bluuebunny/crossref_metadata_2025 huggingface dataset:
An Historical Perspective on Genetic Care
Authors: Jenkins Jean
Published: December 2023

The outcomes of genetic research endeavors have the potential to transform health care with significant implications for both providers and consumers of clinical services. Professional and public integration of genetics knowledge is key to successful utilization of genetics information. This article will provide an overview of genetics including a historical perspective, examples of genetic health care, the nursing perspective, and ethical considerations and challenges. New scientific explanations for health, disease, responsiveness to treatment, and design of options for care may create personal and professional dilemmas. Nurses have a responsibility to become active participants in confronting the demands resulting from this new knowledge for education, practice, and policy. The purpose of this article is to provide a foundation from which the profession of nursing can build to enhance current skills and knowledge about genetics to prepare for this transformation in health care.
Heart Stopper Genes: Would You Recognize a High Risk Patient?
Authors: Greco Karen , Bayan Matthew
Published: December 2023

Coronary artery disease (CAD) is one of the leading causes of death in the United States. Eighty percent of people having heart attacks have normal cholesterol levels. A quarter of the population have a condition called low-density lipoprotein (LDL) pattern B that has been associated with a threefold risk of myocardial infarction. Although early intervention can often prevent an otherwise fatal event, these patients often go unrecognized until after a myocardial infarction has occurred because they may not have the usual risk factors associated with cardiovascular disease. In patients with LDL pattern B, the standard lipid panel may be normal and inadequate for diagnosis and treatment of the condition. This article discusses how to identify a potentially high risk patient, available laboratory tests, management options, and the role of nurses in identifying high risk patients. The second author tells his personal story of surviving multiple cardiac arrests at a young age before being diagnosed with this condition.
Les clowns, délicatement
Authors: Cornut Nicolas
Published: December 2023

Dans cet article, l’auteur déplie l’intuition suivante : la délicatesse est absolument nécessaire au clown. Pourquoi ? Comment ? La transposition créative de la situation scénique dans un imaginaire décalé est une opération délicate : ni trop près ni trop loin du réel. La personne qui apparaît en clown met en scène ses enjeux narcissiques fondateurs. Elle donne forme à ses impasses de contact.
En Corée du Sud, la famille rongée par l’ambition scolaire
Authors: Rocca Nicolas
Published: December 2023

Le pays possède l’un des systèmes éducatifs les plus stricts au monde et la natalité la plus basse des pays de l’OCDE. L’excellence s’y est muée en obsession.
Bacillary Layer Detachment as a Presenting Feature of Ocular Sarcoidosis
Authors: Serels Chad M. , Bhatter Param , Srivastava Sunil K. , Lowder Careen Y. , Mammo Danny A.
Published: December 2023

Background and Objective:

Bacillary layer detachment (BALAD) is a recently described finding on optical coherence tomography (OCT) that has been reported in a variety of uveitic and retinal diseases. To add to the growing literature on conditions associated with this finding, we report on the first cases of BALADs in ocular sarcoidosis.

Patients and Methods:

Observational, retrospective chart review of patients with BALADs as a feature of sarcoid-associated uveitis.

Results:

Three patients presented with blurry vision and bacillary layer detachments on OCT who were either known to have or found to have sarcoid-associated uveitis. All three patients had resolution of the BALAD and improvement in visual acuity with a combination of high-dose oral steroids and/or systemic immunosuppression.

Conclusions:

Patients presenting with BALAD should be assessed for sarcoidosis, if appropriate, given the systemic implications of this diagnosis.

[
Ophthalmic Surg Lasers Imaging Retina
2023;54:686–690.]
The Impact of Employees' Perception of Smart Cities on Employee Green Behavior: A Moderated Mediation Model
Authors: Jun Yin , Li Youling , Xin Zijun
Published: December 2023

The issuance of the 2022 White Paper on Smart Cities has brought the notion of smart cities to the forefront. This conceptual framework revolves around green and sustainable development, aligning seamlessly with China's mission to strengthen ecological civilization in the contemporary era. In this study, we delve into the implications of employees' perception of smart cities on their ecologically conscious behaviors, drawing upon the frameworks of self-determination theory. The empirical analysis encompasses 306 employee respondents hailing from diverse enterprises and backgrounds. The findings extracted from this investigation reveal several crucial insights: (1) A robust and positive correlation between the employees' perception of smart cities and their eco-friendly behaviors; (2) corporate environmental responsibility assumes a partially mediating role between the employees' perception of smart cities and eco-friendly behaviors; (3) environmental awareness emerges as a constructive moderator in the interplay between corporate environmental responsibility and employees' eco-friendly behaviors; (4) notably, the impact of employees' perception of smart cities on employees' eco-friendly behaviors assumes greater prominence when environmental awareness is high, signifying an intensified indirect relationship. This dynamic underscores that during periods of heightened environmental awareness, the influence of employees' perception of smart cities on eco-friendly behaviors becomes more pronounced, reinforced by a more substantial indirect influence channeled through corporate environmental responsibility. These findings enhance the theoretical underpinnings of self-determination theory. Enterprises are encouraged to underscore and incentivize employees' pro-environmental behaviors, integrate environmental preservation paradigms into corporate culture and enhance green management initiatives, synergistically advancing shared ecological objectives for both enterprises and employees.
Long memory cointegration and dynamic connectedness of volatility in US dollar exchange rates, with FOREX portfolio investment strategy
Authors: Ajao Isaac O. , Olayinka Hammed A. , Olugbode Moruf A. , Yaya OlaOluwa S. , Shittu Olanrewaju I.
Published: December 2023

