bluuebunny/crossref_metadata_2025 huggingface dataset:
NuSTAR Observations of Abell 2163: Constraints on Non-thermal Emission
Authors: Rojas Bolivar Randall A. , Wik Daniel R. , Giacintucci Simona , Gastaldello Fabio , Hornstrup Allan , Westergaard Niels-Jorgen , Madejski Grzegorz
Published: January 2021

Since the first non-thermal reports of inverse Compton (IC) emission from the intracluster medium (ICM) of galaxy clusters at hard X-ray energies, we have yet to unambiguously confirm IC emission in observations with newer facilities. RXTE detected IC emission in one of the hottest known clusters, Abell 2163 (A2163), a massive merging cluster with a giant radio halo—the presumed source of relativistic electrons IC scattering CMB photons to X-ray energies. The cluster’s redshift (z ∼ 0.2) allows its thermal and non-thermal radio emission to fit the field of view of the Nuclear Spectroscopic Telescope Array (NuSTAR), permitting a deep observation capable of confirming or ruling out the RXTE report. The IC flux provides constraints on the average magnetic field strength in a cluster. To determine the global diffuse IC emission in A2163, we fit its global NuSTAR spectrum with four models: single- (1T) and two-temperature (2T), 1T+power-law component (T+IC), and multi-temperature+power law (9T+IC). Each represents different characterizations of the thermal ICM emission, with power-law components added to represent IC emission. We find that the 3–30 keV spectrum can be described by purely thermal emission, with a global average temperature of kT = (11.8 ± 0.2) keV. The IC flux is constrained to <4.0 × 10−12 erg s−1 cm−2 using the 1T+IC model and <1.6 × 10−12 erg s−1 cm−2 with the more physical 9T+IC model, both to 90% confidence levels. Combining these limits with 1.4 GHz diffuse radio data from the VLA, we find the average magnetic field strength to be >0.22 μG and >0.35 μG, respectively, providing the strongest constraints on these values in A2163 to date.
The Spectrum and Term Analysis of Singly Ionized Manganese
Authors: Liggins Florence S. , Pickering Juliet C. , Nave Gillian , Ward Jacob W. , Tchang-Brillet W.-Ü L.
Published: January 2021

An extensive analysis of the Mn spectrum was carried out using high-resolution Fourier transform (FT) and grating spectroscopy of Mn–Ne and Mn–Ar hollow cathode discharge sources, over the range 82–5500 nm (1820–121,728 cm−1). Spectral wavelengths for a total of 6019 Mn ii lines have been measured, of which 1345 are obtained through FT spectroscopy. These wavelengths are given to at least an order of magnitude lower uncertainty than previous measurements. These lines were used to identify 6256 Mn ii transitions and improve the values of 505 previously published energy levels with typical uncertainties of a few thousandths of a cm−1, representing an order-of-magnitude reduction in uncertainty. We have verified and improved an additional 57 Mn ii energy levels, previously established through observation of stellar spectra alone, using our FT spectra. In addition, 52 new energy level values have been established. The number of classified lines reported is approximately 50% more than previously published. The new accurate data for 614 energy levels and 6019 lines will allow a more reliable analysis of Mn ii spectral lines in astrophysical spectra.
Retour sur le scandale de Panama
Authors: Mollier Jean-Yves
Published: January 2021

Considéré comme le plus grand scandale politico-financier que la France ait connu, le scandale de Panama (1892-1893) présente trois caractéristiques majeures : la montée en puissance d’un antisémitisme qui prépare le terrain de l’affaire Dreyfus (1894-1899), celle d’un antiparlementarisme également virulent, et le début d’une perte de confiance de la population envers ses élites. En frappant de discrédit les banques et les journaux qui avaient profité des largesses de la Compagnie universelle du canal de Panama, ainsi que les journalistes et les parlementaires qui avaient accepté de l’argent de l’entreprise, ce scandale ébranlait les institutions républicaines du pays. Véritable séisme dont les répliques se feront encore sentir dans les années 1930, le scandale de Panama demeure une expérience fondamentale en matière de désinformation de l’opinion et de construction d’un récit destiné à ménager les véritables responsables d’un désastre financier et à détourner la colère des épargnants vers des boucs émissaires.
Banco Ambrosiano : les sociétés holding et la place financière luxembourgeoise entre scandalisation et banalisation
Authors: Zenner Benjamin
Published: January 2021

L’effondrement à partir de 1982 du Banco Ambrosiano italien compte parmi les faillites bancaires les plus spectaculaires du XX e siècle. Exposée publiquement après le suicide suspect de son directeur Roberto Calvi à Londres, l’affaire a mis en évidence les ingrédients classiques du scandale, tels que l’argent, le sexe et la mort. De plus, les enquêtes ont rapidement révélé des liens entre Ambrosiano, le crime organisé, une loge maçonnique, mais aussi avec la Banque du Vatican. Compte tenu des acteurs et des thèmes engagés, il est difficile de concevoir une faillite bancaire avec plus de potentiel de scandale dans le domaine public. La place financière luxembourgeoise a été impliquée dans la disparition du Banco Ambrosiano en tant que siège de la holding financière utilisée pour coordonner les activités internationales de la banque. Le scandale de ce jeune centre financier avait théoriquement le potentiel pour devenir la tempête du siècle. Avec le modèle d’entreprise opaque et non réglementé de la holding, l’affaire a jeté le discrédit sur l’un des principaux attraits du Grand-Duché pour les investisseurs internationaux. De plus, les centaines de millions de dollars de pertes potentielles menaçaient de déstabiliser le marché des prêts internationaux syndiqués (Euro-loans), un domaine d’activité clé pour les banques basées au Luxembourg, mais qui était en crise en 1982. Hésitants et pris de court dans leur intervention une décennie plus tôt lors de la faillite de la banque allemande Herstatt, les pouvoirs publics luxembourgeois et les principaux acteurs de la place financière ont cette fois agi de manière plus proactive et plus attentive. Le présent article examine la réaction des médias luxembourgeois, mais aussi de son système politique, administratif et judiciaire. Il met en lumière les récits et les stratégies élaborés de manière interconnectée, mais manifestement non coordonnée, par ces différents milieux. La coalition ad hoc qui s’est formée autour de l’objectif commun de protéger les intérêts économiques et la réputation du Grand-Duché sert d›exemple pour montrer comment un scandale - ou son simple potentiel - peut transcender les sphères sociales et mettre en lumière les structures de pouvoir existantes.
« L’ombre du veau d’or ». Crises et scandales financiers en Suisse au XX e siècle
Authors: Mazbouri Malik , Giddey Thibaud
Published: January 2021

