bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anaesthesia in PROstate Biopsy Pain Obstruction Study: A Study Protocol for a Multicentre Randomised Controlled Study Evaluating the Efficacy of Perineal Nerve Block in Controlling Pain in Patients Undergoing Transperineal Prostate Biopsy
Authors: He Bi-Ming , Li Rong-Bing , Wang Hai-Feng 
Published: October 2021

Introduction: Transperineal prostate biopsy is as effective as the transrectal biopsy in detecting prostate cancer and has a lower risk of infection. However, concerning the procedural pain of the transperineal route, a higher level of anaesthesia is needed, which prevents this approach from being widely used. Although several methods of local anaesthesia to relieve pain during transperineal biopsy have been described, few well-designed trials have been conducted to assess the efficacy of local anaesthesia.Methods: This is a prospective, multicentre, randomised controlled study in men suspected of having prostate cancer and planning to undergo transperineal prostate biopsy. The aim of this trial is to determine whether the perineal nerve block and periprostatic block relieve pain to different extents in men undergoing transperineal biopsy. The main inclusion criteria are men aged between 18 and 80 years old, a prostate-specific antigen (PSA) level of 4–20 ng/ml, or/and suspicious rectal examination findings. A sample size of 190 participants, accounting for a 10% loss, is required. All participants will be randomly allocated at a ratio of 1:1 to the perineal nerve block (n = 95) and periprostatic block groups (n = 95). The primary outcome will be the level of the worst pain experienced during the transperineal prostate biopsy procedure, which will be measured by a numerical rating scale (NRS). The key secondary outcomes will include the pain severity score at 1, 6, and 24 h after prostate biopsy.Results: The primary outcome is the level of the worst pain experienced during the prostate biopsy procedure. The main secondary outcomes are as follows: (1) Post-biopsy pain severity score at 1, 6, and 24 h after the prostate biopsy; (2) Changes in blood pressure, heart rate and breathing rate during the biopsy procedure; (3) External manifestations of pain during biopsy; (4) Anaesthesia satisfaction; (5) The detection rate for clinically significant prostate cancer and any prostate cancer.Conclusion: Anaesthesia in PROstate biopsy Pain Obstruction Study (APROPOS) is randomised controlled trial aiming to determine the efficacy of the perineal nerve block in controlling pain in patients undergoing prostate biopsy via the transperineal approach.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT04501055.
Robot-Assisted Middle Ear Endoscopic Surgery: Preliminary Results on 37 Patients
Authors: Veleur Marine , Lahlou Ghizlene , Torres Renato , Daoudi Hannah , Mosnier Isabelle , Ferrary Evelyne , Sterkers Olivier , Nguyen Yann 
Published: October 2021

Background: Endoscopy during middle ear surgery is advantageous for better exploration of middle ear structures. However, using an endoscope has some weaknesses as surgical gestures are performed with one hand. This may trouble surgeons accustomed to using two-handed surgery, and may affect accuracy. A robot-based holder may combine the benefits from endoscopic exposure with a two-handed technique. The purpose of this study was to assess the safety and value of an endoscope held by a teleoperated system.Patients and Methods: A case series of 37 consecutive patients operated using endoscopic exposure with robot-based assistance was analyzed retrospectively. The RobOtol® system (Collin, France) was teleoperated as an endoscope holder in combination with a microscope. The following data were collected: patient characteristics, etiology, procedure type, complications, mean air and bone conduction thresholds, and speech performance at 3 months postoperatively. Patients had type I (myringoplasty), II (partial ossiculoplasty), and III (total ossiculoplasty) tympanoplasties in 15, 14, and 4 cases, respectively. Three patients had partial petrosectomies for cholesteatomas extending to the petrous apex. Finally, one case underwent resection of a tympanic paraganglioma. Ambulatory procedures were performed in 25 of the 37 patients (68%).Results: Complete healing with no perforation of the tympanic membrane was noted postoperatively in all patients. No complications relating to robotic manipulation occurred during surgery or postoperatively. The mean air conduction gain was 3.8 ± 12.6 dB for type I (n = 15), 7.9 ± 11.4 dB for type II (n = 14), and −0.9 ± 10.8 for type III tympanoplasties (n = 4), and the postoperative air-bone conduction gap was 13.8 ± 13.3 dB for type I, 19.7 ± 11.7 dB for type II and 31.6 ± 13.0 dB for type III tympanoplasty. They was no relapse of cholesteatoma or paraganglioma during the short follow-up period (&lt;1 year).Conclusion: This study indicates that robot-assisted endoscopy is a safe and trustworthy tool for several categories of middle ear procedures. It combines the benefits of endoscopic exposure with a two-handed technique in middle ear surgery. It can be used as a standalone tool for pathology limited to the middle ear cleft or in combination with a microscope in lesions extending to the mastoid or petrous apex.
Problem Based Learning in Basic Medical Science Training for 200 Level Physiotherapy Students: Students' Assessment in the First Year
Authors: Aiyegbusi A I , Olabiyi O O , O F I , Noronha C C , Okanlawon A O 
Published: October 2021