Decisions of central banks on foreign exchange rates are based on the comovement of foreign exchange (FOREX) in mature markets such as US dollar rates to the British pound, euro, Chinese yuan, Japanese yen and Australian dollar. We investigate the long-run movement and dynamic quantile connectedness of volatility among pairs of these exchange rates. The updated residual-based fractional cointegration testing framework using narrow-band frequency domain least squares estimator is used to obtain the residual series for fractional cointegration. Quantile dynamic connectedness framework for volatility spillovers at different market conditions, depicted by quantiles, are used. We find evidence of long memory cointegration in seven pairs of exchange rates involving the previously mentioned currencies. These seven cases also correspond to a higher average index of quantile connectedness, with the effect of connectedness phasing out at higher quantiles and being more visible at lower quantiles. A portfolio investment strategy using optimal portfolio weights and hedge ratios for maintaining the accrued profit at the FOREX market is also presented.
Development of the Creative Potential of Future Teachers Based on Smart Education
Authors: Qarkaxhija Jusuf , Assanova Zhanna , Igenbayeva Rabiga , Toxanova Sveta , Yensebayeva Gulzat , Myrzanova Aliya , Turlugulova Nurzhanar
Published: December 2023

The purpose of this research is to examine the impact of smart education on the development of the creative potential of future teachers. If we consider the research as a model, we can see that it was formed using the mixed method. The study group consisted of 172 teacher candidates who are pursuing their education at various universities in Almaty, Kazakhstan. It is noted that the data collection tools used in the research included a semi-structured interview form that was developed by the researchers and supported by experts in the field. The analysis of the quantitative data from the research was conducted using a statistical programme. In addition to calculating percentages, frequencies, and means, independent variables t-tests and one-way analyses of variance were applied. For the analysis of the qualitative data from the studies, they were grouped and analysed. As a result of the research, it has been determined that teacher candidates who use smart education have high creative potential.
Educators’ Perspectives on the Main Challenges and Opportunities for Implementing Digital Solutions in Learning and Teaching
Authors: Sarva Edīte , Puriņa-Biezā Katrīna Elizabete
Published: December 2023

The gap between technological progress and education is one of the international issues that needs to be addressed. Further education of educators is considered one of the best solutions [1]. Nevertheless, schools struggle with the requirements set by national and international authorities, lacking guidance and support [2, 3, 4]. This research aims to identify the primary challenges and opportunities for implementing the use of digital solutions in learning and teaching. The research questions are as follows: (1) What are the primary challenges for educators when implementing digital solutions in learning and teaching? and (2) What are the key opportunities for educators when implementing digital solutions in learning and teaching? This study examines the reflections and evaluations of educators’ learning experiences in a two-year national-level further education programme aimed at enhancing and advancing their pedagogical digital competence. Throughout the course, educators regularly filled out surveys reflecting on the quality of collaboration in their support groups, their progress towards their professional development goals, their main challenges, and their greatest successes in learning and implementing digital solutions in practice. The study analysed 8,636 responses from educators using a mixed-methods design. Quantitative data analysis was used for the Likert scale questions, while deductive and inductive qualitative analysis was used for the open-ended questions. The results show that many of the factors’ educators mentioned as successes in their learning experience were also mentioned as significant challenges, such as learning to use new digital solutions, applying digital solutions in their work, collaborating with colleagues to learn and implement new digital solutions, and effectively managing time to achieve set goals. Educators need dedicated time to experiment with digital solutions, engage in practical and peer-oriented learning approaches, develop a shared vision, foster collaboration, and receive support to enhance their competence and confidence in utilising digital solutions.
Interstitial Lung Abnormality in Asian Population
Authors: Jin Gong Yong
Published: December 2023

Interstitial lung abnormalities (ILAs) are radiologic abnormalities found incidentally on chest computed tomography (CT) that can be show a wide range of diseases, from subclinical lung fibrosis to early pulmonary fibrosis including definitive usual interstitial pneumonia. To clear up confusion about ILA, the Fleischner society published a position paper on the definition, clinical symptoms, increased mortality, radiologic progression, and management of ILAs based on several Western cohorts and articles. Recently, studies on long-term outcome, risk factors, and quantification of ILA to address the confusion have been published in Asia. The incidence of ILA was 7% to 10% for Westerners, while the prevalence of ILA was about 4% for Asians. ILA is closely related to various respiratory symptoms or increased rate of treatment-related complication in lung cancer. There is little difference between Westerners and Asians regarding the clinical importance of ILA. Although the role of quantitative CT as a screening tool for ILA requires further validation and standardized imaging protocols, using a threshold of 5% in at least one zone demonstrated 67.6% sensitivity, 93.3% specificity, and 90.5% accuracy, and a 1.8% area threshold showed 100% sensitivity and 99% specificity in South Korea. Based on the position paper released by the Fleischner society, I would like to report how much ILA occurs in the Asian population, what the prognosis is, and review what management strategies should be pursued in the future.
THE ITALIAN PERSPECTIVE AND CONTRIBUTION TO ISLAMIC STUDIES. FROM ‘ORIENTAL STUDIES’ TO ‘ISLAMIC STUDIES’
Authors: Piacentini Valeria
Published: December 2023

