bluuebunny/crossref_metadata_2025 huggingface dataset:
Une nouvelle dynamique autour du nucléaire au sein de l’Union européenne
Authors: Jérémie Pierre
Published: February 2024

La préservation de l’équilibre entre objectifs européens en matière énergétique et climatique et la compétence souveraine laissée aux États membres par l’article 194 du Traité a été au cœur des débats des derniers mois. Au cœur de la construction européenne des années 1950 dans le cadre du traité Euratom, la coopération en matière d’énergie nucléaire s’était depuis les années 1990 concentrée sur les aspects les plus consensuels : gestion des déchets, protection des travailleurs, principes généraux de sûreté.
Nouveau nucléaire, participation et décision : une difficile mise en cohérence
Authors: Badré Michel
Published: February 2024

Le projet de « nouveau nucléaire » présenté par EDF, portant sur une paire de réacteurs EPR2 à Penly dans le cadre d’un programme de six réacteurs du même type, a fait l’objet d’un débat public en 2022/2023. Les annonces des pouvoirs publics sur une décision comprise comme déjà arrêtée, et la rareté ou l’absence des informations sur quelques questions essentielles, ont rendu difficile l’exercice des droits constitutionnels reconnus à toute personne d’être informé et de participer à l’élaboration des décisions. Une trentaine de questions restées sans réponse ont été consignées dans le compte rendu du débat. Seule la réponse à ces questions permettra d’apprécier l’utilité de sa contribution à l’exercice de ces droits.
Du style musif ( Musivstil ). Langue canonique et langue profane. Karl Kraus lu par Gershom Scholem et Walter Benjamin à la lumière de la poésie néohébraïque
Authors: Barral Céline
Published: February 2024

Gershom Scholem et Walter Benjamin se sont intéressés dans les années 1916-1931 à l’œuvre de « l’anti-journaliste » Karl Kraus et à son procédé citationnel. Scholem le désigne par la notion de Musivstil (style mosaïque ou musif, en hébreu shibboutz ), empruntée à l’histoire de la littérature juive. Cette notion, qui a influencé la réflexion de Walter Benjamin sur la citation, leur donne un regard singulier sur le journalisme de leur époque, et sur l’articulation du canonique et du profane en contexte de sécularisation.
Situation de la PMI et impacts des modes d’accueil sur la santé des jeunes enfants
Authors: Suesser Pierre
Published: February 2024

Alors que la crise de tous les secteurs de la pédiatrie a conduit les autorités à organiser des Assises de la pédiatrie et de la santé de l’enfant, et dans un contexte où la prévention demeure un « enfant pauvre » de la politique de santé 1 , le dispositif de protection maternelle et infantile (PMI) conserve une place originale dans le système de santé préventif. Les atouts et faiblesses de la PMI sont essentiels à cerner, ainsi que les remèdes à lui apporter, à la fois pour son action directe en faveur de la santé des tout-petits et pour sa fonction auprès d’institutions essentielles à leur développement et à leur socialisation : les modes d’accueil du jeune enfant.
Réflexions sur la fin de vie : démocratie participative et travail législatif en France
Authors: Delfraissy Jean-François , Callies Ingrid , Ruault Clara
Published: February 2024

Depuis 1999, les différentes évolutions législatives ont progressivement modifié la prise en charge de la fin de vie en France, selon une approche de plus en plus centrée sur le respect de l’autonomie du patient. Si le suicide assisté et l’euthanasie demeurent illégaux, un patient dont le pronostic vital est engagé à court terme et qui témoigne de souffrances insupportables et réfractaires peut demander la sédation profonde et continue jusqu’au décès. Récemment, plusieurs voix ont souligné quelques lacunes de la législation en vigueur, qui ne permet pas de répondre à certaines situations critiques et exceptionnelles. À la suite de la publication de l’avis 139 du Comité consultatif national d’éthique pour les sciences de la vie et de la santé (CCNE) en septembre 2022, a été mis en place un processus de démocratie participative, qui s’est saisi du débat au moyen d’une Convention citoyenne et de réunions d’information en régions. Aujourd’hui, les rédacteurs du projet de loi à venir doivent opérer des choix, notamment sur l’arbitrage entre euthanasie et/ou suicide assisté, et sur l’élaboration d’un « modèle français » qui prenne en compte à la fois l’opinion publique et celle des professionnels de santé.
Graduate Nursing Faculty Perceptions of LGBTQ+ Health Curriculum: A Mixed-Methods Study
Authors: Patron Skylar , Moyse Jennifer A.
Published: February 2024

Background:

The lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community experiences profound health disparities due to discrimination and lack of health care provider knowledge. Although data exist about undergraduate nursing and medical school education on LGBTQ+ topics, there is a gap in understanding graduate nursing schools' preparation of nurse practitioners.

Method:

A survey measuring faculty perceptions of LGBTQ+ health curricula was sent to graduate nursing schools to collect both qualitative and quantitative data.

Results:

Graduate nursing faculty spent a median of 3 hours teaching LGBTQ+ health topics. LGBTQ+ health content in their courses was limited despite their awareness of LGBTQ+ topics, their readiness to include it, and their belief in the importance of including such topics. Respondents indicated a lack of resources and knowledge about where to start and identified a need for support from their institution.

