bluuebunny/crossref_metadata_2025 huggingface dataset:
Multiple sclerosis and mental health related quality of life: The role of defense mechanisms, defense styles and family environment
Authors: Amaslidou Anthi , Ierodiakonou-Benou Ioanna , Bakirtzis Christos , Nikolaidis Ioannis , Tatsi Theano , Grigoriadis Nikolaos , Nimatoudis Ioannis
Published: November 2023

Background

Multiple sclerosis is a demyelinating chronic neurologic disease that can lead to disability and thus to deterioration of quality of life. Psychological parameters such as ego defense mechanisms, defense styles and family environment are important factors in the adaptation process, and as such they can play important roles in QoL. This study aims to assess the psychological factors as well as the clinical and demographic characteristics related to mental health quality of life (MHQoL).

Methods

This was an observational, cross-sectional study conducted in a sample of 90 people with MS in the years 2018–2020. All participants completed the following questionnaires: MSQoL-54, DSQ-88, LSI, FES-R, SOC, BDI-II, STAI. Disability was assessed using EDSS.

Results

In multiple linear regression, significant roles were played by depression (R2: 41.1%, p: 0.001) and, to a lesser extent, the event of a relapse (R2: 3.5%, p: 0.005), expressiveness (R2: 3.6%, p < 0.05) and image distortion style (R2: 4.5%, p: 0.032). After performing a hierarchical-stepwise analysis (excluding depression), the important factors were maladaptive defense style (R2: 23.7%, p: 0.002), the event of relapse (R2: 8.1%, p < 0.001), expressiveness (R2: 5.5%, p: 0.004) and self-sacrificing defense style (R2: 2.4%, p: 0.071).

Conclusion

Psychological factors play important roles in MHQoL of people with multiple sclerosis. Thus, neurologists should integrate in their practice an assessment by mental health specialists. Moreover, targeted psychotherapeutic interventions could be planned i to improve QoL.
Morceaux choisis : les interactions en EPS
Authors: Baeza Nathalie , Pérez Sylvie
Published: November 2023

Cette recherche s’attache à analyser l’interaction entre une enseignante stagiaire d’Education Physique et Sportive (EPS) et ses élèves comme un moment privilégié pour se construire en tant qu’enseignant. Elle s’inscrit dans une perspective de la didactique professionnelle (Amade-Escot, 1998 ; Bouthier, Pastré et Samurçay, 1995), pénétrant ainsi le lieu de l’activité professionnelle de l’enseignante d’EPS par une observation et une analyse de son activité (Durand, 1998). Les interactions entre l’enseignante et ses élèves sont décrites comme étant des rites ou rituels (Goffman, 1974) qui nécessitent des compétences particulières pour le bon fonctionnement de la classe.Afin d’étudier les différents types d’interaction, une étude de cas a été menée avec Aude, enseignante stagiaire d’EPS et sa classe de seconde. Trois leçons de gymnastique au sol ont été plus précisément analysées. Des données d’observation et d’enregistrement ont été recueillies in situ, complétées par des entretiens. Le traitement des données visait à répertorier les différents types d’interactions et à analyser l’interaction comme de véritables rituels de rencontre et comme le lieu de construction de compétences professionnelles.
Apprendre à lire le mouvement : expérimentation d’un instrument de formation
Authors: Gérard Jean Paul , Bouthier Daniel
Published: November 2023

L’objet de la présente étude est de montrer la pertinence d’un instrument de formation à la lecture du mouvement utilisant les nouvelles technologies de l’information et de la communication. A partir des résultats d’une étude biomécanique qui a permis de définir 6 niveaux d’habileté en course de vitesse chez les enfants d’âge scolaire (2, 11 ans) et une modélisation du développement par l’intermédiaire d’une « poulaine ». Un instrument a été conçu et testé sur des stagiaires professeur d’école. L’analyse des résultats a permis de remettre en cause l’utilisation de la poulaine comme modélisation de l’évolution de la foulée de course et de dresser les pistes pour modifier la première version de l’instrument à former à la lecture du mouvement.
Cyrano de Bergerac d’Edmond Rostand, le triomphe du théâtre de genre
Authors: Mombert Sarah
Published: November 2023

Cette étude propose de relire le succès de Cyrano de Bergerac d’Edmond Rostand comme le couronnement d’une stratégie littéraire inscrite dans la genèse de l’œuvre, les choix génériques et les références intertextuelles dont elle est abondamment nourrie. Conçue pour offrir au monstre sacré Coquelin Aîné un rôle à sa mesure, la pièce de Rostand conquiert le grand public en inventant le théâtre de registre médian qui convient à la culture de l’ère démocratique.
Publier dans ou hors du genre ? Exemples de stratégies en fantasy française contemporaine
Authors: Besson Anne , Bougon Marie Lucie
Published: November 2023

