bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and evaluation of a point-of-care ultrasound curriculum for paramedics in Germany – a prospective observational study and comparison
Authors: Jonck Christopher , Weimer Andreas Michael , Fundel Beatrice , Heinz Wolfgang , Merkel Daniel , Fiedel Hendrik , Ille Carlotta , Kloeckner Roman , Buggenhagen Holger , Piepho Tim , Weimer Johannes
Published: July 2024

Background

Point-of-care ultrasound (POCUS) is steadily growing in use in prehospital emergency medicine. While currently used primarily by emergency physicians, POCUS could also be employed by paramedics to support diagnosis and decision-making. Yet to date, no paramedicine-targeted POCUS curricula exist in Germany. Furthermore, given time and resource constraints in paramedic training, it is unclear whether paramedics could feasibly learn POCUS for prehospital deployment. Hence, this study outlines the development and implementation of a comprehensive POCUS curriculum for paramedics. Through this curriculum, we investigate whether paramedics can attain proficiency in POCUS comparable to other user groups.

Methods

In this prospective observational study, we first developed a blended learning-based POCUS curriculum specifically for paramedics, focusing on basic principles, the RUSH-Protocol and ultrasound guided procedures. Participants underwent digital tests to measure their theoretical competence before (T1) and after the digital preparation phase (T2), as well as at the end of the on-site phase (T3). At time point T3, we additionally measured practical competence using healthy subjects and simulators. We compared the theoretical competence and the practical competence on a simulator with those of physicians and medical students who had also completed ultrasound training. Furthermore, we carried out self-assessment evaluations, as well as evaluations of motivation and curriculum satisfaction.

Results

The paramedic study group comprised n = 72 participants. In the theoretical test, the group showed significant improvement between T1 and T2 (p < 0.001) and between T2 and T3 (p < 0.001). In the practical test on healthy subjects at T3, the group achieved high results (87.0% ± 5.6). In the practical test on a simulator at T3, paramedics (83.8% ± 6.6) achieved a lower result than physicians (p < 0.001), but a comparable result to medical students (p = 0.18). The results of the study group’s theoretical tests (82.9% ± 9.2) at time point T3 were comparable to that of physicians (p = 0.18) and better than that of medical students (p < 0.01). The motivation and attitude of paramedics towards the prehospital use of POCUS as well as their self-assessment significantly improved from T1 to T3 (p < 0.001). The overall assessment of the curriculum was positive (92.1 ± 8.5).

Conclusion

With our tailored curriculum, German paramedics were able to develop skills in POCUS comparable to those of other POCUS learners. Integration of POCUS into paramedics’ training curricula offers opportunities and should be further studied.
Nursing Professional Values Scale (NPVS-3) in an Austrian context: validation of a scale and reliability assessment
Authors: Podgorica Nertila , Rached Chennyfer Dobbins Abi , Crescente Nicole Yamada , Zenzmaier Christoph , Müller Gerhard
Published: July 2024

Background

The Nurses Professional Values Scale-3 (NPVS-3) is a psychometric instrument derived from a set of values initially established by the American Nurses Association (ANA) Code of Ethics. The present study evaluates the reliability of the NPVS-3 scale for nursing students and nurses in Austria.

Methods

A cross-sectional methodological study was conducted on 209 research participants, comprising 139 nursing students and 70 nurses, with the objective of determining the reliability of the Austrian version of the scale. A multilevel approach was employed in the study, encompassing cultural and linguistic validation, content validity, face validity, and construct validity. The scale translation was performed per the established translation stages of back-translation and was subsequently reviewed by an expert committee. The translated instrument was applied to the participants who completed an online survey between April and July 2023. Internal consistency was evaluated using Cronbach’s alpha, while construct validity was assessed using confirmatory factor analysis (CFA).

Results

The Cronbach's alpha values obtained were deemed appropriate, with the following results: Caring (0.852), Activism (0.832), and Professionalism (0.676). Through factorial analysis, three factors were identified as original NPVS-3 and construct validity was verified.

Conclusion

The Austrian version of the NPVS-3 demonstrated satisfactory validity, efficiently evaluating the professional values of nurses and nursing students in Austria.
Spiritual needs and influencing factors among people with stroke in China: a cross-sectional study
Authors: Li Z.-Y. , Cao X. , Li S. , Huang T.-J. , Liu Y.-X. , Qin L.-H.
Published: July 2024

Background

Stroke is one of the primary causes of disability in China and around the world, having an impact on the health and well-being of stroke patients. The importance of spiritual needs for stroke patients has always been a controversial topic internationally, partly because related research was mostly qualitative and may not directly reflect the degree of spiritual needs. In addition, most studies focus on the same cultural background, there is a lack of research that delves into the nuances of Chinese culture and background. The goal of this study is to evaluate the level of spiritual needs and influencing factors in Chinese stroke patients and to explore the mediating role and pathways of these variables on spiritual needs.

Methods

From August 2022 to January 2023, we conducted a cross-sectional questionnaire survey of 422 stroke patients in the affiliated hospitals of Hunan University of Chinese Medicine in Changsha Province by cluster sampling. We measured the patient’s spiritual needs, quality of life, anxiety and depression levels, and family support using the Spiritual Needs Questionnaire (SPNQ), the MOS36 item Short Form Health Survey (SF-36), the Hospital Anxiety and Depression Scale (HADS), and the Family Support Self Rating Scale (PSS-Fa). We used the General Information Questionnaire to gain insight into the sociodemographic characteristics of the patients. Nonparametric tests and multiple linear regression models were used to analyze the independent relationship between spiritual needs and quality of life, anxiety, depression, and family support. The mediation model in AMOS 24.0 software was used to analyze the mediating role among the five variables.