Background: Problem Based leammg (PBL) is increasingly becoming popular worldwide. The Department ofAnatomy at the College of Medicine University of Lagos recently introduced the problem based learning approach as the style of teaching physiotherapy students in their basic medical science year.
Objective: This survey investigated the students' view of the programme, its impact on their learning as well as constraining factors.
Methods: A questionnaire-based survey was conducted at the end of the basic science academic year. The sample was the whole of a group of physiotherapy student that went through the PBL programme of the Department for one year. Results were collated and data processed using computer Microsoft excel in windows office 2003 software.
Results: Astatistically significantproportion ofthe group rated the programme favorably and indicated it was of benefit to their learning experience. Identified areas oftheir learning positively impacted on include; increase in amount of knowledge (81 %), better levels of interaction among colleagues (69%), improved literary research and problem solving skills (72%), higher level of confidence (81 %) and an increased eagerness for clinical school (95%).
Conclusion: Problem Based Learning programme can be beneficial to pioneer physiotherapy students in basic medical science year even when it is administered newly by a Department that is still developing in the programme.
Key Words: Problem Based Learning, Physiotherapy Students, Anatomy.
Kiai, Media Siber, Otoritas Keagamaan: Aktivisme Dakwah Virtual Kiai Azaim di Era Pandemi Covid 19
Authors: Fasadena Nova Saha 
Published: October 2021

Abstract: This study examines the preaching activities of Kiai on social media in the era of the Covid Pandemic 19. As is known, the presence of this pandemic has forced preachers from Islamic boarding schools to choose da'wah virtually. Kiai Ahmad Azaim, a caretaker of the Salafiyyah Islamic Boarding School Syafi'iyyah Ibrahimy Situbondo, East Java, is one of the Kiai who uses cyber media to carry out his preaching activities which were mostly carried out offline before the pandemic. This study argues that the virtual da'wah activism carried out by Kiai Azaim has implications for a shift in authority and at the same time the Kiai's popularity. Through the method of analyzing the assumptions of Kramer's religious authority, an interesting finding is obtained that in terms of opportunity, Kiai interprets cyber media as the right medium to reach wider congregations. In terms of strength, Kiai understands that the presence of cyber media will not affect the power of the pesantren media or traditional recitation. In terms of rights, Kiai considers that as long as the community continues to use them, their rights need to be fulfilled.
Praktik Poligami Masyarakat Kalisat Rembang Pasuruan Tinjauan dalam Perspektif Teori Behavior
Authors: Solikin Nur 
Published: October 2021

Abstract: This study examines the practice of polygamy in the Kalisat community from the point of view of behavior theory. The two main questions to be answered in this paper are about views the Kalisat community about polygamy and the process of polygamy in the perspective of behavior theory which places the actor's actions as being affected by the stimulus and then it becomes a new stimulus for the continuation of the practice of polygamy. Through behavior theory as a study tool, this study concludes that polygamy in the perception of the Kalisat community is no different from the view of the majority of jurists who say that polygamy is permissible on the condition that there is justice in it, regardless of what justice is demanded, whether in the material or immaterial fields. Another conclusion, the practice of polygamy carried out by the Kalisat community, on the one hand as acknowledged by one of the informants is a trait that has been passed down from generation to generation, on the other hand, it is also closely related to the community environment which has considered polygamy as a normal thing and therefore they Those who do not have polygamy are considered as "husbands who are afraid of their wives".
Vocabulary Learning Strategies: The Case of English for Business and Financial Reporting
Authors: Martins Hélder Fanha , Ferro Maria João 
Published: October 2021

