bluuebunny/crossref_metadata_2025_split huggingface dataset:
« Dis-moi où tu habites… » L’accès à l’avortement au prisme de la dévolution dans le Royaume‑Uni contemporain
Authors: Molinari Véronique , Nedelec Alexandrine 
Published: May 2024

Dans un contexte marqué successivement par un référendum sur l’indépendance de l’Écosse, le Brexit, et la pandémie de COVID‑19, le Royaume-Uni a connu, entre 2014 et 2021, une évolution significative de la législation relative à l’avortement. Système fortement décentralisé depuis la fin des années 1990, le pays n’en reste pas moins, contrairement aux États‑Unis, un État unitaire, et non fédéral. Pourtant, la législation relative à l’avortement a différé, historiquement, d’une nation‑région à une autre, de façon parfois significative.Cet article se propose d’analyser, à travers une analyse des jeux d’échelle, les éléments culturels, conjoncturels et constitutionnels qui ont motivé les évolutions récentes des différentes législations relatives à l’avortement. Il questionnera tout d’abord la dimension supranationale de l’avortement pour ensuite examiner les tensions, incohérences, mais aussi influences qui caractérisent les approches nationales et, enfin, s’intéresser aux inégalités dans l’accès à l’avortement à l’échelle locale. Au‑delà des textes de loi, il montrera la pertinence d’interroger les frontières afin de comprendre la question de l’accès à l’avortement dans toutes ses dimensions, et soulignera tout particulièrement combien l’évolution des différents régimes relatifs à l’avortement doit être envisagée dans une relation d’interdépendance entre les différentes composantes du Royaume‑Uni.
L’avortement en Écosse depuis sa légalisation en 1967 : évolution du cadre normatif et des pratiques au sein d’un État d’Union
Authors: Camp-Pietrain Edwige 
Published: May 2024

Avant la dévolution du pouvoir, en 1999, le traitement judiciaire de l’avortement était distinct en Écosse, grâce aux particularités protégées par le traité d’Union de 1707 avec l’Angleterre. Cependant, l’avortement n’a été confié au Parlement écossais qu’en 2016. Cet article analyse les raisons de ce retard, à travers l’étude de débats parlementaires, à la Chambre des communes et au Parlement écossais. Il s’intéresse ensuite aux politiques adoptées par ce dernier, au sein duquel les femmes, dont la proportion était élevée, sont restés alignées sur leur parti. Ainsi, après avoir recensé les pressions endogènes, de nature partisane, et les pressions exogènes, venues de l’extérieur des frontières, il conclut à une instrumentalisation politique de la question de l’avortement.
Knowledge, Attitude, and Practice around Diabetic Eye Disease among Diabetic Patients in Jazan Region, Saudi Arabia
Authors: Najmi Hatim , Otaif Wael , Najmi Muath , Basehi Mohammed , Tobaigy Mohannad , Alsalim Wasan , Awaji Mariam , Najmi Abdulmalik 
Published: May 2024

PURPOSE:
This study aims to assess knowledge, attitude, and practice (KAP) around diabetic eye disease in patients with diabetes mellitus (DM) attending primary health-care centers (PHCCs) in Jazan region, Saudi Arabia.

METHODS:
All diabetic patients attending eight PHCCs in Jazan region between December 2018 and December 2019 were invited to participate in this cross-sectional study. Face-to-face interviews were held to gather responses to a validated 20-item questionnaire.

RESULTS:
In total, 293 patients aged 9–90 years (mean 50 years, standard deviation 14 years) agreed to participate, including 189 (64.5%) females and 104 (35.5%) males. Most (n = 251; 85.7%) had type 2 DM, the remainder (42; 14.3%) having type 1 DM. The mean duration of DM was 8.2 ± 6.4 years. Eye complications were self-reported by 114 (38.9%) participants. More than one-third (36.2%) of the participants had never undergone an eye examination. Less than one-third of participants (29% and 28% respectively) had an excellent level of knowledge or practice about diabetic eye disease, and only 12% demonstrated very positive attitude. KAP levels were independently predicted by patients' age, gender, and eye complication status.

CONCLUSION:
KAP relating to eye disease and eye care among Saudi patients with DM were less than desired. Rigorous efforts are required to raise awareness of eye complications among diabetic patients.
AccuVein® fails to facilitate venous marking for saphenous veins harvesting in untrained students
Authors: Ramondou Pierre , Bura-Rivière Alessandra , Mokaddem Wassim , Hersan Jeanne , Josse Charlotte , Abraham Pierre , Fouquet Olivier , Bossavy Jean-Pierre , Lapébie François-Xavier , Henni Samir 
Published: May 2024

CONTEXT:
Ultrasound marking of saphenous veins before vein harvesting facilitates the surgical procedure but is time-consuming.