This article intends to focus on the contribution of Italian research to the knowledge of the Islamic world, underlining its path and evolution up to the present day in content, objectives and methodology. The Italian path has its roots in a tradition that dates back to the 16th century. Here we take ourselves back to the end of the 19th century, when studies on Islam were part of a generic discipline of Oriental Studies and Linguistics. Rather than on names and bibliographies (there would be too many - for which reference is made to the Treccani Italian Encyclopedia), we focus on the most significant 'stages', starting from the institutional configuration of Studies on Islam and Islamic Studies as autonomous disciplines: Michele Amari and the Italian Geographical Society, and therefore Leone Caetani and The Annals of Islam, the latter "forge" in which the great Islamists of the 20th century were trained: M. Guidi, C. A. Nallino, G. Levi Della Vida, F. Gabrieli. Alongside the academy and new fields of research (Turcology, Iranian studies, Arabic studies, etc.) three large institutions were added - supported by the Ministry of Foreign Affairs: the Institute for the Orient (later IsPO), the Institute for the Middle and Far East Oriente and the Italian Institute for Africa (still active). World War II also marked an important break in Italy, leading studies on the Arab and Islamic world to the use of new disciplines. The influence of the French Annales school and the entry of the 'social sciences' into the new methodological paths were decisive. Studies on Islam were not immune, but distanced themselves from political science and the media fascination with 'analysis' and 'scenarios', to strictly adhere to linguistic knowledge as an indispensable tool for the study and evaluation, including historical, of political, social and current cultures, in regions where very different civilizations and traditions had met, sometimes clashed and overlapped. Multidisciplinarity and 'field-work' were the instrument of this turning point in Italy. In the first years of the Third Millennium, 'sciences' and new research 'technologies' (archaeometry, physics, the drone, etc.) came together which, by supporting textual and non-textual sources, allow the 'confirmation' of those that had remained working hypothesis for a long time.
AN ‘AUSTRIAN’ THEORY OF ORDER
Authors: Cubeddu Raimondo
Published: December 2023

According to 'Austrian' Liberalism, an order could be defined as the unintentional result of individual choices with which, sometimes in unforeseen situations but supported by experience, individuals have managed to select rules of conduct aimed at reducing unintended, unexpected consequences and undesirables of human actions. In this order – which is therefore a provisional 'state' that no one in particular wanted and whose future is open to unexplored possibilities – knowledge and time play a primary role. However, not only has this type of order never existed (because the political regimes we have experienced were formed above all through acts of oppression, of power and through collective and political choices), but today it also has little chance of being realized . In fact, in situations characterized by the continuous emergence of new circumstances and scientific, technological and moral innovations, the time in which individual and social expectations are formed, modified and spread tends to increasingly diverge from that which institutions use to make choices. policies that favor or maintain a dimension of order understood as predictability of the outcomes of behaviors and choices in a non-ergodic world. Nonetheless, starting from 'Austrian' themes such as the theory of exchange, institutions, catallaxy and above all time, the author believes that a perhaps unorthodox but fruitful elaboration of a liberal theory of order is still possible.
LOYALTY E ATTRATTIVITÀ DELLE LAUREE MAGISTRALI. IL CASO DELL’UNIVERSITÀ DI PAVIA
Authors: Gerzeli Simone
Published: December 2023

Obiettivo del presente contributo è riportare i principali risultati sull’attrattività dei corsi di laurea magistrale dell’Università di Pavia. Le analisi condotte evidenziano molti punti di forza e numerose aree di attrattività dell’offerta accademica post-laurea dell’Ateneo. Alcuni corsi di laurea sono considerati di eccellenza, come i corsi di Laurea Magistrale in Comunicazione digitale e Biologia sperimentale e applicata, entrambi al terzo posto a livello nazionale per numero di studenti iscritti. L’analisi dei flussi indica che la mancata iscrizione ai corsi di laurea magistrale da parte dei laureati UNIPV è spesso controbilanciata dal numero di studenti in entrata da altri atenei e che gli abbandoni effettivi sono documentati solo in pochi corsi. Gli eventi di orientamento sono stati molto efficaci per i laureati interni, poiché 3 su 4 si iscrivono a corsi post-laurea. Alcuni studenti non partecipano agli eventi perché hanno già deciso di proseguire la propria carriera accademica all'interno della stessa università. Nonostante i fattori positivi sopra elencati, l’analisi ha portato alla luce alcune aree critiche, che richiedono l’individuazione e l’adozione di strategie ad hoc. Gli eventi di orientamento sono efficaci per uno studente incoming su 4 proveniente da altre università, suggerendo che ci sono ancora margini di miglioramento nel coinvolgimento di questi studenti. Inoltre, i corsi di laurea magistrale con tassi di iscrizione in calo sono spesso in forte concorrenza con Milano. In particolare, i corsi di Ingegneria competono con i Politecnici di Milano e Torino. L’utilizzo di approcci data-driven è sempre più necessario per monitorare e identificare fattori critici e di successo legati al progresso degli studenti universitari.
I nodi dell’Occidente. Sovranismo individuale, crisi delle democrazie, guerra
Authors: De Angelis Massimo
Published: December 2023

Non disponibile.
The pharmacological deprescription in elderly patients
Authors: Ali Chelsey , Huang Daniel , Tugwete Charlene , Del Canale Stefano , Maio Vittorio
Published: December 2023

