bluuebunny/crossref_metadata_2025 huggingface dataset:
The use of uterine artery Doppler studies as predictors for postmolar gestational trophoblastic neoplasia
Authors: De Ramos Maria Febi Billones , Bustamante Lara Marie David , Jacinto Elizabeth Karunungan
Published: January 2024

BACKGROUND:

Gestational trophoblastic neoplasia (GTN) is considered one of the most curable malignancies, especially when diagnosis and treatment are commenced early. Identifying predictors for the development of GTN will enable prompt management equating to an excellent prognosis.

OBJECTIVES:

The objectives of this study were to determine the validity of uterine artery Doppler parameters (UADPs) as predictors for postmolar GTN, compare UADP values before and after evacuation, determine cutoff values and relationship with beta-human chorionic gonadotropin (hCG) levels.

MATERIALS AND METHODS:

This was a prospective cohort study, which included histopathologically confirmed hydatidiform mole (HM) patients who underwent suction curettage. UADPs (pulsatility index (PI), resistive index, and systolic/diastolic [S/D] ratio) were measured preevacuation, 4 weeks postevacuation, and 6 weeks postevacuation. Patients were followed up to determine whether they will develop postmolar GTN or not.

RESULTS:

A total of 31 HM patients were admitted during the study period, 84% (26/31) of whom underwent suction curettage. Of these, 92% (24/26) had histopathology of complete HM and were recruited. However, only 17 patients followed up and completed the study. Results showed that there was an increasing trend of the UADP from preevacuation to 6 weeks postevacuation and the trend between those with and without postmolar GTN was statistically significant. There was also an inverse relationship between the UADP and baseline β-hCG values. UADP showed lower values among patients who developed postmolar GTN compared to those who did not. The cutoff values recommended by the area under curve (AUC) that can be a possible predictor were 4th-week right PI of 2.14 (AUC = 0.71) and right S/D ratio of 2.60 (AUC = 0.73) and 6th-week left PI of 2.80 (AUC = 0.70) and right PI of 2.53 (AUC = 0.74).

CONCLUSION:

Neoangiogenesis, a hallmark of malignancy, is correlated with invasive disease and will show increased myometrial vascularization with lower uterine artery indices. Doppler ultrasound may be a useful tool for postmolar follow-up and GTN diagnosis. However, the small sample size in this study is a limitation and a larger multicenter study is recommended.
Bizarre presentation of choriocarcinoma: A case report
Authors: Cornel Krizia Marie M. , Soriano-Estrella Agnes L.
Published: January 2024

Choriocarcinoma is a malignant subtype of gestational trophoblastic disease that follows any type of pregnancy. It is characterized by rapid hematogenous spread to multiple organs, associated with high human chorionic gonadotropin levels with good response to chemotherapy. We present the case of a 31-year-old Filipina who initially presented with severe headaches and blurring of vision 3 years after an unremarkable term pregnancy. The transvaginal ultrasound was normal. After a series of diagnostic tests, the initial working impression was a primary brain tumor with metastases to the lungs, adrenal, kidney, and vulva. Emergency craniotomy was done due to deteriorating status secondary to an intracranial hemorrhage. The histopathology report showed choriocarcinoma. Chemotherapy using Etoposide-Methotrexate-Actinomycin D-Cyclophosphamide-Vincristine with high-dose methotrexate and concomitant whole-brain irradiation was then instituted with good response. This case highlights the importance of having a high index of suspicion for gestational trophoblastic neoplasia to prevent the performance of unnecessary procedures, leading to a delay in diagnosis and the institution of the appropriate treatment.
Qualitative assessment of the concerns on treatment and patient health among patients with gestational trophoblastic neoplasia and their caregivers during the COVID-19 pandemic
Authors: Mercado Jessabeth Bibat , De Ramos Maria Febi Billones , Cagayan Maria Stephanie Fay Samadan
Published: January 2024

BACKGROUND:

The COVID-19 pandemic has immobilized and impaired the operation of hospitals, clinics, and other health-care facilities leaving a plethora of patients and persons-at-risk in a more precarious position. Cancer patients were vulnerable to infections and complications due to the nature of the malignancy. Their caregivers were likewise predisposed to infection while taking care of them. This paper focused on determining the concerns of both gestational trophoblastic neoplasia (GTN) patients and their caregivers and identified possible factors of improvement in the delivery of essential cancer care.

OBJECTIVE:

The objective of the study was to describe the different concerns of GTN patients and their caregivers during chemotherapy and other adjunctive treatments during the COVID-19 pandemic in a Tertiary Government Hospital.

MATERIALS AND METHODS:

A qualitative type of research was employed in this research, for which an in-depth interview was used. A total of 12 respondents, 6 patients and 6 caregivers, were interviewed using a semi-structured pretested questionnaire.

RESULTS:

Findings showed that infection with COVID-19, financial and logistical constraints exacerbated by the pandemic were the main concerns of both patients and caregivers. Other concerns recorded include change in their attending physician, survivability of the patient, and the availability of caregivers.

CONCLUSIONS:

Despite the recorded apprehensions from the patients and caregivers, there was a general satisfaction in the delivery of health care at the Division of Trophoblastic Diseases due to the clarity in the follow-up and treatment schedules which have been optimized through the revised guidelines and protocols set by the division to adapt to the COVID-19 pandemic.
Association of ultrasound morphological features with serum β subunit human chorionic gonadotrophin and histopathology among sonologically diagnosed cases of gestational trophoblastic neoplasia in a tertiary hospital
Authors: Taub-Hernando Donnabelle R. , Amosco Melissa D.
Published: January 2024

BACKGROUND:

Gestational trophoblastic neoplasia (GTN) presents as vascular mass of varying morphology on ultrasound and confirmed through quantitative serum β subunit human chorionic gonadotrophin (β-hCG). In regions with limited access to β-hCG, ultrasound plays a crucial role in the initial diagnosis for timely management.