Conclusion:

The gaps identified in graduate nursing LGBTQ+ health curriculum demonstrate the need for additional institutional support.

[
J Nurs Educ
. 2024;63(2):65–71.]
A nonmonton active interior point trust region algorithm based on CHKS smoothing function for solving nonlinear bilevel programming problems
Authors: El-Sobky B. , Abo-Elnaga Y. , Ashry G. , Zidan M.
Published: February 2024

In this paper, an approach is suggested to solve nonlinear bilevel programming (NBLP) problems. In the suggested method, we convert the NBLP problem into a standard nonlinear programming problem with complementary constraints by applying the Karush-Kuhn-Tucker condition to the lower-level problem. By using the Chen-Harker-Kanzow-Smale (CHKS) smoothing function, the nonlinear programming problem is successively smoothed. A nonmonton active interior-point trust-region algorithm is introduced to solve the smoothed nonlinear programming problem to obtain an approximately optimal solution to the NBLP problem. Results from simulations on several benchmark problems and a real-world case about a watershed trading decision-making problem show how the effectiveness of the suggested approach in NBLP solution development.
Novel types of supra soft operators via supra soft sd-sets and applications
Authors: Abd El-latif Alaa M.
Published: February 2024

Our purpose in this work is to present a new generalized soft open set in supra soft topological spaces, named supra soft sd-sets. With deep discussion, we found out that they contain almost all kinds of weaker supra soft open sets which have been discussed in earlier studies, as shown in the following figure.

So, directly we can notice the value of the introduced results. Also, the notion of a supra soft sc-set is presented, and many of its basic properties are explored. Furthermore, we show that the new family fails to form soft topology or supra soft topology. In addition, the definitions of the supra soft sd-closure operator, supra soft sd-cluster operator, and supra soft sd- interior operator are introduced, and many of their interesting properties are explored. Finally, we prove that the property of being a supra soft sd-set is a supra soft topological property.
A robust alternating least squares K-means clustering approach for times series using dynamic time warping dissimilarities
Authors: Fernando Vera-Vera J. , Antonio Roldán-Nofuentes J.
Published: February 2024

Time series clustering is a usual task in many different areas. Algorithms such as K-means and model-based clustering procedures are used relating to multivariate assumptions on the datasets, as the consideration of Euclidean distances, or a probabilistic distribution of the observed variables. However, in many cases the observed time series are of unequal length and/or there is missing data or, simply, the time periods observed for the series are not comparable between them, which does not allow the direct application of these methods. In this framework, dynamic time warping is an advisable and well-known elastic dissimilarity procedure, in particular when the analysis is accomplished in terms of the shape of the time series. In relation to a dissimilarity matrix, K-means clustering can be performed using a particular procedure based on classical multidimensional scaling in full dimension, which can result in a clustering problem in high dimensionality for large sample sizes. In this paper, we propose a procedure robust to dimensionality reduction, based on an auxiliary configuration estimated from the squared dynamic time warping dissimilarities, using an alternating least squares procedure. The performance of the model is compared to that obtained using classical multidimensional scaling, as well as to that of model-based clustering using this related auxiliary linear projection. An extensive Monte Carlo procedure is employed to analyze the performance of the proposed method in which real and simulated datasets are considered. The results obtained indicate that the proposed K-means procedure, in general, slightly improves the one based on the classical configuration, both being robust in reduced dimensionality, making it advisable for large datasets. In contrast, model-based clustering in the classical projection is greatly affected by high dimensionality, offering worse results than K-means, even in reduced dimension.
Important of Slip Effects in Non-Newtonian Nanofluid Flow with Heat Generation for Enhanced Heat Transfer Devices
Authors: Oladapo Olayinka Akeem , Akindele Akintayo Oladimeji , Obalalu Adebowale Martins , Ajala Olusegun Adebayo
Published: February 2024

In various fields such as engineering, nanotechnology, and biomedical sciences, the study of non-Newtonian nanofluid flow with heat generation is becoming increasingly important. However, it is challenging to accurately model such flows due to their complex behavior and slip effects at the fluid-solid interface. This research investigates the impact of first and second-order slip conditions on the flow and heat transfer properties of a non-Newtonian nanofluid using a power law model to describe the fluid's non-Newtonian behavior and numerical methods to solve the resulting equations. To determine the influence of various parameters such as slip parameters, Brinkman number, power law index, and Eckert number on the velocity, temperature, and concentration profiles, which this study examines. The study shows that slip parameters significantly determine the flow and heat transfer properties of non-Newtonian nanofluids, the study also reveals that slip parameters are a crucial factor in understanding the flow and heat transfer characteristics of nanofluids, with the second-order slip condition having a greater impact on velocity and temperature profiles than the first-order slip condition. These findings are valuable for developing and optimizing heat transfer devices that involve non-Newtonian nanofluids with heat generation, which is essential for technological advancements in today's industry.
An Algorithm for Detecting Surface Defects in Steel Strips Based on an Improved Lightweight Network
Authors: Zhan Dao Hua , Wang Han , Yang Xiu Ding , Ou Wei Cheng , Huang Ren Bin , Lin Jian , Yi Kun Ran , Zhou Bei
Published: February 2024

