bluuebunny/crossref_metadata_2025 huggingface dataset:
“Una mano aviesa”: de feministas abolicionistas, trabajadoras sexuales y violencias epistémicas en Argentina
Authors: Daich Deborah
Published: July 2024

En junio de 2020 fue lanzado, desde el Ministerio de Desarrollo argentino, el Registro Nacional de la Economía Popular (ReNaTEP) que, entre otras categorías, incluyó las de trabajadora sexual y stripper. Las organizaciones de trabajadoras sexuales festejaron ante la posibilidad de inscribirse y acceder, así, al monotributo y a instrumentos de la seguridad social pero, a las pocas horas del lanzamiento y dada la presión de los sectores abolicionistas, el registro fue eliminado. Este trabajo aborda la historia de esa eliminación en clave de falta de reconocimiento y bajo el lente conceptual de la injusticia y la violencia epistémicas. Para ello, el artículo aborda tanto las formas en que el movimiento de las trabajadoras sexuales produce conocimiento, como el revuelo que causó, entre feministas abolicionistas y funcionarios, la incorporación del trabajo sexual en el ReNaTEP, y que se tradujo en la negación de las trabajadoras sexuales, de su agencia epistémica, de su subjetividad y hasta de su legitimidad como sujeto social.
What’s in a Refusal? Methodological and Ethical Notes from an Ethnography of Mental Health Care in Rural Ghana
Authors: Draicchio Cecilia
Published: July 2024

Drawing on fifteen months of ethnographic fieldwork conducted between 2013 and 2022 on experiences of madness and practices of mental health care in rural southwestern Ghana, in this paper I propose to take as a point of departure, a specific episode in which the relatives of Fadhila—a girl I had first met at the psychiatric unit, where she was diagnosed as “psychotic”—refused to give consent to record an interview with me. The refusal was motivated by the strict instructions that Fadhila and her family were given by the traditional healer who was taking care of her: among many other things, the girl was not allowed to come close to any electronic device and her family felt it was unsafe to record an interview at their house. The refusal had to do with Fadhila being a “patient” as much as it had to do with another refusal: that of drugs and psychiatrisation. Indeed, the refusal had to do with spirits, the spirits that occasionally possessed Fadhila and were trying to make her a healer, according to her, her family members, and the traditional specialists they had visited. The refusal, however, may also have been a polite, indirect way to “withdraw consent”—to use the jargon of informed consent forms and ethics review committees. Though Fadhila and her family kept inviting me to their place, welcomed me warmly in subsequent occasions, and conversed with me about many things including the girl’s “condition,” that episode pushed me to reconsider the limits of formal consent and the need to constantly question it and re-establish it—a complex dynamic that sometimes the bureaucracy of “ethical clearance” processes in academia may contribute, paradoxically, to erase. Analysing this ethnographic episode in light of the powerful concept of ethnographic refusal introduced by Audra Simpson, I propose a reflection on the ethical and methodological implications of considering people as “sources” in ethnographies of madness and mental health.
Qu’y-a-t-il dans un refus ? Notes méthodologiques et éthiques d’une ethnographie des soins de santé mentale dans les zones rurales du Ghana
Authors: Draicchio Cecilia
Published: July 2024

Sur la base de quinze mois de travail ethnographique sur le terrain, mené entre 2013 et 2022, sur la façon dont sont vécues la folie et les pratiques de soins de santé mentale dans le sud-ouest rural du Ghana, je propose dans cet article de prendre comme point de départ l’épisode spécifique du refus des parents de Fadhila – une jeune fille que j’avais rencontrée pour la première fois dans l’unité psychiatrique où elle avait été diagnostiquée comme « psychotique » – à consentir à l’enregistrement d’une interview avec moi. Le refus de Fadhila et de sa famille était motivé par les instructions strictes que leur avait donné le guérisseur traditionnel qui s’occupait de Fadhila : entre autres, Fadhila ne devait pas s’approcher d’un appareil électronique et sa famille estimait donc qu’il était risqué d’enregistrer une interview dans sa maison. Le refus avait trait au fait que Fadhila était une « patiente », tout autant qu’il avait trait à un autre refus : celui des médicaments et de la psychiatrie. En fait, le refus était lié aux esprits, les esprits qui prenaient parfois possession de Fadhila et qui, d’après elle, les membres de sa famille et les experts traditionnels qu’ils avaient consultés, cherchaient à faire d’elle une guérisseuse. Le refus, cependant, représentait peut être aussi une manière polie et indirecte de « retirer le consentement », pour reprendre le jargon des formulaires de consentement éclairé et des comités d’évaluation éthique. Bien que Fadhila et sa famille n’aient cessé de m’inviter chez eux, de m’accueillir chaleureusement à chaque occasion et de discuter avec moi de nombreuses choses, y compris de l’« état » de leur fille, cet épisode de refus m’a poussée à reconsidérer les limites du consentement formel et la nécessité de le remettre en question et de le rétablir sans cesse. Paradoxalement, la bureaucratie des processus d’« autorisation éthique » dans le monde universitaire peut parfois contribuer à éliminer cette dynamique complexe. Grâce à l’analyse de cet épisode ethnographique à la lumière du puissant concept de refus ethnographique introduit par Audra Simpson, je propose une réflexion sur les implications éthiques et méthodologiques qui résultent du fait de considérer les personnes comme des « sources » dans les ethnographies de la folie et de la santé mentale.
Build Orientation Effect on Bending Fatigue Performance and Impact Toughness of Laser Powder Bed Fusion Manufactured Ti6Al4V Without Heat Treatment
Authors: Rautio Timo , Jaskari Matias , Hietala Mikko , Mustakangas Aappo , Keskitalo Markku , Järvenpää Antti
Published: July 2024

