concept of national music education, this paper interprets Orff's localization theory and practice in order to push Orff's music education in China out of the dependent development mode.
Promoting Student-Centered Learning Strategies via AI Chatbot Feedback and Support
Authors: Nghi Tran Tin , Anh Lam Thi Quynh
Published: October 2024

This manuscript investigates the impact of interactive chatbot feedback and support on student-centered learning strategies among Vietnamese learners of English at HUIT. A mixed-methods approach, integrating quantitative and qualitative research techniques, provided a robust analysis of chatbots' effects on learning. The quantitative phase involved a structured questionnaire administered to 211 students, while the qualitative phase included in-depth interviews with 8 participants. Findings revealed that positive student perceptions of chatbots led to increased engagement and effective use, supporting personalized learning by adapting to individual needs and learning paces. Chatbots enhanced self-study abilities, knowledge acquisition, and overall learning satisfaction. The study concludes that chatbots have a significant positive impact on engagement, motivation, and performance, emphasizing the importance of cultural and contextual factors in their implementation. Future research should explore the long-term effects of chatbot use on language mastery and academic performance
Presenting, Dr. Anandi Samarasekara for the honorary fellowship of the College of Ophthalmologists of Sri Lanka
Authors: Bandara Chameera
Published: October 2024

No abstract available
Surgical management of obstructing ureteral stones during pregnancy: A systematic review of different techniques
Authors: Laranjo Tinoco Catarina , Oliveira Maria João , Araújo Ana Sofia , Cardoso Andreia , Oliveira Carlos , Mota Paulo , Pimentel Torres João
Published: October 2024

Introduction: Renal colic is the most common non-obstetric cause of abdominal pain during pregnancy and is associated with a higher risk of complications in these women. When invasive treatment is required, options are temporary drainage with ureteral stent (JJ) or percutaneous nephrostomy (PCN), or immediate definitive treatment with ureteroscopy (URS). Our goal was to review the safety and efficacy of these procedures in treating urolithiasis during pregnancy. Methods: Adhering to the PRISMA checklist guidelines, we searched PubMed, Embase, and Scopus databases for articles on the efficacy and complications of the three procedures in pregnant women. The quality of evidence and risk of bias were evaluated using the Critical Appraisal Skills Programme and the Institute of Health Economics tools.Results: We included 45 articles, totaling 3424 interventions in pregnant women - 2188 URS, 719 JJ, and 517 PCN. URS was the most assessed procedure, with stone-free rates comparable to the non-pregnant patients. The most frequent complications were lower urinary symptoms and infections independently of the intervention. Obstetric complications for all interventions included 167 cases of preterm labor, resulting in 24 premature births. No statistically significant differences in post-operative complications were reported between the procedures in the few comparative studies.Conclusions: Despite the absence of high-quality studies, current evidence suggests that URS, JJ, and PCN are all safe and effective during pregnancy. As most patients submitted to temporary drainage require a second procedure post-delivery, primary URS appears more efficient. Therefore, it is the preferred option unless there are indications for temporary drainage.
Kidney transplantation restores sex hormone profile and improves sexual function in ESRD patients with erectile dysfunction
Authors: El Hennawy Hany M. , Safar Omar , Al Faifi Abdullah S. , Shalkamy Osama , El Madawie Mahmoud Z. , Thamer Saad , Almurayyi Muath , Alqarni Abdullah Mohammed , Amri Sami Saleh , Hawan Ali Abdullah , Elatreisy Adel
Published: October 2024

Background: Erectile dysfunction (ED) and sex hormone profile disturbances are common in ESRD patients. Objective: To assess the effect of kidney transplant (KT) and Hemodialysis/peritoneal dialysis (HD/PD) on the serum sex hormone profile and sexual functions in ESRD patients with ED. Patients and methods: A single-center, nonconcurrent cohort study included a hundred ESRD patients with ED, on regular HD/PD (group A, n = 50) and after KT (group B, n = 50) at Armed Forces Hospitals Southern Region, KSA.Results: the mean age of patients was 47.3 ± 7.01 and 56.8 ± 9.6 years in groups A and B, respectively. The cohorts were comparable regarding patient demographics, apart from a higher incidence of comorbidities in group B. After KT the mean testosterone level was higher in Group B (13.64 ± 3.21 nmol/L vs 10.26 ± 3.26 nmol/L, p < 0.001). Similarly, LH and prolactin levels were lower in group B than in group A (p < 0.05). As regards sexual function, ED was reported in 92% of patients in group A compared to 42% in group B (p < 0.001). In groups A and B, mild ED was found in 48% and 14% of patients, while moderate ED was found in 16% and 8%, respectively. The mean total IIEF-15 score was 36.42 ± 9.33 and 43.87 ± 9.146 in groups A and B, respectively (p = 0.0001). Sexual desire and orgasm were significantly better in Group B.Conclusions: Our study showed that kidney transplantation could improve erectile function and restore normal sex hormone levels in ESRD male patients with ED, with better outcomes compared to HD/PD.
Sexual intercourse before embryo transfer in assisted reproductive technology might enhance probability of pregnancy: An observational study
Authors: Pakpahan Cennikon , Agustinus Agustinus , Sa’adi Ashon , Hinting Aucky , Hinting Lia , Parmanto Christian Melka , Rezano Andri
Published: October 2024