In recent years, surface defect detection methods based on deep learning have been widely applied to steel plate surface defect detection. By locating and classifying defects on the surface of steel plates, production efficiency can be improved. However, there is still a conflict between speed and accuracy in the defect detection process. To address this issue, we propose a high-precision, low-latency surface defect detection algorithm called the GhostConv-ECA-YOLOv5 Network (GEA-Net). The GEA-Net model can predict defect categories without compromising classification and detection accuracy. Experimental results show that our proposed improved model has higher performance compared to other comparative models, achieving a 75.6% mAP on the NEU-DET dataset.
Proposed Etiotypes for Chronic Obstructive Pulmonary Disease: Controversial Issues
Authors: Kim Sang Hyuk , Moon Ji-Yong , Min Kyung Hoon , Lee Hyun
Published: February 2024

The 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) revised the definition of chronic obstructive pulmonary disease (COPD) to broadly include a variety of etiologies. A new taxonomy, composed of etiotypes, aims to highlight the heterogeneity in causes and pathogenesis of COPD, allowing more personalized management strategies and emphasizing the need for targeted research to understand and manage COPD better. However, controversy arises with including some diseases under the umbrella term of COPD, as their clinical presentations and treatments differ from classical COPD, which is smoking-related. COPD due to infection (COPD-I) and COPD due to environmental exposure (COPD-P) are classifications within the new taxonomy. Some disease entities in these categories show distinct clinical features and may not benefit from conventional COPD treatments, raising questions about their classification as COPD subtypes. There is also controversy regarding whether bronchiectasis with airflow limitations should be classified as an etiotype of COPD. This article discusses controversial issues associated with the proposed etiotypes for COPD in terms of COPD-I, COPD-P, and bronchiectasis. While the updated COPD definition by GOLD 2023 is a major step towards recognizing the disease’s complexity, it also raises questions about the classification of related respiratory conditions. This highlights the need for further research to improve our understanding and approach to COPD management.
Sneeze-induced transvaginal small bowel evisceration and obstruction nine months after iatrogenic vaginal vault laceration: a case report
Authors: Salvetti Francesco , Bergna Alessandro , Poletti Lorenzo , Misitano Giulio , Del Re Giulia , Belotti Daniele , Signorelli Fabrizio , Previde Massara Paolo , Del Re Luca
Published: February 2024

Transvaginal evisceration (TE) is the extrusion of intra-abdominal viscera through the vagina. According to the literature, few cases have been reported, most of them involving elderly women who underwent previous pelvic surgery. Here we present the case of a 72-year-old woman who was admitted to our hospital due to the sensation of vaginal obstruction that appeared after a sneeze nine months after a repair of a vault laceration following prior complex pelvic surgery. A clinical diagnosis of small bowel transvaginal evisceration with obstruction was quickly made. In this case, adhesions, bowel obstruction, and the presence of a fibrotic scar on the vaginal vault were the main obstacles to the repair. However, a multidisciplinary evaluation and a combined laparoscopic-transvaginal minimally-invasive approach proved to be safe and effective in achieving good surgical outcomes in the treatment of this condition.
Modified island flap for basal cell carcinoma of the nasal apex
Authors: Kordeva Simona , Tchernev Georgi
Published: February 2024

An 80-year-old female presented with an atrophic lesion in the area of the nasal apex, dating for the past 5-6 years. The lesion had a superficial telangiectasias and a pearly edge, measuring 1 cm in diameter. The patient denies painful sunburns in the past. Previous history of basal cell carcinomas located on the temporal and sacral regions. [...]
Inauguration Speech
Authors: Mainzer Klaus
Published: February 2024

Not available.
Study of On-Site Upgraded Livestock Biogas Production and Carbon Emission Reduction By Substituting Coals For Thermal Power Generation
Authors: Chen Wei-Chen , Su Jung-Jeng
Published: February 2024

The objective of this project is to integrate a farm-scale bio-desulfurization facility with a novel biogas hollow fibre adsorption module for biogas desulfurization and bio-natural gas production. In this study, the desulfurization experimental results showed that the bio-desulfurization system can remove 96.7 ± 6% of H2S from the biogas after an approximately two-month enrichment period. The average CH4, N2, and CO2 concentrations in raw biogas were 63.4, 15.2, and 21.1%, respectively. As for biogas upgrading experiments, the inlet biogas flow rates were applied from 5 to 20 L/min. The removal efficiency of CO2 under all biogas flow rates was 100%. Meanwhile, methane was promoted from 60% to nearly 94% (i.e. 57% increase in methane concentration). The replacement of anthracite and coking coal by upgraded biogas might reduce 44.4% and 42.5% of CO2 equivalent, respectively. The achievement of this project pursues the mitigation of carbon dioxide emissions by using upgraded pig biogas which can be enlarged and extended to all decentralized pig farms worldwide.
3′-Deoxyadenosin alleviates methamphetamine-induced aberrant synaptic plasticity and seeking behavior by inhibiting the NLRP3 inflammasome
Authors: Qi Yize , Zhou Yao , Li Jiyang , Zhu Fangyuan , Guo Gengni , Wang Can , Yu Man , Wang Yijie , Ma Tengfei , Feng Shanwu , Zhou Li
Published: February 2024

JOURNAL/nrgr/04.03/01300535-202410000-00028/figure1/v/2024-02-06T055622Z/r/image-tiff