N/A
Spontaneous resolution and the role of endoscopic surgery in the treatment of primary obstructive megaureter: a review of the literature
Authors: Isac George Vlad , Danila Gabriela Mariana , Ionescu Sebastian Nicolae
Published: December 2023

The megaureter accounts for almost a quarter of all urinary tract dilations diagnosed in utero and is the second leading cause of hydronephrosis in newborns, following pyeloureteral junction obstruction. The current standard treatment for progressive or persistent, symptomatic primary obstructive megaureter is ureteral anti-reflux reimplantation, which can be associated with ureteral remodeling or plication. Due to the associated morbidity, postoperative recovery challenges, and the complications that may arise from the open surgical approach, there has been a natural inclination towards validating new minimally invasive techniques. This study reviews the literature, extracting data from three major international databases, from 1998 to 2022. Out of 1172 initially identified articles, only 52 were deemed eligible, analyzing 1764 patients and 1981 renal units. Results show that 65% of cases required surgical intervention, with minimally invasive techniques constituting 56% of these procedures. High-pressure endoscopic balloon dilation was the preferred endourologic technique. The degree of ureterohydronephrosis is considered one of the factors indicating the need for surgery. There is an inverse relationship between the diameter of the ureter and the likelihood of spontaneous resolution. Conditions such as renal hypoplasia, renal dysplasia, or ectopic ureteral insertion strongly indicate a poor prognosis. Endoscopic surgical techniques for treating primary obstructive megaureter can be definitive, firstline treatment options. In selected cases, they might be at least as effective and safe as the open approach, but with advantages like quicker recovery, fewer complications, shorter hospital stays, and reduced costs.
Ultrasound imaging in crystal arthropathies: a pictorial review
Authors: Tamborrini G. , Hügle T. , Ricci V. , Filippou G.
Published: December 2023

Objective. The prevalence of crystal arthropathies in the general population is rising. The purpose of this pictorial study is to describe the sonographic elements of the most prevalent crystal arthropathies by emphasizing particular sonographic findings using illustrative images and cases while considering technical details and common pitfalls.
Methods. Using established recommendations, specialists in the fields of sonography and crystal arthropathies agreed by consensus on the unique ultrasound signs associated with each of the conditions.
Results. Gout, calcium pyrophosphate deposition arthropathy, and hydroxyapatite arthropathy are the three most prevalent crystal arthropathies. Today’s high-resolution sonography enables reliable evaluation of the underlying crystal deposits, post-inflammatory changes, and a precise description of joint inflammation.
Conclusions. High-prevalence crystal arthropathies are reliably detectable by ultrasound with current ultrasound equipment. It is necessary to have extensive ultrasound training, know specific sonographic findings, and understand all possible differential diagnoses for disorders affecting the musculoskeletal system.
L’udienza civile del tribunale minorile come setting attivatore di cambiamenti intrapsichici e relazionali
Authors: Scarnera Pasquale
Published: December 2023

I tribunali minorili italiani si avvalgono del contributo di esperti esterni, aventi varie competenze e specializzazioni, applicate nell’attività da essi svolta durante le udienze, in cui vengono ascoltati sia servizi sociali e sanitari, che minori e genitori le cui problematiche sono oggetto di intervento. Un contributo fornito anche durante le Camere di Consiglio, attraverso le quali vengono prese decisioni, rivolte sia ai Servizi che ai cittadini, che riguardano la soluzione dei bisogni e delle difficoltà identificate durante l’attività istruttoria. Tale attività, tenuta nel corso delle udienze, genera spesso dinamiche proiettive, di tipo Ego-Superego, che possono rivelarsi utili nell’attivare processi di cambiamento nei convenuti, se gestito con consapevolezza ed accortezza. Tale utile setting attivatore potrebbe perdersi, o causare danni, in seguito alla modifica del processo civile prevista per i prossimi mesi; pertanto, viene proposta una discussione teorica e casi clinici illustrativi di tali dinamiche.
Il periodo perinatale quale delicato momento di transizione. I possibili risvolti dello stress materno in rapporto all’esordio cancerogeno nella vita intrauterina
Authors: Marcí Cristi
Published: December 2023

Il periodo perinatale rappresenta non solo una fase di transizione, bensì un insieme di processi rispetto ai quali sia la madre che il bambino, che porta con sé in grembo, sono esposti ad una serie di fattori in grado di apportare notevoli modifiche sia morfologiche che epigenetiche. Entrambe nel loro insieme se da un lato sono promotrici di un cambiamento neurobiologico e psichico, dall’altro confermano la presenza di un vero e proprio scambio intrauterino rispetto al quale il background materno è in grado di tradursi in un bagaglio neurochimico pronto ad essere trasmesso al feto. Quest’ultimo infatti se sotto il profilo genetico erediterà un patrimonio genitoriale, sotto quello epigenetico acquisirà viceversa un’impalcatura morfologica e comportamentale correlata ad uno stile espressivo dei geni pronti a guidarlo in maniera adattiva e/o disfunzionale. La salute materna pertanto, riflette quella condizione psichica e biologica che durante la gravidanza può apportare al feto notevoli modifiche, quali riflesso di un proprio modo di stare al mondo. La presenza di una modalità di autoregolazione emotiva disfunzionale in gravidanza, può dunque determinare l’insorgenza di una condizione di stress cronica e ripetitiva in grado di intaccare la lunghezza dei telomeri. I quali possono a loro volta aumentare le probabilità di una ipermetilazione del DNA correlata al possibile esordio di una carcinogenesi.
Sulla violenza in sanità: tra la violenza contro i curanti e la violenza delle cure
Authors: Perini Mario
Published: December 2023