Results

The score of spiritual needs of people with stroke included in this study was 37 points [IQR 33 to 40)]. The influencing factors of spiritual needs included primary economic sources for disease-related expenditures (p = 0.044), number of stroke occurrences (p = 0.001), duration of illness (p = 0.023), activities of daily living (p = 0.006), depression scores(p = 0.034), and family support scores(p = 0.008). Anxiety (β = 0.347, p = 0.004), depression (β = 0.368, p = 0.005), and family support (β = 0.167, p = 0.023) had directly or indirectly affected the spiritual needs of people with stroke. Quality of life (β=-0.202, p = 0.017) had a direct effect on spiritual needs.

Conclusions

The spiritual needs of people with stroke were at an intermediate level. Our findings highlight that the SPNQ score is associated with anxiety, depression, quality of life, and family support. Therefore, nurses should identify the spiritual needs of patients and provide them with effective and comprehensive spiritual care by reducing negative emotions and enhancing social support, promoting the development and progress of spiritual care in China. This study offers a theoretical basis for the spiritual care of clinical people with stroke and constructing a stroke spiritual care model.
Communication between alveolar macrophages and fibroblasts via the TNFSF12-TNFRSF12A pathway promotes pulmonary fibrosis in severe COVID-19 patients
Authors: Guo Lei , Chen Qiong , Xu Mengying , Huang Jing , Ye Hua
Published: July 2024

Background

Severe COVID-19 infection has been associated with the development of pulmonary fibrosis, a condition that significantly affects patient prognosis. Understanding the underlying cellular communication mechanisms contributing to this fibrotic process is crucial.

Objective

In this study, we aimed to investigate the role of the TNFSF12-TNFRSF12A pathway in mediating communication between alveolar macrophages and fibroblasts, and its implications for the development of pulmonary fibrosis in severe COVID-19 patients.

Methods

We conducted single-cell RNA sequencing (scRNA-seq) analysis using lung tissue samples from severe COVID-19 patients and healthy controls. The data was processed, analyzed, and cell types were annotated. We focused on the communication between alveolar macrophages and fibroblasts and identified key signaling pathways. In vitro experiments were performed to validate our findings, including the impact of TNFRSF12A silencing on fibrosis reversal.

Results

Our analysis revealed that in severe COVID-19 patients, alveolar macrophages communicate with fibroblasts primarily through the TNFSF12-TNFRSF12A pathway. This communication pathway promotes fibroblast proliferation and expression of fibrotic factors. Importantly, silencing TNFRSF12A effectively reversed the pro-proliferative and pro-fibrotic effects of alveolar macrophages.

Conclusion

The TNFSF12-TNFRSF12A pathway plays a central role in alveolar macrophage-fibroblast communication and contributes to pulmonary fibrosis in severe COVID-19 patients. Silencing TNFRSF12A represents a potential therapeutic strategy for mitigating fibrosis in severe COVID-19 lung disease.
A CNN model for early detection of pepper Phytophthora blight using multispectral imaging, integrating spectral and textural information
Authors: Duan Zhijuan , Li Haoqian , Li Chenguang , Zhang Jun , Zhang Dongfang , Fan Xiaofei , Chen Xueping
Published: July 2024

Background

Pepper Phytophthora blight is a devastating disease during the growth process of peppers, significantly affecting their yield and quality. Accurate, rapid, and non-destructive early detection of pepper Phytophthora blight is of great importance for pepper production management. This study investigated the possibility of using multispectral imaging combined with machine learning to detect Phytophthora blight in peppers. Peppers were divided into two groups: one group was inoculated with Phytophthora blight, and the other was left untreated as a control. Multispectral images were collected at 0-h samples before inoculation and at 48, 60, 72, and 84 h after inoculation. The supporting software of the multispectral imaging system was used to extract spectral features from 19 wavelengths, and textural features were extracted using a gray-level co-occurrence matrix (GLCM) and a local binary pattern (LBP). The principal component analysis (PCA), successive projection algorithm (SPA), and genetic algorithm (GA) were used for feature selection from the extracted spectral and textural features. Two classification models were established based on effective single spectral features and significant spectral textural fusion features: a partial least squares discriminant analysis (PLS_DA) and one-dimensional convolutional neural network (1D-CNN). A two-dimensional convolutional neural network (2D-CNN) was constructed based on five principal component (PC) coefficients extracted from the spectral data using PCA, weighted, and summed with 19-channel multispectral images to create new PC images.

Results

The results indicated that the models using PCA for feature selection exhibit relatively stable classification performance. The accuracy of PLS-DA and 1D-CNN based on single spectral features is 82.6% and 83.3%, respectively, at the 48h mark. In contrast, the accuracy of PLS-DA and 1D-CNN based on spectral texture fusion reached 85.9% and 91.3%, respectively, at the same 48h mark. The accuracy of the 2D-CNN based on 5 PC images is 82%.