Methamphetamine addiction is a brain disorder characterized by persistent drug-seeking behavior, which has been linked with aberrant synaptic plasticity. An increasing body of evidence suggests that aberrant synaptic plasticity is associated with the activation of the NOD-like receptor family pyrin domain containing-3 (NLRP3) inflammasome. 3′-Deoxyadenosin, an active component of the Chinese fungus Cordyceps militaris, has strong anti-inflammatory effects. However, whether 3′-deoxyadenosin attenuates methamphetamine-induced aberrant synaptic plasticity via an NLRP3-mediated inflammatory mechanism remains unclear. We first observed that 3′-deoxyadenosin attenuated conditioned place preference scores in methamphetamine-treated mice and decreased the expression of c-fos in hippocampal neurons. Furthermore, we found that 3′-deoxyadenosin reduced the aberrant potentiation of glutamatergic transmission and restored the methamphetamine-induced impairment of synaptic plasticity. We also found that 3′-deoxyadenosin decreased the expression of NLRP3 and neuronal injury. Importantly, a direct NLRP3 deficiency reduced methamphetamine-induced seeking behavior, attenuated the impaired synaptic plasticity, and prevented neuronal damage. Finally, NLRP3 activation reversed the effect of 3′-deoxyadenosin on behavior and synaptic plasticity, suggesting that the anti-neuroinflammatory mechanism of 3′-deoxyadenosin on aberrant synaptic plasticity reduces methamphetamine-induced seeking behavior. Taken together, 3′-deoxyadenosin alleviates methamphetamine-induced aberrant synaptic plasticity and seeking behavior by inhibiting the NLRP3 inflammasome.
Empathy: Vital in patient care but are we looking at it close enough?
Authors: Gopi Gokul , Taywade Manish
Published: February 2024

Empathy is imperative in patient care. Besides enhancing patients’ satisfaction, comfort, and trust, which may facilitate better diagnosis, shared decision-making, and therapy adherence, empathetic doctors experience less burnout, greater job satisfaction, and better overall psychological well-being. In this article, we focus on empathy needed in modern medicine. The meaning of empathy is briefly explained, along with the concept of detached concern. The need for empathy in patient care is undebatable, but physician burnout, emotional drainage, and overburden are reasons physicians tend to drift away from it. Empathy is the need to communicate with the patient in productive ways. Educators should organize the teaching relevantly and engage the active participation of the students. Skilled physicians and empathic communicators are the need of the hour.
Renal affection among type 2 diabetic patients and their families
Authors: Selim Omar T. , Kenawy Eglal M. , Abdelhafez Abdelhamed A. , Abdelmeguid Mona M.
Published: February 2024

Background and Aim

It was believed that both environmental and genetic factors are involved in the pathogenesis of tyrje 2 diabetes mellitus (T2DM). We aimed to figure out the renal affection in patients with T2DM and their family relatives.

Patients and methods

The current study included 80 patients with T2DM without history of kidney diseases and 80 family members of the diabetic patients neither known to be diabetic nor had kidney diseases compared with 80 apparently healthy persons as a normal control group without a family history of diabetes.

Results

The prevalence of microvascular complications in diabetic patients and their relatives was as follows: nephropathy (27.5 and 5%, respectively), neuropathy (30 and 8.75%, respectively), and retinopathy (18.83 and 6.2%, respectively). Overall, 22.5% of the relatives had metabolic srtndrome. Microvascular complications of diabetes were associated with longer disease duration, elevated blood pressure, and poor glycemic control, whereas microvascular complications in relatives were associated with one or more of t.he metabolic components of metabolic syndrome.

Conclusion

screening of diabetic patients for microvascular complications is mandatory as early as possible.The detection of the metabolic components in T2 diabetic relatives can predict the prediabetic state and also can predict the possible occurrence of microvascular complications before happening, and early management can delay them.
New biomarkers for diagnosis of polycystic ovary syndrome
Authors: Hassan Farid I. , Mohammed Mofeed F. , Ali Lamia H. , Hussein Alaa A. M.
Published: February 2024

Background and aim

The popular endocrine syndrome happening in women of reproductive age is polycystic ovary syndrome (PCOS). It is long understood that chronic ovaries with many tiny cysts, hyper vascularized androgen-secreting stroma, signs of extra androgen, and menstrual cycle irregularity are all related. The aim was to compare several biochemical measures in women with PCOS and age-matched control for a definite diagnosis of PCOS by using by using anti-müllerian hormone (AMH), sex hormone binding globulin (SHBG), total testosterone, serum insulin and lipid profile.

Patients and methods

Case-control research had been performed for patients who were admitted to El-Hussein University Hospital and EI-Minia University Hospital, Department of Obstetrics and Gynecology. The study included two matched groups: group (1) involved 40 eligible women sonographically evaluated and biochemically diagnosed with PCOS (cases group). Group (2): equal number of normal women 40 in a ratio of 1 : 1 had been chosen in the (control group).

Results

Mean value of triglycerides, low-density lipoprotein (LDL), total cholesterol, and very LDL had been greater between the cases group than the control one although there had been no variation among cases and controls regarding high density lipoprotein (HDL). Mean value of serum insulin and homeostasis model assessment-estimated insulin resistance (HOMA-IR) had been greater between cases group than the control.