AIM:
We evaluated the time benefit of saphenous veins marking by the AccuVein® AV400 system (AccuVein Inc., NY, USA) coupled with ultrasound, over ultrasound alone.

SETTINGS AND DESIGN:
Multi-center open-label randomized interventional study in two parallel groups.

SUBJECTS AND METHODS:
After randomization, saphenous veins markings were performed using either AccuVein®coupled with ultrasound or ultrasound alone. One-leg marking time, vascular physician postexamination satisfaction rating, and number of single-use felt markers used were recorded.

STATISTICAL ANALYSES:
The continuous variables were compared using the Fisher test, whereas Likert scale scores were compared using the nonparametric Mann−Whitney test. The learning effect was evaluated by linear and nonlinear regression models.

RESULTS:
The average duration of saphenous veins marking (459 ± 184 vs 555 ± 226 s, P = 0.116) and the number of felt markers used were not significantly different between the two techniques. Vascular physician satisfaction was significantly lower with than without the AccuVein® associated to ultrasound.

CONCLUSIONS:
AccuVein® examination coupled with ultrasound as part of the marking process does not provide a significant benefit in terms of time, satisfaction, or need for markers.
Comparison of the Influence of Intraoperative Use of Sevoflurane and Isoflurane on Postoperative Nausea, Vomiting, and Cough
Authors: Chouhan Akansha , Bhat Sonal N , Rao Sunil Vasudev 
Published: May 2024

Abstract

Introduction:
Postoperative nausea, vomiting, and cough are the most common adverse effects of general anesthesia resulting in high discomfort to the patient resulting in uneasiness during the recovery period. This study aimed to compare the influence of intraoperative use of sevoflurane and isoflurane on postoperative nausea, vomiting, and cough.

Materials and Methods:
After approval from the institutional ethical committee, this quantitative observational institutional study was conducted on all patients aged between 18 and 65 years undergoing surgery under general anesthesia at KMC Hospital, Mangalore. Patients were allocated into the sevoflurane group or isoflurane group.

Results:
All demographic parameters such as age, sex, American Society of Anesthesiologists physical status, and duration were comparable (P > 0.05). The sevoflurane group had higher number of patients (11 [14.86%]) with postoperative nausea at 0 h as compared isoflurane group (7 [9.45%]). Two patients in the isoflurane group reported postoperative vomiting at 0 h, whereas no patient in the sevoflurane group reported vomiting. For cough, a statistically significant correlation was seen between the two groups (P = 0.000) with majority of patients in the isoflurane group, i.e., 50 (67.6%) patients reporting cough at 0 h while only 15 (20.3%) reported cough in the sevoflurane group.

Conclusion:
Sevoflurane was found to be better than isoflurane in terms of postoperative nausea vomiting and cough immediately after emergence in our study. Isoflurane cause the emergence of cough whereas no significant difference in nausea and vomiting was observed in both groups.
Permanent longitudinal strain damage of cardiotoxic drugs in childhood cancer: What is the safe level?
Authors: Mohammadi Hamid , Hosseini Hossein , Bordbar Mohammadreza , Mehdizadegan Nima , Amoozgar Hamid , Edraki Mohammad Reza , Naghshzan Amir , Naderi Nima , Abedi Elham , Keshavarz Kambiz 
Published: May 2024

ABSTRACT

Objective:
Anthracycline administration in children is associated with cardiac dysfunction. Speckle-tracking echocardiography (STE) can detect subclinical cardiac damage that may go undetected by conventional two-dimensional (2D) echocardiography. This study aims to investigate medium-term anthracycline cardiotoxicity using STE and determine a safer administrable level of anthracyclines (ACs).

Methods:
This observational case–control study enrolled 37 healthy controls and 78 pediatric cancer survivors who received chemotherapy. The patients were divided into two groups: cardiotoxic received (CR) and cardiotoxic free (CF). Data on segmental longitudinal strain (LS), global LS (GLS), and 2D echocardiographic parameters were collected after a drug-free period of at least one year.