OBJECTIVES:

This study aimed to investigate the associations between ultrasound vascular morphologic features, serum β-hCG levels, and histopathology in GTN cases.

METHODOLOGY:

A cross-sectional review was conducted on 113 cases with ultrasound impression of GTN over an 8-year period. The patient data were extracted from case records, and ultrasound images were categorized based on the distinct features. Associations with β-hCG levels and histopathology were analyzed using the Chi-square test and Mann–Whitney U-test. Statistical significance was set at P < 0.05.

RESULTS:

A significant association was observed between ultrasound category and serum β-hCG (P < 0.0001). The compact and diffuse types were more prevalent with β-hCG levels between 104 to <105 mIU/mL, while the lacunar type was common among patients with ≥105 mIU/mL. However, there was no significant association between ultrasound categories and mean β-hCG levels. Regarding histopathology, the lacunar type was more common in invasive moles, whereas the compact and diffuse types tended to be seen with choriocarcinoma, although these were not statistically significant (P = 0.182).

CONCLUSIONS:

Morphologic types of GTN by gray scale and Doppler ultrasound vary across the different levels of serum β-hCG and may suggest the histopathological diagnosis. This study provides valuable insights into the ultrasonographic characteristics of GTN, which can aid in its diagnosis and management.
Varied clinical presentations of genitourinary tuberculosis: A case series at a tertiary Philippine hospital
Authors: Lim-Navarro Lilibeth , Amin-Ong Almira Jose
Published: January 2024

Genitourinary tuberculosis (GUTB) represents a critical aspect of extra-pulmonary tuberculosis (TB). While it is the second most common form of this disease, its diverse clinical presentations pose a substantial challenge. This report, titled “Varied Clinical Presentations of Genitourinary Tuberculosis: A Case Series from a Tertiary Philippine Hospital,” aims to shed light on the intricacies of GUTB diagnosis, treatment, and its broader implications. In this case series, we present five unique clinical scenarios. Cases 1, 2, and 3, having completed TB treatment, developed spontaneous genitourinary fistulae. Case 4 was initially managed as interstitial cystitis, while Case 5 underwent diverticulectomy for a urethral diverticulum. The diagnosis of GUTB as the underlying cause in these cases, despite conventional treatment, highlights the diagnostic challenges posed by this disease. All five patients, experienced irritative voiding symptoms and recurrent urinary tract infections with limited improvement following antibiotic therapy. Imaging studies consistently revealed upper urinary tract involvement. Importantly, only one case exhibited histologic evidence of granuloma suggestive of GUTB, and microbiologic confirmation of Mycobacterium
tuberculosis infection was obtained in only two cases. This underscores the need for a multidimensional diagnostic approach. The findings in this case series emphasize that GUTB diagnosis, often reliant on clinical findings supported by imaging studies and suggestive cystoscopy findings, remains critical for prognosis, even in the absence of microbiologic confirmation. Beyond the individual cases, this series offers insights into the complexity of GUTB, raising questions about the overall management and implications for TB control.
Clinical and ultrasound features of pseudomyxoma peritonei and its histopathological subtypes among women seen at a Philippine tertiary hospital: A 10-year review
Authors: Viloria Toni Andrea Marie D. , Amosco Melissa D.
Published: January 2024

OBJECTIVES:

Pseudomyxoma peritonei (PMP) in women arises from an appendiceal or ovarian pathology and presents either of two histological subtypes of differing prognosis, disseminated peritoneal adenomucinosis (DPAM), or peritoneal mucinous carcinomatosis (PMCA). This study aimed to evaluate the demographic, clinical, and sonographic features among affected women and the differences between the two histological subtypes.

METHODS:

A retrospective study was conducted involving 36 women with histopathological diagnosis of PMP who had preoperative ultrasound and underwent surgery at the department of obstetrics and gynecology in a tertiary hospital. Demographic and clinical data, ultrasound images and reports, and final histopathology were reviewed. To compare the subtypes, one-way analysis of variance for continuous data and Chi-square/Fisher exact test for categorical data were used, with P < 0.05 indicating statistical significance.

RESULTS:

Patients were mostly >50 years of age, multigravid, and presented with abdominal distention. Ultrasound examinations consistently showed amorphous, mixed echo or echogenic ascites, peritoneal thickening, and omental caking. Adnexal/ovarian masses were detected in 66.7% of cases. Omental caking was significantly more prevalent in PMCA (83.3%; P = 0.0002), whereas larger ovarian tumors (>20 cm) and papillarities were more common in DPAM (both 92.9%; P = 0.0005). Most patients underwent gynecologic surgery (n = 31; 86.1%), and 14 (38.9%) required readmission due to recurrence. The final histopathology revealed largest tumor involvement of the appendix (n = 13; 36.1%), the ovaries (n = 11; 30.5%), or undetermined (n = 12; 33.3%).

CONCLUSIONS:

Preoperative diagnosis of PMP is possible based on its clinical and ultrasound features. Although the subtypes are similar in most of these features, certain ultrasound findings may aid in distinguishing them.
Sonologic features of vulvar cancer and lymph node status among patients at a tertiary hospital – A 10-year review
Authors: Siao Ma. Patricia Grace O. , Comia Leovegildo L.
Published: January 2024

CONTEXT:

Vulvar cancers are rare gynecologic tumors. Ultrasound can characterize primary tumors and guide the biopsy of suspicious nodes. Currently, there are no studies on the sonologic features of different vulvar cancer types.

AIMS:

The aim is to determine the sonologic features of different vulvar malignancies. To compare the accuracy of ultrasound in identifying lymph node status.

SETTINGS AND DESIGN:

This is a retrospective descriptive study.