Background: Modifying the maternal immune system is necessary to facilitate embryo implantation. Modifying the immune system can occur in several ways, including maternal exposure to the partner’s seminal plasma. Seminal plasma exposure can occur through sexual intercourse. To prove this theory, we investigate the effect of sexual intercourse on the chances of successful in vitro fertilization (IVF) in both fresh and frozen embryo transfer (ET) groups in terms of biochemical and clinical pregnancy.Methods: This is an observational analytical study with a retrospective cohort study design. This study compared biochemical and clinical pregnancy in patient groups who had sexual intercourse with those who did not have sexual intercourse during the IVF process. This study involved 132 participants.Results: The results of this study reported that there was no significant difference in pregnancy rates between patients who had sex before ET and those who did not have sex before ET. However, patients who experience orgasm during sex show significant rates of biochemical (p = 0.009) and clinical pregnancy (p = 0.027) rates.Conclusions: Sexual intercourse did not show a significant difference between the groups who had sex before ET and those who did not have sex, but the experience of orgasm every time they had sex recently had a positive impact on reproductive health, especially pregnancy.
Combining ultrasound and elastography for the detection of a non-palpable, non-sonographically visualized Peyronie's plaques. Our experience
Authors: Paulis Gianni , De Giorgio Giovanni , Paulis Andrea
Published: October 2024

Background: B-mode ultrasound (US) medical imaging is very effective in localizing and describing Peyronie's disease (PD). Moreover, elastography is a new technique used to evaluate tissue elasticity to detect penile Peyronie's plaques that are not visible using standard B-mode US. Objective: The main objective of this study was to evaluate the diagnostic efficacy of real-time elastography (RTE) in PD patients and to determine whether its combined use with standard US improved diagnostic accuracy. RTE is also known as strain elastography (SE). Additionally, this study aimed to assess whether RTE was useful for monitoring PD patients undergoing conservative treatment.Methods: A group of 37 PD patients in the active phase was selected based on US examination showing isoechoic or hypo-isoechoic plaques, with or without associated hyperechoic or calcified plaque areas. All patients underwent traditional US combined with RTE before starting conservative treatment with antioxidants, during treatment and after treatment. After each examination with RTE, a specific “Strain Ratio”(SR) was used to identify the specific elasticity of the tissue. Results: Using B-mode US with RTE, we detected all 13 non-palpable penile plaques present in the 37 PD patients (100% of cases). Using only B-mode US, we detected only 8 of the 13 non-palpable plaques (61.5% of cases). The DI of the plaque decreased during and after treatment in all cases, indicating that RTE is effective for monitoring conservative PD treatment. A statistically significant correlation was found between the DI and plaque volume in all patients (p=0.002). Conclusion: Our study has shown that the combination of US and RTE methods allowed for a more accurate diagnosis in PD patients.
Comment to “An unusual “linitis plastica” like breast cancer bladder metastasis”
Authors: Diaz Raquel , Leonardi Rosario , Murelli Federica , Fregatti Piero , Terrone Carlo , Mantica Guglielmo
Published: October 2024

Dear Editor,We read with interest the recently published article by Farci et al., titled “An unusual ‘linitis plastica’ like breast cancer bladder metastasis” and we congratulate the authors for the very interesting topic and case presented.......
Prospective observational study on the efficacy and tolerability of a complex of phytochemicals vs. dutasteride in the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia
Authors: Saitta Giuseppe , Mantovani Franco A. , Calabrese Benedetto , Aliboni Camilla , Di Paola Giuseppe , Meazza Attilio L. , Seveso Mauro
Published: October 2024