Titanium alloys are highly valued in various industries due to their exceptional qualities. This study examines how the build orientation affects the mechanical and fatigue properties of Laser Powder Bed Fusion (PBF-LB) produced Ti6Al4V, without heat treatment. The research shows mechanical properties vary based on build orientation with vertically oriented specimens exhibiting the highest yield and tensile strengths, while vertical orientation excels in ductility, measured through elongation at break. Impact toughness sees variations with horizontal orientation performing the best. However, build orientation has minimal influence on flexural bending fatigue performance. Both diagonal and vertical orientations show similar fatigue limits at around 40 MPa. Dry electropolishing proves to be an effective technique, significantly enhancing fatigue performance with limits stabilizing at about 150 MPa. This study underscores the importance of considering build orientation in PBF-LB manufacturing for specific mechanical and impact properties and the potential of dry electropolishing in improving the fatigue performance of Ti6Al4V components. These findings offer valuable insights for the additive manufacturing industry, aiding in the optimization of Ti6Al4V component production.
Effect of Heat Treatment on Mechanical Properties and Corrosion Response of HVOF Sprayed High Entropy Alloy Coatings
Authors: Abhijith N.V. , Kumar Deepak , Rawat Karun
Published: July 2024

Surface and sub-surface related degradation of steels can be minimized using suitable surface coatings. High entropy alloys (HEA) are prominent and emerging materials among many coating materials. The current study investigates the effect of heat treatment of HEA coating on mechanical, metallurgical, and corrosion properties. The HEA coatings on SS304 steel were deposited using a High-Velocity Oxy-Fuel (HVOF) thermal spray process. The developed coatings were furnace heat treated at 700 °C, 900 °C, and 1100 °C, respectively, and their performance was benchmarked with the as-sprayed coatings. The metallurgical, mechanical, and microstructural analyses were performed using X-ray diffraction (XRD), Nanoindentation, Scratch test, and Field Emission Scanning Electron Microscope (FESEM) techniques. The corrosion response of the as sprayed and heat-treated coatings were recorded using a Potentiostat. The results indicated that as-sprayed coatings consisted of a single-phase BCC solid solution; however, the single-phase changed to a dual dual-phase system after heat treatment (BCC+FCC). The 900 °C heat-treated HEA coating exhibited superior mechanical and corrosion properties. But those characteristics started diminishing when the heat treatment temperature exceeded 900 °C. The introduction of the new FCC phase softened the coating, thereby leading to the evolution of microcracks in the coating. These micro-cracks acted as channels for electrolyte diffusion and further corroded the coatings. The current study surmised that HVOF-sprayed HEA coating should not be heat treated at above 900 °C.
Anaesthetic Challenge in a Child with Hurler’s Syndrome: Encouraging Experience with Neuraxial Blockade
Authors: Ali Shahna , Nisanth N. S. , Rehman Faiqa
Published: July 2024

Mucopolysaccharidoses are uncommon genetic diseases with multisystem involvement. The potential for airway difficulties and varying success rate of neuraxial blockade demands considerable expertise in the anesthetic management in these patients. Airway management has evolved significantly in such syndromic patients with the increasing use of video laryngoscopes and Supraglottic airway devices. However, airway catastrophes are not uncommon. This calls for better utilization of neuraxial and peripheral nerve blocks along with the use of newer agents for sedation having a favorable pharmacological profile. Here, we present a case of child having Hurler disease with an inguinal hernia successfully operated under subarachnoid blockade.
Vitiligo in the 19th-century dermatological works of Vincenzo Chiarugi, Robert Willan, Jean-Louis Alibert, and Ferdinand von Hebra
Authors: Stocco Flavio , Picardo Mauro , Lora Viviana
Published: July 2024

Vitiligo is an iconic dermatological pathology as its clinical manifestations indelibly mark the patient through the appearance of white spots all over the body. The oldest written testimonies referring to vitiligo are: the first texts of Ayurveda, the Ebers Papyrus and the Leviticus of the Old Testament. During the Roman Empire, the doctors Aulus Cornelius Celsus and Galen, respectively in the I and II centuries AD, were the first to describe this skin disease and their statements were used by all subsequent authors. Hieronymus Mercurialis in the XVI century, Joseph Jakob Ritter Plenck in the XVIII century and Vincenzo Chiarugi again in the XIX century based their writings on the references of the two Roman doctors. After centuries of scientific inaction in the XIX century, there was an exponential increase in dermatological studies and the medical-scientific works produced in this period laid the foundations of modern dermatology. The nineteenth-century texts of Robert Willan and Thomas Bateman, Jean-Louis Alibert, Ferdinand von Hebra, and Moriz Kaposi proved fundamental for the study of skin pathologies, including vitiligo. The nineteenth-century medical-scientific vision and approach to vitiligo is shown in this work through the presentation of direct quotes extrapolated from the most important works of the authors mentioned above, this served to historically contextualize the gradual progress of medical study regarding this skin pathology.
Examining the relationship between health literacy and quality of life in patients with coronary heart disease: a quantitative study at a cardiology clinic
Authors: Lita Lita , Khairiyah Nadila , Utami Agnita , Anggreini Silvia Nora , Said Faridah Mohd.
Published: July 2024