Contrairement à certaines idées reçues, l’histoire de la place financière suisse est jalonnée de plusieurs épisodes d’instabilité, de crises et de scandales. Le présent article cherche à comprendre pour quelles raisons ces crises ont rarement débouché sur des scandales d’ampleur nationale, en dépit même de la gravité des dérives constatées ou de l’ampleur des pertes occasionnées. Si faillites et crises peuvent en effet constituer une condition permissive au déclenchement de scandales, ces phénomènes ne sont pas nécessairement liés. En outre, certaines particularités des structures politiques et bancaires helvétiques, combinées au poids des associations économiques, constituées depuis la fin du XIX e siècle en de puissants « corps intermédiaires », tendent à favoriser le confinement des mobilisations, qui débordent aussi rarement des frontières cantonales qu’elles s’affranchissent avec difficulté des formes institutionnelles établies. Autant d’éléments qui contribuent à expliquer pour quelles raisons, en dépit même de mobilisations ponctuelles parfois tumultueuses, les scandales financiers ne semblent pas avoir marqué outre mesure les mémoires helvétiques.
Développer l’offre sociale et médico-sociale : l’utopie de la régulation concurrentielle
Authors: Janvier Roland
Published: January 2021

Doit-on réguler l’accès aux droits fondamentaux ? C’est la question que posent aux interventions sociales les pratiques concurrentielles. L’analyse de quelques caractéristiques du travail avec et pour autrui nous enseigne que l’inclusion n’est pas une compétition car l’exercice de la solidarité suppose la fraternité. La transformation sociale n’est pas un marché et le pouvoir d’agir, que l’on cherche à développer pour les personnes accompagnées, implique des pratiques de développement durable, non de concurrence. C’est pour ces raisons que cet article réfute la mise en concurrence comme mode de régulation de l’offre sociale et médico-sociale, pour des motifs éthiques et déontologiques qui s’appuient sur la confrontation des savoirs telle que la pose la définition légale du travail social. Les conséquences de cette mise en concurrence des établissements et services sociaux et médico-sociaux portent atteinte à la nécessaire socio-diversité des acteurs et, surtout, aux principes de solidarité qui requièrent de « faire ensemble »
Les appels à projets, une tentative d’articuler régulation de l’offre et projet associatif
Authors: Gueydan Geneviève , Jourdan Jean-Robert
Published: January 2021

À la légitimité des pouvoirs publics pour organiser l’offre médico-sociale, de nature politique, stratégique et technique, répond une légitimité associative citoyenne, de projet et de proximité avec les usagers. Les appels à projets sont nés de la volonté d’organiser l’offre de façon plus cohérente et transparente, tout en laissant une grande part à l’initiative des acteurs. Les critiques sur des appels à projets bureaucratiques, sous-financés, favorisant les structures importantes dans le médico-social et épuisant les plus petites dans la politique de la ville, doivent être lues au prisme des tensions générales de financement du secteur et de la montée des concurrences inter--associatives. La nouvelle stratégie de transformation de l’offre médico-sociale permet aujourd’hui d’assouplir les règles du jeu, en lien étroit avec les acteurs en place.
Les pratiques concurrentielles au regard des EHPAD et des résidences autonomie
Authors: Collet-Berling Marilys
Published: January 2021

Le secteur de l’accueil en établissements des personnes vieillissantes est passé, à partir des années 1980-1990, d’un marché « captif » à un marché « concurrentiel ». Il est donc important de comprendre les raisons qui ont conduit à ce changement et de s’interroger sur la manière dont les pratiques concurrentielles se matérialisent, aujourd’hui, entre les trois principaux secteurs qui composent ce marché, à savoir le secteur public, le secteur privé solidaire, acteurs historiques , et le secteur privé commercial, en privilégiant les deux catégories institutionnelles majeures de l’hébergement des personnes vieillissantes : pour celles qui sont autonomes en résidences autonomie ; et pour celles en perte d’autonomie, voire dépendantes, en établissements d’hébergement pour personnes âgées dépendantes ( ehpad ).
Suicide, conatus et conflictualité chez Spinoza
Authors: Kim Eunju
Published: January 2021

La doctrine du conatus chez Spinoza est formulée de façon si radicale que le suicide apparaît comme incompréhensible. Cela contraste avec la référence importante aux actes suicidaires dans ses ouvrages. Pour résoudre ce contraste et défendre la compatibilité entre le suicide et le conatus, nous proposons une lecture nouvelle de la proposition 5 de l’Éthique III sur la contrariété. Nous dégageons la complexité de chaque individu, la conflictualité entre ses parties, et enfin le conatus de chacune de ces parties, qui jouit, en fonction des relations avec les choses extérieures, d’une certaine indépendance par rapport au conatus de l’individu dans son ensemble.
Le bien de l’homme chez Spinoza : vers un existentialisme positif
Authors: Renz Ursula
Published: January 2021