Among the essential challenges faced by students in foreign language learning processes is vocabulary learning. Lexical competence has been acknowledged as critical to the use of language in which the students’ inadequate knowledge of the vocabulary causes problems in learning a second language. Therefore, learners require being educated with vocabulary in learning strategies when learning a second language. Contemporary research has not scrutinised to the fullest the categories of strategies of vocabulary learning used by learners who are majoring in Accounting. The main objective of this research was to understand how students use vocabulary learning strategies. For that, we adopted a qualitative approach, based on open-ended individual interviews with fifteen learners. The strategies that were concluded include the monolingual and bilingual dictionary use, usage of several media of English language, learning a word by specific texts, and application of new words in everyday conversation, interrelated to memory, strategies of metacognitive, and determination. These are common strategies and have keenly been used by students.
A novel biome concept and classification system based on bioclimate and vegetation – a Neotropical assay
Authors: Navarro Gonzalo , Molina José Antonio 
Published: October 2021

The knowledge of biomes as large-scale ecosystem units has benefited from advances in the ecological and evolutionary sciences. Despite this, a universal biome classification system that also allows a standardized nomenclature has not yet been achieved. We propose a comprehensive and hierarchical classification method and nomenclature to define biomes based on a set of bioclimatic variables and their corresponding vegetation structure and ecological functionality. This method uses three hierarchical biome levels: Zonal biome (Macrobiome), Biome and Regional biome. Biome nomenclature incorporates both bioclimatic and vegetation characterization (i.e. formation). Bioclimate characterization basically includes precipitation rate and thermicity. The description of plant formations encompasses vegetation structure, physiognomy and foliage phenology. Since the available systems tend to underestimate the complexity and diversity of tropical ecosystems, we have tested our approach in the biogeographical area of the Neotropics. Our proposal includes a bioclimatic characterization of the main 16 Neotropical plant formations identified. This method provides a framework that (1) enables biome distribution and changes to be projected from bioclimatic data; (2) allows all biomes to be named according to a globally standardized scheme; and (3) integrates various ecological biome approaches with the contributions of the European and North American vegetation classification systems.
Taxonomic reference: Jørgensen et al. (2014).
Dedication: This work is dedicated to the memory of and in homage to Prof. Dr. Salvador Rivas-Martínez.
La mère de toutes les réformes : la guerre du Golfe et la politique de défense française
Authors: Gautier Louis 
Published: October 2021

Après la construction de la dissuasion nucléaire par le général de Gaulle, un des fondamentaux de la V e République, la guerre du Golfe marque une mutation de la politique de défense de la France. Trente ans après, le cycle de réformes s’achève, obligeant à envisager une nouvelle phase pour le projet stratégique national.
Le financement des armées au sortir de la guerre du Golfe et de la guerre froide
Authors: Malizard Julien 
Published: October 2021

La fin de la guerre froide et la guerre du Golfe sont concomitantes. Les budgets consacrés à la défense ont alors entamé une décroissance surnommée « les dividendes de la paix ». Les conséquences pour la France ont été le non-respect des lois de programmation militaire, la baisse et le vieillissement des équipements.
L’ambassadeur de famille, diplomate et courtisan au service des Bourbons
Authors: Lemaigre-Gaffier Pauline 
Published: October 2021

Cette contribution étudie le statut d’étranger à la cour de France à travers l’analyse des prérogatives de l’ambassadeur de famille au xviiie siècle. Au titre de ses fonctions de représentant d’un autre souverain de la maison de Bourbon, l’ambassadeur d’Espagne en France pouvait prétendre à un rang qui le distinguait notamment des autres ambassadeurs en atténuant sa qualité d’étranger. En poste entre 1773 et 1787, le comte d’Aranda fit du respect de ces prérogatives dynastiques l’un des objectifs politiques de sa mission. Il s’employa aussi à prolonger son intégration cérémonielle à Versailles par son active participation à la vie mondaine parisienne. C’est ainsi qu’il entendait paradoxalement transcender son statut d’étranger, en s’intégrant le mieux possible à la société de cour française, pour incarner dignement la nation espagnole et en défendre les intérêts.
Robotic enucleation of oesophageal leiomyoma technique and surgical outcomes
Authors: Asaf Belal Bin , Bishnoi Sukhram , Puri Harsh Vardhan , Pulle Mohan Venkatesh , Cerfolio Robert James , Kumar Arvind 
Published: October 2021