Coronary Heart Disease (CHD) is the leading cause of death worldwide and is rising, annually. Improved health outcomes require early treatment and self-monitoring, which need health literacy. This study examined how health literacy affects CHD patients’ Quality of Life (QoL) at the Hospital’s Cardiology Clinic. This quantitative, descriptive correlation study was cross-sectional. The sample was 164 respondents, sampled consecutively. Patients must be willing to participate, diagnosed with CHD, and attend cardiology outpatient follow-up appointments. Health literacy was measured with the HLS-EU-SQ10 and QoL with the Seattle Angina Questionnaire. This study used chi-square to analyze the relationship between two ordinal scale variables in a contingency table. The average age was 58.07 years, according to research. Of the respondents, 59 (36.0%) had graduated high school. Health literacy was assessed in three QoL domains: physical limitation (P=0.024), angina frequency (P=0.570), and QoL (P=0.338). Service agencies should be able to use pamphlets to improve health literacy and provide rehabilitation to acute coronary syndrome patients to improve QoL.
Outcomes of middle meningeal artery embolization for treating chronic subdural hematoma
Authors: Hai Dao Xuan , Thong Pham Minh , He Dong-Van , Dung Le Thanh , Hung Duong Duc , Huyen Nguyen-Thi , Minh Duc Nguyen
Published: July 2024

The study evaluates chronic subdural hematoma (cSDH) middle meningeal artery (MMA) embolization efficacy and safety. A prospective interventional study was conducted in Viet Duc Hospital from November 2021 to April 2024. All consecutive cSDH MMA embolization patients were included. Clinical and imaging data were collected before and one month after treatment. The study included 31 42-cSDH patients. Of these, 25.8% had hematoma evacuation, 83.9% were treated with surgery and embolization, and 16.1% with embolization alone. 92.9% of procedures used polyvinyl alcohol particles. The success rate was 92.9% and complications 7.1%. Asymptomatic external carotid artery vasospasm and MMA rupture occurred. Functional improvement occurred in 91.7% of patients one month after treatment. Significantly lower mean modified Rankin Scale (mRS) score (0.2±0.7 vs. 1.7±0.9; P=0.000) and higher proportion of patients with ≤2 mRS score (95.8% vs. 74.1%) were observed after treatment. Hematoma thickness decreased significantly (P=0.00) from 21.5±7.9 mm to 8.3±4.1 mm. The midline shift decreased significantly from 7.4±5.0 mm to 0.7±1.2 mm (P=0.00). Just one patient (4.2%) needed surgery. MMA embolization alone or with surgery appears to treat cSDH safely and effectively.
Effect of pretransplantation serum activin A on outcomes in patients undergoing allogeneic hematopoietic stem cell transplantation
Authors: Hafez Gehad H.F. , Azzazi Mohamed O. , Hassan Essam A. , Mekawy Mohamed A.M. , El-Ghammaz Amro M.S. , Mohamed Inas A.M.
Published: July 2024

Background

Allogeneic hematopoietic stem cell transplantation (HSCT) is the preferred treatment for a number of life-threatening diseases, including acute leukemia and aplastic anemia. However, HSCT is frequently complicated by syndromes characterized by endothelial dysfunction, such as graft-versus-host disease (GVHD) or veno-occlusive disease. The transforming growth factor beta (TGF-beta) superfamily protein activin A is required for endothelial integrity and tissue repair. TGF is a tumor suppressor that induces apoptosis or autophagy, inhibits the cell cycle, and regulates cytokine and chemokine expression. Many mutations in genes encoding receptors and decreased expression of TGF pathway components have been observed in carcinoma. Activin A has been shown to play dual roles in cancer progression, depending on genetic and cellular context as well as tumor stage, exerting early tumor-suppressive and late prometastatic effects.

Aims

The goal of this study was to measure activin A levels before and after allogeneic HSCT and to correlate serum activin A with posttransplantation GVHD.

Patients and methods

Serum activin A was measured using an enzyme-linked immunosorbent assay in 30 preallogenic bone marrow transplant patients in comparison with 10 healthy controls recruited from the bone marrow transplantation unit at Ain Shams University Hospitals.

Result

The serum activin A level was higher in allogenic transplantation patients than in controls, with a statistically significant difference between patients and controls (P=0.001). Activin A was found to be associated with chronic GVHD (P=0.004 and 0.002, respectively).

Conclusion

Activin A levels are useful biomarkers for detecting GVHD from allogeneic bone marrow transplantation.
Cardiac function in long-term survivors of children posthematopoietic stem cells transplantation
Authors: Sayed Safa Matbouly , Mohamed Wafaa Ezzat Ibrahim , Elzoghby Naira Mohamed , Elsamman Nora
Published: July 2024

Introduction

Hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for many refractory malignancies, bone marrow failure syndromes, and primary immune deficiencies. Despite the significant improvement in survival after HSCT, the therapy is associated with major short and long-term morbidity and mortality. Cardiovascular complications are increasingly recognized as potential outcomes following HSCT. Echocardiography is the method of choice for detecting myocardial dysfunction before, during, and after chemotherapy. Cardiotoxicity was defined as a decrease in left ventricle ejection fraction (LVEF) more than 10% from the baseline cardiac function or ejection fraction ≤50%.

Methods

This cross-sectional study was conducted at the pediatric transplantation and cardiology units at Ain Shams University, Cairo, Egypt. Twenty-two long-term survival children underwent hematopoietic stem cells transplantation from 2011 to 2019. Full medical history and examination data were collected. Conventional and two-dimensional (2D) speckle tracking echo were done.