Comment la conception de l’homme impliquée dans les notions et principes métaphysiques de la première et de la deuxième partie de l’Éthique peut-elle être conciliée avec le rôle que l’orientation vers le bien de l’homme joue dans la pensée éthique et politique de Spinoza ? L’article suivant propose de dissoudre cette tension en attribuant à Spinoza une sorte d’existentialisme. Or, cet existentialisme n’est caractérisé ni par une réflexion sur la mortalité humaine, ni par l’invocation de la notion des possibilités humaines. En revanche, l’existentialisme spinoziste fait usage d’une notion tout à fait positive de la finitude humaine, et c’est de cette dernière idée que dérive la notion d’humanité. Cette lecture existentialiste du spinozisme exige que nous renoncions à toute interprétation de la doctrine du conatus dans des termes essentialistes. Mais elle ne conteste pas que la notion de conatus soit utilisée par Spinoza pour défendre son naturalisme. Contrairement aux approches existentialistes de Jean-Paul Sartre ou Martin Heidegger, l’existentialisme spinoziste ne s’oppose pas au naturalisme. L’article énonce finalement la double thèse que (1) le rationalisme spinoziste implique l’affirmation que l’homme peut accéder aux propriétés fondamentales de l’être, à savoir l’intelligibilité et la perfection de tout étant, et que (2) cela peut être éprouvé dans des expériences humaines affectives communes.
Resilience and Its Importance to Online Students
Authors: Dereshiwsky Mary I.
Published: January 2021

Resilience is a key life success trait that can spell the distinction in success or failure of learning experiences for students. The online classroom is characterized by some unique challenges regarding student resilience. These challenges, as well as prospective strategies to overcome them, will be specifically discussed in the areas of technology, communication, and student assessment. Individual focus will be given to the impact of the COVID-19 pandemic and lockdown on mandated all-online instruction and its impacts on resilience of students, many of whom were suddenly required to adapt to online learning. Understanding the factors that facilitate development of online student resilience will enable instructors to create maximally effective learning experiences for their students.
Fostering Effective Learning in the Online Classroom
Authors: Dereshiwsky Mary I.
Published: January 2021

Online learning communities are an important aspect of successful virtual learning experiences. They bring opportunities for peer collaboration and sharing of ideas in a globally based classroom unrestricted by time and space. At the same time, online learning community participants may face some challenges of effective communication and collaboration as compared to traditional face-to-face learning environments. The author discusses issues, concerns, and potential solutions with regard to online learning communities in the areas of discussion participation, group work on assignments, faculty concerns, and miscellaneous issues such as technology access. Strategies for leveraging social media and live chat sessions in fostering online learning community interaction are also shared. Maximizing the potential of online learning communities will facilitate higher-order learning in the technologically-mediated 21st century classroom.
Report and Abstracts of the 17th Meeting of IIM, the Interuniversity Institute of Myology:Virtual meeting, October 16-18, 2020
Authors: Sorci Guglielmo , Gabellini Davide
Published: January 2021

In 2020, due to the COVID-19 pandemic, the annual meeting of the Interuniversity Institute of Myology (IIM), took place on a virtual platform. Attendees were scientists and clinicians, as well as pharmaceutical companies and patient organization representatives from Italy, several European countries, Canada and USA. Four internationally renowned Keynote speakers presented recent advances on muscle stem cells regulation, skeletal muscle regeneration, quantitative biology approaches, and metabolic regulation of muscle homeostasis. Novel, unpublished data by young trainees were presented as oral communications or posters, in five scientific sessions and two poster sessions. On October 15, 2020, selected young trainees participated to the High Training Course on “Advanced Myology”, organized together with the University of Perugia, Italy. The course, on a virtual platform, showcased lectures on muscle development and regulation of muscle gene expression by international speakers, and roundtables discussions on “Single cell analysis of skeletal muscle” and “Skeletal muscle stem cell in healthy muscle and disease”. The Young IIM Committee, composed by young trainee winners of awards in the past IIM Meeting editions, was directly involved in the selection of keynote speakers, the organization of scientific sessions and roundtables discussions tailored to the interests of their peers. A broad audience of Italian, European and North American participants contributed to the different initiatives. The meeting was characterized by a friendly and inclusive atmosphere, facilitating lively and stimulating discussions on emerging areas of muscle research. The meeting stimulated scientific cross-fertilization fostering novel ideas and scientific collaborations aimed at better understanding muscle normal physiology and the mechanisms underlaying muscle diseases, with the ultimate goal of developing better therapeutic strategies. The meeting was a success, and the number of meeting attendees was the highest of all IIM Meeting editions. Despite the current difficulties imposed by the COVID-19 pandemic, we are confident that the IIM community will continue to grow and deliver significant contributions to the understanding of muscle development and function, the pathogenesis of muscular diseases and the development of novel therapeutic approaches. Here, abstracts of the meeting illustrate the new results on basic, translational, and clinical research, confirming that our field is strong and healthy.
Incidence rate and time to serious adverse events among rifampicin resistant tuberculosis patients in Georgia treated with new and repurposed anti-tuberculosis drugs, 2016-2018
Authors: Buziashvili Mariana , Davtyan Hayk , Sereda Yuliia , Denisiuk Olga , Gozalov Ogtay , Lomtadze Nino , Hovhannesyan Arax
Published: January 2021