Conclusion

This research confirms that obese women having PCOS have atherogenic lipoprotein profiles that are marked by elevated levels of cholesterol, LDL, and triglycerides and could be a danger point for later leading to cardiovascular complications.
Upper endoscopic findings in patients attending the endoscopy unit of al-azhar assiut university hospital: 2019–2020
Authors: Moustafa Hamdy M. , Mohamed Ahmed Q. , Sawy Safwat S. , Moustafa Amel A.
Published: February 2024

Background and aim

An endoscope is a visual instrument used to inspect the internal cavities of the human body. Upper endoscopy has effective diagnostic and therapeutic functions; it can be used in patients with signs or symptoms suggestive of upper gastrointestinal (GI) disease, surveillance for upper gastrointestinal tract (GIT) malignancy in high-risk population, and also stoppage of upper GIT bleeding.

The work is aimed to document the demographic characteristics, indications, endoscopic findings, and interventions done among patients referred to Al-Azhar Assiut University Hospital in the last 2 years (2019–2020).

Patients and methods

The study was conducted at the endoscopy unit in from January 2019 to December 2020.

Results

Our study showed that the most prevalent age group was aged between 20 and 50 years (65.4%). There is a slight predominance of female patients (51%) versus 49% who were males and the most common indications, while peptic ulcer disease was the most common endoscopic finding.

Conclusion

The most common indications were epigastric pain and upper GIT bleeding, while the most common GI finding was peptic ulcer disease. Also, esophageal varices were common esophageal findings for which band ligation and injection sclerotherapy were done.
Efficacy of peribulbar bupivacaine at the end of surgery in the management of postoperative pain after scleral buckling
Authors: Kumar R Madhu , Sumanth I M , Kanakamedla Ashok , Sagar Pradeep , Konana Vinaya K
Published: February 2024

Purpose:

To compare the efficacy of peribulbar bupivacaine with routine analgesics for pain management in patients undergoing scleral buckling.

Methods:

In total, 72 patients undergoing scleral buckling or combined with vitrectomy were enrolled in this study. Patients were randomized into two groups, each containing 36 patients. Patients of group A received 5 mL of bupivacaine (0.5%) injection at the end of surgery, whereas group B patients received routine analgesics. The postoperative pain score was assessed in the first 24 hours of the postoperative period with the visual pain analog score.

Results:

Maximum postoperative pain scores were lower in patients receiving bupivacaine block (median: 3; range: 3–7) than in the control group (median: 5; range: 3–9). Pain scores in group A were lower than in the control group both at 3 and 6 hours after surgery, which was statistically significant (P < 0.001). Four patients in group A and 17 patients in group B needed additional analgesia in the first 24 hours of the postoperative period. In addition, two patients in group A and seven patients in group B experienced episodes of nausea and vomiting in the first 24 hours of surgery.

Conclusion:

The results of this study suggest that the postoperative experience of patients undergoing scleral buckling surgery can be made more comfortable with the use of bupivacaine block at the end of surgery.
Comparative posterior corneal profile of keratoconus hydrops versus Haab’s striae in congenital glaucoma
Authors: Mandal Sohini , Singh Abhishek , Sen Seema , Titiyal Jeewan S , Gupta Viney , Gupta Shikha
Published: February 2024

Keratoconus eyes develop corneal decompensation more often compared to eyes with primary congenital glaucoma (PCG) following Descemet’s membrane (DM) tear. This study was conducted to compare the posterior corneal morphology in areas with DM breaks with regards to DM and pre-Descemet’s layer (PDL) between the two. In this cross-sectional comparative study, anterior segment optical coherence tomography (AS-OCT) scans of the posterior cornea of advanced keratoconus eyes with hydrops (n = 12), PCG eyes with Haab’s striae (n = 15), and healthy control eyes (n = 14) were compared for DM–PDL morphology. These were further corroborated by the histopathology of corneal buttons from keratoconus (n = 14) and PCG (n = 13) cases obtained following penetrating keratoplasty and compared with controls (enucleated retinoblastoma globes, n = 6) on light microscopy and collagen IV immunostaining. AS-OCT showed a thicker median DM/PDL complex in PCG (80 μm) versus keratoconus eyes (36 μm, P = 0.01; Kruskal–Wallis test). The median height and length of detached DM–PDL were significantly more in keratoconus versus PCG (145 μm, 1766.1 ± 1320.6 μm vs. 26.5 μm, 453.3 ± 303.2 μm, respectively, P = 0.012; Kruskal–Wallis test). Type-1 DM/PDL detachment (seen as a characteristic taut chord) in keratoconus (90%) was the most common morphological pattern versus intracameral twin protuberance (92%) following DM breaks in PCG. Histopathology confirmed thicker DM in PCG (median: 63.4 μm) versus keratoconus eyes (median: 33.2 μm) or controls (27.1 μm) (P = 0.001; Kruskal–Wallis test). Greater height/length of DM/PDL detachment compounded by poor healing response (lower DM/PDL thickness) probably causes more frequent corneal decompensation in keratoconus eyes when compared to PCG eyes following DM tears.
Comparative results of use and switching of anti-TNF-alpha agents in adult Behçet’s uveitis
Authors: Mesen Selma , Ozer Muhammet D , Batur Muhammed
Published: February 2024

Purpose:

This study was planned to compare the clinical results and optical coherence tomography (OCT) data of patients who underwent adalimumab (ADA), infliximab (IFX) and switched protocols between these two methods in cases of Behçet’s associated uveitis (BAU).