SUBJECTS AND METHODS:

Patient records, ultrasound images, and reports of vulvar cancer with long- and short-axis (L/S) ratio of inguinal nodes were reviewed from the year 2010 to 2019.

STATISTICAL ANALYSIS USED:

The accuracy of ultrasound to detect lymph nodes and the correlation of L/S ratio to histopathology were done.

RESULTS:

The study included 49 patients. The most common histopathologies were squamous cell carcinoma (SCCA), vulvar melanoma (VM), and adenocarcinoma (ADCA). Most tumors were > 4 cm, unifocal, and lateral in location. SCCA, verrucous carcinoma, VM, ADCA, adenosquamous carcinoma (ASCA), eccrine carcinoma (ECCA), and carcinosarcoma (CS) were irregular heterogeneous masses. Leiomyosarcoma (LMS) and proximal-type epithelioid sarcoma (PES) were regular, heterogeneous masses. Paget’s disease of the vulva (PDV) was hypoechogenic with regular borders. Vascularities were absent in PDV and LMS, minimal in ECCA, moderate in ASCA and PES, moderate to abundant in CS, and variable in VM. The accuracy of ultrasound in detecting lymph nodes was 78%; the accuracy of the L/S ratio was 75%. Tumor border and FIGO stage showed significant association with histopathologic type.

CONCLUSIONS:

Sonologic features and accuracy of ultrasound in predicting lymph node status help prognostication in vulvar cancer. Nodal morphometric studies are recommended for future researches.
A comparative study of subjective and objective techniques using two-dimensional ultrasound in the preoperative assessment of cervical and myometrial invasion in patients with endometrial cancer
Authors: Abria-Ybañez Doreen Baco , David-Bustamante Lara Marie , Reforma Kareen Nora
Published: January 2024

CONTEXT:

Endometrial cancer is the third most common malignancy of the female genital tract in the Philippines, following cervical and ovarian cancer. Ultrasound as the first line in imaging has a major role in preoperative treatment and planning.

AIMS:

To compare the diagnostic accuracy of subjective versus objective ultrasound measurement techniques in detecting cervical stromal invasion (CSI) and deep myometrial invasion (MI).

MATERIALS AND METHODS:

Fifty-seven patients were enrolled in this cross-sectional study. Deep MI and CSI were evaluated both subjectively and objectively by measuring tumor-free distance (TFD), distance from the outer cervical os to lowest edge of the tumor border (Dist-OCO), and distance from the internal cervical os to caudal tumor border (Dist-ICO). Histopathological result used as the gold standard.

RESULTS:

Subjective assessment for deep (MI) had 79.3% sensitivity, 82.1% specificity, 82.1% positive predictive value (PPV), 82.1% negative predictive value (NPV), and 80.7%. Subjective assessment for CSI had a sensitivity, specificity, PPV, NPV, and overall accuracy of 80%, 90.4%, 44.4%, 97.9%, and 89.5%. Objective measurement (TFD ≤0.8 cm) to detect deep MI had 86.2% sensitivity, 57.1% specificity, 67.4% PPV, 80% NPV, and 71.9% overall accuracy. Adjusting TFD cutoff to 0.65 increased to 71.4% specificity, making it comparable with subjective assessment. Dist-OCO (≤2.1 cm) yielded 100% sensitivity, 86.3% specificity, 30% PPV, 100% NPV, and 87% overall accuracy. Dist-ICO was first used in this study, hence no cutoff yet. By using receiver operating characteristics, cutoff was 0.45 cm, which yielded a 60% sensitivity and 92% specificity (area under the curve 0.731, P = 0.09).

CONCLUSIONS:

Subjective assessment of CSI and deep MI performs better than objective measurement techniques. TFD and Dist-OCO as the objective measurements showed clinically comparable accuracy to subjective assessment by an expert. Dist-ICO needs to be validated to a larger population to determine its clinical value in predicting CSI.
A life-threatening benign vascular lesion of the uterus, cavernous hemangioma: A case report
Authors: Miranda Maria Lalaine Aviles , Valencia Eleyneth Ilagan
Published: January 2024

The objective of this clinical report is to present the first local case of rare cavernous uterine hemangioma. This is a case of a 28-year-old G2P1 (1001) during her first trimester of pregnancy who was admitted to our institution for the second time due to profuse vaginal bleeding and severe anemia. The transvaginal scan revealed an embryonic demise of 8 weeks age of gestation noted at the endocervical canal. There is a posterofundal heterogeneous mass measuring 6.3 cm × 5.7 cm × 5.0 cm (volume: 94.2 ml) with multiple cystic spaces, which on Doppler studies showed abundant vascularity suggestive of uterine hemangioma. Antifibrinolytics were administered. The patient underwent emergency hysterectomy with bilateral salpingectomy due to profuse vaginal bleeding with histopathology result of cavernous hemangioma of the uterus. Cavernous uterine hemangioma is a rare vascular lesion that poses a great challenge in the diagnosis and management. There were limited published articles regarding cavernous hemangioma of the uterus. There were conservative treatment options such as uterine artery embolization, the use of hormonal oral contraception, intralesional glucocorticoid therapy, the use of interferon-α, laser therapy, and surgical excision. Hysterectomy is the definitive treatment for intractable bleeding. It is recommended to establish an international registry for this rare case. The experts in different specialties such as obstetrician-gynecologists, interventional radiologists, and vascular surgeons, can also formulate an algorithm for its diagnosis and treatment.
Pelvic arteriovenous malformation involving the uterine and internal iliac vessels with concomitant true aneurysm of uterine artery diagnosed through color Doppler ultrasound
Authors: Salamilao-Sabularce Ma Cresilda Paz B. , Cruz-Javier Gumersinda
Published: January 2024

BACKGROUND:

Pelvic arteriovenous malformations (AVMs) are rare but carries life-threatening consequences.