Considering the complexity of second-line anti-tuberculosis (TB) treatment regimens, the management of drug-resistant TB (DR-TB) in Georgia remains a major challenge. Since the introduction of new and repurposed anti-TB medications, the implementation of active TB Drug Safety Monitoring (aDSM) was a critical program component to help establish safety and manage all treatment related Serious Adverse Events (SAEs). In our study, we aimed to describe the occurrence, characteristics and timing of SAE among patients with Rifampicin Resistant and Multi-Drug Resistant TB (RR/MDR-TB) receiving new and/or repurposed anti-TB medications (bedaquiline, delamanid, linezolid, clofazimine, imipenem) during the period of 2016-2018 in Georgia and identify predictors of SAE. The data were obtained from the medical charts, electronic database and standardized aDSM reports During 2016-2018 period in total 970 people with RR/MDR-TB were notified in Georgia and 388 of them received new and/or repurposed TB drugs as part of their treatment regimen and all were included into the study. The results showed a total of 73 SAEs registered among 49 (12.6%) patients receiving new and/or repurposed drugs. The overall SAE incidence rate per 100 person-months was 1.16. The severity of the majority of the SAEs (46.6%) was grade III and 21.9% were grade IV. The most common SAE reported was hepatotoxicity, with an incidence of 0.26 per 100 person-month (n=16, 21.9%) followed by cardiotoxicity with an incidence of 0.16 per 100 person-month (n=10, 13.7%). Median time to SAE occurrence was 183 days (IQR 84 – 334) after treatment initiation. Resistance profile was the only predictor associated with occurrence of a SAEs. There was increased hazard of SAEs among patients with XDR-TB (adjusted HR=2.18, 95% CI: 1.12-4.23). Our findings on SAEs among patients treated with new or repurposed anti-TB drugs are echoing the findings available in the literature. They highlight the need for close monitoring of patients and underlines the importance of the aDSM during the whole treatment. Safety profile of the medications and combinations used are yet to be established and larger datasets comprised of patients receiving same treatment regimens need to be utilized.
Performance of semi-quantitative lung ultrasound in the assessment of disease severity in interstitial lung disease
Authors: Kumar Ishan , Siddiqui Zeeshan , Verma Ashish , Chokhani Aarushi , Srivastava Govind Narayan , Shukla Ram C.
Published: January 2021

BACKGROUND:

Accurate staging of disease severity and its serial monitoring thus is central to the effective management protocols of interstitial lung disease (ILD).

PURPOSE:

The aim is to evaluate the effectiveness of semi-quantitative parameters of lung ultrasound (LUS) in patients of ILD as a means of staging disease severity.

MATERIALS AND METHODS:

LUS of 47 patients of ILD and 20 age-matched controls was performed, and findings such as B-line distance, pleural thickening, subpleural changes, decreased lung sliding, and fragmented pleural lining were charted, and an LUS score was done using these parameters. Findings were compared with the Modified Medical Research Council (MMRC) dyspnea grade and spirometry parameters.

RESULTS:

The presence of B-lines and fragmented pleural lining were the most common findings observed in patients of ILD. Predicted forced vital capacity (FVC) and predicted forced expiratory volume in 1 s (FEV1) showed a good correlation with all the LUS parameters. B-line distance was the most significant LUS parameter to predict the variability in predicted FEVI, FVC, and MMRC dyspnea score. LUS severity score also showed good negative correlation with predicted FEV1 (r = −0.674, P < 0.001) and predicted FVC (r = −0.65, P < 0.001). LUS severity score of 4 or more predicted MMRC dyspnea score of > 3 with 82% sensitivity and 70% specificity.

CONCLUSION:

Semi-quantitative LUS score and B-line distance can provide a simple but effective estimate of disease severity in ILD.
Comparison of typical and atypical computed tomography patterns regarding reversibility and fibrosis in pulmonary sarcoidosis
Authors: Susam Seher , Ucsular Fatma Demirci , Yalniz Enver , Cinkooglu Akin , Polat Gulru , Komurcuoglu Berna Eren , Anar Ceyda , Karadeniz Gulistan , Cirak Ali Kadri , Tellioglu Emel , Guldaval Filiz , Gayaf Mine , Aksel Nimet , Batum Ozgur , Alizoroglu Dursun , Bilaceroglu Semra
Published: January 2021

PURPOSE:

This study aims to investigate whether there is a significant difference between typical and atypical parenchymal patterns in the development of fibrosis, which is the most crucial factor affecting morbidity in pulmonary sarcoidosis.

METHODS:

In our hospital, 145 cases with Siltzbach Types 2 and 3 sarcoidoses diagnosed by clinical, radiological, and histopathologic were retrospectively investigated. Perilymphatic nodules, accompanying mosaic attenuation, and interlobular septal thickening and central peribronchovascular bunch-like thickening on high-resolution computed tomography were assessed as typical. Solid nodules, galaxy finding, consolidation, ground-glass opacity, isolated mosaic attenuation, and interlobular septal thickening, and pleural fluid were accepted as atypical findings. Findings indicating fibrosis were fine and rough reticular opacity, traction bronchiectasis, volume loss, and cystic changes. For the analysis of variables, SPSS 25.0 program was used.

RESULTS:

Ten (16%) of the 61 cases with typical findings and 16 (19%) of the 84 with atypical findings developed fibrosis (P = 0.827). The mean age of cases with fibrosis was higher. With the cut-off of 50 years, sensitivity was 61.5%, and specificity was 68.9%. The highest fibrosis rate was in cases with ground glass pattern (n = 7/17), whereas higher reversibility rates were in those with miliary pattern (n = 9/12) and galaxy sign (n = 5/6).