En dépit du très grand succès public de la fantasy depuis un quart de siècle, les romanciers et romancières françaises écrivant dans ce genre peinent à accéder à une reconnaissance qui dépasse le seul lectorat spécialisé, dans un contexte national très marqué par les conceptions élitistes de la création. Cet article s’efforcera d’évaluer les stratégies aujourd’hui disponibles dans le champ littéraire pour la production française de genre. Après une rapide contextualisation dressant un état des lieux de la visibilité de la fantasy littéraire en France, nous nous arrêterons sur deux trajectoires exemplaires et opposées : celle de Jean‑Philippe Jaworski, auteur pleinement reconnu dans le genre au sein duquel il s’inscrit, faisant valoir des aspirations littéraires légitimes, et de Muriel Barbery, autrice adoubée sur la foi d’un premier roman réaliste à succès, publiant ensuite de la fantasy sous une couverture blanche. Ces deux exemples illustrent la confrontation persistante de valeurs entre les espaces éditoriaux de la littérature « blanche » et de la littérature « de genre », en dépit de (ou à cause de) leur rapprochement partiel.
Inventer le futur en collectif : stratégies auctoriales à rebours de la singularisation dans la littérature de science-fiction contemporaine
Authors: Pluvinet Charline
Published: November 2023

Dans la science-fiction, l’affirmation d’une posture auctoriale des auteurs et autrices a longtemps été mise en retrait, plus ou moins fortement, par les logiques collectives de publication. L’autorialité en science-fiction se pense au pluriel, et même comme une « transauctorialité » (Margot Châtelet). Cependant, dans le champ de la science-fiction française, certaines publications très récentes portent une signature collective, comme Bâtir aussi des Ateliers de l’Antémonde et Subtil Béton des Aggloméré·e·s, tandis que se constituent des collectifs comme Zanzibar. Dans ces œuvres se met en place une auctorialité partagée, à rebours d’une singularisation auctoriale, mais pour autant sans renoncer à l’affirmation d’une autorité et d’une stratégie auctoriale. Une auctorialité désindividualisée se négocie en écho aux démarches collectives de la littérature et de l’art contemporains.
Phenomenon-Based Model for Virtual Hot Strip Rolling
Authors: Ilmola Joonas , Paananen Joni , Seppälä Oskari , Pyykkönen Juha , Larkiola Jari
Published: November 2023

Every year digitalization is taking a bigger role in the steel industry. Models for predicting metallurgical phenomena, roll forces and microstructure have been commonly used in development of novel steel grades. These individual models may predict certain phenomena thoroughly, but input values are usually based on an assumption or on a “good guess”. To produce reliable boundary conditions for these models of individual phenomena, a virtual rolling model is developed. This model computes the whole process of the hot strip mill from roughing to accelerated water cooling on a run-out table. Strip location and temperature evolution is calculated continuously. Thermal and thermo-mechanical (rolling stands) boundary conditions are according to process layout. Input data for the model is automatically read from raw process data. Rolling parameters are calculated using a coupled ARCPRESS model, which is developed by authors, and calculates normal and frictional shear stress distributions in the roll gap to predict roll forces and displacements of the work roll surface. Recrystallization is considered when calculating the flow stress of the rolled strip. Phase fractions during water cooling are calculated as well. The virtual rolling model minimizes the need for parameter speculation as all parameters are calculated throughout the process. All the input values are read from actual process data and the metallurgical and mechanical state of the strip are computed throughout the whole process. As required by the state-of-art virtual rolling model, this model is based on generally accepted theories and experimentally studied metallurgical and physical phenomena along with the thermo-mechanical response of the actual rolling process.
Quench and Bainite (Q&B) Thermal Cycle as an Alternative to Standard Quench and Partitioning (Q&P) Annealing to Produce AHSS
Authors: Arlazarov Artem , Pipard Jean Marc , Kabou Nora , Targy Pierre , Thénot Marc Olivier
Published: November 2023

In this work a new kind of thermal treatment, called Quenching and Bainite (Q&B), was proposed and studied. A rather standard Fe-C-Mn-Si composition was used for this study. Annealing trials were performed using a combination of salt pots on relatively big samples allowing to perform the standard tensile and hole expansion tests. The obtained results were compared with the properties obtained using more known Q&P annealing. Generated microstructures were also compared. Characterization was done using optical and Scanning Electron Microscopy as well as magnetization saturation method for measuring retained austenite fractions. The Q&B heat treatment provides an alternative way to obtain 3G AHSS with promising strength-ductility-formability compromise.
Friction Stir Welding of Various Aluminium Alloys to Titanium
Authors: Grassel Sebastian Felix , Bergmann Luciano , Klusemann Benjamin
Published: November 2023

Aluminium and titanium are currently in demand as lightweight materials. However, their combination is challenging due to their significantly different thermo-mechanical properties. Here, solid-state joining processes such as Friction Stir Welding open up new opportunities. Within this study, four commercial aluminium alloys (AA2024, AA5754, AA6056 and AA7050) were welded to Ti6Al4V. The results show a direct relationship between the solidus temperature of the aluminium alloys, the process temperature, energy input and resulting lap-shear strength. Regardless of the process parameters, AA5754 and AA6056 with higher solidus temperatures (600 °C and 555 °C) show superior bonding strength compared to AA2024 and AA7050, having a lower solidus temperature of 500 °C and 490 °C, respectively. Therefore, it is assumed that the maximum process temperature, proportional to the solidus temperature, has a major influence on the bonding. This, conversely, would imply that there is a physical limitation in the achievable joint strength between aluminium and titanium alloys as the required process temperature would exceed the solidus temperature of certain alloys. This assumption is verified for AA7050 by systematic variation of the rotation speed and therefore process temperature.
Influence of the Holding Thickness and Process in the Microstructure and Mechanical Properties of a Microalloyed 380 MPa Structural Steel
Authors: Cohn Jorge Adam C. , de Souza Altair L. , Isasti Nerea , Uranga Pello , Haddad Paulo , Rebellato Marcelo A. , Gorni Antonio A.
Published: November 2023