Dopo avere indicato alcune caratteristiche psicologiche della violenza, l’articolo si rivolge in particolare ai fenomeni della violenza sociale, istituzionale e politica, notando come dopo gli scritti di Freud sulla guerra e sulla psicologia delle masse questo argomento sia stato piuttosto trascurato dalla ricerca psicoanalitica. Viene poi osservato come in questi ultimi anni, dopo l’11 settembre, sul tema si sia destato un grande interesse da parte degli psicoanalisti e dei gruppoanalisti. Quindi vengono esplorate le radici socio-culturali della violenza e il ruolo esercitato congiuntamente dalle norme e dalle pressioni dei gruppi e delle culture istituzionali e dalle tendenze passivo-dipendenti e conformistiche degli individui. L’articolo si occupa poi specificamente della violenza nei contesti sanitari, esplorando quella agita contro i curanti, in particolare dopo la pandemia da COVID, sia da parte degli utenti sia da parte dei media e della pubblica opinione, sul piano fisico, verbale e psicologico, così come la violenza istituzionale – che alimenta conflitti tra i vari attori del sistema sanitario - e quella intrinseca ai processi di cura, i quali spesso richiedono al paziente di sottoporsi a misure e condizioni oggettivamente penose o costrittive. Nella parte conclusiva vengono indicati alcuni approcci e metodi che si sono rivelati utili per prevenire queste forme di violenza.
Il patrimonio evolutivo della vulnerabilità: commento all’articolo ‘Passione e tenerezza come forze politiche’ di Jô Gondar
Authors: Ciardi Alessandro
Published: December 2023

Sono felice di aver incontrato, per così dire, le riflessioni di Jô Gondar nel suo intenso intervento sulla passione e tenerezza come forze politiche e ritengo una occasione poter condividere qui i pensieri che la lettura dell’articolo ha evocato in me. La riflessione di Gondar mi sembra potente ed elegante, nella sua capacità anzitutto di ricordarci, a mo’ di prologo, la dimensione olistica, oggi si direbbe, dell’essere umano o, in altri termini, il fatto che, ben prima e al di là di qualsiasi speculazione e astrazione, l’essere umano è un intero complesso. [...]
Risposta al commento dei colleghi
Authors: Perini Mario
Published: December 2023

È importante il riferimento di Pellegrini alla violenza verbale, ai ‘discorsi dell’odio’, non solo per rilevare le determinanti socio-culturali che sempre più spesso la sdoganano o addirittura giungono a legittimarla nella dialettica paranoide del ‘noi/loro’, ma anche per osservare con quanta frequenza la corrente cultura digitale, articolata nei social media e negli altri spazi virtuali offerti dalla rete, renda ‘l’altro’ totalmente invisibile o irrilevante; per questo può trovarsi esposto ad aggressioni verbali e a violenze denigratorie di cui gli autori spesso sono del tutto inconsapevoli o che minimizzano come se fossero alle prese con un combat game dove giocano da soli contro personaggi immaginari. Il guaio è che a volte lo stesso schema si riproduce anche negli scambi reali, dove al posto della spada laser o dei messaggi su Tik Tok si utilizzano le ingiurie o magari anche delle concrete percosse. [...]
Commento al film: Border – Creature di confine
Authors: Santi Sara , Morselli Giulio
Published: December 2023

Tina è un’agente presso la dogana svedese. Ha un aspetto quasi deforme, a tratti ripugnante. Ma ha la capacità di fiutare l’emotività degli altri esseri umani. Grazie al suo dono, riesce a portare alla luce un perverso traffico di materiale video illegale. Un giorno incontra Vore, un uomo con deformità fisiche simili, dal quale si sente irresistibilmente attratta. Tra i due scoppia una passione potente e Vore le rivela che non sono semplici esseri umani, ma creature che vivono in pieno accordo con la parte più istintuale e primitiva della Natura: i troll. Grazie a questo incontro Tina inizia ad accettarsi e ad amarsi, per giungere solo nel finale a un nuovo equilibrio esistenziale.
Commento del caso di Zaccaria e Balestra
Authors: Coin Romina
Published: December 2023

Zaccaria e Balestra hanno presentato un caso che pone al centro dell’attenzione il tema del conflitto e della sua gestione all’interno di una terapia di coppia. Lo fanno con riferimento all’approccio sistemico, ma mettendo in evidenza alcuni aspetti che possiamo ritenere comuni ai differenti modelli di intervento con la coppia. Partirei proprio da questi ultimi, quali ambiti di interesse trasversale, per poi proporre una riflessione sul conflitto di coppia nella prospettiva di Psicoanalisi della Relazione. [...]
Effectiveness of Caregiver Intervention for Improving Medication Adherence on Level of Medication Adherence and Attitude toward Medications among Nonadherent Patients with Mental Illness
Authors: Kaur Simrat , Baby Renju Sussan , Padhy Susanta Kumar
Published: December 2023

Background:

Nonadherence to medication is the major challenge in treating mental illness, resulting in worsening symptoms and prolonging the course of the illness. Caregivers spend a considerable amount of time with the patients. Therefore, proper training and education for caregivers help to improve treatment outcomes.

