bluuebunny/crossref_metadata_2025_split huggingface dataset:
Compétence pour ordonner la mainlevée d'une saisie conservatoire transfrontière
Authors: Cuniberti Gilles 
Published: April 2021

1) L'article 1 er , paragraphe 1, du règlement (UE) n° 1215/2012 du Parlement européen et du Conseil, du 12 décembre 2012, concernant la compétence judiciaire, la reconnaissance et l'exécution des décisions en matière civile et commerciale, doit être interprété en ce sens qu'une action en référé, introduite devant une juridiction d'un État membre, dans le cadre de laquelle une organisation internationale invoque son immunité d'exécution afin d'obtenir tant la mainlevée d'une saisie-arrêt conservatoire, exécutée dans un État membre autre que celui du for, que l'interdiction de pratiquer de nouveau une telle saisie sur le fondement de mêmes faits, et engagée parallèlement à une procédure au fond portant sur une créance résultant du non-paiement allégué de carburants fournis pour les besoins d'une opération de maintien de la paix assurée par cette organisation, relève de la notion de « matière civile ou commerciale », pour autant que cette action n'est pas exercée en vertu de prérogatives de puissance publique, au sens du droit de l'Union, ce qu'il appartient à la juridiction de renvoi d'apprécier. 2) L'article 24, point 5, du règlement n° 1215/2012 doit être interprété en ce sens qu'une action en référé, introduite devant une juridiction d'un État membre, dans le cadre de laquelle une organisation internationale invoque son immunité d'exécution afin d'obtenir tant la mainlevée d'une saisie-arrêt conservatoire, exécutée dans un État membre autre que celui du for, que l'interdiction de pratiquer de nouveau une telle saisie sur le fondement de mêmes faits ne relève pas de la compétence exclusive des juridictions de l'État membre dans lequel la saisie-arrêt conservatoire a été exécutée.
L'interdit de l'analogie en droit pénal de l'Union : entre principe de sauvegarde et exigences d'effectivité
Authors: Manzoni Giovanni 
Published: April 2021

Résumé Le présent article analyse le statut et les implications de l'interdit de l'analogie en matière pénale au sein du droit de l'Union. Le but de la recherche est de vérifier dans quelle mesure le principe est reconnu en tant que corollaire de la légalité pénale européenne. En particulier, la réflexion se penche sur les tensions potentielles avec des principes majeurs de l'ordre juridique de l'Union, tels que la primauté et l'effet utile. Abstract Le présent article analyse le statut et les implications de l'interdit de l'analogie en matière pénale au sein du droit de l'Union. Le but de la recherche est de vérifier dans quelle mesure le principe est reconnu en tant que corollaire de la légalité pénale européenne. En particulier, la réflexion se penche sur les tensions potentielles avec des principes majeurs de l'ordre juridique de l'Union, tels que la primauté et l'effet utile. La Cour de justice a reconnu le principe lex stricta comme faisant partie du principe de légalité inscrit à l'article 49 de la Charte, dans une série d'arrêts rendus à propos de directives. Les différentes conceptions de la légalité qui émergent de la culture juridique européenne, tout comme la nature éminemment téléologique du droit de l'Union, se reflètent dans les incertitudes de la jurisprudence de la Cour de justice. L'article s'emploie à approfondir l'analyse de cette jurisprudence au regard de concepts clés : l'obligation d'interprétation conforme par les juges nationaux, les obligations d'effectivité et d'équivalence qui découlent du droit primaire et les limites du pouvoir d'interprétation de la Cour de justice s'agissant des normes européennes appelées à intégrer une disposition d'incrimination nationale. Il est argué que le principe fait partie de la légalité pénale européenne qui reconnaît le rôle primordial et, en principe, exclusif joué par le législateur. Toutefois, en cas de conflit avec d'autres obligations découlant du droit primaire, la portée de la légalité est réduite à un seuil minimal. Ce seuil correspond à celui de la prévisibilité raisonnable élaboré par la Cour de Strasbourg et n'empêche pas une transgression significative de l'interdiction de l'analogie. Des conclusions similaires s'imposent par rapport au respect du principe lex stricta par la Cour elle-même s'agissant de l'exégèse du droit de l'Union.
Impact of Die Attach Sample Preparation on Its Measured Mechanical Properties for MEMS Sensor Applications
Authors: Misrak Abel , Chauhan Tushar , Bhandari Rabin , Chowdhury A S M Raufur , Lakshminarayana Akshay , Mirza Fahad , Bazehhour B. Gholami , Vujosevic Milena , Agonafer Dereje 
Published: April 2021