Conclusions

The research indicates that Phytophthora blight infection can be detected 48 h after inoculation (36 h before visible symptoms). This study provides an effective method for the early detection of Phytophthora blight in peppers.
NGF-BMSC-SF/CS composites for repairing knee joint osteochondral defects in rabbits: evaluation of the repair effect and potential underlying mechanisms
Authors: Zhang Yong , Huang Wenliang , Xiao Hongli , Ruan Shiqiang , Deng Jiang
Published: July 2024

Background

With the rapid growth of the ageing population, chronic diseases such as osteoarthritis have become one of the major diseases affecting the quality of life of elderly people. The main pathological manifestation of osteoarthritis is articular cartilage damage. Alleviating and repairing damaged cartilage has always been a challenge. The application of cartilage tissue engineering methods has shown promise for articular cartilage repair. Many studies have used cartilage tissue engineering methods to repair damaged cartilage and obtained good results, but these methods still cannot be used clinically. Therefore, this study aimed to investigate the effect of incorporating nerve growth factor (NGF) into a silk fibroin (SF)/chitosan (CS) scaffold containing bone marrow-derived mesenchymal stem cells (BMSCs) on the repair of articular cartilage defects in the knees of rabbits and to explore the possible underlying mechanism involved.

Materials and methods

Nerve growth factor-loaded sustained-release microspheres were prepared by a double emulsion solvent evaporation method. SF/CS scaffolds were prepared by vacuum drying and chemical crosslinking. BMSCs were isolated and cultured by density gradient centrifugation and adherent culture. NGF-SF/CS-BMSC composites were prepared and implanted into articular cartilage defects in the knees of rabbits. The repair of articular cartilage was assessed by gross observation, imaging and histological staining at different time points after surgery. The repair effect was evaluated by the International Cartilage Repair Society (ICRS) score and a modified Wakitani score. In vitro experiments were also performed to observe the effect of different concentrations of NGF on the proliferation and directional differentiation of BMSCs on the SF/CS scaffold.

Results

In the repair of cartilage defects in rabbit knees, NGF-SF/CS-BMSCs resulted in higher ICRS scores and lower modified Wakitani scores. The in vitro results showed that there was no significant correlation between the proliferation of BMSCs and the addition of different concentrations of NGF. Additionally, there was no significant difference in the protein and mRNA expression of COL2a1 and ACAN between the groups after the addition of different concentrations of NGF.

Conclusion

NGF-SF/CS-BMSCs improved the repair of articular cartilage defects in the knees of rabbits. This repair effect may be related to the early promotion of subchondral bone repair.
A practical approach on the classifications of myeloid neoplasms and acute leukemia: WHO and ICC
Authors: Xiao Wenbin , Nardi Valentina , Stein Eytan , Hasserjian Robert P.
Published: July 2024

In 2022, two new classifications of myeloid neoplasms and acute leukemias were published: the 5th edition WHO Classification (WHO-HAEM5) and the International Consensus Classification (ICC). As with prior classifications, the WHO-HAEM5 and ICC made updates to the prior classification (revised 4th edition WHO Classification, WHO-HAEM4R) based on a consensus of groups of experts, who examined new evidence. Both WHO-HAEM5 and ICC introduced several new disease entities that are based predominantly on genetic features, superseding prior morphologic definitions. While it is encouraging that two groups independently came to similar conclusions in updating the classification of myeloid neoplasms and acute leukemias, there are several divergences in how WHO-HAEM5 and ICC define specific entities as well as differences in nomenclature of certain diseases. In this review, we highlight the similarities and differences between the WHO-HAEM5 and ICC handling of myeloid neoplasms and acute leukemias and present a practical approach to diagnosing and classifying these diseases in this current era of two divergent classification guidelines.
Inspection prioritization of gravity sanitary sewer systems using supervised machine learning algorithms
Authors: Loganathan Karthikeyan , Najafi Mohammad , Kermanshachi Sharareh , Maduri Praveen Kumar , Pamidimukkala Apurva
Published: July 2024

Underground wastewater collection systems degrade with time, necessitating utility owners to engage in ongoing evaluations and enhancements of their asset management frameworks to preserve the performance of their assets. The inspection and condition assessment of sewer pipes are crucial for the effective operation and maintenance of sewer systems. The closed-circuit television (CCTV) is frequently employed to examine sewer pipes in the United States. This procedure is both costly and laborious because of the extensive number of pipes in a metropolis. Prioritisation of inspection for sanitary sewage pipe segments requiring repair or maintenance can be done in advance depending on their past performance. Hence, the aim of this study is to construct a predictive model for the state of sanitary sewer pipes, utilising data collected from a city located in the southcentral region of the United States. The main contribution is that this study used multiclass classification and predicted PACP scores of the pipes. Condition prediction models were developed using extensively utilised supervised machine learning algorithms including logistic regression (LR), k-nearest neighbors (k-NN), and random forest (RF). However, the bulk of the constructed models were assessed using a limited number of assessment measures, such as the receiver operator characteristic (ROC) curve and the area under the curve (AUC) value. This paper asserts that the assessment of the predictive capacity of these models cannot be determined only by relying on ROC and AUC values. Out of the three models evaluated in this study, the LR model had an AUC value of 0.76. However, this model had a higher number of misclassifications or inaccurate predictions compared to the other models. Consequently, these models were assessed using additional assessment measures, including precision, recall, and F-1 scores (which represent the harmonic mean of precision and recall). Curiously, the LR model achieved an F1-score of 0.28 on a scale ranging from 0 to 1. The RF model yielded an F1-score of 0.45 and an AUC value of 0.86. The existing model can be enhanced before it is employed by asset managers during the inspection phase to assess the state of their sanitary sewers and identify essential sewers that require immediate care.
Confronting the Legacy of Eugenics and Ableism: Towards Anti-Ableist Bioscience Education
Authors: Da Silva Sarah-Marie , Hubbard Katharine
Published: July 2024