CASE REPORT:

A 47-year-old multipara who had previously undergone four cesarean sections came for re-evaluation of a malignant ovarian new growth. She was asymptomatic. Repeat ultrasound revealed normal ovaries, and a cystic structure at the left adnexa with abundant mixing of colors, turbulent flow and pulsative waveforms on spectral Doppler. It arises from serpentine tubular structures from the uterine isthmus. Uterine artery aneurysm was considered. Magnetic resonance angiography confirmed the findings of aneurysm and pelvic arteriovenous malformation. The patient underwent a hysterectomy with ligation and excision of aneurysm. Histopathologic findings showed pelvic AVM and a true aneurysm of the uterine artery.

CONCLUSION:

Ultrasound with color Doppler is a low-cost and readily available tool for gynecologists for the diagnosis and management of pelvic AVM.
Ultrasound-guided Tru-cut biopsy of pelvic tumors: First reported case series in the Philippines
Authors: Suarez Ferdinand Luis Guzman , Reforma Kareen Nora
Published: January 2024

This paper documents the first reported cases of patients in the country who underwent transvaginal ultrasound-guided Tru-cut biopsy of pelvic tumors in a tertiary level health institution in 2019. Different indications for Tru-cut biopsy were demonstrated highlighting its clinical utility in the diagnosis and management of malignant pelvic tumors. All patients warranted histologic diagnosis for further planning of the most appropriate management. Adequate tissue samples were obtained from all three patients with no procedure-related complications.
Human papillomavirus-DNA test in patients with abnormal cervical smears: A tool to improve the detection of invasive cervical cancer in early stages
Authors: Agarwal Neelima , Jain Ritu , Gupta Manisha , Agrawal Alpana
Published: January 2024

Introduction:

Cervical cancer is the second most frequent cancer among women in developing countries. Human papillomavirus (HPV) can be detected in 99.7% of cervical cancers. Its detection can be used as a tool to detect women, at risk for consequent development of cervical cancer. The objective of the study was to determine the prevalence of high-risk HPV in women with or without cervicitis and to evaluate the associated risk factors.

Materials and Methods:

A total of 66 patients who met with the inclusion criteria were included as case group. Thirty cytologically normal cervical smears were also included as a control and were collected from asymptomatic patients. Two cervical specimens were collected for Pap smear and HPV 16/18 reverse transcription polymerase chain reaction (PCR).

Results:

In the case group, 45.5% of patients had abnormal cervical cytological findings and majority of them had one or more menstrual abnormalities and vaginal infection, as compared to control group (P < 0.5). 13.6% of patients were HPV-PCR positive in the case group compared with none in the control group. In the HPV-positive group, the mean age was of 50.26 ± 13.293 years, while in the HPV-negative group, it was 35.29 ± 8.768 years (P < 0.0001). The rate of positivity of HPV-DNA test increased as the severity of dysplastic changes increased in cervical cytology.

Conclusion:

HPV-DNA testing should be used as an adjunct to Pap smears for the detection of cervical precancerous lesions and cervical cancer at its early stages.
Masked GANs for Face Completion: A Novel Deep Learning Approach
Authors: Sharma Anshuman , Nath Biswaroop , Kar Tejaswini , Khasim D
Published: January 2024

INTRODUCTION: Recent deep learning based image editing methods have achieved promising results for removing object in an image but fail to generate appreciable performance for removing large objects of complex nature, especially mask from facial images. Towards this goal the objective of this work is to remove mask objects in facial images. In this study, authors propose a novel approach for face completion using Generative Adversarial Networks (GANs) that utilize masked data. This technology can help in image restoration and preservation, thus enabling us to cherish those memories that are held dear to our hearts.OBJECTIVES: Train a GAN to learn the mapping from incomplete to complete face images by utilizing a masked input image.METHODS: The discriminator is trained to distinguish between face images and full ground truth images. Our results indicate that our technique generates high-quality, realistic facial images that are visually comparable to the ground truth and that it can generalise to new faces that were not encountered during training.RESULTS: Our findings indicate that GANs with masked inputs are a good approach for generating whole face images from partial or masked data.CONCLUSION: Our experimental findings show that our method produces facial images of great quality and realism that are visually equivalent to the actual thing. Our proposed approach can also be applied to fresh faces that weren’t seen. The performance can still be improved further using larger dataset. Also, further investigation into adversial attacks may help in improving performance. This technology can be further utilized for developing realtime mask removal software as well.
White Blood Cells Classification using CNN
Authors: Kiran Jinka Chandra , Naseeba Beebi , Sathwik Abbaraju Sai , Badrinath Reddy Thadikala Prakash , Lokesh Kokkula , Teja Reddy Tatigunta Bhavi , Challa Nagendra Panini
Published: January 2024

One kind of cancer that arises from an overabundance of white blood cells produced by the patient's bone marrow and lymph nodes is leukaemia. Since white blood cells are the primary source of immunity, or the body's defence, it is imperative to determine the type of leukocyte cell the patient has leukaemia from as soon as possible. Failure to do so could result in a more serious condition. Haematologists typically use a light microscope to examine the necessary cell traces in order to classify and identify the features of the cell cytoplasm or nucleus in order to diagnose leukaemia in a patient. One form of cancer is leukaemia, which develops when a patient's bone marrow and lymph nodes produce an excessive amount of white blood cells. It is vital to determine the type of leukocyte cell the patient has leukaemia from as soon as possible because postponing diagnosis can worsen the situation. Our white corpuscles are the primary source of immunity, which is the body's defence. In order to define and identify the features found in the cell cytoplasm or nucleus, hematopathologists typically use a light microscope to examine the necessary cell traces in order to diagnose leukaemia in patients.
On definable groups andD-groups in certain fields with a generic derivation
Authors: Peterzil Ya’acov , Pillay Anand , Point Françoise
Published: January 2024

We continue our study from Peterzil et al. (2022,Preprint, arXiv:2208.08293) of finite-dimensional definable groups in models of the theory$T_{\partial }$, the model companion of an o-minimal${\mathcal {L}}$-theoryTexpanded by a generic derivation$\partial $as in Fornasiero and Kaplan (2021,Journal of Mathematical Logic21, 2150007).