Introduction:
Complete enucleation of oesophageal leiomyoma is the treatment of choice, traditionally performed by open surgery. Minimally invasive thoracoscopic approaches have been proposed as an alternative to thoracotomy. Robotic surgical systems with improved dexterity, tremor filtration and stereoscopic vision are advancement over conventional thoracoscopy and may make the preservation of mucosal integrity relatively easier. We present herein our technique of robotic-assisted thoracoscopic (RATS) enucleation of oesophageal leiomyoma along with surgical outcomes and intermediate follow-up of 11 cases.

Materials and Methods:
The present study retrospectively reviews patients undergoing robotic portal oesophageal leiomyomectomy from March 2012 to October 2019. The collected data were analysed for demographic details, clinical presentation, size, shape, tumour location, operating time, post-operative complications, length of hospital stay and recurrence on follow-up.

Results:
Twelve patients underwent robotic portal oesophageal leiomyomectomy with a clinical diagnosis of oesophageal leiomyoma. Of these, 11 patients were included in the study. The average operative time was 110 min, with a mean blood loss of 26 ml. There was no conversion in this series. At a median follow-up of 44 months (range 6–78 months), all patients were symptom-free with no recurrence or diverticula.

Conclusion:
Our series demonstrates the safety and feasibility of RATS oesophageal enucleation with good short and intermediate outcomes. In our opinion, the robotic system's technical advantages are particularly beneficial for oesophageal leiomyoma enucleation.
Age-specific serum anti-Mullerian hormone reference values for infertile Filipino women in a tertiary in vitro fertilization center in the Philippines
Authors: Novero. Virgilo M. , Yu Mary Liezl N. , Gamilde Arnel D. , Beramende Rowena B. , Sy Alvin Duke R. 
Published: October 2021

BACKGROUND:
Anti-Mullerian hormone (AMH) levels have been used as an invaluable tool in reproductive medicine for over a decade, especially in predicting ovarian reserve and follicular response during in vitro fertilization (IVF) cycles. Age-specific reference values of AMH levels have been derived from mostly Western and few Asian population groups but none from the Philippines. In this study, we attempted to determine the first age-specific AMH reference values from infertile Filipino women to be able to provide local infertility centers a guide in treating Filipinos and those with similar racial and lifestyle characteristics.

MATERIALS AND METHODS:
This was a retrospective cross-sectional study that was conducted at the Center for Advanced Reproductive Medicine and Infertility at St. Luke's Medical Center Global City. Age, serum AMH levels, body mass index (BMI), and cause of infertility of Filipino women who underwent IVF from August 2015 to March 2020 were taken. AMH was assayed using the automated Access AMH Immunoassay (Beckman Coulter).

RESULTS:
A total of 1463 women who underwent IVF and with valid AMH results were initially found but only 1233 were included in the study. Mean age was 36.67 + 4.35 years and mean BMI was 24.43 + 4.14 kg/m2. There was minimal effect of BMI on AMH levels and increasing age (R
2 = 0.0068), but there were significant differences of mean AMH levels among the general causes of infertility. The mean and median AMH values decreased with advancing age (R
2 = 0.1391) although the mean values were consistently higher than the median values. The mean level of the AMH was 2.32 ± 1.90 ng/mL with a 0.16 ng/ml (confidence interval: 0.14–0.19 ng/ml) level decrease per year of increase in age. By age category, the following were the derived AMH values (ng/ml) at the 25th to 75th percentiles: 25–29 = 1.52–4.92; 30–34 = 1.60–4.10; 35–39 = 0.95–3.13; 40–44 = 0.44–1.99; 45 = 0.47–1.08. The mean AMH in this study appears to be similar to several but lower than most other reported AMH nomograms from other population groups.