CONCLUSION:

The incidence of fibrosis is higher in the atypical group with no significant difference. The incidence of fibrosis differs in each atypical pattern, being highest in ground-glass opacity and lowest in the miliary pattern.
Framework for obstetrics and gynecology department change management in response to COVID-19 pandemic
Authors: Madkhali Azza M. , Al Ghamdi Sharifa O. , Al-Sum Hythem , Al-Kadri Hanan M. , Sinnappan Suwarnnah , Al Ghilan Nadia A. , Hamam Heba , Al-Rabiea'a Hayat , AL-Shamrani Saad M. , Al Saif Saif , Tashkandi Nabiha A. , Al-Moamary Mohamed S.
Published: January 2021

Coronavirus (cov) disease 2019 pandemic caused by severe acute respiratory syndrome cov 2 has imposed significant demands on healthcare systems across the world. These demands were more significant on obstetrics and gynecology (obgyn) patients, who required services that had to continue despite the closure of other services. This paper describes the change management of an obgyn department at a tertiary health-care center. That experience resulted in a complete management shift in the institution and the formation of an infectious disease epidemic plan for respiratory infections. Description of the change management performed, difficulties encountered, and achievements obtained can assist other departments change management when they face similar situations.
Performing Laryngotracheobronchial Procedure in Coronavirus Disease 2019 Pandemic
Authors: Swain Santosh Kumar , Behera Ishwar Chandra
Published: January 2021

The current novel coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 is presenting a significant challenges to the surgical specialties specifically otolaryngologists and head and neck specialties those are dealing with upper airway such as larynx, trachea, and bronchus. The traditional airway procedure like microlaryngeal surgery, tracheostomy, and bronchoscopy are highly aerosol generating surgery often managed by otolaryngologists. The laryngotracheobronchial airway has a high viral density and so it is expected to expel more transmission of the infections in COVID-19 pandemic. This is why the otolaryngologists or laryngologists are more vulnerable medical professional in this dreaded pandemic. Surgeons have high risk for getting the infections during examinations or surgical procedure on the laryngotracheobronchial airway. The surgical interventions should adopt adequate precautions to limit the viral dissemination. Effective management of the suspicious or positive cases of COVID-19 required careful consideration for the safety of the surgeons and associated team members for ensuring the best possible care of the patients. This review article will provide an overview of common methods to limit the viral transmission to the otolaryngologists/surgeons and assisting health care staffs from COVID-19 infections during management of the laryngotracheobronchial airway.
Obstetric Outcome in Pregnancies Complicated with Fibroids
Authors: Posh Sheema , Rafiq Suhail , Nisa Quraishi Azhar Un , Wani Saima
Published: January 2021

Background:

Fibroid is the most frequently recorded benign, monoclonal smooth muscle tumor of the uterus, affecting 20%–60% women of reproductive age. Being remarkably common, fibroids are an important health concern. Fibroids are the most frequent indication for the performance of hysterectomy. The health-care consequences of these tumors are substantial both for the mother as well as the fetus.

Objective:

The objective is to study the obstetric outcome in pregnancies complicated with uterine fibroids.

Materials and Methods:

This is an observational study conducted in the Department of Obstetrics and Gynaecology, SKIMS, Soura, Srinagar, from May 2019 to February 2020. A prospective evaluation of a series of 28 antenatal patients presenting with fibroids (>1 cm), who delivered in our hospital was done. Maternal age, parity, size of fibroid, type of fibroid, complications during pregnancy, and mode of delivery were noted. Ultrasonogram was done at booking visit and during subsequent visits to assess the size of the fibroid and degeneration. Obstetric outcome was assessed in terms of abortion, premature delivery, malpresentation, abruption, postpartum hemorrhage (PPH), subinvolution, and puerperal pyrexia. Fetal outcome was assessed in terms of intrauterine growth retardation (IUGR), low-birth weight, and neonatal intensive care unit (NICU) admissions.

Results:

Majority of the patients belonged to the age group of 25–29 years (35.7%), majority 19 (67.9%) were multigravida, most 17 (60.7%) of the fibroids were >3 cm in size. There were 2 (7.1%) cases of miscarriage, 6 (21.4%) cases of malpresentation, abruption in 2 (7.1%) cases, 3 (10.7%) had PPH and only 1 (3.6%) needed blood transfusion. A total of 18 (69.2%) patients delivered by lower segment caesarean section and 8 (30.7%) had vaginal delivery. Of 26 babies, 6 (23.1%) had low-birthweight, 2 (7.7%) were IUGR and there were 2 (7.7%) NICU admissions.

Conclusion:

Even though most of the fibroids in pregnancy are asymptomatic but such pregnancies should be considered as high risk pregnancies. Hence, pregnancy has to be cautiously screened in the antenatal period, through regular follow-up, to detect any adverse obstetric complications thereby improving fetomaternal outcome. Our study also suggests that reduction in fibroid size pre-pregnancy may play a vital role in preventing maternal and fetal complications which became inevitable once pregnancy reaches advanced gestation.
The Supreme Court's decision in Unwired Planet – what comes next?
Authors:   Barrister, Blackstone Chambers, London, Jones Rachel
Published: January 2021

The Supreme Court's decision in two appeals relating to telecommunications licensing disputes and ‘Standard Essential Patents’, or ‘SEPs’, has profound implications for patent owners and implementers. It established that UK courts have the power to settle the terms of global licences for SEPs, and developed the meaning of the non-discrimination component of ‘FRAND’ (Fair, Reasonable and Non-Discriminatory) terms. However, these appeals leave unanswered a number of related questions – from the proper role of foreign courts to the drafting and practical operation of ‘adjustment’ clauses – that courts are likely to have to grapple with in future. This article summarizes the issues at stake in the two appeals, examines the arguments in the lower courts and the Supreme Court's reasoning, and looks ahead to the potential impacts of this long-awaited judgment.
Using competition tools during the COVID-19 pandemic: are merger control and state support substitutes or complements?
Authors:   Partner, Oxera Consulting LLP, London, Granatstein Michele
Published: January 2021