Abstract
Computational modeling is often leveraged to design and optimize electronic packages for both performance and reliability purposes. One of the factors that affect the accuracy of computational models is the accuracy of the material properties. Microelectromechanical system sensors, in particular, are usually extremely sensitive to slightest material property changes in the package. Therefore, even small measurement variations in material characterization due to different sample preparation methods or different testing techniques can impact accuracy of computational models that are leveraged for designing or analyzing sensor performance. The challenge in material characterization is even greater for materials that require curing. Die attach polymers, for example, have strict curing profile requirements that are used during the manufacturing process. Such curing conditions are usually hard to duplicate in laboratories, and the samples used for material characterization may not necessarily be representative of the actual component in the final product. In this study, the effect of parameters such as temperature curing profile, application of pressure during curing, and sample preparation technique on temperature-dependent thermomechanical properties of two types of die attach elastomers is investigated. The mechanical properties, including the elastic modulus (E), coefficient of thermal expansion, and glass transition temperature of the die attach material, are measured using a suite of techniques such as dynamic mechanical analysis and thermomechanical analysis. The analysis is performed for a wide temperature range corresponding to typical sensor applications. It is shown that sample preparation and characterization techniques have a considerable impact on the measurements, which results in different MEMS sensor performance predictions through computational modeling.
Effect of Menopause on Arterial Stiffness and Central Hemodynamics
Authors: Solanki Jayesh Dalpatbhai , Bhatt Devanshi Nishantbhai , Patel Ravi Kanubhai , Mehta Hemant B. , Shah Chinmay J. 
Published: April 2021

Background:
Menopause, a cardiovascular risk in mid-life women, is studied in terms of blood pressure mostly. Arterial stiffness (AS) and central hemodynamics (CH) are direct surrogates measured by pulse wave analysis (PWA) with no study from our region.

Objective:
We studied AS, CH in relation to menopause using PWA.

Materials and Methods:
A cross-sectional study was performed in 134 middle-aged females divided into groups with or without menopause. Oscillometric PWA done by Mobil-o-Graph (IEM, Germany) gave – AS like augmentation pressure, augmentation index at heart rate (HR) 75, aortic pulse wave velocity (aPWV), and total AS pulse pressure amplification; CH like aortic blood pressure, cardiac output and related parameters, peripheral resistance, stroke work, prevalent brachial/central hypertension, and raised central pulse pressure. They were further compared between groups, in relation to body mass index (BMI) and by multiple regressions with P < 0.05 as statistical significance.

Results:
Postmenopausal women were significantly elder, physically inactive with comparable BMI and showed higher AS (only aPWV was significantly different) and CH. BMI was unrelated to AS or CH in postmenopausal group. Age (except for aPWV), BMI, and HR (except for AIx@75) were insignificant predictors, while systolic blood pressure (SBP) in premenopausal and diastolic blood pressure (DBP) in postmenopausal group was major AS predictors. Age, HR, and BMI were insignificant predictors, while SBP more than DBP was significant predictors of CH.

Conclusions:
In obese, predominantly sedentary midlife Gujarati women, menopause negatively affects AS and hemodynamics, central more than peripheral. Menopause accelerates cardiovascular aging, independent of BMI, and age that calls for further studies.
Perceived Stress and Its Determinants among Postmenopausal Women in Urban Puducherry
Authors: Sarveswaran Gokul , Jayaseelan Venkatachalam , Krishnamoorthy Yuvaraj , Sakthivel Manikandanesan , Arivarasan Yashodha , Vijayakumar Karthiga , Marimuthu Yamini 
Published: April 2021

Background:
Menopause characterized by a gradual decline in ovarian hormones takes its toll on the women both physically and mentally. These health problems can negatively impact the mental status. Hence, the current study was done to determine the level of stress and its associated factors among postmenopausal women in urban Puducherry, India.