Society and education are inherently ableist. Here, we explore antiableist approaches to bioscience education in an essay coauthored by a disabled student and able-bodied faculty member. We explore the relationship between eugenics and bioscience education and propose a “disability-competent bioscience curriculum” for all students.
“Just a Way to Trick the French”
Authors: Le Guelte Johann
Published: July 2024

This article examines the lived experience and self-advocacy of three troupes of colonial actors displayed globally between 1929 and 1931: two troupes of Sara men and women from Chad and a troupe of Kanak actors from New Caledonia and Dependencies. While multiple studies of colonial ethnic displays have focused on the nature and reception of these spectacles, actors themselves have rarely been researched as subjects. In listening to their voices and retracing their agency, this article shows the numerous and nuanced ways they resisted the violence of their displays and the strategies they deployed to make their voices heard on the global stage of empire. Furthermore, this research argues for a scholarly reconsideration of the term human zoo and demonstrates the central role played by those on display in the gradual disappearance of this phenomenon of colonial entertainment.
Beliefs, Learning, and Personality in the Indefinitely Repeated Prisoner’s Dilemma
Authors: Gill David , Rosokha Yaroslav
Published: July 2024

We aim to understand the role and evolution of beliefs in the indefinitely repeated prisoner’s dilemma (IRPD). To do so, we elicit beliefs about the supergame strategies chosen by others. We find heterogeneity in beliefs and changes in beliefs with experience are central to understanding behavior and learning in the IRPD. Beliefs strongly predict cooperation, beliefs respond to the return to cooperation, most subjects choose strategies that perform well given their beliefs, and beliefs change with experience while becoming more accurate over time. Finally, we uncover a novel mechanism whereby trusting subjects learn to cooperate through their interaction with experience. (JEL C72, C73, C91, D83, D91)
Concentration and Geographic Proximity in Antitrust Policy: Evidence from Bank Mergers
Authors: Benson David , Blattner Samuel , Grundl Serafin , Kim You Suk , Onishi Ken
Published: July 2024

Antitrust often uses the Herfindahl-Hirschman Index (HHI) for merger screening and review. We argue that HHI-based antitrust policy using predefined markets in the banking industry misses anticompetitive effects that are predicted by the proximity of merging branch networks. Difference-in-differences estimates from thousands of mergers reveal that close-proximity bank acquisitions have harmful effects, including branch closures, even if they fall below the HHI threshold for enforcement. Neither lowering the threshold nor using narrower predefined markets addresses this underenforcement without introducing significant overenforcement and underenforcement of other transactions. However, using a proximity threshold to complement the HHI policy could improve bank antitrust. (JEL G21, G28, G34, K21, L13, L41)
New-onset diabetes mellitus in patients with COVID19 infection admitted to a tertiary care hospital: A single-center experience
Authors: Afridi Muhammad Abdur Rahman Afridi , Zafar Ali  , Naveed Iqbal  , Usman Zeb
Published: July 2024

Objective: To determine the frequency of new-onset diabetes mellitus (NODM) in patients with COVID-19 in a tertiary care hospital.
Method: It was a retrospective descriptive study carried out in Lady Reading Hospital Peshawar, Khyber Pakhtunkhwa province of Pakistan from November 2021 to April 2022. All patients having new onset Diabetes Mellitus (NODM) were identified among a total of 300 patients admitted to the hospital with COVID-19 infection. Patients’ data including relevant investigations were accessed through the hospital management information system (HMIS). SPSS version-23 was used for data entry and statistical analysis.    
Results: Out of 300 COVID-19 patients included in the study, 163 (54.3%) were female and 137(45.7%) were male. The mean age of the patients was 56.80±13.72 (IQR 15) years. Frequency of the new onset diabetes was 44(14.7%); 19 (6.33%) male and 25(8.33%) female. Among the 44 NODM patients, the majority (57%) were female (p=0.720). Most (64%) of the patients with new-onset DM were in the middle age (p=0.018).
Conclusion: A significant number of patients with COVID-19 infection are prone to develop new-onset diabetes during their admission to the hospital.
doi: https://doi.org/10.12669/pjms.40.8.8797
How to cite this: Afridi MAR, Ali Z, Iqbal N, Zeb U. New-onset diabetes mellitus in patients with COVID19 infection admitted to a tertiary care hospital: A single-center experience. Pak J Med Sci. 2024;40(8):---------. doi: https://doi.org/10.12669/pjms.40.8.8797
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Comparison of treatment of volar Barton’s fracture with T plate using distal end screws and without distal end screws
Authors: Sajjad Haider  , Awais Muhammad Zarak , Eman Salik  , Iqbal Muhammad Tahir
Published: July 2024