Many firms are facing financial difficulty as a result of COVID-19. However, we have not (yet) seen the predicted increase in merger activity or bankruptcies in some of the sectors most affected by the pandemic, including aviation. This may be, in part, a result of the substantial state support that has been provided to a number of companies in the sector. This article considers whether it is preferable to provide state aid to companies in order to allow them to continue operating, or should these ‘failing’ or ‘flailing’ firms be allowed to be acquired by others. It further considers whether there could be more alignment between these tools.
Extinction Rebellion and environmental activism – the XR interviews
Authors:   Regional coordinator, XR Southern Tasmania, Australia, Burgess Claire , Read Rupert ,   Spokesperson, XR England and Reader in Philosophy, University of East Anglia, UK
Published: January 2021

For this publication on environmental activism and the law, we interviewed representatives of Extinction Rebellion (XR) in the United Kingdom and Australia to explore their views on the goals, tactics and challenges for the movement. This report features interviews conducted in late 2019 with Claire Burgess (then regional coordinator XR Southern Tasmania, Australia) and Rupert Read (spokesperson for XR England and Reader in Philosophy, University of East Anglia). Both interviews, with identical questions, were conducted by Benjamin J Richardson, Professor of Environmental Law, University of Tasmania.
Dâhiliye Hemşirelerinin Kanıta Dayalı Hemşireliğe Yönelik Tutumları
Authors: MENEKLİ Tuğba , KORKMAZ Medet
Published: January 2021

Giriş: Kanıta dayalı sağlık hizmeti yaklaşımı, klinik karar verme sürecinde oldukça önemlidir. Bakım sürecinde hemşire tarafından alınan her karar, mevcut en iyi kanıtlara, klinik deneyimlere ve hasta tercihlerine dayanmalıdır. Amaç: Bu araştırmanın amacı dâhiliye kliniklerinde çalışan hemşirelerin kanıta dayalı hemşireliğe yönelik tutumlarının belirlenmesidir. Yöntem: Tanımlayıcı tipteki bu çalışma, Mayıs 2018- Aralık 2018 tarihleri arasında Şanlıurfa bölgesindeki hastanelerin dâhiliye kliniklerinde çalışan 964 hemşire ile gerçekleştirildi. Araştırmanın verileri “Hemşire Bilgi Formu” ve “Kanıta Dayalı Hemşireliğe Yönelik Tutum Ölçeği” (KDHYTÖ) ile toplandı. Verilerin analizi SPSS 23.0 programında yapıldı. Bulgular: Hemşirelerin %65.7’sinin hemşirelik uygulamalarında kanıta dayalı uygulamaları kullanmadıkları ve %63.1’inin hemşirelik uygulamaları ile ilgili kanıtlara ulaşabileceği kaynakları bilmedikleri saptandı. Hemşirelerin “Kanıta Dayalı Hemşireliğe Yönelik Tutum Ölçeği” toplam puan ortalaması 43.53 ± 3.08; kanıta dayalı hemşireliğe yönelik inanç ve beklentiler alt boyut puan ortalaması 23.18 ± 2.07, kanıta dayalı uygulama niyeti alt boyut puan ortalaması 11.44 ± 3.16 ve kanıta dayalı hemşirelikle ilgili duygular alt boyut puan ortalaması ise 8.91 ± 2.7 olarak belirlendi. Yaşı 25 ve altı olan, eğitim durumu lisans ve üzeri düzeyde olan, 1-6 altı yıldır ve sorumlu hemşire olarak çalışan, bilimsel araştırma yapan ve toplantılara katılan hemşirelerin toplam tutum puanlarının istatistiksel olarak anlamlı derecede daha yüksek olduğu belirlendi (p = 0.000). Sonuç: Dâhiliye kliniklerinde çalışan hemşirelerin kanıta dayalı hemşireliğe yönelik tutumları orta düzeydedir ve geliştirilmeye gereksinimi vardır.
Menstrual Hygiene Practices among Adolescent School Girls in Pakistan
Authors:   Department of Community Health Sciences, Hamdard College of Medicine & Dentistry, Hamdard University, Karachi, Pakistan, Mansoori Naveed , Tanweer Hiba ,   House Officer, Hamdard University Hospital, Karachi, Pakistan, Ahmed Imtiaz ,   House Officer, Sheikh Zayed Hospital, Rahim Yar Khan, Pakistan, . Abdullah ,   House Officer, Hayatabad Medical Complex, Peshawar, Pakistan, Noor Itesham ,   House Officer, Bacha Khan Medical Complex, Swabi, KPK, Pakistan, Mubeen Syed Muhammad ,   Department of Community Health Sciences, Hamdard College of Medicine & Dentistry, Hamdard University, Karachi, Pakistan
Published: January 2021