We generalize Buium’s notion of an algebraicD-group to${\mathcal {L}}$-definableD-groups, namely$(G,s)$, whereGis an${\mathcal {L}}$-definable group in a model ofT, and$s:G\to \tau (G)$is an${\mathcal {L}}$-definable group section. Our main theorem says that every definable group of finite dimension in a model of$T_\partial $is definably isomorphic to a group of the form$$ \begin{align*}(G,s)^\partial=\{g\in G:s(g)=\nabla g\},\end{align*} $$

for some${\mathcal {L}}$-definableD-group$(G,s)$(where$\nabla (g)=(g,\partial g)$).

We obtain analogous results whenTis either the theory ofp-adically closed fields or the theory of pseudo-finite fields of characteristic$0$.
Integral mean estimates for univalent and locally univalent harmonic mappings
Authors: Das Suman , Sairam Kaliraj Anbareeswaran
Published: January 2024

We verify a long-standing conjecture on the membership of univalent harmonic mappings in the Hardy space, whenever the functions have a “nice” analytic part. We also produce a coefficient estimate for these functions, which is in a sense best possible. The problem is then explored in a new direction, without the additional hypothesis. Interestingly, our ideas extend to certain classes of locally univalent harmonic mappings. Finally, we prove a Baernstein-type extremal result for the function
$\log (h'+cg')$
, when
$f=h+\overline {g}$
is a close-to-convex harmonic function, and c is a constant. This leads to a sharp coefficient inequality for these functions.
Infinite torsion in Griffiths groups
Authors: Schreieder Stefan
Published: January 2024

We show that there are smooth complex projective varieties with infinite

2

-torsion in their third Griffiths groups. It follows that the torsion subgroup of Griffiths groups is in general not finitely generated, thereby solving a problem of Schoen from 1992.
The 2022 Crimean-Congo Hemorrhagic Fever outbreak in Iraq
Authors: Al Salihi Karima , Hassan Younise Mohammed , Zuhair Mahmoud Zakaria , Hussain Tanveer
Published: January 2024

Crimean-Congo Hemorrhagic fever (CCHF) is an endemic, zoonotic, viral, and tick-borne disease that causes hemorrhagic symptoms. The disease has been reported in Iraq since 1979 comprising six cases between 1989 and 2009. Subsequently, 11, 3, and 33 cases were reported in 2010, 2018, and 2021, respectively. This study describes the 2022 Crimean-Congo Hemorrhagic fever virus (CCHFV) outbreak in different Iraqi governorates. In the 2022 outbreak, 212 cases of human CCHFV were reported between January 1 and May 22. These included 97 (46%) cases confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) and 115 (54%) suspected cases. Most human cases have been reported for livestock breeders and butchers. Approximately half of the confirmed cases (48%) were reported in the Dhi Qar governorate, whereas the others were reported in Missan, Muthanna, Wasit, Diwaniya, Karkh/Baghdad, Rusafa/Baghdad, Kirkuk, Basra, Najaf, Nineveh, Babylon, and Karbala. Patients with CCHFV showed symptoms of the pre-hemorrhagic phase, including sudden fever, anorexia, vomiting, diarrhea, headache, nose bleeding, and abdominal and joint pain. Later, hemorrhagic symptoms started with unexplained bleeding lesions, ranging from small petechiae to large hematomas. The factors responsible for the re-emergence of CCHFV included a shortage of veterinary services during the COVID-19 pandemic and illegal slaughtering of animals outside the abattoirs. This led to massive tick infestations that acted as viral vectors.
In conclusion, this is the first report documenting the 2022 CCHFV outbreak in Iraq, with a total of 212 patients and 27 overall deaths, including 13 laboratory-confirmed cases. The authors recommend improving veterinary services provided to farmers. Additionally, future studies need to be done including the sero-epidemiology and molecular studies on local livestock and ticks to understand their roles in circulating the virus to humans.
The Herchel Smith Intellectual Property Lecture 2022*The UK courts' striving for consistency with international decisions in patent law
Authors: Meade Richard
Published: January 2024

The Patents Court, the Court of Appeal and the Supreme Court (before that, the House of Lords) have all and for many years stressed the need for consistency with decisions of the Boards of Appeal of the EPO. They have also taken account of decisions of the national courts of other EPC member states on many occasions in pursuit of consistency, in relation to validity but also infringement. This lecture will consider: how this has been done; when it has worked well and less well; how it can and should work if the EPO (in particular) changes or develops its law differently from the UK; and how that fits with the law of precedent. It will also consider the issues that may arise with decisions under the UPC.
What IP owes to antitrust – and which IP paradigm is required to foster innovation and creativity in the digital era
Authors: Ghidini Gustavo
Published: January 2024

The Essential Facilities (EF) doctrine meant that the ‘interference’ of antitrust principles on intellectual property regimes progressively made room for third parties to access IPR-protected intangibles, inventions, and software products in particular. A substantial step indeed against the ‘monopolization’ of top-notch, ‘non-substitutable’ innovation. But the objective limits of the applicability of said doctrine appear nowadays too strict vis-à-vis the necessities of the technical mode of production of digital innovation, AI first and foremost. A proposal for a new IP paradigm is submitted – one that could reconcile said necessities with the legitimate interests to an adequate compensation of authors of (utilitarian or ‘intellectual’) digital works.
Interpretation of differences in a comparative analysis of handwriting
Authors: Dziechciaruk Janusz
Published: January 2024

According to experts’ opinion which was also confirmed by many different experiments on handwriting, most errors made by document examiners result from a misjudgment (or misinterpretation) in the significance of a difference found between the questioned and exemplar materials. The article introduces a number of ideas for improving methodology for examination of handwriting, especially how to understand one of the main principles respecting writing identification that a writer cannot ameliorate his maximum writing ability or skill without effort, practice and/or training over a period of time, or how to prepare writing standards for examination of distorted writing.
Case study: using forensic data analysis to link crime scenes
Authors: Pertsev Roman , Aronson Ayal , Tychyna Dmytro , Pasternak Zohar
Published: January 2024

Burglary crimes inflict a significant toll on society, both financially and psychologically. Most of these cases are never solved, many times because no visible signs of entry or forensic evidence are found at the scene.