Flat low carbon microalloyed structural steels processed by controlled rolling have excellent mechanical properties, particularly regarding toughness, since austenite is rolled with full recrystallization between rolling passes (roughing stage at high temperatures), and, subsequently, with no recrystallization at all between passes (finishing stage at low temperatures), maximizing nucleation of ferrite grains during austenite transformation after hot rolling. However, rolling must be prompted in an intermediate temperature range where recrystallization of austenite between rolling passes occurs partially, as this can lead to great heterogeneity in the grain size distribution of the product, a potential condition to impairs its low temperature toughness. On the other hand, this holding period that is necessary to avoid rolling within this temperature range can last several minutes, reducing the productivity of the rolling line and, in this way, potentially harming the financial performance of the plant. This work was developed to analyze several proposed rolling conditions for the finishing stage during controlled rolling of 16 mm thick strips of a low C Nb-Ti microalloyed steel strip, 380 MPa structural grade, processed in a Steckel mill, to identify the best condition that provides maximum productivity without affecting the required microstructural, toughness and mechanical characteristics of the final product.
Evaluation of Simulated Heat Affected Zone of Molybdenum- and Niobium Alloyed Ultra-High-Strength Steels
Authors: Hannula Jaakko , Kaijalainen Antti , Kömi Jukka I.
Published: November 2023

Gleeble 3800-thermomechanical simulator was used to simulate the heat affected zone of quenched and tempered 0.16 wt.% C steels with variation of molybdenum-and niobium contents. The purpose of the study was to evaluate the effect of alloying content on the properties of the coarse-grained zone of HAZ region (CGHAZ) and partially re-austenitised inter-critical zone (ICHAZ) with two different t8/5 times (5 s and 15 s). Results showed that Mo and Nb decreased the amount of softening in the HAZ-region, especially with longer t8/5 -time (15 s). 0Mo steel had mixed microstructure of bainite and martensite in the CGHAZ region with t8/5 time of 15 s, which led to higher degree of softening compared to other steels. Shorter t8/5 time of 5 s produced martensitic microstructure in CGHAZ region in all cases leading to higher hardness values. Impact energy values at-40 °C were at least 34 J/cm2 in all cases. Highest hardness values in the ICHAZ-region were achieved in the case of 0.5Mo steel. Also, at-40 °C impact energy values of ICHAZ were at least 34 J/cm2 in all cases, however Mo-free steel achieved clearly higher impact energies in ICHAZ region, which is result from softer microstructure with relatively low hardness compared to other steels. Overall, it can be concluded that longer t8/5 time can be used, which corresponds to higher heat input in welding, if Mo and/or Nb alloying is used.
Importance of through Hardening of Low-Alloy High Performance Martensitic Steels for Large Section Applications
Authors: Rupinen Michael Christopher , Clarke Amy J. , Speer John G.
Published: November 2023

The effects of Mo and V on impact toughness in martensitic steels tempered at low temperatures were investigated using three low-alloy medium-C steels. Previous examination of these alloys had identified differences in impact toughness without a clear cause. In this work, the Base alloy with a reduced Mo addition experienced a significant loss in hardenability leading to the formation of small fractions of bainite during quenching even at relatively high quench rates. The use of different quench media to simulate cooling rates throughout a heavy section demonstrated that the variation in previously reported Charpy V-notch impact absorbed energies was readily explained by some regions cooling fast enough to avoid bainite while others formed some small fraction of upper bainite leading to increased cleavage fracture and decreased impact toughness. Small amounts of bainite transformation were not detected by dilatometry or tensile properties. These results emphasize the importance of effective through-hardening and careful microstructure evaluation in alloys that are meant to maintain good toughness and strength in thicker sections.
Gleeble Simulation of HAZ in S690QL Steel: Microstructural and Mechanical Properties
Authors: Tomerlin Damir , Gubeljak Nenad , Kozak Dražan
Published: November 2023

When investigating the heterogeneous properties of welded joints, mechanical testing of certain Heat Affected Zone (HAZ) regions, using standard approach test specimens, is very difficult or sometimes even impossible. Inability to precisely position and extract mechanical test specimens, even ones of the subsize dimensions, from the narrow HAZ regions is a limiting factor in the mechanical testing implementation. Detailed investigation of the HAZ is made possible by the use of thermo-mechanical simulations on the Gleeble welding simulator. In scope of this paper several characteristic HAZ microstructures of S690QL grade High Strength Steel (HSS) are being simulated. Multi-pass welding simulations are done on special 10x10 mm square section bar specimens in order to reproduce thermal gradients and characteristic microstructures at any location in a weld. Such simulated HAZ microstructures are of a sufficiently large volume, with homogeneous and repeatable properties, that standard specimen methods for mechanical testing can be readily implemented. Metallographic optical examinations, as well as hardness measurements were done initially. Mechanical properties are focused on determining stress-strain curves for each characteristic weld region. The paper investigates whether the mechanical properties of Gleeble simulated hard-soft combined HAZ regions are better in comparison to exclusively hard or soft HAZ regions. The obtained results can subsequently be used for the material model development.
Effect of Mo and Mo+Nb Additions on the Phase Transformation and Microstructure of a Developed Low-Carbon CrNiMnB Ultrahigh-Strength Steels with a Preceding Hot Deformation
Authors: Ali Mohammed , Alatarvas Tuomas , Nyo Tun , Kömi Jukka I.
Published: November 2023