Objectives: To evaluate menstrual hygiene practices among teenage girls and to compare menstrual hygiene practices among secondary and higher secondary school girls in Pakistan Methodology: A cross-sectional study of adolescent girls (grades 9 to 12) from different secondary and higher secondary schools across Pakistan was conducted between November 2017 and September 2018. A pre-tested and standardized questionnaire was administered using a non-probability sampling technique. The menstrual hygiene practices were evaluated and comparisons were made between secondary and higher secondary school girls about these practices. Data was analysed using SPSS version 22. P-value < 0.05 was set for being statistically significant. Results: Out of a total of 2,000 adolescent girls, an equal number of adolescent girls (n=1,000) were chosen from secondary and higher secondary schools. The mean menarchal age was 12.5 ± 1.2 years. Majority of the participants (63.6%) belonged to public sector schools and (71.3%) responded that menstrual blood comes from the womb. One in five (19.3%) girls missed 2 days/month of school due to pain (54.5%). Two-thirds (68.6%) of the participants were using sanitary pads and one of three changed their pads three times/day, and forty-six percent of the girls were unable to carry out daily activities due to menstrual period. Statistically significant (P < 0.05) association was observed between knowledge of menstruation among secondary and higher secondary school girls. Conclusion: The study showed that menstrual hygiene was understood well among young girls. However, a substantial association was noted between secondary and higher secondary school girls’ hygiene practices.
Effectiveness of Educational Training related to Disaster Preparedness among Nursing Students
Authors:   Benazir College of Nursing, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, Pakistan, Ghouri Aftab , . Badil ,   Institute of Nursing, Dow University of Health Sciences Karachi, Pakistan, . Raja ,   Department of Plastic and Reconstructive Surgery, Dr. Ruth K.M. Pfau, Civil Hospital, Karachi, Pakistan, Zahir Ali Shaheen ,   Indus College of Nursing & Midwifery, Karachi, Pakistan, Khan Abdu Rehman ,   College of Nursing, Ziauddin University, Karachi, Pakistan
Published: January 2021

Objective: To evaluate the effectiveness of educational training related to disaster preparedness among nursing students at Karachi Methodology: This quasi-experimental study was performed in Indus College of Nursing and Midwifery in Karachi. The study was carried out from June to November 2019 over a period of six months. Total sample size was 40. Both male and female final year nursing students were included. The participants were approached by using non-probability purposive sampling method. Validated questionnaire was used to collect the data. Data was entered and analyzed using SPSS version 22.0. Results: Out of total 40 subjects, 19 (47.5%) were males. A large number 23 (57.5%) of respondents’ ages lied between 23 and 27 years. Nearly half 21 (52.5%) of the participants’ educational qualifications were Matriculation. Majority 34 (85%) of participants did not have any formal education of disaster management. On the other hand, few 6 (15%) study participants had training of disaster management. Significance difference was found between pre and post knowledge score of disaster, burns, flood and earthquake practices among study participant and it is also statistically significant. Conclusion: It is concluded that there is an effect of educational intervention on pre and post knowledge of disaster, burns, flood and earthquake practices among study participants.
Knowledge, Attitude and Practices of Pharmaceutical Waste Disposal in Community Pharmacies of Karachi
Authors:   Department of Pathology, Sindh Medical College, Jinnah Sindh Medical University, Karachi, Pakistan, Khan Amna , Jaffar Nazish ,   Department of Pathology, Sindh Medical College, Jinnah Sindh Medical University, Karachi, Pakistan, Razzak Sadaf ,   Department of Pathology, Sindh Medical College, Jinnah Sindh Medical University, Karachi, Pakistan, Zeesahn Faizan ,   Department of Pathology, Sindh Medical College, Jinnah Sindh Medical University, Karachi, Pakistan, Shabbir Asma ,   Department of Pathology, Sindh Medical College, Jinnah Sindh Medical University, Karachi, Pakistan, Ishaque Syed Muhammad ,   Department of Pathology, Bolan University of Medical & Health Sciences, Quetta, Pakistan
Published: January 2021

Objectives: The aim of the study was to assess the knowledge of community pharmacies about recommended methods of drug disposal and hazardous effects of improper disposal of pharmaceutical waste and to determine the attitude as well as practice of community pharmacies about the proper disposal of pharmaceutical waste. Methods: A cross-sectional study was performed with 139 community pharmacies in Karachi, Pakistan by using non-probability convenient sampling technique. Predesigned structured questionnaire was distributed to different community pharmacies in Karachi and filled questionnaires were collected after one day. Data was analyzed using SPSS 22.0 Results: About 65 (46.8%) of the participants reported to have a system for regularly removing the expired or unused drugs by returning them to contractors/distributors. More than half 86 (61.9%) of the participants disposed of solid, liquid, semi-solid, controlled, and p-listed drugs in the rubbish bin. Approximately half of the participants believed that standard method for disposal of solid, liquid, semi-solid, controlled, and p-listed drugs is by flushing them down the toilet/sink. Conclusion: Our study showed that knowledge and practices of community pharmacies regarding disposal of unused and expired medicines were not satisfactory. However, most of the participants were well aware of the harmful effects caused by improper disposal of pharmaceutical waste on environment and showed positive attitude towards learning safe methods of management and disposal of unused and expired drugs.
Knowledge, Attitude and Practices of Undergraduate Medical and Nursing Students Regarding Basic Life Support Training
Authors:   Shalamar Medical and Dental College, Shalamr Link Road, Mughalpura, Lahore, Pakistan, Nisar Omar , Ahmed Sameet ,   Shalamar Medical and Dental College, Shalamr Link Road, Mughalpura, Lahore, Pakistan, Tariq Rida ,   Shalamar Medical and Dental College, Shalamr Link Road, Mughalpura, Lahore, Pakistan, Arif Muneeba ,   Shalamar Medical and Dental College, Shalamr Link Road, Mughalpura, Lahore, Pakistan, Waheed Sana ,   Shalamar Medical and Dental College, Shalamr Link Road, Mughalpura, Lahore, Pakistan, Nisar Samaha ,   Shalamar Medical and Dental College, Shalamr Link Road, Mughalpura, Lahore, Pakistan
Published: January 2021