Introduction: The aim of our study was to treat two similar groups of patients suffering from BPH: one group with a complex based on phycocyanin, PEA and selenium; the other group with dutasteride. So the effectiveness of these treatments was checked, especially regarding the improvement of LUTS and the reduction of PSA and prostate volume.
Materials and methods: We included 104 patients in the study. All patients aged between 50 and 70 years, PSA values between 4 and 10 ng/ml, prostate volume calculated by transrectal ultrasound between 50 and 70 cc, flowmetry with maximum flow value greater than or equal to 10 ml/s, no suspicious nodules on DRE, no suspicious lesions on MRI (PI-RADS 1-2), negative previous prostatic biopsies or never bioptied, moreover absence of diabetes mellitus or chronic renal failure (blood creatinine >2 mg/dl). We considered: -Group A of 54 men who used the complex; -Group B of 50 patients treated with dutasteride. Then we controlled all patients 6 months after starting therapy, considering the following parameters: PSA, prostate volume, flowmetry.Results: Our results showed that both dutasteride and complex decreased PSA levels (both had a p<0.0001), with a more significant contribution of dutasteride (mean decrease of -2.743 ng/ml vs -0.971 ng/ml). Uroflowmetry also improved with both ( p<0.0001) with a mean increase in maximum flow of urine of + 3.03 ml/min for the former and + 13.02 ml/min for the latter. Lastly, dutasteride proved to be highly effective on reducing the prostate volume on TRUS (- 22.14 ml, p<0.0001) compared to Ficoxpea, which showed a mean decrease of – 10.04 ml (p<0.0001). Moreover the consistent reduction in prostate volume obtained through the use of dutasteride proved to be more intense than the one obtained by using the complex even in statistical analysis (p<0.0001).Conclusions: Both Ficoxpea and Dutasteride showed reduction of PSA values after 6 months of treatment. The complex based on phycocyanin, PEA and selenium showed a statistically significant improvement in urinary flow, while dutasteride acts more on the volume of the prostate. However, the natural complex is a product with good efficacy on the phlogistic component and does not have the side effects of dutasteride (e.g. gynecomastia, reduced libido). Therefore, we believe it can be used by a large part of the population, in order to reduce LUTS and PSA and improve urinary flow, without side effects.
Penoscrotal transposition: Long-term outcome in 29 patients
Authors: Perez Dolev , Kocherov Stanislav , Jaber Gaudat , Raisin Galiya , Chertin Boris
Published: October 2024

Objective: Penoscrotal transposition (PST) is a rare anomaly of the external genitalia characterized by malposition of the penis in relation to the scrotum. This transposition may be partial or complete and may be associated with hypospadias, chordee, and other anomalies. We have reviewed our experience with the surgical repair of PST utilizing a modified Glenn-Anderson technique.Materials and Methods: Twenty-nine patients with a median age of 5.6 years (8 months -15 years) underwent surgical repair of PST at our institution between 2004-2022. Of those, 20 (69%) had complete PST, while 9 (31%) had partial PST. All children were divided into three groups. In the first group of 8 (28%) children, repair of PST was an integral part of one-stage male genitoplasty; in the second group of 18 (62%) children, repair of PST was an isolated last stage of the staged hypospadias repair and the remaining 3 (10%) children underwent PST repair without the presence of hypospadias. All patients underwent modification of the Glenn-Anderson technique involving utilization of bilateral rotational advancement scrotal flap, complete de-tethering of the testis from the internal part of the scrotum when indicated, and relocation of the scrotal compartment in a normal dependent position. The follow-up ranged from 6 months to 18 years.Results: In the first group, five children (62%) underwent Onlay Prepucial Island Pedicle Flap (OIF) hypospadias repair, and three (38%) underwent Long Tubularized Incised Plate Repair (TIP). In the second group, 8 (44%) underwent OIF hypospadias repair, 2 (12%) had Long TIP repair, and the remaining 8 (44%) underwent staged hypospadias repair. Post-operative Clavien Dindo grade III presented among three patients in group I and only one patient in group II. In the third group, no postoperative complications were observed.Conclusion: Our data show that penoscrotal transposition correction utilizing the Glenn-Anderson technique is a reliable and durable surgery in the pediatric population. These children require careful monitoring till adolescence to ensure that no re-operation is needed.
Clinical utility of lung ultrasound for the detection of interstitial lung disease in patients with rheumatoid arthritis
Authors: Tanten Zabaleta R. , Marín J. , Zacariaz Hereter J.B. , Maritano J. , Fullana M. , Alvarado N. , Soriano S.R. , Rosa J.E.
Published: October 2024