Objective: To compare the functional and radiological outcomes of treatment of volar Barton’s fractures using T plate with and without distal end screws.
Methods: This randomized control trial was conducted at the department of Orthopedics, Mayo Hospital, Lahore, Pakistan from December 2021 to May 2022. Total 60 patients (30 in each group) were randomly allocated to either group A (T-Plate with distal end screws) or B (T-Plate without distal end screws). Patients were followed up on day-0, day-14, day-28 and day-90. Assessments of patients were done by Green O’Brien Score for pain, Modified Warden Score for callus formation on radiographs at 12-weeks of follow-up and Stewart Score for displacement of fracture.
Results: At 90th day, significant difference was seen in Green O’Brien Score (Excellent score: Group-A: 80% vs. Group-B: 90%, p=0.278) while Stewart scores remained comparable (Excellent Score: Group-A: 93.33% vs. Group-B: 96.67%, p=0.221) between treatment groups. Fracture healing assessed with Modified Warden score for score 4 did not show significant difference between both groups at 90th day. i.e. (Group-A: 96.67% vs. Group-B: 96.67%). However, callus formation assessed with Modified Warden score for score 3 showed significant differences between groups at 90th day. i.e. (Group-A: 53.33% vs. Group-B: 86.67%, p=0.001).
Conclusion: Both treatment approaches appear to yield comparable outcomes in terms of clinical assessment, Stewart scores, and fracture healing, with a potential advantage for T-plate without distal end screw in callus formation at the 90th day.
Trial registration: IRCT20221231056999N1.
doi: https://doi.org/10.12669/pjms.40.8.8799
How to cite this: Haider S, Awais MZ, Salik E, Iqbal MT. Comparison of treatment of volar Barton’s fracture with T plate using distal end screws and without distal end screws. Pak J Med Sci. 2024;40(8):---------. doi: https://doi.org/10.12669/pjms.40.8.8799
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Caesarean Section frequency in Nulliparous Women induced at 39 weeks versus conventional management: An open label random allocation study
Authors: Shaikh Erum Majid , Zuberi Bader Faiyaz , Gul Kanwal , Jam Hira , Haseena Gul
Published: July 2024

Objective: To compare frequency of caesarean section in singleton primary-para women induced at 39 week and its comparison with conventional management. The other objective was comparison of perinatal and neonatal outcomes.
Method: Open random allocation study was conducted at Gynae/Obst Department JPMC during period from 1st June 2022 to 30th September 2023. Primiparous women with singleton pregnancy without risk factors with gestational age 38 weeks 0 days to 38 weeks six days attending the anti-natal clinic offered to participate after consent. Non-probability convenience sampling method was used for induction. Randomization was done using random number table into one of the two groups, Group-A in which induction was done at 39 weeks while in Group-B induction was done conventionally. Mean age ±SD, gestational age and delivery time was calculated and compared by Student’s t test. Frequency of CS, perinatal and neonatal outcomes was compared by χ2 test.
Results: Eighty-two women were inducted in Group-A and eighty-five in Group-B. The mean delivery time in Group-A was significantly more at 8.12±2.77 hours while in Group-B was 7.0±2.62 hours (p = .005). Frequency of CS between two groups was not statistically significant, it was 5 (6.1%) in Group-A and 2 (2.4%) in Group-B (p = 0.412). No significant difference in frequency of NICU admission was seen, in Group-A 8.54% babies were admitted to NICU while in Group-B 16.47% were admitted to NICU (p = 0.122).
Conclusion: No significant difference was observed in frequencies of CS, Foetal, Neonatal, and Maternal outcomes.
doi: https://doi.org/10.12669/pjms.40.8.9099
How to cite this: Majid E, Zuberi BF, Gul K, Jam H, Haseena G. Caesarean Section frequency in Nulliparous Women induced at 39 weeks versus conventional management: An open label random allocation study. Pak J Med Sci. 2024;40(8):---------.  doi: https://doi.org/10.12669/pjms.40.8.9099
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Supine Percutaneous Nephrolithotomy: Preliminary experience in a single hospital
Authors: Naweed Bhatty Tanweer Ahmed , Nathaniel Eemaz , Noureen Sadaf , Iqbal Nadeem
Published: July 2024

Background and Objective: Percutaneous Nephrolithotomy (PCNL) is recommended for large Kidney Stones. It is mostly done in prone position. However, PCNL in Supine position is another safe option. Only few centers in country are doing it and so it is challenging task to adopt supine PCNL approach in an institution initially. In this study our purpose was to assess initial experience of Supine PCNL in our center.
Methods: It is a preliminary retrospective study of our first fifty-one supine PCNL procedures, performed by a single Surgeon, over Twelve months period, from April 2021 to April 2022. We managed a retrospective review of patients’ records. Analysis was completed by utilizing SPSS version 20. Implementation of Mean along with standard deviation values was utilized for continuous variables. While frequency/percentages represented categorical factors.
Results: Patients mean age was 39 years, comprising of 62.74% male and 37.25% female patients. Thirty patients had their stones treated on the left side. Mean Stone burden was 3.2 cm. Most of the stones were GUYs score one and two (complexity wise). The mean procedure time 147minutes. Mean hospital stay of 2.17 days was observed in this study. Forty patients were stone free. Only seven patients (14%) had level I-II complications (Clavien-Dindo classification).
Conclusion: Supine PCNL can be adopted safely in an institute if careful selection of patients is done before surgery. In our center it had acceptable success rates and few complications.
doi: https://doi.org/10.12669/pjms.40.8.9188
How to cite this: Bhatty TAN, Nathaniel E, Noureen S, Iqbal N. Supine Percutaneous Nephrolithotomy: Preliminary experience in a single hospital. Pak J Med Sci. 2024;40(8):---------. doi: https://doi.org/10.12669/pjms.40.8.9188
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Retrospective cohort study of video-assisted thoracoscopic precise positioning reduction and internal fixation and thoracotomy reduction and internal fixation in treating multiple rib fractures
Authors: Shi Jinlong , Liu Jing
Published: July 2024