Results

The mean age of patients at the time of study was 12.95 ± 4.82 years. Mean age at the time of transplant was 7.02 ± 3.84 years. They were 50% males & 50% females. Long-term survival mean duration was six years. About eighty-six percent of the patients had nonmalignant diseases, while 13% patients had malignant diseases. Regarding the conditioning regimen used; 41% received Cy/ATG, 50% received Cy/Bu and 9% received BEAM. Twenty percent of patients developed acute GVHDs (grade I to II), while 22.7% patients developed chronic GVHDs included 13.7% patients limited skin and ocular manifestations, while 9% had extensive chronic GVHDs. Echocardiography showed that all patients had normal systolic and diastolic function. Only one patient (4.5%) had borderline left ventricle dilatation by M mode, while two patients (9%) had abnormal global longitudinal strain (GLS) by 2D speckle tracking. One had a GLS of 16% and the other one had mild hypokinesia with a GLS of 14%. There was no significant difference between studied patients with cardiac affection and those without cardiac affection as regards demographic data, conditioning regimens, GVHDs prophylaxis and complications of transplant (P value > 0.05).

Conclusion

Monitoring of cardiac function by 2D speckle tracking echo is important to detect any subtle cardiac affection in long-term survivors of HSCT.
Study of the effect and safety of oral lactoferrin therapy for functional iron deficiency anemia in prevalent hemodialysis patients
Authors: Abdelwahab Khaled G. , Elshinnawy Howayda A. , Elsaid Tamer W. , Mohammed Mohammed A. , Elsharabasy Reem M.
Published: July 2024

Background

The commonly available therapeutic approaches for treating anemia of chronic kidney disease include oral and IV iron supplementation and erythropoiesis-stimulating agents. Lactoferrin, an iron-binding glycoprotein, has been studied for its effect on iron homeostasis.

Aim of the work

To study the effect and safety of oral lactoferrin therapy for functional iron deficiency anemia in prevalent hemodialysis patients.

Patients and methods

This is an interventional case–control study, conducted at Ain Shams University Hospital hemodialysis unit on 70 prevalent hemodialysis patients, who were divided into two groups: (Group A): 35 patients with functional iron-deficiency anemia, who received lactoferrin together with the recommended dose of ESA therapy for 3 months, (Group B): 35 patients with functional iron-deficiency anemia, who received only their recommended dose of ESA therapy for 3 months.

Results

Both groups were age and sex-matched. Both groups showed a significant improvement in their hemoglobin, ferritin, and iron levels after 3 months’ follow-up, with no difference between both groups. No significant difference was noticed in either WBCs or platelets during the study period.

Conclusion

Oral lactoferrin failed to show a superior effect on ESAs alone and could not be used as a substitute to totally replace IV iron supplementation in hemodialysis patients with FID.
Irisin in myelodysplastic syndromes: connecting inflammation, oncogenesis, and atherogenesis
Authors: Abdelhafez Mohamed Ahmed , Shoeib Sabry Abdallah , Arafa Ayman Fathy , Dawood Ashraf Abdelrouf , Elkholy Aly Mohamed , Elrahman Shrief Ramadan Abd Elkhalek Abd , Elrefy Mahmoud Ahmed , Akl Ghada Hamdy
Published: July 2024

Objective

This study aimed to measure irisin level and carotid intima-media thickness (CIMT), and, to unravel their correlations with other variables in patients with myelodysplastic syndromes (MDS).

Background

Multiple components of the marrow environment and of the MDS cell hierarchy itself can contribute to an inflammatory state which can influence MDS emergence, propagation, and evolution. Irisin is an adipomyokine that is involved.in.the.regulation.of.metabolic.processes.and.also.influences.processes.related.to.inflammation including cancer. Atherosclerosis is a chronic inflammatory vascular disease driven by traditional and nontraditional risk factors.

Patients and methods

This case–control study was carried out on 40 MDS patients and 40 age-matched and sex-matched healthy controls. Serum irisin level and CIMT were measured.

Results

The median irisin level and high-density lipoproteins were significantly lower in MDS patients compared with controls whereas CIMT, fasting blood glucose, 2 h postprandial blood sugar, hemoglobin A1c, homeostatic model assessment of insulin resistance, triglycerides, homocysteine, and high sensitive C-reactive protein were significantly higher in patients than controls.

Conclusion

Irisin level is significantly lower in patients with MDS where as CIMT is significantly higher in MDS patients compared to controls.
Estimation of antioxidant enzymes in hemodialysis patients
Authors: Majeed Safaa A. , Jewad Abdulkareem M. , Al Atbee Mohammed Y.N.
Published: July 2024

Background

Oxidative stress in hemodialysis (HD) is a critical concern in the management of patients. HD, a life-sustaining renal replacement therapy, exposes individuals to various factors that promote the production of harmful reactive oxygen species within the body. These reactive oxygen species, including free radicals, can overwhelm the body’s antioxidant defenses, leading to oxidative stress.

Objective

This study aimed to evaluate the activities of superoxide dismutase (SOD), glutathione peroxides (GPx) and catalase (CAT), and serum malondialdehyde (MDA) levels with dyslipidemia in HD patients and compare them with control groups.

Patients and methods

The case–control study was conducted on 75 patients undergoing HD and 75 age-matched healthy controls. Oxidative stress markers include CAT, SOD, GPx, and MDA. Serum electrolytes including potassium ion (K+), phosphate (PO4), calcium (Ca+), urea, and creatinine (Cr) were measured for each group.

Results

Our results show a significant difference between patients and the control group in each of the oxidative stress markers, which are CAT, GPx, and SOD, showing a decrease that is statistically significant in patients in comparison to the controls. The level of MDA shows an increase that is statistically significant in patients in comparison to the controls. Serum electrolyte levels, which are K+, PO4, urea, and Cr, show a statistically significant increase in patients in comparison to the controls. Ca+ shows a decrease that is statistically significant in patients in comparison to the controls.