Objective. To establish the diagnostic value of lung ultrasound (LUS) in patients with rheumatoid arthritis (RA) for the detection of interstitial lung disease (ILD).
Methods. A cross-sectional study was performed. Consecutive patients with RA (American College of Rheumatology/European League Against Rheumatism 2010 criteria) who had a chest high-resolution computed tomography (HRCT) performed within 12 months before inclusion, regardless of symptomatology, were included. Demographic, clinical, laboratory, and pharmacological data were recorded. Each patient underwent a LUS with assessment of B-lines (BL) and pleural irregularities (PI). HRCT was considered the gold standard for the confirmatory diagnosis of ILD. Receiver operating characteristic (ROC) curves were calculated to test the ability of LUS findings (BL and PI) in discriminating patients with ILD.
Results. A total of 104 RA patients were included, of which 21.8% had ILD. Patients with ILD had more BL (median 26 versus 1, p<0.001) and PI (median 16 versus 5, p<0.001) than patients without ILD. The diagnostic accuracy in ROC curves was: area under the curve (AUC) 0.88 and 95% confidence interval (CI) 0.78-0.93 for BL and AUC 0.82 and 95% CI 0.74-0.89 for PI. The best cut-off points for (ILD detection) discriminating the presence of significant interstitial lung abnormalities were 8 BL and 7 PI.
Conclusions. The presence of 8 BL and/or 7 PI in the LUS showed an adequate cut-off value for discriminating the presence of significant interstitial lung abnormalities, evocative of ILD.
The cholera paradox: Removing the pump handle
Authors: Agogo Emmanuel
Published: October 2024

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Reversible Cerebral Vasoconstriction Syndrome And Fibromuscular Dysplasia: An Epiphenomenon Or A Causal Relationship?
Authors: Neto Elizeu Pereira dos Santos , de Sousa Ícaro Araújo , Ricarte Irapuá Ferreira , Pontes-Neto Octávio Marques
Published: October 2024

Fibromuscular dysplasia (FMD) is a rare non-atherosclerotic arterial disease that primarily affects middle-aged Caucasian women. Carotid web (CW) is a variant of FMD characterized by a non- atheromatous, membrane-like tissue protrusion into the carotid bulb. Reversible cerebral vasoconstriction syndrome (RCVS) is defined by severe headaches and reversible narrowing of cerebral arteries, which typically resolves within three months. While most RCVS cases have identifiable triggers, a significant portion occurs without known causes. Recent studies have reported a high prevalence of neurovascular abnormalities in RCVS patients. We present a case of a thirty-year-old woman with a sudden-onset severe headache, diagnosed with RCVS associated with carotid web. The patient had no ischemic involvement and responded well to flunarizine treatment. Follow-up imaging showed no stenosis. This case highlights a potential association between carotid web and RCVS, suggesting that FMD may contribute to vascular hyperreactivity and presents as a risk factor for RCVS. Further investigations are needed to understand the underlying mechanisms connecting these two vascular disorders.
Molecular, Biochemical and Histological Assessment in Paraquat Induced Neurotoxicity: Restoring Role of Nano-curcumin in an Experimental Study
Authors: Mohammadi Mojdeh , Tajedini Seyed Sina , Sadeghian Zohre , Asl Sara Soleimani , Kheiripour Nejat , Sabahi Mohammadmahdi , Ranjbar Akram
Published: October 2024

Background:

Paraquat (PQ) is known to cause damage to various organs, including the brain. Although curcumin have anti-inflammatory and anti-oxidant properties, it is not yet clear how they relate to PQ-induced neurotoxicity. This study’s objective was to compare the effects of curcumin and nanocurcumin on PQ-induced neurotoxicity in male rats.

Methods:

36 rats were randomly divided into 6 groups. control subjects and animals poisoned with PQ that received treatment with or without curcumin and nano-curcumin for 7 days. The brain tissues were collected at the end of this period. Total antioxidant capacity (TAC), lipid peroxidation (LPO), and total thiol groups (TTG) were assessed by using spectrophotometry. Moreover, the histopathology of brain and antioxidant gene expression were assessed by biochemical and reverse transcriptase polymerase chain reaction (RT-PCR) analysis.