In this report, we detail a police case involving a series of burglaries in Israel, all of which lacked any visible signs of forced entry. Thirteen burglaries were initially linked by the so-called forensic intelligence method and the analysis of additional forensic data obtained during the inspection of the scene and in the forensic laboratory.

Linking seemingly unrelated crime scenes through forensic data analysis can increase the effectiveness of case investigations.
Nazal Non-İnvaziv Mekanik Ventilasyon Uygulanan Yenidoğan Bebeklerde Cilt Hasarlanmalarının Değerlendirilmesi
Authors: GÜNER BAŞARA Sultan , SARIKAYA KARABUDAK Seher , ÇALIŞIR Hüsniye , KELEŞ Aylin , KAYNAK TÜRKMEN Münevver
Published: January 2024

Giriş: Nazal noninvazif mekanik ventilasyon (nNİMV) uygulamasında kanül/maske kullanımına bağlı hafif, orta ve şiddetli cilt hasarlanmaları oluşmaktadır..

Amaç: Bu araştırmanın amacı, yenidoğan yoğun bakım ünitesinde yatan ve nNİMV desteği alan bebeklerde cilt durumunu değerlendirmek ve cilt hasarı gelişme oranını belirlemektir.

Yöntem: Tanımlayıcı retrospektif desende bir arşiv taraması olan bu araştırmada yenidoğan yoğun bakım ünitesinde yatan ve 24 saatten daha uzun süre nNİMV desteği alan 95 bebeğin dosyası araştırmacılar tara-fından incelendi. Hemşire gözlem formunda yer alan Yenidoğan Cilt Durum Değerlendirmesi kullanılarak veriler toplandı.

Bulgular: Araştırmaya alınan yenidoğan bebeklerin cilt durum puanları 1. gün 3.61±0.68, 2. gün 3.82±0.66, 3. gün 3.92±0.70 ve 4. gün 4.08±0.57 idi. Bebeklerin doğum ağırlığına ve doğum şekline göre cilt durum puanları arasında istatistiksel olarak anlamlı fark bulundu (sırasıyla; p=.002, p=.010). Bebeklerin cilt durum puanları incelendiğinde; 1. gün %50.5, 2. gün %67.7, 3. gün %74.1 ve 4. gün %90 oranında ciltte hasarlanma olduğu ve buna göre nNİMV desteği alma süresi arttıkça cilt hasarlanmasının arttığı saptandı.

Sonuç: Bu araştırmada nNİMV uygulanan yenidoğan bebeklerin yatış süresi arttıkça cilt durum puanlarının ve cilt hasarlanmasının arttığı saptandı. Nazal NİMV uygulanan yenidoğan bebeklerde cilt yaralanmalarının önlenmesi ile ilgili rehber geliştirilmesi önerilir.
COVID-19 Pandemisinde Bireylerin Sağlık Kaygısı Düzeyleri ve Başa Çıkma Tutumları
Authors: ÖZBAŞ GENÇARSLAN Derya , KAPLAN Songül Nida , AÇIKGÖZ Eda , IŞIL Özlem
Published: January 2024

Giriş: Tüm dünyayı etkileyen Covid-19 pandemisi ortaya çıkardığı birçok olumsuzluğun yanı sıra bireylerin sağlık kaygısı yaşamalarına da neden olmuş ve bireyler bu süreçle uzun süre baş etmek zorunda kalmıştır.

Amaç: Bu çalışmanın amacı Covid-19 pandemi sürecinde bireylerin sağlık kaygısı düzeyleri ve başa çıkma tutumlarını belirlemektir.

Yöntem: Kesitsel ve ilişki arayıcı nitelikte olan çalışma, Temmuz 2021- Kasım 2021 tarihleri arasında bir ilde ikamet eden, çalışmaya gönüllü olarak katılmayı kabul eden, 18 yaş üstü 161 kişi ile gerçekleştirilmiştir. Veriler “Kişisel Bilgi Formu”, “Sağlık Kaygısı Envanteri” ve “Başa Çıkma Tutumlarını Değerlendirme Ölçeği” ile online olarak toplanmıştır.

Bulgular: Covid-19 pandemi sürecinde bireylerin sağlık kaygısı puanının 15.05±6.43 ve başa çıkma puanının 91.76 ±12.43 olduğu, sağlık kaygısı ile başa çıkma tutumu arasında anlamlı bir ilişki olmadığı (p>.05), bekar bireylerin evli bireylere göre daha yüksek sağlık kaygısına sahip olduğu, pandemi sürecinde psikolojik ve fiziksel yönden olumsuz etkilendiğini bildiren bireylerin sağlık kaygısının daha yüksek olduğu belirlenmiştir (p
The Identification of the Perceptions of Final-Year Midwifery Students on The Profession of Midwifery
Authors: ERGİN Ayla , KAYA ODABAŞ Resmiye , DEMİR Gözde
Published: January 2024

Background: Thoughts and perceptions of midwifery students, who are the midwives of the future, about

the profession of midwifery are quite important.