Materials and Methods:
A facility-based cross-sectional study was done among 219 postmenopausal women attending the outpatient department in urban primary health center during May 2017–June 2017. Information regarding sociodemographic profile was collected using pretested semi-structured questionnaire and Cohen's Perceived Stress Scale was used to assess the stress level. We calculated adjusted prevalence ratios (aPRs) to identify the determinants of stress.

Results:
Among 219 participants, 46.6% were in the age group of 60–74 years; 32.9% had primary to secondary level of education; 56.2% were unemployed; 42.5% belonged to lower socioeconomic class; and 32.9% had both diabetes mellitus and hypertension. The prevalence of stress among the postmenopausal women was 26.0% (95% confidence interval: 20.7–32.2). Postmenopausal woman with higher education (aPR – 2.18), belonging to nuclear family (aPR – 1.93), lesser parity (aPR – 1.18), and current alcohol/tobacco users (aPR-2.32) were found to have a significant association with stress among the study participants.

Conclusion:
The current study showed that more than one-fourth of the postmenopausal women had high to very high level of stress. Education, religion, parity, and substance abuse were the significant determinants of stress. However, further longitudinal research needs to be done to determine whether the factors informed in the current study are truly associated with stress and develop interventions accordingly.
A Mini-Review of Office Hysteroscopic Techniques for Endometrial Tissue Sampling in Postmenopausal Bleeding
Authors: Haimovich Sergio , Tanvir Tanvir 
Published: April 2021

Postmenopausal bleeding (PMB) is a common cause for a gynecological visit. Endometrial cancer risk varies from 3% to 25% in women with PMB. There is a significant concern of malignancy of the endometrium and the endocervical canal by a physician in postmenopausal women, and hence, most prefer operating room hysteroscopies with dilation and curettage (D & C) compared to in-office procedures. With increased availablility of miniaturized instruments such as mini- resectoscope and tissue removal systems, there is high likelihood of blind D & C being replaced by hysteroscopic- guided targetted biopsy or visual D & C. The cost-effectiveness of office hysteroscopy is also well demonstrated. In December 2020, an electronic search was performed of PubMed, MEDLINE, and Cochrane Library to look for articles on office hysteroscopic biopsy techniques in postmenopausal women from 2010 to 2020. Relevant studies were included where various office hysteroscopic techniques are used for endometrial sampling in PMB. Studies with 5 Fr scissors, biopsy forceps, crocodile forceps, cup forceps, bipolar electrode, in-office tissue removal system (morcellator), flexible hysteroscope, and mini-resectoscope were included. Standard reference was used as an adequate endometrial sample for histology. The objective of this review is to explore the current evidence on different office hysteroscopic techniques available for endometrial tissue sampling in PMB.

Research Question:
What are the different available in - office hysteroscopy techniques for obtaining endometrial biopsy?

Clinical Importance:
Understanding the adequacy of an endometrial tissue sample obtained by different in - office hysteroscopy techniques and their accuracy by histology.
Mifepristone in Fibroids
Authors: Shaikh Neelofar , Mehra Reeti , Goel Poonam , Kaur Ravinder 
Published: April 2021

Background:
Leiomyomas are the most prevalent benign tumors of the uterus and are seen more with increasing age. 50 mg biweekly dose was compared with 25 mg daily dose in terms of efficacy and safety in symptomatic women as the biweekly dose maybe an economically better alternative. Two different dosages of mifepristone for medical management of fibroids were compared in terms of efficacy and safety in symptomatic women.