Results:

Curcumin and nanocurcumin therapy alleviated the PQ-triggered oxidative stress in brain tissue by raising the levels of anti-oxidant biomarkers like TAC and TTG, up-regulating the expression of Nrf2, HO-1, and NQO-1, reducing the levels of oxidative stress indices like LPO, and down- regulating the expression of Keap-1 in brain tissue.

Conclusions:

Treatment with curcumin and nano-curcumin improves brain function in PQ toxicity and nanocurcumin was more advantageous than ordinary curcumin.
Understanding the public knowledge, attitude, and practice toward screening and risk factors of lung cancer in Saudi Arabia: A cross-sectional study
Authors: Alamri Sadin Ayman , Alzahrani Manal Mutlaq , Alamri Aseel Ayman , Khalifa Waad Waleed , Alsulami Ruba Yosof , Bardesi Jameel , Salah Wed , Zakariyah Abeer F.
Published: October 2024

CONTEXT:

Early detection of lung cancer through screening can improve outcomes; yet public knowledge, attitudes, and practices regarding lung cancer screening in Saudi Arabia are limited.

AIMS:

The aim is to assess knowledge, attitudes, and practices toward lung cancer risk factors and screening, and understand the impact of demographic factors on these variables.

SETTINGS AND DESIGN:

An observational cross-sectional study was conducted from October 2023 to March 2024, involving 708 participants.

METHODS:

A validated questionnaire from a previous Malaysian study, translated into Arabic, was distributed to participants.

STATISTICAL ANALYSIS USED:

Descriptive statistics, Shapiro–Wilk test, one-way analysis of variance, Tukey’s test, and logistic regression were used.

RESULTS:

Most participants (95.9%) recognized smoking as a major risk factor. Common misconceptions included viewing lung cancer as infectious (84.0%) or affecting only men (14.4%). Nonetheless, 66.4% expressed willingness for future screening. Younger participants (18–40 years) and those with higher education demonstrated better knowledge scores (mean score: 11.33 ± 2.97 for ages 18–40; 11.42 ± 2.88 for those with master’s or doctorate degrees), with significant differences based on age (P = 0.007) and education level (P = 0.025). No significant differences were observed based on gender, region of residence, or monthly family income.

CONCLUSIONS:

There is a positive inclination toward lung cancer screening among the Saudi public, but there are significant knowledge gaps, particularly regarding nonsmoking-related risk factors and misconceptions, suggesting a need for enhanced public education and screening programs.
Validation of the Arabic version of the Obstructive Sleep Apnea-18 quality of life questionnaire for evaluating children with sleep apnea–hypopnea syndrome
Authors: Al-Iede Montaha , Alshrouf Mohammad Ali , Al-Ani Abdallah , Alkurdi Alaa , Jaber Areej H. , Husain Omar , Abusabra Batool , Almasri Nihad A.
Published: October 2024

BACKGROUND:

Pediatric obstructive sleep apnea (OSA) poses a significant health concern, affecting the well-being and quality of life of affected children. This study focuses on the translation, adaptation, and validation of the OSA-18 questionnaire for Arabic-speaking pediatric patients, aiming to contribute to the understanding of OSA and its implications on the quality of life in this population.

METHODS:

A study was conducted at Jordan University Hospital, involving 186 Arabic-speaking pediatric patients with suspected OSA. The OSA-18 questionnaire was translated and culturally adapted following the World Health Organization guidelines. Overnight polysomnography was conducted to assess OSA severity. Internal consistency, construct validity, convergent validity, and predictive/discriminant validity were analyzed.

RESULTS:

The study sample (68.8% of males, median age: 10.87) showed a median Apnea–Hypopnea Index (AHI) of 7.0, OSA-18 score of 46.5, and Pediatric Sleep Questionnaire (PSQ) score of 7.0. Internal consistency of OSA-18 was acceptable, except for the “physical symptoms” domain. Exploratory and confirmatory factor analyses revealed five factors corresponding to different OSA-18 domains. Convergent validity was supported by significant correlations between OSA-18 and PSQ scores. However, no correlation was found between OSA-18 scores and AHI. OSA severity was associated with higher PSQ scores but not with AHI.

CONCLUSION:

This study provides valuable insights into pediatric OSA in Arabic-speaking children. While the translation and validation of the OSA-18 questionnaire demonstrated acceptable reliability and convergent validity, the lack of correlation between OSA-18 scores and AHI raises questions about the survey’s ability to capture the full impact of OSA objectively. Future research should focus on developing more reliable diagnostic tools, especially in resource-limited settings.