Objective: This study aims to identify the perceptions of final-year midwifery students on the profession of

midwifery.

Methods: This analytical cross-sectional study was conducted from December 2021 to January 2022 The

population was final-year undergraduate midwifery students enrolled in 11 public universities selected by lot in Turkey, whilst the sample comprised final-year midwifery students selected from this population (n=330). The data were collected online using a Personal Information Form and the Midwifery Vocational Perception Scale. In the analysis of the data, descriptive statistics, the Mann-Whitney U test, and the Kruskal-Wallis H test were used.

Results: The participants had a mean age of 22.06±2.02 years. Of all participants, 93.3% stated that they

viewed the profession of midwifery positively. Moreover, the mean Midwifery Vocational Perception Scale

score of the participants was 75.58±5.14, and the Cronbach’s alpha coefficient of the scale was calculated as .89. There was no statistically significant difference in the mean Midwifery Vocational Perception Scale scores of the participants based on their age, marital status, family type, economic status, employment status, maternal education level and employment status, paternal education level and employment status (p>.05), Midwifery Vocational Perception Scale scores of those who viewed the profession positively (76.03±4.58) were statistically higher than those who thought negatively (69.18±7.85) (p
Yenidoğan Yoğun Bakım Ünitesinde Preterm Bebeği Yatan Annelerin Memnuniyetleri ile Hastaneden Eve Geçişte Yaşadıkları Sorunlar Arasındaki İlişkinin İncelenmesi: Kesitsel Bir Çalışma
Authors: ARIKAN Cansu , MENEKŞE Dilek
Published: January 2024

Giriş: Yenidoğan Yoğun Bakım Ünitesinde (YYBÜ) preterm bebeği yatan ebeveynler için hastanedeki yatış

ve eve geçiş dönemi kritik bir zamandır.

Amaç: Bu çalışma yenidoğan yoğun bakım ünitesinde preterm bebeği yatan annelerin memnuniyetleri ile

hastaneden eve geçişte yaşadıkları sorunlar arasındaki ilişkiyi belirlemek amacıyla yapılmıştır.

Yöntem: Tanımlayıcı, kesitsel ve ilişki arayıcı olarak planlanan araştırma, İstanbul ilinde bir eğitim ve

araştırma hastanesinin YYBÜ’nde preterm bebeği yatan 200 anne ile yapılmıştır. Veriler Nisan 2021- Nisan

2022 tarihleri arasında “Tanıtıcı Bilgi Formu”, “Preterm Yenidoğan Tanıtıcı Bilgi Formu”, “Yenidoğanda

Ebeveynlerin Güçlendirilmesi (EMpowerment of PArents in THe Intensive Care/ EMPATHIC-30)” anketi

ve “Eve Geçiş: Preterm Ebeveyn Ölçeği (EG: PEÖ)” kullanılarak toplanmıştır. Veriler, SPSS programı

kullanılarak yüzdeler, ortalamalar, bağımsız t-testi, ANOVA, pearson korelasyon analizi ile değerlendirilmiştir.

Bulgular: Annelerin EMPATIC-30 ölçek toplam puan ortalaması 5.41±.34, EG: PEÖ toplam puan ortalaması

73.82±8.31’dir. EMPATHIC-30 ölçeği ile EG: PEÖ arasında anlamlı bir ilişki bulunmamıştır (r=-.06; p=.331).

EMPATHIC-30 ölçeği bakım-tedavi alt boyutu ile EG: PEÖ endişe ve izolasyon boyutu arasında istatistiksel

olarak anlamlı ve negatif yönlü bir ilişki olduğu saptanmıştır (r=-.156; p=.028).

Sonuç: Yenidoğan yoğun bakım ünitesinde preterm bebeği yatan annelerin memnuniyetleri ile hastanedeneve geçişte yaşadıkları sorunlar arasında herhangi ilişki bulunmamıştır.
The Correlation between the Compassion and Moral Sensitivities of Nurses during COVID-19 Pandemic
Authors: SEVİNÇ Sibel , ELMAOĞLU Erhan , SUNGUR Meltem , ÖZDEMİR Serap
Published: January 2024

Background: Nurses have encountered with care load, different physical, psychological and emotional ef-fects during Covid-19 pandemic.

Objectives: This study conducted to investigate the correlation between nurses compassion and moral sen¬sitivities during Covid-19 pandemic.

Method: The study was designed in descriptive and correlational type. The study was completed with 713 nurses between January 20 and February 20, 2021 at the Training and Research Hospital, which has been serving as a pandemic hospital for a year. In the study, a questionnaire including data about the socio-demo¬graphic and professional characteristics of the nurses and Compassion Scale and Moral Sensitivity Ques¬tionnaire were used. The data were collected online. In the analysis of comparative data, Pearson correlation analysis, t-test, one way ANOVA analysis and tests were used.

Results: In the study, it was found that the total mean scores of the nurses were 94.45±11.75 for the com-passion scale and 76.76±26.91 for the moral sensitivity questionnaire. There was negative correlation be-tween the compassion total score and holistic approach, orientation while positive correlation between the total score and conflict, practice subscales. There was positive correlation moral sensitivity total scale and subscales kindness, common humanity, mindfulness while negative correlation between total score and disengagement. Younger, female, single, childless, getting opinion from patient/relative nurses have high compassion. High school graduate, employed 11 years and above, nurses have high moral sensitivity.