Objective: This study aimed to assess the clinical effect of video-assisted thoracoscopic precise positioning reduction and internal fixation and thoracotomy reduction and internal fixation in the therapy of multiple rib fractures.
Methods: A total of 80 patients with multiple rib fractures in First People’s Hospital of Jingzhou from January 2021 to December 2022 were separated into control group (CG, 40 cases) and research group (RG, 40 cases) by random number table method. Patients in the CG received thoracotomy reduction and internal fixation. Patients in the RG received video-assisted thoracoscopic precise positioning reduction and internal fixation. Surgery-related indexes, serum interleukin, visual analogue scale (VAS) was used to evaluate postoperative pain, arterial oxygen saturation (SaO2) and oxygenation index (PaO2/FiO2), and pulmonary function indexes were measured in the two groups.
Results: After surgery, Visual analog scale (VAS) scores at 24 hour after surgery were reduced compared to six hour and 12 hour after surgery (P<0.05). VAS score at 12 hour after surgery was increased relative to 6 h after surgery (P<0.05), and VAS score at six hour, 12 hour as well as 24 hour after surgery in the RG was lessened in comparison with the CG (P<0.05). One day after surgery, SaO2 and PaO2/FiO2 in two groups were elevated compared to before surgery, and those in RG was increased in contrast to the CG (P<0.05). forced expiratory volume (FEV1), forced vital capacity (FVC), peak expiratory flow velocity (PEF) along with FEV1/FVC levels in two groups were increased (P<0.05).
Conclusion: Compared with thoracotomy reduction and internal fixation, video-assisted thoracoscopic accurate positioning and internal fixation in treating patients with multiple rib fractures had a short treatment time, obvious advantages, and strong feasibility.
doi: https://doi.org/10.12669/pjms.40.8.9196
How to cite this: Shi J, Liu J. Retrospective cohort study of video-assisted thoracoscopic precise positioning reduction and internal fixation and thoracotomy reduction and internal fixation in treating multiple rib fractures. Pak J Med Sci. 2024;40(8):---------.  doi: https://doi.org/10.12669/pjms.40.8.9196
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cairo Consensus Statement on Research Integrity of Randomised Clinical Trials
Authors: Chien Patrick , Khan Khalid S , Fawzy Mohamed , Khalaf Yacoub
Published: July 2024

doi: https://doi.org/10.12669/pjms.40.8.9779
How to cite this: Chien PFW, Khan KS, Fawzy M, Khalaf Y. Cairo Consensus Statement on Research Integrity of Randomised Clinical Trials. Pak J Med Sci. 2024;40(8):---------. doi: https://doi.org/10.12669/pjms.40.8.9779
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Pomoc obywatelom Ukrainy z niepełnosprawnością w związku z konfliktem zbrojnym na terytorium tego państwa - analiza z odniesieniem do wybranych państwowych jednostek sektora finansów publicznych
Authors: Bożek Wojciech
Published: July 2024

W opracowaniu skoncentrowano się na finansowoprawnym ujęciu zagadnień dotyczących pomocy udzielanej obywatelom Ukrainy z niepełnosprawnością w związku z konfliktem zbrojnym na terytorium tego państwa. Rozważania rozpoczęto od wyjaśnienia podstawowych pojęć dotyczących m.in. „niepełnosprawności”, osoby z niepełnosprawnością, które odnoszono do obywateli Ukrainy, dalej zaś na omówieniu wybranych jednostek sektora finansów publicznych, którym powierzono zadania publiczne związane z ww. pomocą. Badaniami objęto również fundusze tworzone w Banku Gospodarstwa Krajowego, by uwidocznić zasięg pomocy udzielanej obywatelom Ukrainy. Ostatni rozdział poświęcono państwowym funduszom celowym, tj. Państwowemu Funduszowi Rehabilitacji Osób Niepełnosprawnych oraz Funduszowi Solidarnościowemu. Celem artykułu było ukazanie zakresu zaangażowania jednostek sektora finansów publicznych w działalność pomocową na rzecz obywateli Ukrainy, źródeł finansowania tych zadań, jak i kierunków wprowadzanych zmian w porządku finansowoprawnym. We wnioskach końcowych zwrócono uwagę na różnorodność form jednostek realizujących zadania, o których mowa w tytule opracowania, jak i konsekwencje tych rozwiązań dla stanu finansów publicznych. Badania prowadzono w oparciu o metodę dogmatycznoprawną i analityczną. Wykorzystane źródła są właściwe naukom prawnym i obejmują akty prawne, literaturę przedmiotu oraz inne źródła.
Diagnosis, Clinical Manifestations and Treatment of Lyme Disease
Authors: Jakubowska Katarzyna , Janocha Aleksandra , Jerzak Aneta , Ziemba Paweł
Published: July 2024