The influence of molybdenum, and molybdenum with niobium addition on the phase transformation behaviour of a developed low-carbon CrNiMnB ultrahigh-strength steels, was investigated. Gleeble 3800 thermomechanical simulator was employed to simulate the hot-rolling process and to get the dilatation curves. After austenitization at 1250 °C for the complete dissolution of carbides, specimens received 0.6 total strain (i.e., 0.2 at 1100 °C and 2 x 0.2 at 900 °C) followed by cooling at various cooling rates (CRs) in the range of 2-60 °C/s. The final microstructures were investigated using laser scanning confocal microscopy, field emission scanning electron microscopy, and hardness measurements. Then the continuous cooling transformation diagrams were constructed based on the dilatation curves, microstructure, and hardness values. The electrolytic extraction method was used to assess the elements' distribution and the composition of the forming precipitates. The addition of Mo increased the hardenability, decreased the transformation temperatures, and promoted the formation of low-temperature transformation products i.e., martensite and bainite ferrite, at different CRs and inhibit the formation of polygonal ferrite. The formation of coarse precipitates neglected the effect of Mo+Nb addition, decreased the hardenability and expanded the region of BF formation to high CRs. The variation in the hardness with microstructural changes was discussed.
Effects of Pre-Strain and Tempering on Mechanical Properties in High-Strength Martensitic Steels
Authors: Tsuchida Noriyuki , Ueji Rintaro , Gong Wu , Kawasaki Takuro , Harjo Stefanus
Published: November 2023

Effects of pre-strain and tempering on mechanical properties in high-strength martensitic steels were investigated. In this study, strain tempering (ST) and quenching and tempering (QT) martensitic steels were prepared, and their mechanical properties were studied. In the tensile tests at the deformation temperatures between 296 and 573 K, the ST sample increased both of tensile strength (TS) and uniform elongation (U.El) from 473 to 523 K whereas the QT sample increased U.El with little change of TS. From the in situ neutron diffraction experiments, stress partitioning to the bcc phase increased with an increase in the deformation temperature from 296 to 523 K. The difference of phase stress between the bcc and cementite phases decreased with increasing the temperature because of a decrease in the cementite strength. In the ST sample, Pre-straining of 0.5% increased YS at 296 K with slight work hardening. The initial value of dislocation density (ρ) decreased at 523 K but ρ increased significantly after yielding, leading to better combination of TS and U.El. The combinations of pre-strain, tempering, and deformation temperatures have changed ρ before deformation and the increase of ρ after yielding of the martensitic steels.
Report of the public review panel on the government of Canada moratorium on offshore oil and gas activities in the Queen Charlotte Region, British Columbia
Authors: Priddle R , Scott D , Valiela D
Published: November 2023

The Public Review Panel (the Panel) was established to hold public hearings to obtain the views of British Columbians on matters relevant to the federal moratorium on oil and gas activities focusing on the Queen Charlotte Region (QCR). The Panel's public process
took place between January and August 2004. THe Panel's Terms of Reference (ToR) require it to submit a report to the Minister of Natural Resources Canada, which is to outline the work carried out, summarize the views of participants, provide the Panel's evaluation of those views and present its
conclusions and recommendations.
Short- and long-term effects of the COVID-19 pandemic on patients with cardiovascular diseases: A mini-review
Authors: Caldeira Daniel , Brito Joana , Gregório Catarina , Plácido Rui , Pinto Fausto J.
Published: November 2023

The COVID-19 pandemic had profound implications for patients with cardiovascular diseases (CVDs), both in the short- and long-term. In this article, we provide an overview of the effects of the pandemic on individuals with preexisting cardiovascular conditions. In the short term, the severe acute respiratory syndrome coronavirus 2 infection increased the risk of many cardiovascular events. Furthermore, the pandemic has disrupted health-care systems worldwide, leading to constraints in routine care, and limited access to specialized cardiovascular services and procedure. This has resulted in increased morbidity and mortality rates among patients with CVD (coronary artery disease, hypertrophic cardiomyopathy, heart failure (HF), heart transplant recipients, atrial fibrillation, atrial flutter, previous stroke, or previous peripheral artery disease). In the long term, the COVID-19 impact on patients with CVD extends beyond the acute phase of the disease. Studies have highlighted the development of long-term cardiovascular complications in COVID-19 survivors, such as acute coronary syndrome myocarditis, HF, stroke, venous thromboembolism, and arrhythmias, which may lead to a surge of new cases associated with CVD in the postpandemic era. Health-care systems must prioritize cardiovascular care, developing strategies to identify the patients at higher risk and provide the care to minimize the impact of the pandemic on patients with CVD.
What is associated with caregiver burden for adults with bipolar affective disorder: Illness severity or financial well being?
Authors: Rao Rachita , Majhi Gobinda , Rashmi A. , Ponnuchamy Lingam
Published: November 2023

Background:

Persons with bipolar affective disorder (BPAD) need long-term care and support. As most of the expenses for this are met personally by the caregivers, it will have financial implications for them. However, we do not know how much financial well-being is associated with the caregivers' burden as compared to the illness severity.