Conclusion: It can be said that compassion affects moral sensitivity in positive and negative dimensions during the pandemic process. In this stressful process, it can be suggested to organize trainings to support nurses morally and psychologically and to increase moral sensitivity.
Studiul profilului de personalitate al femeii agresor privată de libertate
Authors: CHIȚOI Anca Daniela
Published: January 2024

This experimental study aims to determine the specifi c personality traits of female incarcerated aggressors in Romanian prisons, a category of inmates that has been insuffi ciently investigated regarding their personality profi le. The research sample consisted of 200 incarcerated women, defi nitively convicted for off enses including homicide, drug traffi cking and consumption, theft, and economic crimes. The investigation of the personality profi le of female aggressor inmates was conducted using the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ), the Nonverbal Personality Questionnaire in Five Factors (FFNPQ), and the Freiburg Personality Inventory (FPI). Analyzing and synthesizing the results of this research, we can conclude that female aggressor inmates exhibit a distinct personality profi le compared to female inmates who have committed non-violent off enses.
Peculiarities of social representation of forensic psychological expertise
Authors: MELENTIEVA Aliona
Published: January 2024

Forensic psychological expertise is at the beginning of its development and establishment, being used rarely in criminal/civil proceedings. The “status” of forensic psychological expertise is undefined, mainly because of the lack of specialists, as well as because psychologists face negative and skeptical attitudes from legal workers. In this context, the purpose of this research is to reveal the social representations of forensic psychological expertise among specialists working in the legal field. The given research has involved 417 specialists in the legal field (officers of criminal investigation, lawyers, attorneys), aged between 24-62, men and women, with different professional experience in the legal field, who have completed a questionnaire (elaborated by the author). The analysis of the results emphasized the knowledge, attitudes and beliefs of specialists regarding the forensic psychological expertise integrated in the structure and silent zone of the social representation.
Euronews as a Tool for the Formation of Europe’s Image
Authors: Melkumyan Yuliana , Harutyunyan Karine
Published: January 2024

The ongoing political and economic transformations affect the image of Europe: the economic crisis, Brexit, the migration crisis, the Russian-Ukrainian war and other events are a challenge to the image of Europe. Euronews, being Europe’s leading TV channel, is used as a tool to shape Europe’s image by demonstrating European democracy, unity, identity and values.
This article presents interpretations of the term ‘regional image’, analyzes the regional image of Europe, the role of the media and, in particular, of Euronews in shaping the regional image, and also presents the results of a content analysis of the channel’s live broadcasts and publications of the official Euronews website. The study clearly demonstrates how Euronews uses the techniques of repetition, exclusion, framing, agenda setting, and the context of the Russian-Ukrainian war to shape the image of Europe in line with the main goals of the EU.
This article proposes the features of creating content for the regional image of Europe for the news television broadcast Euronews, scientifically argued from the perspective of communication theory, and examines the features of preparing journalistic material for broadcast.
Digital Authoritarianism as a Modern Threat to Democratic Stability: Restriction of Freedom or Network Politicization?
Authors: Mirzoyan Armen
Published: January 2024

This article is dedicated to the identification of contemporary instances of digital authoritarianism, exploring its definitions, characteristics, methodologies, and the tools employed by authoritarian governments to manipulate the social and political conduct of their citizens and control the flow of information. It aimed to consolidate power, control and manipulate information, and suppress dissent. The article delves into the various interpretations of digital authoritarianism by analyzing its fundamental elements and evident expressions. Through a comprehensive review of scholarly literature, reports, news publications and case studies, the article aims to unravel the dynamic nature of digital authoritarianism, shedding light on how it adjusts to technological progress and confronts conventional notions of liberty within the digital era. Digital authoritarianism materializes through mass surveillance, cyber attacks, information censorship, and the targeted utilization of citizen data. A thorough exploration of digital authoritarianism can empower democratic societies to preclude potential infiltration of such manifestations, uphold democratic principles, and arrange the landscape based on these principles while ensuring unfettered access to information.
Demir İpek Yolu Güzergahında Kuruluş Yeri Seçimi: Kapıkule-Kars Örneği
Authors: YIKIN Mehmet Taha , ÖZCAN Evrencan
Published: January 2024

İpek Yolu, tarihi boyunca birçok medeniyet arasında ticaretin yapıldığı en önemli yollarından biri olmuştur. Coğrafi keşiflerden sonra yeni ticaret yollarının bulunması sonucunda önemini kaybeden İpekyolu, güzergâh ülkeleri tarafından demir İpek Yolu olarak yeniden canlandırılmış, Trans Hazar Uluslararası Taşıma Koridoru olarak taşımalara açılmıştır. Özellikle Marmaray tüp geçidinin yapılması ile Çin’den gelen yüklerin bu geçidi kullanarak Avrupa’ya gitmesi, Türkiye’nin özellikle Jeopolitik konumu itibari ile Avrupa ve Uzak Doğu arasında önemli bir transit ülke olması ile Kars ve Kapıkule sınır kapılarının yoğun olarak kullanılması, ülkemizi önemli bir cazibe merkezi haline getirmiştir. Kuruluş yeri seçiminde ön önemli etkenler dikkate alındığında, gerek dopolama gerek bakım, gerekse diğer lojistik süreçlerin etkin ve verimli performansı için seçilecek yerin özellikle diğer taşıma modlarına kolay erişim sağlayan bir lokasyonda olması büyük önem arz etmektedir. Bu çalışmada, Kapıkule-Kars arasında Türkiye’deki demiryolu ağının karayolu kavşak noktaları ile kesiştiği noktalar seçilerek 27 dal 31 düğümden oluşan bir şebeke oluşturulmuştur. Yer ve güzergâh seçimini etkileyen 6 tane kriterler belirlenmiş pisagor bulanık analitik hiyerarşik prosesi ile kriterlerin ağırlıkları belirlenmiş, COPRAS yöntemi ile alternatifler önem derecelerine göre sıralanmıştır. Bulunan değerler Dijkstra Algoritması kullanılarak Python programlama dilinde kodlanarak çözülmüştür. Kapıkule-Kars arasındaki hat kesiminde demiryolu güzergahının karayolu kavşak noktaları ile kesiştiği noktalarda en uygun yer ve rota seçimi yapılmıştır.