Introduction and purpose
Lyme disease was identified in the 1970s. It is an anthropozoonosis caused by spirochetes from the Borrelia family. This disease is the most common one caused by pathogens transmitted by ticks. It can manifest in various ways and typically progresses through three phases, each of which can present characteristic symptoms of infection. However, it often progresses asymptomatically. Antibiotics are widely used in the treatment of various forms of Lyme disease and demonstrate satisfactory efficacy. However, the most important aspect is the prevention of infections through personal protection against exposure. The aim of the article is to summarize information on Lyme disease, its risk factors, diagnosis, clinical manifestations, and treatment.
                                                       
Materials and methods
The literature available in the PubMed database is searched using terms such as Lyme borreliosis and Lyme disease.
 
Results
Lyme disease is a moderately understood condition. Its risk factors have been studied, allowing us to identify those particularly at risk. However, despite this, the condition often presents diagnostic challenges, requiring considerable experience from clinicians. The disease can manifest in various ways, and antibiotics are an effective therapy in most cases. Despite numerous scientific studies on Lyme disease, not all pathophysiological mechanisms have been elucidated. Additionally, there is an ongoing debate regarding the validity of post-treatment Lyme disease syndrome (PTLDS).
 
Conclusions
Research on Lyme disease continues to provide new information, from diagnostics and clinical manifestations to treatment. Knowledge about infections caused by genospecies of the Borrelia family is extensive. However, there are still areas that are less well understood.
Dynamics of Shared Security in the Cloud
Authors: Clement Nan , Arce Daniel
Published: July 2024

This paper shows that shared security in the cloud manifests a new public goods paradigm owing to the dynamics of cloud economics and endogeneity between usage, vulnerability, and security. Users must balance the need for security with the risk of becoming locked into a particular cloud services provider (CSP) over time. CSP managers must recognize that security competition is neither a race to the bottom nor an arm’s race. Our results provide guidelines for designing a vulnerability prediction algorithm that emphasizes CSP managers’ understanding of users’ risk and time preferences. In addition, CSP managers should be aware of the nature of security technologies and associated costs, aiming to simplify security architecture and reduce future orchestration expenses. Over the long term, cloud users should consider judiciously repatriating cloud assets as taking refuge in the cloud presents a dynamic fallacy of composition.
Can lesions in the right basal ganglia cause aphasia? Crossed aphasia in a right-handed patient
Authors: Trindade Miguel , Pinto Sílvia , Campillo José , Mesquita Teresa
Published: July 2024

Background: Aphasia is a common neurocognitive disorder caused by impaired speech and language, with stroke being the most frequent cause. The neuroanatomical mechanism underlying this condition is not yet fully understood. Case description: This case describes a 74-year-old Caucasian woman admitted with a clinical picture of right total anterior circulation infarct (TACI) and aphasia, scoring 17 on the National Institutes of Health Stroke Scale. Neuroimaging showed a large cortico-subcortical frontotemporoparietal and insular infarct involving the basal ganglia of the right hemisphere and bilateral focal atherosclerotic stenosis on the M1 segment of the middle cerebral artery. There was no left hemispheric lesion or abnormal electric activity on the electroencephalogram. A formal evaluation was compatible with transcortical motor aphasia. The aetiological study revealed atrial fibrillation, and the case was admitted as an ischaemic stroke of undetermined aetiology with two possible causes – intracranial atherosclerotic stenosis or atrial fibrillation. Conclusion: Our patient fulfilled all the formal criteria for crossed aphasia in dextral (CAD): aphasia, a lesion in the right hemisphere coupled with the structural integrity of the left hemisphere, an established preference for right-hand use without a familial history of left-handedness individuals, and an absence of brain damage in childhood. Our patient’s case adds to the evidence that deep structures – alone or in combination with cortical structures – are primarily affected in CAD.
A Franciscan Critic of the Catholic Clergy During the Protestant Reformation: Johannes Pauli’s Schimpf und Ernst as a Literary-Historical Source
Authors: Classen Albrecht
Published: July 2024

Church historians have already studied the Protestant Reformation from many different perspectives considering both the years leading up to the publication of Luther’s ninety-five theses and following. Although many different textual genres have been scoured for relevant information, literary and didactic narratives have attracted rather little attention. Studying Johannes Pauli’s Schimpf und Ernst (1522), which was an enormous bestseller for the next centuries, in light of Reformation history, his moralizing and entertaining exempla reflect the contemporary discourse also on the status of the Church and especially the clergy, seen through the lens of a Franciscan preacher, addressing thereby primarily his clerical colleagues high and low in the religious hierarchy.
Ikam as the Social and Economic Heritage of the Bujuur Tribe
Authors: Chara Elija , Moyon NG Khosirngak
Published: July 2024