Aim:

This study aimed to examine the association between financial well-being and illness severity with the caregivers' burden in the context of BPAD.

Materials and Methods:

This study adopted a cross-sectional descriptive design. The first 50 consenting caregivers of persons with an International Classification of Diseases (ICD)-10 diagnosis of BPAD, who visited the National Institute of Mental Health and Neurosciences (NIMHANS) within 2019–2021, were included in the study. The patients were assessed on the Clinical Global Impression (CGI) and the Global Assessment of Functioning (GAF) for the severity of the symptoms and the current level of functioning, respectively. Caregivers were assessed on the Personal Finance Well-Being Scale.

Results:

In this study, the majority of caregivers were males (62%), with a median, monthly household income of Rs. 24,000, and expenditure of Rs. 12,000. The median cost of medicine was Rs. 1000 per month. The majority (64%) of patients did not have any health insurance. A total of 28 (56%) caregivers reported the cost of damage due to illness behavior. It was found that the severity of illness and current level of functioning had a significant negative correlation with caregivers' burden. The financial well-being as reflected through income and health expenditure did not have a significant correlation with the caregivers' burden.

Conclusions:

Caregivers of persons with BPAD meet the treatment expenditure out of their pocket. Though they have the financial burden, it is the illness severity and functioning capacities that are associated with caregivers' burden. These findings have implications for mental health care in persons with BPAD.
Stress and coping strategy among coaching and non-coaching students in Kota: A comparative study
Authors: Shekhawat B. S. , Meena Deepika , Yadav Sandhya , Dhaka Vikas , Vignesh K.
Published: November 2023

Background:

About 1.5 lakh students study in over 100 coaching centers in Kota. There is a highly competitive environment, and students often land up in stress and even suicide. So, the estimation of the magnitude of this problem and timely intervention can be of great value to students.

Aim:

This study aimed to assess and compare stress and coping strategies used by coaching and non-coaching students studying in Kota.

Material and Methods:

This cross-sectional study included 90 coaching and 90 non-coaching students fulfilling inclusion criteria that were specifically laid down for the study. A semi-structured specially designed pro forma, Scale of Academic Stress (SAS), and Coping Strategies Scale (CSS)-Hindi version were used. Appropriate statistical methods were then used to classify, tabulate, and analyze the collected data.

Results:

In this study, it was found that of all coaching students, 44.45% were suffering from high levels of academic stress, 34.44% suffered from average and 21.11% reported suffering from low levels of academic stress. Likewise, among non-coaching students, 70% were suffering from low academic stress, 26.67% from average, and 3.33% from high levels of academic stress. It was also evident that the majority of both coaching and non-coaching students used a low level of active coping strategy (cognitive approach, behavioral approach, and cognitive behavioral approach) and a high level of avoidance coping strategy (cognitive avoidance and behavioral avoidance).

Conclusion:

There is a significantly high prevalence of stress among coaching students as compared to non-coaching students. Stress levels of greater severity were found to be more prevalent in female students, 12th-class students, those belonging to urban and middle-class backgrounds, and those whose stream was chosen by their parents. Both coaching and non-coaching students used the same type of coping strategies to cope with stress.
The CAPE (Compassion, Assertive Action, Pragmatism, and Evidence) vulnerability index – Second Edition: Putting mental health into foreign policy to address globalization, conflict, climate change, and natural disasters
Authors: Torales Julio , Castaldelli-Maia João Mauricio , Ventriglio Antonio , Barrios Iván , Almirón-Santacruz José , García Oscar , Caycho-Rodríguez Tomás , Day Geraint , Menon Valsraj , Sri Anna , Persaud Albert , Bhugra Dinesh
Published: November 2023

Background:

The CAPE Vulnerability Index serves as a worldwide foreign policy indicator that implies which countries should get assistance first. It provides an evidence-based, well-structured, and well-reasoned strategy for employing aid in bilateral arrangements with mental health as a basis.

Objective:

The second edition of the CAPE VI has been developed to identify which nations should get priority foreign aid.

Materials and Methods:

We considered various indices or measures at the country level reflecting the average national health status or factors influencing public health. To make our choice, we used 26 internationally accessible and verified indicators. For the study, we have scored the countries according to these indices and prioritized those with the worst scores.

Results:

The CAPE Vulnerability Index is based on the number of times a country is ranked among the low-scoring nations. It is based on nine parameters and is an independent measure even though there may be a correlation with similar indices such as life expectancy, disability-adjusted life years(DALYs), physician numbers, and gross domestic product(GDP).

Conclusion:

We concluded that low-scoring countries were fragile or failed states, such as nations where governments lack complete oversight or power, are often oppressive and corrupt, have allegations of violations of human rights, or are marked by political turmoil in different forms, drawbacks from severe environmental damage, severe impoverishment, inequalities, cultural and racial divisions, cannot supply fundamental amenities, are victims of terrorism, and so on. To address these essential problems impacting fragile nations, administrations, aid donors, local organizations, mental health specialists, and associations should collaborate.
The effect of the COVID-19 pandemic and lockdown on the psychosocial health of medical students
Authors: Jain Nitya , Ali Tahoora , Chaudhury Suprakash , Chaudhari Bhushan , Saldanha Daniel
Published: November 2023

Background:

The COVID-19 pandemic had many psychological adverse effects due to fear and panic of infection. However social distancing and lockdown restrictions imposed to curb the spread of infection had an impact on the social life of people. The effects of this on the psychosocial health of the population were less explored area.