CONCLUSION:
The first age-specific AMH reference values for infertile Filipino women are presented and may serve as a useful diagnostic marker in local infertility centers, especially those treating Filipino patients or others with similar characteristics.
An evaluation of the awareness, perceptions, and practice of ultrasound and the use of telesonography among obstetrics and gynecologic sonologists in the Philippines during COVID-19 pandemic
Authors: Amosco Melissa D. , David-Bustamante Lara Marie G. , Ramos Maria Febi B. De , Cacas-David Ireene G. 
Published: October 2021

BACKGROUND:
Major changes in the practice of medicine have been adopted due to the COVID-19 pandemic and have not spared the practice of ultrasound among obstetrician–gynecologists, considered to have higher risk due to unique attributes of an ultrasound examination.

OBJECTIVES:
This study evaluated the awareness, attitudes, perceptions, and practices of the obstetric–gynecologic sonologists in the country during the pandemic, including the use of telesonography.

METHODOLOGY:Adescriptive, cross-sectional survey was conducted through a self-administered, structured questionnaire using an online survey software.

RESULTS:
There were 120 respondents with postresidency training in ultrasound (54.2%) or in maternal and fetal medicine (43.3%), practicing in different regions, and mostly with teaching affiliations (56.7%). Most are aware of the guidelines on the practice of ultrasound this pandemic and they perceived themselves to be especially vulnerable to the infection. They admitted having feelings of stress, sadness, and depression, and their concerns centered on being infected and potentially transmitting it to their family. These perceptions translated to specific practices that include use of level 3 personal protective equipment, patient screening, triaging, and use of physical barriers to minimize environmental and contamination. While most are consistent with guidelines, some practices are neither based on sound scientific evidence nor correctly adhered to, including noncompliance with appropriate ultrasound transducer cleaning and disinfection. Regarding telesonography, only half of the respondents had good knowledge, with most having informal sources of information on the technology. Although the respondents have a good attitude toward it, only a few (15.8%) admitted to using it, mainly to confer with an expert or colleague (38.3%), and for teaching purposes (11.7%).

CONCLUSIONS:
Obstetric–gynecologic sonologists in the Philippines are aware of the risks and have the same attitudes and perspective on COVID-19 infection as other health-care providers. Specific practices have been modified; however, the use of telesonography is not among the changes adopted.
Practice of minimally invasive gynecologic surgery in the Philippines during the COVID-19 Pandemic
Authors: Habana Maria Antonia E. , Aquino-Aquino Prudence V. , Aranzamendez Jennifer A. , Abat Marinella Agnes G. , Alensuela Anna Belen I. , Go-Du Jean S. , Fernandez Ma. Asuncion A. , Tan-Garcia Joan , Tanangonan Gladys G. , Trinidad Anne Marie C. , Sua-Lao Chiaoling 
Published: October 2021

OBJECTIVE:
This study aims to establish baseline information on the practice of minimally invasive gynecologic surgery (MIGS) among Filipino gynecologic endoscopists amid the COVID-19 pandemic.

MATERIALS AND METHODS:
An online survey was conducted among Fellows of the Philippine Society for Gynecologic Endoscopy (PSGE) practicing in private and government hospitals in the Philippines after informed consent. The survey had five subsections: (1) demographic data, (2) impact of COVID-19 pandemic on MIGS practice, (3) changes of practice during the COVID-19 pandemic, and (4) changes in the conduct of surgery and postoperative care.

RESULTS:Atotal of 119 out of 144 PSGE Fellows based in the Philippines participated in the survey, 83% were Fellows in both laparoscopy and hysteroscopy. The majority had more than 15 years of practice and were practicing in the National Capital Region. Surgeries were canceled initially but have since resumed. The majority were hysteroscopy cases, the most common being polypectomy. Majority of the respondents reduced their clinic hours and appointments. Most have used telemedicine for consultations. Use of face masks, face shields, and personal protective equipment (PPE) were the top precautions taken in the clinics. Screening and precautions per guidelines inside the operating room setting were observed. Modifications during surgery include the use of smoke evacuators, minimizing energy device use, and wearing enhanced PPE.

CONCLUSION:
The volume of laparoscopy and hysteroscopy cases was greatly reduced during the pandemic. The pandemic has disrupted the practice of MIGS both in the outpatient clinics and the operating rooms. Most of the changes made are congruent to local and international automotive task force guidelines. Precautionary measures and screening procedures must remain in place to reduce the risk of severe acute respiratory syndrome coronavirus 2 transmission to patients and health-care workers.