Ikam, or Feast of Wealth, is one of the most important traditional events for the Bujuur community of Chandel and Tengnoupal Hills of Manipur State in India. Traditionally held during the spring season by wealthy individuals following bumper harvests, Ikam was significant for the Bujuur not just as an event of merry-making but a space to display the unique Bujuur customs. Celebrated for hundreds of years and part of the social history-identity, Ikam abruptly disappeared after the year 1946 as a result of the paradigm shift in religion, social lifestyle and economic outlooks. The legacy of Ikam can be witnessed from many Rutha (megaliths) erected in historical Bujuur villages. This article explores the cultural heritage of the Bujuur with specific reference to Ikam through the comprehensive description of the Ikam events including its various components, unique features and megaliths attributed to it. In addition, the paper also discusses the relationship between Ikam, agriculture and customs with the objective of relooking the Bujuur socio-economic heritage.
MOVIMENTOS SOCIAIS E "SOCIEDADES EM MOVIMENTO" NA AMÉRICA LATINA NEOLIBERAL: ASPECTOS CONVERGENTES E BALANÇO DAS CONQUISTAS
Authors: Tomazine Eduardo
Published: July 2024

A resposta criativa dos setores populares aos efeitos da guinada neoliberal na América Latina fez emergir à esfera pública novos sujeitos políticos, em especial movimentos sociais e “sociedades em movimento” (conceito cunhado pelo jornalista, ativista e teórico Raúl Zibechi). Em que pese a pluralidade desses movimentos no continente e a grande variedade de seu repertório de ação, é possível encontrar neles alguns elementos convergentes. Muitos analistas concordam que um dos principais aspectos em comum é o seu enraizamento territorial. Isto é, sua capacidade de constituir enclaves territoriais no âmbito dos quais os movimentos reorganizam o espaço e desenvolvem relações que os constituem enquanto sujeitos políticos. A partir de seus territórios, parcelas significativas dos setores populares latino-americanos têm influenciado a conjuntura política e econômica regional, competindo ainda para ampliar o próprio horizonte do fazer político em vários níveis e possibilitado um entrecruzamento de bandeiras de luta, as quais frequentemente se encontram separadas na ação coletiva.
GEOPROCESSAMENTO NA CONSTRUÇÃO DO ÍNDICE DE BEM-ESTAR SOCIAL (IBES)
Authors: Lima do Amaral Thaís , Nyland do Amaral Ribeiro Júlia
Published: July 2024

Áreas Verdes (AVs) geram benefícios à população. Por isso, para compreender sua distribuição em Rio Grande – RS, foi construído o Índice de Bem-Estar Social (IBES). Ele considera o número de residentes de uma localidade, a quantidade de AVs e sua tipologia. Com a identificação das AVs, pode-se calcular aquela mais próxima de um setor censitário urbano e o número de pessoas mais próximas de cada uma. Também, calculou-se o Índice de Áreas Verdes (IAV), razão entre m² de AVs da localidade e a população residente. Diferentemente, o IBES é o produto entre o IAV e o somatório da quantidade de AV de um determinado tipo, multiplicado pelo seu respectivo peso, definidos entre 1 e 5, em ordem de: área sem atrativos, com atrativos, de esportes, praça e misto. Assim, verificou-se que a AV mais próxima de residentes está menos distante de 9.780 pessoas e a praça é o tipo que está menos distante. O IBES permitiu constatar as localidades carentes de AVs e o número de habitantes atendidos por cada uma. Além de reconhecer as AVs que devem ser prioridade da gestão pública, pois a maioria das localidades possuem um IAV menor que o recomendado pela Organização Mundial da Saúde.
A AMAZÔNIA NO MAPA: DESAFIO OLÍMPICO NO CONTEXTO DA V OLIMPÍADA BRASILEIRA DE CARTOGRAFIA
Authors: Carvalho Di Maio Angelica , Alves de Carvalho Marcus Vinícius , Gomes e Santos Kellen Milene , Dezidério Souto Raquel , De Moraes Vestena Kauê
Published: July 2024

A V edição da Olimpíada Brasileira de Cartografia (OBRAC 2023), com o tema "A Amazônia no Mapa", focou no mapeamento de recursos naturais e povos indígenas da Amazônia utilizando geotecnologias. O evento destacou a importância da Amazônia através de mapas que exploraram biodiversidade, desmatamento, bacias hidrográficas e questões sociais. A metodologia envolveu provas teóricas e práticas, com atividades de mapeamento participativo e colaborativo, utilizando plataformas como OpenStreetMap (OSM) e ferramentas como uMap, QGIS e Jamboard. O mapeamento participativo engajou estudantes e comunidades na criação de mapas que representassem a cultura e as potencialidades da Amazônia, enquanto o mapeamento colaborativo permitiu a participação remota via internet, utilizando bases cartográficas digitais. Esses métodos visaram empoderar comunidades e tornar visíveis suas questões locais, além de preencher lacunas cartográficas, especialmente em áreas rurais e subnormais. As equipes produziram mapas que refletiram as dinâmicas regionais, destacando aspectos positivos e desafios da região amazônica. Durante a etapa final presencial, as equipes visitaram instituições como o Instituto Nacional de Pesquisas Espaciais e o CEMADEN. A equipe vencedora do Instituto Federal do Pará desenvolverá um projeto de iniciação científica júnior sobre a Floresta de Carajás em 2024.
Legal duty of care and the community nurse
Authors: Dowie Iwan
Published: July 2024

In this month's Policy column, the author explores the concepts of duty of care, forseeability and proximity, and how the community nurse can be better prepared when caring for the patient.
Knowledge is power
Authors: Mahajan Tripat
Published: July 2024

Tripat Mahajan lists the top tips for performing mouth cancer checks.