Methods:

The patients with BAU who were treated with anti-TNF-α agents for at least one year were qualified for the chart review. The outcome parameters were the steroid-free remission state, the best-corrected visual acuity (BCVA), the central macular thickness (CMT), and the subfoveal choroidal thickness (SFCT) of the patients at the last visit.

Results:

After a mean follow-up of 16.60 months, the rate of active inflammation decreased from 63.6% to 15.1%. Mean BCVA increased, mean CMT and mean SFCT decreased significantly at the last visit (P < 0.001, P < 0.001, respectively).

Conclusion:

Anti-TNF-α treatment and switching protocols between these two agents effectively and safely control intraocular inflammation in BAU patients.
Regional analysis of posterior corneal elevation after laser refractive surgeries for correction of myopia of different degrees
Authors: Chen Tong , Li Na , Ge Tian , Lin Yue , Wu Xiaohui , Gao Hua , Liu Mingna
Published: February 2024

Purpose:

To evaluate regional changes in the posterior corneal elevation after three laser refractive surgeries for correction of myopia of different degrees.

Settings and Design:

Retrospective, comparative, and non-randomized study.

Methods:

Two hundred patients (200 eyes) who underwent laser epithelial keratoplasty (LASEK), femtosecond-assisted laser in-situ keratomileusis (FS-LASIK), and small-incision lenticule extraction (SMILE) were included in this study. According to preoperative spherical equivalent (SE), each surgical group was divided into two refractive subgroups: low-to-moderate myopia (LM group) and high myopia (H group). The posterior corneal elevation from Pentacam Scheimpflug tomography was analyzed preoperatively and at 1 month, 3 months, 6 months, and 12 months postoperatively. Three subregions of the posterior cornea were divided in this study as the central, paracentral, and peripheral regions.

Statistical Analysis Used:

Generalized Estimating Equations (GEE).

Results:

For all three surgical groups, similar changing trends were seen in the two refractive subgroups. H group presented a larger changing magnitude than the LM group in FS-LASIK over time (P < 0.05), whereas no significant difference was noted in the two refractive subgroups of LASEK or SMILE (P > 0.05). At 12 months postoperatively, the central posterior corneal elevation returned to the preoperative level in LASEK (P > 0.05) but shifted forward significantly in FS-LASIK and SMILE (P < 0.05).

Conclusion:

Different posterior corneal regions respond differently to corneal refractive surgeries. LASEK, FS-LASIK, and SMILE demonstrate different trends in the regional changes in posterior corneal elevation. The corneal shape seems more stable in LASEK than in FS-LASIK and SMILE.
Management of acute corneal hydrops – Current perspectives
Authors: Bafna Rahul K , Kalra Nidhi , Asif Mohamed I , Beniwal Abhijeet , Lata Suman , Sharma Sumant V , Agarwal Rinky , Vanathi Murugesan , Maharana Prafulla K , Titiyal Jeewan S , Sharma Namrata
Published: February 2024

Acute corneal hydrops (ACH) is a rare but sight-threatening complication of corneal ectasias. We aim to review the current literature on etiopathogenesis, histology, role of ancillary investigations, management, and outcomes of ACH by classifying the various management strategies based on their site of action and the underlying mechanism. A review of the literature was conducted by searching the following databases: PubMed (United States National Library of Medicine), Embase (Reed Elsevier Properties SA), Web of Science (Thomson Reuters), and Scopus (Elsevier BV) till April 2023. The literature search used various combinations of the following keywords: acute corneal hydrops, keratoconus, ectasia, management, keratoplasty. Nine hundred eighty-three articles were identified based on the above searches. Case reports which did not add any new modality of treatment to the existing literature, articles unrelated to management, those with no full text available, and foreign-language articles with no translation available were excluded. Eventually, 75 relevant articles that pertained to the management of ACH were shortlisted and reviewed. Recent studies have described newer surgical interventions like full-thickness or pre-Descemetic sutures, thermokeratoplasty, and plasma injection that aim to close the posterior stromal break. Posterior lamellar keratoplasties act by replacing the posterior torn Descemet’s membrane (DM), and early deep anterior lamellar keratoplasty (DALK) has been attempted to combine the correction of the anatomical defect and visual rehabilitation in a single surgery. These surgical interventions may help by reducing the scarring and increasing the number of patients who can be visually rehabilitated with contact lenses rather than keratoplasty.
Safety and therapeutic efficacy of 577 nm yellow solid krypton laser for retinopathy of prematurity; A prospective pilot study
Authors: Vyas Aneesha , Tiwari Sarvesh , Subramanyam Anand
Published: February 2024

Purpose:

To evaluate the outcome of 577 nm yellow solid krypton laser as an independent treatment modality for Retinopathy of Prematurity.

Design:

Prospective, non-comparative, non-randomized, interventional.