Conclusions

From the results, we could conclude that oxidative stress plays a role in HD patients and can affect the management of end-stage renal failure patients.
The Association between Post-Partum Depression and Nutrition and Dietary Patterns: Systematic Review
Authors: Ghaedrahmati Maryam , Alipour Zahra
Published: July 2024

Background:

Postpartum Depression (PPD) is a common illness with long-term effects on mother and child. Nutrition is a crucial factor in mental health, but research findings on its connection to PPD are inconsistent. This review aims to explore the correlation between PPD and dietary patterns.

Materials and Methods:

We conducted a comprehensive search of several databases including PubMed/MEDLINE, Embase, ISI and ISI/Web of Science (WOS), Scopus, and Iranian databases such as Magiran, Scientific Information Database (SID), and IRANDOC from 2003 to 2020. Our search was based on the keywords “postpartum depression” and “nutrition, vitamin D, Folic acid, iron, zinc, and vitamins.” We applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist to select articles based on inclusion/exclusion criteria. Of the 100 articles identified, only 24 articles met our criteria and were selected for further analysis.

Results:

Research suggests that low levels of vitamin D, iron, folate, and carbohydrates, and an unhealthy diet lacking in vegetables are potential causes of PPD. However, the impact of zinc, omega-3 essential fatty acids, and other nutrients such as antioxidants, vitamin E, and vitamin C on PPD is unclear due to conflicting information. Additionally, limited research has been conducted on the association between group B vitamins and PPD.

Conclusions:

In conclusion, we can lower the risk of PPD by providing dietary guidance and working with healthcare providers. It is important to pay attention to our diet and make sure we are consuming enough vitamins and nutrients to support our mental health.
Relationship between Resilience and Social and Organizational Support among Nurses Working with COVID-19 Patients: A Cross-Sectional Study
Authors: Mehdizadeh Soudabeh , Aghamohammadi Phateme , Maleki Maryam , Hasanlo Masoumeh , Abbasi Soheila
Published: July 2024

Background:

One of the coping strategies in stressful situations effectively is resilience skills. Due to the coronavirus disease 2019 (COVID-19) pandemic and its resulting stresses, this study was conducted to determine the relationship between resilience and social and organizational support among nurses working with COVID-19 patients.

Materials and Methods:

A cross-sectional study was undertaken on 224 nurses working with COVID-19 patients in Iran in 2021. A demographic questionnaire, the Connor–Davidson Resilience Scale, Multidimensional Scale of Perceived Social Support, and Survey of Perceived Organisational Support were used for data collection. Data analysis was performed using descriptive and interpretive statistics (Pearson correlation coefficient test and linear regression).

Results:

The mean [Standard Deviation (SD)] resilience score was 65.86 (14.01). In addition, the mean (SD) scores of organizational support and social support were 21.57 (4.46) and 65.10 (10.93), respectively. The Pearson correlation coefficient test results showed a statistically significant direct relationship between social support and resilience (r = 0.41,p< 0.001). In addition, there was a statistically significant relationship between organizational support and resilience (r = 0.16,p= 0.01). Multivariate linear regression analysis showed that for each unit increase in social support and organizational support scores, resilience scores increased by 0.41 (p= 0.01) and 0.15 (p< 0.001) units, respectively.

Conclusions:

The results of the present study showed a direct relationship between resilience and social support and organizational support in nurses. Due to the prolongation of the COVID-19 pandemic and the high prevalence of the disease in our country, nursing managers should seriously consider measures to protect their staff.
Lifestyle Interventions vs. Multi Interventional Therapy on Physiological Parameters of Metabolic Syndrome among Women: A Comparative Study
Authors: Elizabeth A. J. , Aruna J , Mercy P. J.
Published: July 2024

Background:

Metabolic syndrome is one of the emerging health issues in developing countries. It includes diabetes, high Blood Pressure (BP), obesity, and elevated blood cholesterol.

Materials and Methods:

This comparative study was conducted from March 2019 to February 2020 in selected areas of Ernakulam district, Kerala. The study used a quasi-experimental design with a nonequivalent control group. One-way analysis of variance and paired t-tests were used for statistical analysis. Women (aged between 35 and 55 years) with metabolic syndrome were recruited by multistage sampling (N = 220) and randomly assigned into three groups: (a) control, (b) Lifestyle Interventions (LI), and (c) Multi Interventional Therapy (MIT). LI was given to the LI group, and reflexology foot massage along with LI was given to the MIT group for 12 weeks. The control group received routine care. Physiological variables were assessed before and after the intervention.

Results:

Women who received MIT and LI had significantly lower values of weight, Body Mass Index (BMI), and waist circumference after the treatment from baseline and compared with control (F = 12.09, 15.58, 22.37, p < 0.001). A remarkable change in systolic and diastolic BP was found in the MIT group (pretest mean of systolic BP and diastolic BP in control: 142.3 and 90.1, LI: 141.7 and 89.7, MIT: 141.8 and 89.8, p = 0.945, posttest means control: 142.6 and 90.4, LI: 131.5 and 85.5, MIT: 118.5 and 78.3, (F = 54.83, 57.87, p < 0.001).