Results:
A total of 115 children with a mean age of 108 ± 55 months, of whom 66% were males, were included in the study. Both the groups of cancer survivors exhibited significantly reduced GLS compared to healthy controls (CR vs. controls, P = 0.001; CF vs. controls, P = 0.013), but no significant difference in left ventricular ejection fraction (LVEF) was observed (P = 0.75). Overall, cancer survivors treated with ACs demonstrated a significant reduction in strain in 10 left ventricular segments, particularly in the basal segments (P < 0.05). Among CR patients, those with impaired GLS (n = 43, GLS worse than −21.9) had significantly higher mean age and cumulative anthracycline dose compared to CR patients with normal GLS (age, P = 0.024; anthracycline dosage, P = 0.036). Using an anthracycline cutoff of 223 mg/m2 resulted in a higher detection rate (49% vs. 25%) and fewer missed cases (51% vs. 74%) compared to the 360 mg/m2 anthracycline cutoff.

Conclusion:
Childhood cancer survivors demonstrate significantly reduced GLS while preserving a normal LVEF, which does not differ significantly from reference values of healthy children. The reduction in strain appears to be associated with higher anthracycline doses and older age. Lowering the anthracycline threshold to 223 mg/m2 may improve the predictability of a decline in cardiac function using strain imaging at medium-term follow-up.
Innominate vein occlusion by the fabric of covered stent during transcatheter closure of sinus venosus defects – Causes, management, and outcome
Authors: Sivakumar Kothandam , Sagar Pramod , Thejaswi Puthiyedath , Ramaswamy Rajeshkumar , Chandrasekaran Ramyashri 
Published: May 2024

ABSTRACT
Transcatheter sinus venosus defect (SVD) closure with covered stents is emerging as an alternative to surgery. An adequate anchor zone in the superior vena cava is mandatory for the stability of the covered stent to prevent caudal embolization. There is a potential risk of innominate vein occlusion by the fabric of the covered stent in patients with a very short superior caval vein. Three among a total of 105 patients who underwent SVD closure at our institution developed innominate vein occlusion. Predisposing anatomical factors, identification and management of occluded innominate vein, and follow-up outcomes are discussed.
Evaluation of left ventricular function and volume by two-dimensional echocardiography in a pediatric population: Correlation with cardiac magnetic resonance imaging
Authors: Bhansali Suneet , Tokar Ella , Saharan Sunil , Khalil Ramzi , Bhatla Puneet 
Published: May 2024

ABSTRACT

Background:
Echocardiographic quantification of left ventricular (LV) volume and ejection fraction (EF) is widely used in the pediatric population. However, there is no consensus on the most accurate method of quantifying ventricular volumes and systolic function.

Purpose:
The purpose of this study is to compare two commonly used echocardiographic methods for the evaluation of LV volume and quantification of EF, the five-sixth area-length (5/6 AL) and the modified biplane Simpson (BS), to cardiac magnetic resonance (CMR) imaging in children.

Methods:
CMR studies were paired with echocardiograms and retrospectively analyzed in children 18 years of age and younger. Studies performed more than 3 months between modalities, patients with congenital heart disease, and patients who had changes in medication regimen between corresponding CMR and echocardiograms were excluded. LV volumes and EF were calculated using the 5/6 AL and BS methods and compared to volumes and EF measured on corresponding CMR studies. Subgroup analyses were conducted based on LV function, pathology, and weight.

Results:
We retrospectively analyzed 53 CMR and corresponding echocardiogram studies (23 studies for myocarditis and 30 studies for cardiomyopathy) in 46 patients. LVEF derived by both echocardiographic methods showed a good correlation to CMR (5/6 AL r = 0.85 and BS r = 0.82). However, both echocardiographic methods overestimated LVEF and underestimated LV volumes when compared to CMR.

Conclusion:
Left ventricular volumes and EF, as measured by echocardiography, correlate well with CMR measurements. Echocardiography underestimates LV systolic and diastolic volumes and overestimates LVEF. While echocardiography is a good surrogate for estimating LVEF, CMR should be considered in patients for whom accurate measurements are needed for critical clinical decision-making.
Prevalence of pregnancy complications in Nnewi, South-East Nigeria
Authors: Afonne Anulika J. , Okafor Jerome O. 
Published: May 2024

Aims
This study was set to determine the prevalence of pregnancy complications and associated sociodemographic factors in Nnewi, South-East Nigeria, from 2014 to 2018.

Patients and methods
This was a retrospective, descriptive study of pregnant women, who received antenatal care and/or delivered at the Nnamdi Azikiwe University Teaching Hospital, Nnewi.