Aim:

To study the effect of the COVID-19 pandemic and lockdown on the psychosocial health of medical students.

Materials and Methods:

A cross-sectional observational study was conducted on medical students with the help of an online Google Form administering a questionnaire consisting of sociodemographic information; Coronavirus Social Distance Attitudes Scale and Attitude toward lockdown measure to assess favorable or opposing attitudes of participants toward social distancing and lockdown; Bergen Social Relationship Scale, Evaluation of Social System scale and Social Support Questionnaire to measure quality of social relations and social support satisfaction; and three item loneliness scale to evaluate feeling of loneliness.

Results:

The loneliness levels in participants were high (mean = 6.74 ± 0.79). There was a gender difference in the variables measured. Male students showed a favorable attitude toward social distancing (Positive social distance attitude scale P < 0.001, negative social distance attitude scale P < 0.001) and a better quality of social relations (Bergen Social relationship P < 0.001, evaluation of social system P < 0.001, SSQN P < 0.001, SSQS P < 0.001). However, male students scored more for loneliness as compared to females during the lockdown period (P < 0.001).

Conclusion:

The loneliness levels were high in medical students during the COVID-19 pandemic and lockdown and even higher in males who were considered a non-vulnerable group. So the balanced approach between preventive restriction measures and the social connectedness of the population is advised for making social distancing policies in the future.
Biopsychosocial correlates of emotional problems in women during pregnancy and postpartum period
Authors: Javadekar Archana , Karmarkar Arpita , Chaudhury Suprakash , Saldanha Daniel , Patil Jaideep
Published: November 2023

Background:

Transition to motherhood is associated with several emotional problems that can have long-term consequences on the mother and baby.

Aim:

To examine the association of various biomedical and cultural factors with the new onset of emotional problems during pregnancy and postpartum period.

Materials and Methods:

This prospective longitudinal study included 300 pregnant women interviewed in the third trimester.

Results:

The prevalence of emotional problems in the study group was 31.58%. The prevalence of anxiety disorder NOS and mixed anxiety and depressive disorder in the last trimester of pregnancy in our study was 4% and 1.33%, respectively, and 0.67% and 1.33%, respectively, at 4 days postpartum. At 6 weeks postpartum, the prevalence of anxiety disorder NOS was 1.33%, generalized anxiety disorder was 0.67%, and major depression was 1.33. The prevalence of postpartum blues in our study was 25.33%.

Conclusion:

There was a significant association between psychiatric disorders during and postpartum period and the following factors: higher parity, increased maternal age, low hemoglobin levels, cesarean section, planned pregnancy, and extended family. Postpartum blues was associated with higher parity and low blood pressure.
Mobile usage among degree college students in industrial township of western Maharashtra - “A descriptive study”
Authors: Borgaonkar Chaitali , Lakhute Sadhana , Vajjala Sai M. , Shivale Shubham J. , Nagar Akash , Nallapu Sandeep
Published: November 2023

Background:

With the advent of smartphones, there is an exponential increase in mobile usage and addiction. The statistics pointing toward mobile dependence in adolescents are of paramount importance to assess the prevalence in them and suggest measures accordingly.

Aim:

To observe the usage and dependence among the degree college students in an industrial township.

Materials and Methods:

A validated and structured questionnaire was distributed among the students at a women's degree college in western Maharashtra and responses were collected after obtaining consent. Along with sociodemographic details, qualitative and quantitative information regarding mobile usage were collected. Data were cleaned, coded, and analyzed after ensuring the confidentiality of their information using SPSS v26.0.

Results:

The mean age of the participants was 18.9+/-1.8 years. The mean time spent on mobile was 2.4+/-0.4 hours per day. Mobile dependency was found in 48% of participants. The mean total score was 92. The primary purpose for using the internet was to browse (41%) and social media 36%. The main benefit of using the internet was searching for information urgently (62.5%). A major limitation of using was felt as the internet to be very slow 61 (42.3%).

Conclusion:

There is a high prevalence of smartphone dependence in college students.
Prevalence of internet gaming addiction and its association with sleep quality in medical students
Authors: Shakya Makhan , Singh Rajesh , Chauhan Amrita , Rure Daisy , Shrivastava Akshat
Published: November 2023

Background:

In Asia, there are approximately 2.3 billion internet users. Addiction to internet gaming takes a multifaceted toll on an individual's physical and mental well-being, casting a long shadow over their daily endeavors and also their sleep cycle.

Aim:

To study the prevalence of internet gaming addiction and how it affects sleep quality in medical students.

Materials and Methods:

A cross-sectional study was performed with a sample size (n = 112) in the Government Medical College, Datia (M.P.), and data were collected using a semi-structured proforma including the Internet Gaming Disorder Scale and Mini Sleep Questionnaire in the study population.

Results:

In the study population with age group 18–28 years (mean age: 21 ± 1.7 years), the majority of them belong to the Hindu religion (91.1%), nuclear family (66.1%), and urban community (75.9%). Most students (n = 74) had mild to moderate sleep difficulty related to internet gaming addiction, that is, 65.1%. The most common response was “sometimes” on the Internet Gaming Disorder Scale. A significant association was observed between gaming disorder and parameters of sleep mainly in waking up too early, daytime sleepiness, snoring, feeling tired, and headache upon waking up with gaming disorder.