Aim:

This study aims to evaluate the effectiveness of caregiver intervention for improving medication adherence (CIIMA) on level of medication adherence and attitude toward medications among nonadherent patients with mental illness.

Methods:

This study was an experimental study using a randomized pretest posttest control group design. The study was conducted in the psychiatric outpatient department of tertiary care hospital in the eastern India. Eighty nonadherent patients with mental illness and their primary caregivers were randomly allocated to the experimental and control group using the concealment allocation method. Patients were assessed for their level of medication adherence using medication adherence rating scale, their attitude toward medication were assessed using drug attitude inventory and reasons for medication nonadherence were assessed using the Rating of Medication Influence. CIIMA consisted of individual psycho-education, pill card monitoring, weekly telephonic and text reminders provided to the experimental group, and routine treatment was provided to the control group. The level of medication adherence and attitude toward medication were reassessed for both groups after 1 month of the initial assessment.

Results:

After 1 month of CIIMA, 87.2% of patients in the experimental group were adherent to medication as compared 18.4% in the control group (P < 0.001), significant improvement in their attitude toward medication and treatment in the experimental group as compared to the control group (P = 0.001).

Conclusion:

CIIMA is an effective, low-cost, nurse-led intervention can be delivered in the inpatient and outpatient units for improving medication adherence thereby preventing future relapse of their mental illness.
Percutaneous fixation of bilateral anterior column fracture and bladder repair in a single setting
Authors: Mohan Ravindra , Singh Arpit , Kumar Sanjiv , Tewari Prakash Gaurav , Bhanu Divya , Saxena Suraj
Published: December 2023

Patients sustaining pelvic fractures following trauma are known to be at risk for an associated bladder and/or urethral injury. In an attempt to overcome the morbidity of extensile surgical approaches, percutaneous fixation of the pelvis has been receiving increasing attention. We report the case of a 30-year-old male who presented to a tertiary care trauma center for fractured bilateral acetabulum with bilateral fracture superior and inferior pubic rami with bladder injury. In pelvic trauma patients, percutaneous techniques have been specially recommended in patients with polytrauma, severe open injuries, extensive closed degloving injuries, and in elderly with medical comorbid conditions. Percutaneous screw fixation of acetabulum fractures is a relatively new procedure, and the indication for its use is not fully defined and needs to be explored.
Osteosarcoma of the proximal femur masquerading as infective osteomyelitis
Authors: Asif Naiyer , Khan Asad , Jesan Khan Mohammad , Siddiqui Yasir Salam
Published: December 2023

Osteosarcoma is the most prevalent primary malignancy of bone in pediatric and adolescent patients. Infections, benign bone tumors, and various cancers are included while considering the differential diagnosis of osteosarcoma. Particularly among these alternate diagnoses, septic arthritis, and osteomyelitis can exhibit symptoms that are strikingly similar to those of osteosarcoma. To facilitate prompt evaluation and treatment, we describe a case of proximal femoral osteosarcoma that originally had characteristics of both septic arthritis and infectious osteomyelitis. We also go through the various distinctions between these two conditions.
A case report on patient with giant cell tumor of the distal ulna
Authors: Ahmed Parwez , Adnan Mohd , Khan Azad , Tomar Vishvendra
Published: December 2023

Giant cell tumors, however benign, are locally aggressive bone tumors with a high recurrence rate. The distal radius, distal femur, proximal tibia, and humerus are the most typically affected. A bone giant-cell tumor (GCT) in the distal ulna is extremely uncommon. Wide excision is typically advised in such cases, and a long chunk of the distal ulna may need to be removed. In such cases, the conventional treatment for GCT is distal ulna resection.
Crystal deposition disease as an unusual cause of knee pain in an adult male: Report of a rare case
Authors: Adil Mohd , Julfiqar  , Sabir Aamir Bin , Siddiqui Bushra
Published: December 2023

Gout is a monosodium urate crystal deposit disease which generally occurs in middle aged male and post-menopausal females. It is typically characterized by episodic acute and chronic arthritis due to deposition of monosodium urate crystals in joints and connective tissue. Palpable deposits of crystals known as tophi may form particularly around joints but also elsewhere. This is a single case based prospective work-up and follow up study done at our institute of a middle-aged male having chronic right knee pain since 1 year year. Meticulous history and clinical examination, laboratory investigations were done like ESR (erythrocyte sedimentation rate) and CRP (c- reactive protein) and radiological investigation including plain radiograph and MRI (Magnetic resonance imaging) right knee was done and was suggestive of giant cell tumor of patella. Excision and curettage of the lesion was done and sample was sent for HPE (histopathological examination) which showed fibrocartilaginous tissue with features of gouty arthritis. Serum uric acid was done which came out to be raised (10.14 mg/dl). At final follow-up patient had satisfactory outcome. It is important to have in mind that tophus of patella can cause chronic knee pain in patients with gouty arthritis. Early diagnosis and treatment are essential. Patients with tophaceous gout require strict disease control and close follow-up.
Management of Wilms’ Tumor with Cavoatrial Extension Using Deep Hypothermic Cardiac Arrest and Selective Antegrade Cerebral Perfusion
Authors: Dhabe Vaibhav V. , Rawlani Sujata Shivlal , Dave Nandini Malay , Karnik Priyanka Pradeep , Majhi Lopa Mudra
Published: December 2023