Materials and Methods:
Ninety-two women were recruited who fulfilled the criteria after informed consent and were randomized in two groups. Sample size was calculated on the basis of earlier literature, for response in terms of reduction in fibroid volume, assuming 1% level of significance and 95 % power of study, the optimum sample size came out to be minimum 27 in each group. Assuming loss to follow up of few patients, we took 45 patients in group 1 and 47 patients in group 2. Group 1 was given mifepristone in a dose of 25 mg once a day and Group 2 was given mifepristone 50 mg biweekly for 3 months. Fibroid volume, uterine volume, endometrial thickness, pictorial blood loss assessment chart score, hemoglobin levels, and liver transaminases were recorded at the beginning and at the end of treatment. Side effects were noted at the end of the treatment.

Results:
Both the dosages lead to improvement in symptoms of the patients. Mifepristone significantly reduced fibroid volume in both the groups, but the difference between the groups was not significant (P = 0.99). Mifepristone treatment significantly reduced bleeding and increased hemoglobin levels in both the groups. The side effects were mild and tolerable.

Conclusion:
Mifepristone in both dosages is highly efficacious in causing amenorrhea, improving anemia, and enhancing the quality of life, and hence 50 mg biweekly dosage shows potential for being cost efficient.
Trends in dental-related visits to a tertiary hospital emergency department in Saudi Arabia
Authors: Alammar Raghad A. , Alsulaiman Nada A. , Alabdullatif Moath A. , Alwhaibi Abdullah M. , Alkadi Lubna T. 
Published: April 2021

Introduction:
Emergency medicine department visits for odontalgia, related to traumatic and non traumatic dental events has seen a shift towards increase in cases. Emergency departments provide palliative care especially for the non traumatic dental injuries Aims: To explore the trends of emergency department (ED) visits for dental-related conditions in Saudi Arabia. The study also aimed to analyze visit management patterns, including procedures, prescriptions, and recall visits.

Materials and Methods:
A cross-sectional retrospective observational study was done using simple random sampling on dental emergency visit data to the ED at hospitals under renowned university of health sciences in Riyadh and Al-Ahsa between January 2016 and May 2019.

Results and Discussion:
A total of 5050 charts were included. An increase in dental emergency visits was observed between 2016 and 2017. Pulpal and periapical lesions were the most frequently diagnosed conditions every year (53.83% of all dental-related ED visits), and traumatic injuries were the least frequently (6.37%) diagnosed condition.

Conclusion:
Dental-related visits to EDs in Saudi Arabia increased remarkably from 2016 to 2019. Pulpal and periapical conditions were the most frequent cause of dental-related ED visits. To ensure better use of ED time and resources, it is imperative to raise public awareness of what types of urgent dental conditions require an ED visit, as well as to increase the number of public health unit dental clinics and their ease of access.
A narrative review of Diabetes mellitus
Authors: AL-Haddad Alaa , Hassona Yazan , Silawi Alia , Al Kayed Awni 
Published: April 2021

Introduction:
Diabetes mellitus (DM) is a common metabolic disorder and a leading cause of mortality and morbidity worldwide. Dentists are increasingly encountered with patients affected by this chronic condition.

Aim:
To a review on updates in DM, dental management and emergencies.

Methods:
Database search was carried out in PubMed and Google scholar limited to articles of English language from 1998 to 2021 and pertaining to the keywords diabetes, orofacial manifestations, dental management diabetic emergency. A narrative review of this search is presented in this article.

Results and Discussion:
This article gives a concise update on DM and discuss the management of diabetic patients in a dental setting.

Conclusion:
Discussion of the possible orofacial manifestations of DM and management of diabetic emergencies is emphasized for efficicient dental practice.
Evaluation of practices of self-medication among undergraduate dental students in Riyadh
Authors: Muhammad Umbreen Noor 
Published: April 2021

Introduction:
Self-medication (SM) and purchase of over-the-counter medication have been in practice in medical fields. Dental students have the knowledge of pharmacological drugs and they have a higher chance than the population to indulge in SM.

Aim:
The aim of the study was to evaluate the practice, awareness, and attitude of undergraduate dental students toward SM and its relation with gender and to assess whether this practice differs among students of different years of study.