Results
Of the 821 deliveries documented at Nnamdi Azikiwe University Teaching Hospital, Nnewi, 435 (52.98%) had complications. Sixteen clinical conditions were identified in the complicated pregnancies; the most common being malaria (20.23%), hemorrhage (13.79%), and HIV infection (10.11%). The least were ectopic pregnancy (2.07%), uterine rupture (2.07%), and placenta abruption (2.30%). The number of pregnancies with complications were significantly higher than those without (P=0.039). There was a statistical association between pregnancy complication and the woman’s occupation (P=0.028).

Conclusion
The prevalence of pregnancy complications in Nnewi was found to be 52.98%, with malaria being the most common complication (22.23%), and ectopic pregnancy and uterine rupture the least (2.07%).

Recommendation
Women are advised to access antenatal care during pregnancy to stem complications, while efforts should be intensified by relevant bodies to control malaria in pregnancy.
Response of nurses toward interim infection prevention and control recommendations for coronavirus disease 2019 in healthcare settings at the early stage
Authors: Abdulah Deldar M. , Mohammedsadiq Hawar A. 
Published: May 2024

Background
Healthcare workers are at high risk for coronavirus disease 2019 (COVID-19). The nurses need to ensure the minimal risk of infection during treating and caregiving to patients with COVID-19 through using personal protective equipment.

Aim
This study aimed to explore the nurses’ response toward interim infection prevention and control recommendations for patients with suspected COVID-19.

Participants and methods
In this cross-sectional study, 232 nurses who dealt with suspected COVID-19 patients were invited from four public hospitals between 14 and 18 March 2020.

Results
Nurses adhered to minimizing close exposure to a suspected person by disinfecting contaminated areas. However, 36.2% did not limit the entry number to the rooms dedicated to patients infected with COVID-19. Moreover, 58.2% reported that triage stations outside the facility to screen patients have not been set up yet. The hospital’s administration limits the visit of patients’ facilities by 89.7% and using personal protective equipment (72.4–97.4%). About 31.9% of nurses did not launder clothes after they finished a day and entered a room with suspected patients. In addition, 49.1% of the nurses reported that dedicated rooms are in a single-person room with the door closed. Specimen collection was performed in a normal examination room with the closed door (63.4%). Also, 81.0% of the nurses reported that the clinical ward limits the transport and movement of nurses outside of the room.

Conclusion
This study showed that one-third of the nurses do not adhere to interim prevention and control recommendations for suspected COVID-19.

Recommendation
The study suggests that healthcare workers and their family members be monitored for the suspected symptoms of COVID-19 because they are at a high risk of exposure and may impose a high risk on their colleagues.
An Analysis of Patients with Chronic Pain amid COVID-19 Pandemic: A Cross-Sectional Observational Trial
Authors: Ahuja Vanita , Thapa Deepak , Mitra Sukanya , Singh Kushagrita , Nair Lekshmi V. 
Published: May 2024

Context:
The unpredictable nature of COVID-19 pandemic and the limited patient–doctor interaction led to the change in chronic pain management during the pandemic.

Aims:
The study aimed to compare pain scores and bio-psycho-social aspects of chronic pain in patients during prepandemic versus COVID-19 pandemic period.

Settings and Designs:
This was a prospective, cross-sectional observational trial conducted in a tertiary care hospital.

Subjects and Methods:
The study was conducted between September 2021 and January 2022 which corresponded with the end of the second wave and beginning of the third wave of COVID-19 pandemic. A set of 20 web-based questionnaires were sent to adult patients of both genders and who had visited pain clinic before the onset of pandemic.

Statistical Analysis Use:
Discrete categorical data were presented as n (%); continuous data were written either in the form of its mean and standard deviation or in the form of its median and interquartile range. All statistical tests were two-sided and were performed at a significance level of P < 0.05.

Results:
A total of 408 patients of chronic pain participated in the web-based questionnaire. The most common diagnosis was low back pain, facial pain, and knee pain. The patients continued to consume analgesics during the pandemic, had ≥2 burnout score, and reported “poor to fair” quality of sleep score. During the pandemic, pain score increased in those subsets of patients who earlier had no pain (odds ratio [OR]: 68.33, confidence interval [CI]: 24.10–193.72, P = 0.000), mild pain (OR: 22.78, CI: 9.49–54.64, P = 0.000), and moderate pain. On the contrary, chronic pain decreased or remained same in the population having moderate or severe pain before the pandemic. Patients with increased pain during the pandemic wanted the outpatient department to reopen for consultation with pain physician. The majority of the patients 350 (85.78%) who had participated in the study did not suffer from COVID-19 infection.