Methods:

A prospective pilot study was conducted on 30 treatment eyes with retinopathy of prematurity (ROP) who underwent treatment with a 577 nm yellow solid state krypton laser. 3nethraNEO pediatric retinal imaging system was used to screen these infants born between March to August 2022. Pre procedure data such as gestational age (weeks), birth weight (g), and exposure to risk factors were recorded. Power (mW), exposure duration (msec), and number of laser spots administered were noted. Pain was assessed using the Neonatal Pain/Agitation and Sedation Scale (N-PASS). Post procedure data such as regression, persistence or reactivation of disease, and adverse effects were looked for. All eyes were followed up for a period of 3 months.

Statistical Analysis Used:

Chi-square test, Fisher’s exact test.

Results:

Out of 30 eyes, 09 (30%) had type I and 21 (70%) had non-type I ROP. In type I disease, the mean power used was 88+/-10 mW with exposure duration of 130+/-27 msec and an average number of 890+/-260 burns were administered. In non-type I disease, the mean power used was 87+/-10 mW with an exposure duration of 150 ms and an average number of 900+/-290 burns were administered. The mean pain score calculated was 5 in type I and 6 in non-type I ROP. All eyes showed regression of disease after treatment.

Conclusion:

577 nm yellow solid krypton laser was safe and effective in treating retinopathy of prematurity disease.
Effects of stress management and relationship-enrichment counseling on sexual and marital satisfaction of working women with high occupational stress
Authors: Kazemi Leily , Mirghafourvand Mojgan , Esmaeilpour Khalil , Kamalifard Mahin
Published: February 2024

BACKGROUND:

Industrialization of societies has placed considerable stress on employees influencing marital and sexual satisfaction. This study investigated the effects of stress management (SM) and relationship enrichment (RE) counseling on marital and sexual satisfaction in stressed women working at Tabriz University of Medical Sciences hospitals, Iran.

MATERIALS AND METHODS:

In this quasi-experimental study, 75 nurses and midwives experiencing moderate-to-severe occupational stress after obtaining written informed consent were assigned to SM and RE counseling and control groups randomly. The SM and RE attended six-related counseling sessions, and control group received no intervention. The participants completed Osipow’s Revised Occupational Stress Inventory (OSI-R), ENRICH Marital Satisfaction Scale, and Larson’s Sexual Satisfaction Questionnaire before and 2 weeks after the intervention. The data were analyzed using one-way ANOVA and ANCOVA.

RESULTS:

SM counseling led to relatively good increase in sexual satisfaction. In addition, there was no significant difference between the three groups in the mean occupational stress scores and marital satisfaction scores.

CONCLUSION:

SM counseling increased the level of sexual satisfaction. The approaches had no significant effect on occupational stress and marital satisfaction. Further studies are required to identify the best counseling approaches.
The effect of “clinical virtual round” on clinical self-efficacy among midwifery students
Authors: Naysanian Ghazal , Kardan Elahe , Mohamadirizi Soheila
Published: February 2024

BACKGROUND:

One of the methods of clinical education is clinical rounds which makes students more skilled in the comprehensive care of patients. since midwifery students are faced with low-risk and high-risk cases of mothers during the perinatal period, Therefore, it is necessary to pay attention to their clinical self-efficacy. The aim of this study was to determine. The effect of “clinical virtual round” on clinical self-efficacy among midwifery students.

MATERIALS AND METHODS:

The study was experimental with the control group design. The subjects were randomly divided into the intervention (n = 30) and control (n = 30) groups. two groups received clinical virtual round and report back model (respectively). subjects in both groups responded to the 20-item clinical self-efficacy Questionnaire, before and after the intervention. Data were analyzed with paired t-test and t-student by SPSS v 22.

RESULTS:

The baseline mean ± SD scores for clinical self-efficacy in interventional and control groups were 10.1 ± 1.32, and 10.1 ± 3.05 respectively (P = 0.233). clinical virtual round increased clinical self-efficacy (65.1 ± 1.42) of midwifery students compared with the control group (11.1 ± 1.72) (P = 0.002).

CONCLUSION:

According to this study’s results, it is recommended that clinical virtual rounds can be increasing clinical self-efficacy among midwifery students.
Commonly used diagnostic label, classes, domain, and formulation among nursing students in Ibadan, Oyo State Nigeria
Authors: Ojo Iyanuoluwa O. , Kazeem Elizabeth O. , Oyediran Olufemi O. , Oladosu Timothy O. , Olaogun Adenike A. , Adejumo Prisca O.
Published: February 2024

BACKGROUND:

In order to select nursing actions that will produce the desired results, a nursing diagnosis is crucial. Despite this, it can be challenging for nursing students to recognize and create precise nursing diagnostic labels that are particular to a patient’s situation. The study’s objectives are to identify the diagnostic labels, classes, and domains that are frequently formulated by nursing students.

MATERIALS AND METHODS:

A descriptive cross-sectional methodology and a self-developed questionnaire were utilized to gather information from 120 nursing students who were chosen using a simple random sampling technique. Descriptive and inferential (Chi-square) statistics were used to analyze the data. The 0.05 P- value was chosen.

RESULTS:

The respondent’s average age is 23 ± 21.4 years. The majority of respondents (94.2%) concurred that greater exposure to clinical settings, case discussion methods (92.5%), as well as group case studies (90.8%) strategy, can all improve the creation of precise diagnostic labels. Additionally, the deficient fluid volume diagnostic label is the one that is most usually utilized (78.3%). Overall results show that the diagnostic labels that are used the most frequently are those for domains 4 (Activity/Rest) and 11 (Safety/Protection). There was no relationship (P = 0.061) between the commonly used diagnostic label and the chosen schools.