Conclusion:

Among medical students, gaming addiction is significantly associated with poor sleep quality. Steps need to be taken to promote healthy internet use to improve sleep quality and mitigate negative effects to avoid long-term health impacts.
The effect of cage type on local and total cervical lordosis restoration and global spine alignment in single-level anterior cervical discectomy and fusion based on EOS® imaging: A comparison between standalone conventional interbody polyether ether ketone cage and integrated cage and plate (Perfect-C®)
Authors: Chehrassan Mohammadreza , Nikouei Farshad , Shakeri Mohammadreza , Moeini Javad , Hosseini Farrokhlagha , Mahabadi Ebrahim Ameri , Ghandhari Hasan
Published: November 2023

Background:

There is a small level of evidence regarding the alterations in global spine alignment following the restoration of cervical lordosis using anterior cervical discectomy and fusion (ACDF). Different cage types are available to restore cervical lordosis through ACDF. In this study, we evaluate the impact of two types of these cages on local and global spine alignments.

Patients and Methods:

Thirty-two patients with a mean age of 46 ± 10 who underwent ACDF for cervical disc herniation were included in this retrospective study. Patients were divided according to their cage type into two groups, 17 patients with standalone conventional polyether ether ketone cages and 15 patients with integrated cage and plate (ICP) (Perfect-C®). Cervical alignment and global spine alignment were evaluated on the pre- and post-operative EOS® images.

Results:

Three months after the ACDF, total cervical lordosis correction was higher in patients with ICP (P = 0.001), while the local cervical lordosis correction was not significantly different between conventional cages and prefect-C cages (P = 0.067). Lumbar lordosis and pelvic tilt change were significantly higher among patients with Perfect-c cages (P = 0.043).

Conclusion:

In patients undergoing ACDF, alignment of the global spine changes along with the restoration of the cervical spine. Cage type affects this association, mainly through the compensatory alteration of pelvic tilt.
Surgical treatment of an all-spine epidural empyema
Authors: Reinas Rui , Alves Óscar L. , Kitumba Djamel , Baptista António Marques
Published: November 2023

Spinal epidural empyema (SEE) is a severe infectious disease of the spine which may cause significant morbidity and mortality. Surgical drainage of the empyema is a key feature. However, approach-related morbidity may be significant in very extensive collections. We present the case of a 55-year-old female with an empyema due to methicillin-susceptible Staphylococcus aureus spawning from C2 to S1. She underwent drainage of the pus through skip-level laminectomies and catheter epidural saline irrigation. The technique described was both safe and effective at treating the SEE, and the patient returned to normal life.
Atlas fractures with and without simultaneous dens fractures differ with respect to clinical, demographic, and management characteristics
Authors: Cloney Michael Brendan , Texakalidis Pavlos , Roumeliotis Anastasios G , Tecle Najib El , Dahdaleh Nader S.
Published: November 2023

Background:

Patients with simultaneous fractures of the atlas and dens have traditionally been managed according to the dens fracture’s morphology, but data supporting this practice are limited.

Methods:

We retrospectively examined all patients with traumatic atlas fractures at our institution between 2008 and 2016. We used multivariable regression and propensity score matching to compare the presentation, management, and outcomes of patients with isolated atlas fractures to patients with simultaneous atlas-dens fractures.

Results:

Ninety-nine patients were identified. Patients with isolated atlas fractures were younger (61 ± 22 vs. 77 ± 14, P = 0.0003), had lower median Charlson Comorbidity Index (3 vs. 5, P = 0.0005), had better presenting Nurick myelopathy scores (0 vs. 3, P < 0.0001), and had different mechanisms of injury (P = 0.0011). Multivariable regression showed that having a simultaneous atlas-dens fracture was independently associated with older age (odds ratio [OR] =1.59 [1.22, 2.07], P = 0.001), worse presenting myelopathy (OR = 3.10 [2.04, 4.16], P < 0.001), and selection for surgery (OR = 4.91 [1.10, 21.97], P = 0.037). Propensity score matching yielded balanced populations (Rubin’s B = 23.3, Rubin’s R = 1.96) and showed that the risk of atlas fracture nonunion was no different among isolated atlas fractures compared to simultaneous atlas-dens fractures (P = 0.304). Age was the only variable independently associated with atlas fracture nonunion (OR = 2.39 [1.15, 5.00], P = 0.020), having a simultaneous atlas-dens fracture was not significant (P = 0.2829).

Conclusions:

Among patients with atlas fractures, simultaneous fractures of the dens occur in older patients and confer an increased risk of myelopathy and requiring surgical stabilization. Controlling for confounders, the risk of atlas fracture nonunion is equivalent for isolated atlas fractures versus simultaneous atlas-dens fractures.
“Only fixation” in cases with failed decompression for lumbar canal stenosis – Analysis of outcome in 14 cases
Authors: Goel Atul , Prasad Apurva , Shah Abhidha , Maheshwari Shradha , Vutha Ravikiran
Published: November 2023

Aim:

The rationale of “only fixation” of affected spinal segments without any form of bone or soft-tissue decompression in cases with failed decompressive laminectomy for lumbar canal stenosis is discussed on the basis of an experience with 14 cases.