Conclusions:
Regular intake of analgesics during the COVID-19 pandemic reduced the number of patients experiencing severe pain. However, the patients suffering from moderate-to-severe pain during the pandemic had a direct correlation between higher pain severity and poor quality of sleep.
Predictive ability of complete blood count, mean platelet ratio, mean platelet volume, and neutrophil/lymphocyte ratio for severe pneumonia among RT-PCR or radiologically proven COVID-19 patients
Authors: Bohra Harishkumar R. , Suthar Om P. , Rehana V R , Baskaran Pritish , Nivedita A , Lakra Prima Suchita , Raghav Pankaja R. , Tandon Ashwani 
Published: May 2024

ABSTRACT

Background:
Immuno-inflammatory markers related to white blood cells, and platelets are shown to be associated with COVID-19 infection, and considered to be independent markers for clinical outcomes and mortality. The present study aimed to study the predictive value of these hematologic parameters in progression of COVID-19 to severe pneumonia.

Methods:
This was an analytical cross-sectional study conducted among RT-PCR or radiologically proven COVID-19 patients in a tertiary care hospital in Rajasthan. Semi-structured questionnaire was used to collect the epidemiological information of the patients with COVID-19. Complete blood count and other laboratory parameters were also studied among the patients.

Results:
Mean age of participants in the study was 52 years, with about 70% being males. Cough and breathlessness were the most common symptoms among the patients. It was found that the parameters related to white blood cells were significantly different between patients with COVID-19 infection and severe pneumonia (except absolute monocyte count). NLR was significantly higher among those with severe pneumonia. In the univariate analysis, age (OR - 1.02), NLR (OR - 1.16), and albumin (OR - 0.45) were found to be significant predictors of progression to severe pneumonia. In the final model, adjusted for confounders, only NLR and albumin levels significantly predicted progression to severe pneumonia among COVID-19 patients.

Conclusion:
The study consolidates the predictive ability of NLR for severe pneumonia. It is an important finding, as health facilities with limited access to laboratory investigations can rely on simple markers in routine practice to predict the progression of COVID-19 infection to severe pneumonia.
A parallel-arm randomised control trial to study the effects of risk communication methods for prevention of cardiovascular diseases: EFFRICO trial
Authors: Singhal Kritika , Prasad Pankaj , Pal Deb Kumar , Bhagtana Parneet Kaur , Gupta Suruchi 
Published: May 2024

ABSTRACT

Introduction:
Cardiovascular diseases (CVDs) have many risk factors; few can be modified through health education. Traditional patient counselling methods fail to impact health behaviours to prevent or reduce the risk of CVDs.

Objectives:
This study was conducted to estimate the effect of various risk communication methods on CVD risk reduction and medication adherence.

Design:
An open-label superiority randomised control trial was conducted where 159 patients were randomised into three groups: Communication of 10-year Framingham CVD risk score, heart age, and routine care. Follow-up was done 3 months after recruitment. The primary outcome was a difference in excess 10-year Framingham CVD risk score in the end-line compared to baseline. The status of modifiable behavioural risk factors at baseline was expressed as ‘yes’ and ‘no’, and follow-up was defined as ‘action’, ‘positive maintenance’, ‘negative maintenance’, and ‘defaulter’. The trial was registered with the Clinical Trials Registry India (CTRI NO. CTRI/2020/10/028614).

Setting:
The study setting was screening outpatient department (OPD), General Medicine OPD, and Cardiology OPD of a tertiary care hospital in Central India.

Participants:
Participants aged >30 years, residing in Bhopal for more than 6 months, diagnosed with hypertension or diabetes mellitus or both, and having any of the four CVD behavioural risk factors: tobacco use, alcohol use, physical inactivity, or unhealthy diet.

Results:
Median excess 10-year Framingham CVD risk scores were 0.945% (CI: 1.275–4.297), –0.850% (–3.932–2.075), and –1.300% (–5.100–0.900) (10-year Framingham CVD risk score vs Heart age vs Routine care) and 0.000% (–3.125–5.925), –1.600% (–3.760–1.475), and –1.400% (–6.600–5.900) before and after intervention, respectively (P > 0.05). Positive maintenance was higher in both intervention groups concerning all modifiable behaviours, with a higher proportion reported in the 10-year Framingham risk score. The action phase was reported higher in intervention groups for medication adherence, addiction, and dietary changes.

Conclusion:
Systematic risk communication methods reduced the probability of contracting CVD in the future, though this finding was statistically insignificant.