Conclusions:

Both LI and MIT should be considered as interventions for reducing the physiological parameters of metabolic syndrome, such as body weight, BMI, and obesity. MIT was found to be more effective in reducing blood pressure.
Association between Vitamin D Levels During Pregnancy and Postpartum Depression: A Narrative Reviews
Authors: Bateineh Sajedah , Atoum Manar Fayiz
Published: July 2024

Background:

Postpartum Depression (PPD) is a serious depression that develops in the first year, with unknown explained reasons. Many studies evaluated the impact of Vitamin D (VD) levels on depression during pregnancy and postnatal. This narrative review aims to review any association between serum VD levels during pregnancy and the development of PPD.

Materials and Methods:

PPD data from published trials and research articles (period from 2012 to 2022) were assessed through PubMed, Scopus, Science Direct, and Google Scholar using the following terms: Depression, pregnancy, 25-hydroxyvitamin D (25OH VD), vitamin D deficiency (VDD) and postpartum (PP). Articles were selected manually and with careful tracking to avoid duplication. Articles that investigated any association between VD levels during pregnancy and PPD in the time frame were included in the study, while articles investigating VD levels of PP without depression were excluded.

Results:

In this narrative review, five out of seven studies showed an association between PPD and VDD during pregnancy. Danish National Birth Cohort (DNBC), Edinburgh Postnatal Depression Scale (EPDS) and Center for Epidemiologic Studies Depression Scale (CES-D) enrolled among different studies from 3 days to 1 year PP to assess PPD.

Conclusions:

Pregnant women with VDD are significantly associated with PPD. Longitudinal follow-up studies are needed to evaluate the association between VDD with PPD. Screening VD levels among pre-postnatal mothers may be essential for awareness programs that can be implemented to promote remission of postnatal depression.
Artificial Intelligence Applications in Neonatal Critical Care: A Scoping Review
Authors: Sakore Surekha Satish , Devi Seeta , Mahapure Prachi , Kamble Meghana , Jadhav Prachi
Published: July 2024

Background:

The development of artificial intelligence (AI) approaches impacted drug discovery, medical imaging, customized diagnostics, and therapeutics. Medicine will be transformed by AI. One such area of medicine where AI is significantly improving care is neonatology.

Objective:

The objective of this scoping review is to explore the applications of AI in neonatal critical care and its outcome.

Methods:

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a scoping review was conducted utilizing the Web of Science, MEDLINE (PubMed), and Scopus databases. The search was limited to full-text publications on AI applications in neonatal critical care that were published between January 1, 2019, and December 31, 2023. Articles specifically addressing the application of AI in neonatal care have been considered within the scope of this review. At least three reviewers had independently executed the screening, data abstraction, and exploration.

Results:

Database searches yielded 631 articles, of which 11 met the inclusion criteria. The research encompassed extensive AI applications in neonatal critical care, employed for prognosis, diagnosis, and therapy strategizing. Artificial neural networks, machine learning, deep learning, and shallow hybrid neural networks were the commonly utilized AI techniques (neonatal critical care). These methods were applied to screen for inborn metabolic abnormalities, predict various outcomes, including death and sepsis, identify diseases such as sepsis, and assess neurodevelopmental outcomes in preterm newborns, helping plan several medical treatments. The included research demonstrated encouraging outcomes when using AI in neonatal critical care.

Conclusions:

AI-driven electronic arrangements upgrade neonatal basic care by improving risk forecast, promising critical commitments to future health care. Be that as it may, careful appraisal, evidence-based considers, and determination of safety, ethics, and information straightforwardness issues are essential before implementation. Acceptance by administrative bodies and the therapeutic community pivots on tending to these concerns.
Highly Elevated Alpha-fetoprotein Concentration in a Premature Infant
Authors: Berej Martyna E. , Kośka Joanna J. , Orzeł Maria Marta , Borek-Dzięcioł Beata
Published: July 2024

Alpha-1-fetoprotein (AFP) is a protein produced by the liver. Although its biological function is not fully understood, it is often used as a marker for cancer. High levels of AFP are also observed in premature infants. Reference ranges for AFP levels in premature infants are not specified. The authors present a case of a male newborn born at 25+5/7 weeks of gestational age. The boy underwent oncological diagnostics due to the detection, on the 24th day of life, of a liver lesion in an abdominal ultrasound examination, as well as significantly elevated AFP levels (>430,000 ng/mL). With each passing day, the AFP level gradually decreased, and the suspicious lesion was not visualized on abdominal ultrasound or magnetic resonance imaging on the 59th day of life. Based on the conducted examinations, prematurity and its treatment were considered the cause of high AFP levels. The aim of the study was to present the diagnostic difficulties associated with the lack of AFP norms for premature infants.
Neonatal Enteroviral Meningoencephalitis: Clinical and Paraclinical Characteristics of a Nosocomial Outbreak in Colombia
Authors: Martín Delia Edith Theurel , Socarras Jorge Luis Alvarado
Published: July 2024

Enteroviruses (EVs) are a common cause of infection in neonates, they spread from person to person by a variety of routes and can cause severe symptoms and complications, including meningoencephalitis, myocarditis, and hepatic failure. We report the clinical and paraclinical characteristics of six patients diagnosed in a hospital cluster with late-onset sepsis, mostly preterm newborns. The most common symptoms were the same as a sepsis-like syndrome, the predominant sign of presentation was fever. The most frequent laboratory finding was elevated C-reactive protein, and later positive cerebrospinal fluid multiplex for EVs. Support treatment was given. A benign course was observed. Seizures were the only complication, with a normal electroencephalography at 6-month follow-up. In-hospital cases would benefit from a high clinician suspicion and early detection for achieving immediate isolation and containment measures to limit the spread to sick and vulnerable newborns, avoiding clusters.
The Effect of Plastic Wrap Use to Prevent Hypothermia on Neonatal Mortality and Morbidity in Extreme Preterm Infants
Authors: Alsafadi Tariq , Albaloushi Mohammad Hakim , Alsafadi Faris Tariq , Jarrada Shadi , Alshoibi Jamal
Published: July 2024

Background:

Hypothermia immediately afterbirth is common, especially in preterm (PT) infants because of their skin immaturity. If it is prolonged, it can lead to mortality and morbidity. Although plastic wrap (PW) can improve neonatal hypothermia by decreasing evaporative heat loss, its effect on mortality and morbidity is uncertain.