Methods:
A cross-sectional survey was conducted using simple random sampling among undergraduate dental students in a private dental college in Riyadh. A self-designed online questionnaire was used to collect data, which was validated and used for the research

Results and Discussion:
A total of 465 students (31% males and 69% females) responded to the survey. 60% of the students agreed to practice SM and it was significantly (P < 0.05) higher in females than males. With each successive year of study, there was significant decrease (P < 0.05) in the practice of SM and significant increase (P = 0.000) in the level of awareness toward SM. Body aches (57%) and mouth ulcers (35%) were the most common indications to practice SM regarding general and oral health, respectively. Most commonly used medicines were analgesics. Previous experience to treat the same illness was the most common reason for practicing SM, and the primary source of medicine was the medicine present at home.

Conclusion:
More than half of the respondents practiced SM for minor illnesses, and it was higher among females and students of preparatory years. There was less awareness among dental students relating to survey items such as importance of completing the course of medicine and adverse drug reactions. This study highlights the need to develop awareness and interventions to assess this health problem among dental undergraduates.
Comparing the Effects of Design Thinking and A3 Problem-Solving on Resident Attitudes Toward Systems Change
Authors: Buckley Ryan , Spadaro Anthony , Rosin Roy , Shea Judy A. , Myers Jennifer S. 
Published: April 2021

ABSTRACT

Background
Quality improvement (QI) is a required component of graduate medical education. Many medical educators struggle to foster an improvement mindset within residents.

Objective
We conducted a mixed-methods study to compare a Design Thinking (DT) approach to QI education with a Lean, A3 problem-solving approach. We hypothesized that a DT approach would better promote a mentality of continuous improvement, measured by residents' resistance to change.

Methods
Thirty-eight postgraduate year 2 internal medicine residents were divided into 4 cohorts during the 2017–2018 academic year. One cohort participated in an experimental QI curriculum utilizing DT while 3 control cohorts participated in the existing curriculum based on Lean principles. Participants voluntarily completed a quantitative Resistance to Change (RTC) scale pre- and post-curriculum. To inform our understanding of these results, we also conducted semistructured interviews for qualitative thematic analysis.

Results
The effect size on the overall RTC score (response rate 92%) was trivial in both groups. Three major themes emerged from the qualitative data: factors influencing the QI learning experience, factors influencing creativity, and general attitudes toward QI. Each contained several subthemes with minimal qualitative differences between groups.

Conclusions
This study found similar results in terms of their effect on attitudes toward systems change, ability to promote creative change agency, and educational experience. Despite positive educational experiences, many residents still did not view systems-based problem-solving as part of their professional identity.
Effect of Teaching Sessions Implementation on Performance of Internship Nursing Students Regarding IntraOsseous Access
Authors: Mahmoud Sarah F. , Maarouf Dina M. 
Published: April 2021

Context: Intraosseous (IO) access is an emergency vascular access for providing venous administration of drugs and fluids in emergencies. Nurses are responsible for preparing and administering fluids and medications through IO access so that nurses should be aware of IO indications, contraindications, complications, and also practicing Intraosseous (IO) access insertion.
Aim: The current study was conducted to assess the effect of teaching sessions implementation on the performance of internship nursing students regarding intraosseous access.
Methods: A quasi-experimental (pre/post-test) design was unitized to conduct this study. The study recruited a convenient sample of fifty (50) internship nursing students. The Critical care lab at Faculty of Nursing Ain Shams University was used to conduct the teaching sessions. The study used two tools to achieve the aim of this study; Intraosseous Access Self-Administered Questionnaire and Internship Nurses' Practice Observational Checklist regarding intraosseous access.
Results: After teaching session implementation regarding intraosseous access, there were statistically significant improvements in the level of performance of internship nursing students at P >0.05.
Conclusion: Teaching session implementation had a statistically significant positive effect on internship nursing students' performance regarding intraosseous access. Repetitive training regarding IO access is recommended to be integrated as a part of the nursing faculty's clinical skills to ensure the highest standard of care in emergencies and to maximize skill retention.