ABSTRACT

Wilms’ tumor is one of the most common genitourinary malignancies in children. It may be associated with extension of the tumor in the inferior vena cava (IVC) (4%–8%) and right atrium (1%–3%) of cases. In such a scenario, management of cases is further challenging and involves a multidisciplinary approach with medical and surgical specialties, including pediatric cardiac surgery involvement. We present a case of successful management of Wilms’ tumor involving the IVC, right atrium, and hepatic veins where we achieved synchronous surgical resection of both renal and vascular extension. Case management involved anticipated complications involving temperature management, fluid balance, and hemodynamic fluctuation due to intermittent IVC compression, bleeding, arrhythmias, complications involving deep hypothermic cardiac arrest and selective antegrade cerebral perfusion and possibility of tumor embolism.
Aggressive Angiomyxoma Vulva: A Series of Three Cases
Authors: Agarwal Savita , Pandey Pinki , Ralli Megha , Agarwal Roopak , Chaturvedi Vineet
Published: December 2023

ABSTRACT

Aggressive angiomyxoma (AA) is a rare tumor seen in female genital tract. This tumor is aggressive as it shows local spread and has a high recurrence. We describe three cases of AA in females with age ranging from 26 to 32 years which were clinically diagnosed as either fibroepithelial polyp or Bartholin’s cyst. Due to vast clinical differentials, histopathological examination becomes important in these cases. Tumor has good prognosis and surgery with long-term follow-up is treatment of choice.
A Rare Presentation of Perforated Meckel’s Diverticulum
Authors: Meganathan Sunanth , Yatheendranathan Gokul D. , Harish Mamilla
Published: December 2023

ABSTRACT

A 27-year-old female presented with right lower abdominal pain was associated with nausea and vomiting for a 12-h duration. The examination revealed a tender abdomen and localized guarding in the right iliac fossa, and this semblance often results in diagnostic inaccuracy. In an erect abdomen X-ray air under the diaphragm was noted. The patient was taken up for surgery with a working diagnosis of intestinal perforation. After surgical exploration, the final diagnosis was a perforated Meckel’s diverticulum.
Effect of Pulsed Electromagnetic Field Therapy in Cervical and Lumbosacral Spine-Related Pain: A Systematic Review
Authors: Palekar Tushar J. , Gonsalves Nigel Joel
Published: December 2023

ABSTRACT

Introduction:

Spine-related pain is a very common musculoskeletal disorder seen among the general population. There are many approaches to manage spine-related pain which are being implemented by physiotherapists, worldwide. Pulsed electromagnetic field (PEMF) therapy is a novel electrotherapeutic approach, which consists of magnetic field packed in impulse bundles which permeate all cells in the body simultaneously working at the cellular level, thus reaching all parts of the body. There is a dearth of systematic reviews conducted to prove its effect.

Methods:

The keywords search included “pulsed electromagnetic field therapy” AND (“spinal pain” OR “lumbar pain” OR cervical pain’ OR “low back ache” OR “chronic low back pain” OR “lumbago” OR “chronic neck pain” OR “chronic low back ache”) AND “randomised controlled trial.” This systematic review is registered with PROSPERO-215632. Only randomized controlled trials are included. The databases searched include PubMed, Medline, PEDro, and Google Scholar and other database resources available. All research articles till October 21, 2020, are included. Bias is avoided as two different authors are reviewing the articles independently and wherever a question of dispute arises a third author intervened.

Results:

A total of 235 articles were selected in the preliminary search. Two hundred and twenty-three articles were rejected either due to duplication or full text not available or not related to PEMF therapy and spine-related pain. Twelve articles were finally selected for the systematic review. Articles were analyzed according to a verified data extraction format. A synthesis of results was obtained by analyzing for the main outcome measure, i.e., pain and function.

Discussion:

A brief summary of strengths and limitations of research articles was noted.

Conclusion:

It concluded that PEMF therapy was effective in treating.
Successful Outcome after Regional Anesthesia in a Parturient with Dilated Cardiomyopathy for Elective Cesarean Section: Navigating a Stormy Sea
Authors: Sawant Siddhi Mahadev , Oak Shrikanta Pradyumna , Gangakhedkar Gauri Raman , Hemantkumar Indrani Chincholi
Published: December 2023

ABSTRACT

Dilated cardiomyopathy (DCM) is a primary disorder of the myocardium characterized by impaired ventricular dilatation and impaired ventricular contractility. DCM in pregnancy could be associated with adverse cardiac events. Hemodynamic changes occurring at the time of delivery challenge the functional adaptability of the already compromised cardiovascular system. Perioperative anesthetic management of a parturient with DCM undergoing cesarean section thus requires that anesthesiologists have thorough knowledge and understanding of the disease and its management. Here, we describe the successful anesthetic management of a pregnant woman with DCM with low ejection fraction who underwent a cesarean section under central neuraxial blockade.
Identification and Analysis of fatal Road Crash Black spot Clusters in an Urban Setting in South Coastal India
Authors: Anand N. , Soman Biju , Kumar Sajin
Published: December 2023

ABSTRACT

Introduction:

Deaths from road crashes form the leading cause of mortality in India. Streamlining road crash data systems are essential for building robust prevention strategies. This study explores objectivisation of fatal road crash data by spatiotemporal analysis (geographical information system [GIS] technology) in an urban setting in South India.