Aim:

The aim of the study was to detect if PW can decrease mortality and morbidity in PT infants from 240to 296weeks’ gestation.

Design:

The study design was a retrospective study.

Setting:

The study was conducted at two neonatal intensive care units (NICUs).

Materials and Methods:

NICUs medical records from 2021 to 2023.

Statistical Analysis:

The data were analyzed using logistic regression analysis.

Results:

A total of 187 PT infants from 240to 296-week gestation were admitted to both NICUs during that period, 148 PT infants were included in the study. Mean gestational age (GA) was 27.2 ± 2.7 weeks and mean birth weight was 865 ± 375 g; 75 PT infants (51%) were male, and 30 PT infants (20.2%) were hypothermic on admission. After adjusting for risk factors that potentially increased the mortality, admission temperature did not affect the mortality significantly (odds ratio [OR]: 0.8, confidence interval [CI]: 0.6–1.1). The only factor that increased the mortality significantly was GA (OR: 1.1, CI: 1.05–1.4). The other model that tested the effect of admission temperature on the morbidity showed that none of the morbidities were significantly decreased after adjusting for risk factors, necrotizing enterocolitis (OR: 1.05, CI: 0.8–1.3), intraventricular hemorrhage (OR: 0.8, CI: 0.6–1.09), bronchopulmonary dysplasia (OR: 1.1, CI: 0.8–1.3), retinopathy of prematurity (OR: 1.2, CI: 0.9–1.4), and late-onset sepsis (OR: 1.1, CI: 0.9–1.4).

Conclusion:

PW applied immediately after birth seemed to improve admission temperature in PT infants from 240to 296-week gestation, but it did not improve neonatal mortality or morbidity.
Intergrowth 21 Versus Fenton 2013 Growth Charts: Congruence in Assessing the Birth Size and the Proportion of Extra-uterine Growth Restriction in Preterm Babies
Authors: Jose Georgeena Elsa , Khamkar Anilkumar M. , Pote P. D.
Published: July 2024

Background:

Intergrowth-21st and Fenton 2013 growth charts are used for postnatal growth monitoring in preterms. There is no international consensus on which graph to refer to and why. This study is a local validation, of which graph would be plausible for the Indian population to detect small-for-gestational-age (SGA) and extra-uterine growth restriction (EUGR) babies, abetting in the settlement of this ambiguity.

Objectives:

The primary objective was to compare the Intergrowth-21st with Fenton 2013 growth charts for birth size classification and to detect the proportion of EUGR in preterms. The secondary objective was to assess the proportion of comorbidities in SGA babies by both these graphs.

Methods:

The design of the study was a prospective comparative observational study. All preterm newborns (24–<37 weeks of gestation) admitted to the neonatal intensive care unit of Noble Hospital and Research Center, Maharashtra, were the participants. Weight, length, and head circumference were plotted on Intergrowth 21 and Fenton growth charts at birth and at 4 weeks of age or at 36 weeks of postmenstrual age whichever is later. Corresponding Z-scores and percentiles were calculated electronically from their respective online software.

Outcome:

the reliability of Intergrowth-21st when compared to Fenton 2013 growth charts in assessing the birth size was better, and detection of the proportion of EUGR in preterm babies was better with Fenton charts.

Results:

A total of 429 preterm babies with a mean gestational age of 33.3 ± 2.4 weeks were included in the study. Fenton (67.1%) overestimated the proportion of EUGR when compared to Intergrowth-21st (18.6%) which was statistically significant (P < 0.001). On the contrary, although the proportion of SGA babies detected was higher with Intergrowth-21st (29.8%) when compared to Fenton (19.6%), there was moderate-to-high statistically significant agreement observed between the two growth charts in detecting SGA babies (Kappa = 0.716, P < 0.001). The proportion of comorbidities did not vary significantly among the SGA babies between the growth charts (P > 0.05).

Conclusion:

Fenton overestimates EUGR when compared to Intergrowth-21st, whereas both the growth charts are equally good in identifying SGA babies with no differences in the comorbidities detected. Intergrowth-21st standards look more pertinent for growth monitoring in the current study setting for Indian preterm babies.
The Value of CEUS LI-RADS combined with AFP in early diagnosis of hepatocellular carcinoma in low- and high-risk patients
Authors: Wu Yafei , Chen Yuanyuan , Wei Lili , Ding Zhanling , Zhao Shengfa , Bao Shengxian , Tang Jiali , Li Hang , Liu Junjie , Zhu Shangyong
Published: July 2024

Background:

We found that the occurrence of hepatocellular carcinoma (HCC) has increased significantly in non-cirrhotic individuals, with HCC being frequently overlooked or misdiagnosed. Contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) is known to have a high diagnostic quality in high-risk HCC patients. Therefore, we aimed to compare the detection accuracy of CEUS LI-RADS for HCC between low- and high-risk individuals, to confirm its value in low-risk patients at increased risk of HCC, but not yet included in the high-risk groups of LI-RADS. In addition, since CEUS LR-4 and LR-M categories contain a relatively high proportion of HCC, and serum alpha-fetoprotein (AFP) is the most commonly used biomarker for HCC, and the clinically valid, we attempted to further improve the early diagnostic capability of CEUS LI-RADS for HCC in the low-risk and high-risk patients by combining CEUS LR-4 and LR-M categories with AFP.