Objective: To assess and compare the Knowledge, Attitude, and Practices of Medical and Nursing Students regarding Basic Life Support Training Methodology: This cross-sectional study was done at the Shalamar Institute of Health Sciences, Lahore in a period of three months. Students from all years of MBBS and BS Nursing were taken as subjects. Participants satisfying inclusion criteria were requested to fill out a self-structured pre-tested questionnaire after informed consent. Data was analyzed using SPSS v.21. Results: There were 330 participants from MBBS and BS Nursing (50 from each class of MBBS and 20 from each class of BS Nursing). The age of participants ranged from 18 to 30 (Figure 1). Only 250 subjects had heard about BLS. Out of 330 participants, only 204 had good knowledge about BLS (Table 2) and 126 had poor knowledge of BLS where score of higher than 3 out of 7 was considered as good. Knowledge of Medical and Nursing students was compared and the p-value came out to be 0.088, which was considered insignificant. Only 34.5% of the participants had learned BLS by training and only 13.3% of the participants (Table 3) had practically done BLS. Most of the people gave no reason for not attending a training session for BLS. Conclusion: It was concluded that medical and nursing students had satisfactory knowledge of BLS and more attention was needed towards this important life-saving skill.
Arsenic: A Cause of Cardiometabolic Syndromes
Authors:   Government College University Kotwali Road, Gurunanakpura, Faisalabad, Pakistan, Khan Aimen Umer , Ahmed Khawaja Zafar ,   Jinnah College of Pharmacy Street 6, Sector 7-A, Korangi industrial Area, Karachi, Pakistan
Published: January 2021

Objective: The objective of the study is to identify major pathological biomarkers and their possible mechanisms in arsenic-induced cardiometabolic syndrome. Methodology: The present review summarizes the data and literature taken from previously done studies from Research Gate, Science Direct, PubMed, PubMed Central, Medline, and some other scientific databases emphasizing the role of arsenic in cardiometabolic syndrome. The results obtained through this database were assembled, composed, critically elucidated and presented in explanatory and tabular form. Results: The major pathological target of arsenic is antioxidant defense system and increase in Reactive Oxygen Species reduces the Nitric oxide production, reduction in vascular permeability, increases adhesion and production of inflammatory mediators (IL-6, TNF-á,), TCs, TGs, LDL-C, lipid peroxidation, â-cells dysfunction. The persistent accumulation and generation of these pathological biomarkers in blood vessels can induce hyperlipidemias, dyslipidemias, atherosclerosis, hypertension and diabetes. Conclusion: There is a need to propose natural antioxidant with minimum side effects in the treatment of CMTs.
Frequency of ABO Blood Groups and RhD Factor in Donors of District Nowshera
Authors:   Nowshera Medical College, Qazi Hussain Ahmed Medical Complex, Nowshera, Pakistan, Khan Hamzullah
Published: January 2021

To screen the donors for the frequency of different blood groups, reason for deferral and comparative analysis of the donation in two consecutive years in the blood bank of Qazi Hussian Ahmed Medical Complex Nowshera, a cross sectional study was carried out from April 25, 2017 to May 5, 2019. A total of 3,429 donors were included in the study. The mean age of donors with standard deviation was 35+ 3.24 years. Three thousand eighteen (88%) of the donors were males. The distribution of RhD+ and RhD- blood groups was 89.90% and 10.09% respectively. The frequency of ‘RhD+ blood groups in target population’ was B: 1226 (35.75%), O: 807 (23.53%), A: 754 (22%) and AB: 296 (8.63%). The frequency of ‘Rh Negative blood groups’ was: B: 139 (4.05%), O: 95 (2.77%), A:84 (2.45%) and AB: 28 (0.82%). The packed cell wastage rate in our blood bank was 185 (5.4%). The donor deferral rate was 0.7%. Hepatitis B Virus was the major cause of deferral that was reported in 14 cases followed by HCV Virus in 13 cases. It was concluded that the frequency of ‘Rh-positive blood group’ was B,O,A and AB respectively. Blood Group B was noted in 35% of the donors that counted to be the major prevalent Rh positive blood group in our population. Regarding the Rh Negative blood group, again the frequency was B,O,A and AB. Blood group B- was prevalent as a major negative blood group in our population that was recorded in 4.05% cases. The seroprevalence of hepatitis in the donors was 0.7%.
Do Family Wishes Trump Verbal Advance Directive? An Ethics Case Report Amidst COVID-19
Authors:   Shalamar Medical and Dental College, Lahore, Pakistan, Saleem Sarosh , Malik Nuzhat Irfan ,   The Indus Hospital, Karachi, Pakistan, Shamsi Nida Ilyas ,   The Indus Hospital, Karachi, Pakistan
Published: January 2021

Covid 19 pandemic brought many challenges for public and healthcare workers. Healthcare workers all around the world are at the heart of this dreadful situation. While providing critical care to Covid 19 patients, they have faced many clinical as well as ethical dilemmas. The novelty and profound uncertainty associated with the clinical course of the disease introduced a dimension to the context of ethical dilemmas faced in clinical practice.
Knowledge of physiological and hygienic foundations of the effective organization of educational activities by school teachers
Authors:   Institute of Developmental Physiology of the Russian Academy of Sciences, Moscow, Russian Federation, Makarova L.V. , Paranicheva T.M. ,   Institute of Developmental Physiology of the Russian Academy of Sciences, Moscow, Russian Federation, Lukyanets G.N. ,   Institute of Developmental Physiology of the Russian Academy of Sciences, Moscow, Russian Federation, Bezrukikh M.M. ,   Institute of Developmental Physiology of the Russian Academy of Sciences, Moscow, Russian Federation, Tyurina E.V. ,   Institute of Developmental Physiology of the Russian Academy of Sciences, Moscow, Russian Federation, Orlov K.V. ,   Institute of Developmental Physiology of the Russian Academy of Sciences, Moscow, Russian Federation
Published: January 2021

The article presents the analysis of the knowledge of the physiological and hygienic foundations of the effective organization of the educational process by teachers and the assessment of teachers ' readiness for health-creating professional activities