Aim:

To identify clusters of fatal road crash black spot clusters in an urban setting and to analyze crash-related variables in clusters.

Settings and Design:

Secondary data analysis of fatal road crashes in Puducherry.

Methods:

Fatal road crash data from 2016 to 2018 were collected from South Traffic Police records. Spatiotemporal analysis was done using GIS to map high-density locations (black spots); these were further grouped into clusters. Crash-related variables in each cluster were studied to identify profiles of crash victims, alleged offenders, and risk factors.

Results:

Raw data accessed in descriptive format were converted to analyzable objective format using a self-developed data extraction template. A total of 154 fatal road crashes occurred in Puducherry South during the study period. Total 11 black spots and 3 clusters were mapped. One particular stretch of National Highway witnessed maximum (59%) black spots. Clusters differed from each other for variables such as age (of both victims and causing persons), time of the crash, and causing vehicle type. Intercluster similarities were observed in the preponderance of males (82.3%), youth (mean age: 28.9 years), vulnerable road users (92.6%), rainy season (43.4%), and weekends (46.7%) witnessing most fatal crashes.

Conclusion:

Standardized, objective format for data capturing, and seamless mechanism for data processing are essential. The crash location is a key index variable for data systems, with the feasibility to superimpose other data layers.
Susceptibility of Contemporary Staphylococcus aureus Isolates to a Novel Antibiotic Levonadifloxacin: A Report from a Tertiary Care Center
Authors: Qureshi Dhruv , Gandham N.R. , Das N.K. , Vyawahare C.R. , Bhaumik Shalini , Kannuri Sririam , Mukhida Shajid , Mirza S.
Published: December 2023

ABSTRACT

Background:

Levonadifloxacin and its oral prodrug, Alalevonadifloxacin, are novel antibiotics licensed in India for the treatment of acute bacterial skin and soft tissue infections, including diabetic foot infections and concurrent bacteremia.

Objective:

The objective of this study is to assess the activity of levonadifloxacin against contemporary Staphylococcus aureus clinical isolates, including methicillin-resistant S. aureus (MRSA).

Methods:

A total of 102 S. aureus isolates (non-duplicate one per patient from diverse specimens) were collected from January to December 2021. Isolates were further screened for methicillin-resistance by the disk-diffusion method using Cefoxitin (30 mcg). Susceptibilities of levonadifloxacin and other antibiotics were then determined using the disk-diffusion method performed as per the recommendations of the Clinical and Laboratory Standards Institute.

Results:

Among 102 isolates, 49 (57.8%) were MRSA. Against all isolates, the susceptibilities to gentamicin, cotrimoxazole, erythromycin, clindamycin, and ciprofloxacin were 61.8, 60, 30.4, 57.8, and 12.7%, respectively, while levonadifloxacin showed 100% susceptibility. Furthermore, the susceptibilities of linezolid and vancomycin were also 100%.

Conclusion:

Levonadifloxacin is a newer, safer, and alternative treatment option for infections caused by diverse multidrug-resistant S. aureus, including MRSA. This study, in conjunction with other previous studies, also re-established that levonadifloxacin susceptibilities can be reliably determined using the disk-diffusion method.
Profile of SnakeBite Patients in Intensive Care Unit: A Clinicoepidemiological Study from North India
Authors: Gupta Heena , Jamwal Anju , Pangotra Anshu
Published: December 2023

ABSTRACT

Background:

Snakebite is a common public health emergency which requires immediate medical attention and intensive care. Globally, more than 11,000 deaths occur every year due to snakebite. We carried out this study to evaluate the epidemiology, clinical profile, and outcomes for patients with snakebite in the intensive care unit (ICU) of our hospital.

Materials and Methods:

It was a record-based retrospective, descriptive study carried out over a period of 3 years in which the clinicoepidemiological profile of all snakebite patients admitted in the ICU of our hospital was analyzed.

Results:

Eighty-six patients of snakebite were admitted in our ICU from April 2017 to April 2020. The mean age of the patients in our study group was 32.14 years (range: 18–64 years with male predominance (male: female - 2.44:1). The most common occupational groups were agriculture workers and laborers (77.9%, n = 67). Majority of the snakebites occurred during the night and early morning time (87.2%, n = 75) and were unprovoked. Lower limbs were the most common site of snakebite (63.95%, n = 55), followed by upper limbs (23.25%, n = 20), trunk (11.62%, n = 9), and neck (2.32%, n = 2). Out of 86 patients admitted in ICU, 84 (97%) were intubated. Neuroparalytic symptoms were predominant in most of the patients (95.35%, n = 82), whereas four patients presented with hemotoxic envenomation. Ptosis with double vision and respiratory distress were the most common clinical features of snake envenomation (100% and 95.34%). Coagulopathy in terms of prolonged bleeding time was found in 40.69% cases (n = 35) only. Mechanical ventilation was the most common intervention (97.67%, n = 84) done in the ICU. Four patients developed acute renal failure and were put on hemodialysis. Mortality was seen in two patients (2.32%) due to disseminated intravascular coagulation and intracranial hemorrhage.

Conclusions:

Neuroparalytic envenomation predominated in our study. Early medical management in the ICU can significantly reduce the mortality.