Methods:

We defined high-risk groups (HR)-included in the high-risk patients of LI-RADS, low-risk groups (LR)-not included in the high-risk patients of LI-RADS and enrolled 189 HCC patients with LR and HR settings in a retrospective study. All lesions were confirmed histopathologically. The CEUS LI-RADS accuracy for detecting HCC in these two patients was compared. In addition, the diagnostic algorithm in our study was proposed (for CEUS LR-4 and LR-M patients with AFP>20 ng/ml). we analyzed the ability of CEUS LI-RADS as a valid method of establishing the early diagnosis of HCC in LR and HR patients by combining LR-4 and LR-M categories with AFP.

Results:

Through comparative analysis, the specificity of the CEUS LR-5 category for HCC in the HR group was 78.4%, whereas in the LR group, it was 94.2%. Meanwhile, the sensitivity (63.2% vs. 63.0%) and positive predictive value (PPV) (75.0% vs. 88.7%) did not differ between the LR and HR groups (P = 0.990, P = 0.299). It is noteworthy that there were the high proportion of HCC in CEUS LR-4 and LR-M categories in our cases and when we combined CEUS LR-4 and LR-M categories with AFP significantly improved the sensitivity by 21.0% (84.2%) in the LR group, and by 16.0% (79.0%) in the HR group, with statistically difference in sensitivity after combination in the HR group (P = 0.014).

Conclusions:

The CEUS LR-5 category has real meaningful utility in the diagnosis of HCC in both LR and HR patients. The early detection power of the CEUS LI-RADS category for HCC patients was further increased when the CEUS LR-4 and LR-M categories were combined with elevated AFP.
The Efficacy of the Combination of Microneedling with Jessner’s Plus 35% Trichloroacetic Acid Peel versus the Efficacy of the Combination of Microneedling with Platelet-rich Plasma Therapy for the Treatment of Atrophic Acne Scars: A Comparative Study
Authors: Deepika Meda , Chittla Sravan , Swetha Donakonda , Dheeraj Sathaiahgari , Sougandhika Bandaru
Published: July 2024

Background:

Acne is a common skin condition that is prevalent in 90% of the adolescent population. Inflammatory lesions of acne may lead to scarring. Various treatment modalities such as subcision, punch excision, chemical peels, microdermabrasion, and fractional lasers have been tried for acne scars but with unsatisfactory results.

Purpose:

The aim of the present study is to compare the efficacy of microneedling with Jessner’s plus 35% trichloroacetic acid (TCA) peel versus the efficacy of microneedling with platelet-rich plasma (PRP) therapy for the management of atrophic acne scars.

Methods:

Sixty patients having atrophic scars due to acne were segregated into two groups each containing 30 patients. On Group A, patients microneedling was performed at weeks 0, 6, and 12 and Jessner’s plus 35% TCA peel was performed at weeks 3, 9, and 15. On Group B, patients microneedling and intradermal PRP were performed sequentially at weeks 0, 3, and 6. Patients were followed at the outset of the procedure and 24 weeks after the procedure using the Echelle d’Evaluation Clinique des Cicatrices d’acne (ECCA) score.

Results:

The difference in the mean ECCA score at the outset of the procedure and 24 weeks after the procedure was more in Group B as compared to Group A (47.8 ± 13.6 vs. 39.1 ± 11.4).

Conclusion:

The efficacy of the combination of microneedling with PRP was higher than the combination of microneedling with Jessner’s plus 35%TCA peel for the treatment of atrophic acne scars.
Utility of Hyaluronidase in Combination with Triamcinolone Acetonide and 5-Fluorouracil in Treatment of Hypertrophic Scars and Keloids: A Comparative Study
Authors: Bhangdiya Divya , Dhurat Rachita , Sharma Richa , Shah Bhavika , Shinde Geeta
Published: July 2024

Background:

Keloids and hypertrophic scars are a commonly encountered problem in dermatology. There are many treatment modalities available with variable efficacy and recurrences. This study highlights the use of hyaluronidase with triamcinolone acetonide (TAC) and 5-fluorouracil (5-FU).

Purpose:

To assess the utility of hyaluronidase in combination with TAC and 5-FU in treatment of hypertrophic scars and keloids.

Methods:

In this study a combination of hyaluronidase along with TAC and 5-FU was given in one part and a combination of TAC and 5-FU was given in another half of same hypertrophic scar/keloid keeping 1cm gap in between the two untreated at 4 weekly interval for 24 weeks. Results were assessed by measuring height, volume of lesion and their percentage decrease. Also, pliability, vascularity, pigmentation of lesion and Vancouver scar assessment scale score were assessed. Side effects like ulceration, surrounding skin atrophy and telangiectasias were noted.

Results:

There was a reduction in all the parameters in both the treatment segments. Faster improvement in height, volume, pliability, vascularity, pigmentation, and Vancouver scar assessment scale score was noted with combination of hyaluronidase, TAC, and 5-FU compared to TAC and 5-FU alone. Side effect profile of ulceration, surrounding skin atrophy and telangiectasias was comparable in both the segments.

Conclusion:

Combination of hyaluronidase along with TAC and 5-FU offered a better outcome and faster response when compared to combination of TAC and 5-FU.