Materials and Methods:

During the period between 2010 and 2022, 14 patients who symptomatically worsened or did not improve following a long-segment “wide” decompressive laminectomy for multisegmental lumbar canal stenosis were identified. All patients were treated by segmental spinal stabilization aimed at arthrodesis by facetal distraction by Goel’s facetal spacers (6 cases) or Camille’s transarticular facetal fixation (8 cases). No bone, soft tissue, or disc resection was done for spinal or neural canal “decompression.” Oswestry Disability Index and Visual Analog Scale were used to clinically assess the patients before and after the surgery and at follow-up. In addition, video recordings of patient’s self-assessment of clinical outcome were used to monitor the outcome.

Results:

During the average period of follow-up of 71 months (range 6 months to 16 years), all patients recovered in majority of their major symptoms, the recovery was observed in the immediate postoperative period. During the period of follow-up, none of the patients complained of recurrent symptoms or needed any additional surgery. There was firm stabilization and evidences of bone fusion of the treated spinal segments in all patients. There were no infections or implant failure. No patient worsened after treatment.

Conclusions:

Instability of the spinal segments is the primary issue in cases with lumbar canal stenosis and stabilization in the treatment.
Different C2 screw placement techniques with mobilization of the vertebral artery in high-riding vertebral artery cases: Cadaver dissection
Authors: Harman Ferhat , Oglin Volkan , Yilmaz Mehmet Ozgur , Orhun Omer , Baran Oguz , Boyukyilmaz Seyma , Gezercan Yurdal , Dalbayrak Sedat , Dagcinar Adnan
Published: November 2023

Objective:

In neurosurgery, posterior approaches intended at the craniovertebral junction are frequently used. The most popular procedures for treating upper cervical instability are C1 lateral mass, C2 pedicle, and C1-C2 transarticular screw stabilization. Due to their proximity to neural structures and the presence of the high-riding vertebral artery (VA), these techniques are complicated. The risk of VA damage can be decreased by mobilizing the VA. Using cadaveric specimens in this study was aimed to demonstrate C2 pedicle and C1-C2 transarticular screw placement with VA mobilization and a novel C2 inferior corpus screw placement technique.

Methods:

In this study, twelve adult cadaveric specimens and two adult dry cadaveric C2 bones were used with the permission and decision of the University Research Ethics Committee. Colored silicone was injected into the arteries and veins of these twelve cadaveric specimens. Then, muscle dissection was performed stepwise, and the C2 vertebrae of the cadavers were revealed with a surgical microscope. Each specimen and entire stages of the dissections were recorded photographically. After cadaver dissections, screw placement was performed with three different techniques. Finally, radiological imaging was done with fluoroscopy.

Results:

After dissection, the lateral mass of the C2 vertebra was observed, and lateral to it, the transverse process and foramen were detected with the help of a hook. Next, the posterior wall of the VA groove was removed using a 1 mm thin plate Kerrison rongeur until the VA loop could partially be observed the VA. This enables us to find the top of the loop of the VA and mobilize it inferiorly using a dissector. Following this step, the C1-2 transarticular, C2 pedicle, and the novel C2 inferior corpus screw placement can be performed safely by directly visualizing the artery.

Conclusions:

Due to the nearby neurologic and vascular structures, placing the C2 pedicle and C1-2 transarticular screw is a challenging procedure, especially in high-riding VA cases. However, it is possible to place the C2 pedicle, C1-2 transarticular, and novel C2 inferior corpus screw after the mobilization of the VA. This study aimed to show all of them together on a cadaver for the first time, to understand the anatomy of the C2 vertebra, and to use screw placement techniques to minimize the risk of complications.
Surgical management of spinal schwannomas arising from the first and second cervical roots: Results of a cumulative case series
Authors: Corrivetti Francesco , Roperto Raffaelino , Sufianov Rinat , Cacciotti Guglielmo , Musin Arslan , Sufianov Albert , Mastronardi Luciano
Published: November 2023

Objective:

Schwannomas of the first and second nerve roots are rare neurosurgical entities, harboring specific surgical features that make surgical resection particularly challenging and deserve specifics dissertations. This study is a retrospectively analysis of 14 patients operated in two different neurosurgical centers: the San Filippo Neri Hospital of Rome and the Federal Centre of Neurosurgery of Tjumen.

Materials and Methods:

In the last 6 years, 14 patients underwent neurosurgical resection of high cervical (C1–C2) schwannomas, in two different neurosurgical centers. Patients data regarding clinical presentation, radiological findings, and surgical results were retrospectively analyzed.

Results:

The mean age was 50 years (range 13–74), the follow-up mean duration was 30 ± 8.5 (range 24–72 months), and there was no significant differences among different tumor locations (intradural, extradural, and dumbbell). Surgical results were excellent: gross total resection was achieved in all cases and there were no intraoperative complications or postoperative mortality. All patients presented postoperative clinical improvement except one who remained stable. Karnofsky performance status, at the last follow-up, confirmed a global clinical improvement. No vertebral artery (VA) injury neither spinal instability occurred; nerve root sacrifice was reported in one case.

Conclusions:

Neurosurgical treatment of C1–C2 schwannomas is associated with good outcomes in terms of extent of resection and neurological function. In particular, dumbbell shape and VA involvement do not represent limitations to achieve complete tumor resection and good clinical outcome. In conclusion, microsurgery represents the treatment of choice for C1–C2 schwannomas.