CONCLUSION:

The study offered empirical data on the most used diagnostic labels and domains. Therefore, it will be important that nursing students involve critical reasoning skills as well as familiarize themselves with other significant domains and classes that are useful in the patient’s care.
Evaluating the effect of a training program on type 2 diabetic patient’s self-care: A quasi-experimental study
Authors: Hermis Alaa Hamza , Muhaibes Fakhria Jaber
Published: February 2024

BACKGROUND:

Diabetes mellitus is one of the growing medical problems that affect people of all ages worldwide. Education is an important part of treatment in this chronic condition. The primary objectives of diabetes education include improving knowledge and skills, changing the patient’s behavior, motivating them to follow therapeutic recommendations, establishing self-care habits, and increasing their psychological resilience. The authors aimed to examine the effect of a training program on type 2 diabetic patients’ self care and investigate their perspectives on the educational program.

MATERIALS AND METHODS:

The current study used a quasi-experimental, pretest-posttest design that was conducted in Iraq. Sixty patients who met the selection criteria were included in the study. Data were collected by demographic questionnaire and the Diabetes Self-Care Scale (DSCS). Data analysis was done by independent T-tests and Paired t-tests were used to compare the scores before and after the intervention.

RESULTS:

The sample included 60 diabetic patients with more than half of them being female (55%). Most respondents aged between 50 and 60 years old, and next to half of them had only primary school education. We found that training programs can improve self-care behavior among diabetic patients so that following the intervention, the self-care score increased from 1.79 ± 0.360 to 3.17 ± 0.546 (P = 0.01).

CONCLUSION:

Since diabetes is a chronic condition that affects the whole individual’s life, self-care plays an important role in preventing potential complications and improving quality of life. Training programs, on the other hand, increase the awareness and knowledge of patients and enable them to handle this chronic condition properly.
Self-directed learning for medical graduates: A boon or bane in disguise? A cross-sectional study in Chennai
Authors: Siraja Ameenah A. H. , Mohamed Sher A. , Krishnamoorthy Yuvaraj , Lonimath Ashwini , Rushender C. Rajan
Published: February 2024

BACKGROUND:

Self-directed learning (SDL) is an essential aspect of adult education or andragogy, gaining significance in medical education with the introduction of competency-based medical education. The primary objective of this study is to assess the self-directed learning abilities of second-year medical undergraduates in Chennai, South India, and to identify potential challenges and gaps in their learning process.

MATERIALS AND METHODS:

A cross-sectional study was conducted among 82 second-year medical students attending self-directed learning sessions at a medical college in Chennai. Data were collected using the self-directed learning instrument (SDLI), a standardized questionnaire, administered through Google Forms. Participants’ identities were maintained confidential. Data were analyzed using SPSS version 22.0. Descriptive data were presented as proportions and percentages. Normally distributed quantitative data were expressed as mean and standard deviation. Non-normal continuous data were expressed as median and interquartile range (IQR).

RESULTS:

The majority of the students (61%) demonstrated a high level of SDL ability, with a median score of 76. Students exhibited strong learning motivation (mean score 4.11) but struggled with planning and implementation (mean score 3.07). The maximum mean score was 4.11 for item 3 (constant improvement and excelling in learning), and the minimum mean score was 3.07 for item 11 (arranging and controlling learning time). The students showed high self-monitoring (mean score 3.76) and interpersonal communication skills (mean score 4.00).

CONCLUSIONS:

SDL emerges as a boon for medical undergraduates in this study. By providing adequate training to faculty members on SDL implementation and guidance to students on planning and time management, SDL can play a pivotal role in enhancing medical education quality and fostering life-long learning among future medical professionals.
Students’ perspectives on their early dropout of medical school
Authors: Hefny Ashraf F. , Albawardi Alia , Khan Moien AB , Fathi Mai A. , Mansour Nirmin A.
Published: February 2024

BACKGROUND:

Enrolling in medical school launches a more demanding and stressful way of life for newly admitted students. Some students will struggle academically and will ultimately drop out from medical school. The study aims to understand the perspectives that dropped-out students have and their opinion regarding possible preventative solutions.

MATERIALS AND METHODS:

This study uses a mixed-method approach. The results of students’ examinations in the first 2 years of admission (within four academic years from 2016 until 2020) were collected from the medical school records. A questionnaire was developed to investigate the causes of early attrition during the study period. All dropped-out students who were admitted were included in this study.

RESULTS:

The study included 479 admitted students, 349 (72.9%) were females; 152 (31.7%) students dropped out in the premedical program (first two years); 104 (68.4%) of the dropped-out students were females. Thirty-five (23%) students responded to the questionnaire. Twenty-eight (80%) respondents believed that their low academic performance and leaving medical school was primarily related to psychological problems, 19 (54%) of respondents reported leaving for social reasons, and lack of self-organization in 13 (37.1%) respondents. Human anatomy was recorded as the most difficult course in the first year by 21 (63.6%) students.

CONCLUSIONS:

The cause of attrition is often multifactorial and complex. Psychological problems are one of the important factors in students with low academic performance and dropping out of the students. Some difficult courses in the curriculum may affect the students’ academic performance leading to their attrition.