bluuebunny/crossref_metadata_2025_split huggingface dataset:
Le competenze infermieristiche avanzate in area critica: formazione e strumenti di valutazione. Una revisione narrativa
Authors: Stellabotte Michele , Pinto Floriana 
Published: October 2023

Introduzione: le competenze infermieristiche avanzate si riferiscono a servizi ed interventi sanitari ampliati e migliorati forniti da infermieri che, con capacità avanzate, influenzano gli outcome clinici e forniscono servizi sanitari diretti a persone, famiglie e comunità. L’area critica si contraddistingue dagli altri contesti dove gli infermieri possono sviluppare competenze avanzate per la sua complessità e dinamicità. l'obiettivo di questo studio è la descrizione dei percorsi formativi necessari e gli strumenti utilizzati per la valutazione delle competenze avanzate in area critica nel contesto internazionale.
Materiali e Metodi: è stata condotta una revisione narrativa attraverso le principali banche dati (Medline/PubMed, CINAHL, Cochrane Library, EMBASE), selezionando articoli in lingua inglese e italiana pubblicati negli ultimi dieci anni, ovvero dall’anno di costituzione del gruppo di lavoro per le competenze avanzate dell’European federation of Critical Care Nurses Association (EfCCNa). Sono stati inclusi tutti gli studi che trattassero delle competenze avanzate in area critica, i requisiti necessari, la formazione richiesta e i relativi strumenti valutativi.
Risultati: sono stati ritrovati 183 articoli e selezionati un totale di 13 articoli, di cui 2 revisioni della letteratura. In 17 su 24 Paesi Europei, sono presenti dei programmi formali di formazione per gli infermieri di area critica. L’infermieristica in area critica è stata riconosciuta come specialità in 13 di essi. Esistono almeno dieci strumenti per la valutazione delle competenze avanzate in area critica.
Discussione: lo status formativo degli infermieri di area critica è estremamente variegato e disomogeneo. Attualmente la letteratura propone diversi strumenti di valutazione per le competenze validi ed affidabili, ma eterogenei e non utilizzabili in ogni contesto.
Conclusioni: risulta necessario un intervento istituzionale a livello nazionale e comunitario, mirato a standardizzare e definire la formazione ed il riconoscimento delle competenze avanzate in area critica.
Modified Mallampati Score – Does it Predict More Than a Difficult Airway? A Community-based Study Assessing the Association between Modified Mallampati Score and Obstructive Sleep Apnea
Authors: Abraham Jithin Mathew , Varghese Sangeetha Merrin , Lukachan Gincy Ann , Mathai Ashu Sara 
Published: October 2023

Background and Aim:
The suspicion of obstructive sleep apnea (OSA) has serious implications for an anesthesiologist perioperatively. This study examines the association between the modified Mallampati scoring (MMS) and the STOP-BANG score in a community setting.

Materials and Methods:
This was a community-based cross-sectional survey among 702 adults in a rural area in South India. Airway assessment using MMS and assessment for OSA using STOP-BANG scoring were made by junior doctors trained in the anesthesia department. The association between the Mallampati score and the STOP-BANG score was tested by the Chi-square test using the SPSS version 21.

Results:
Among the community-dwelling adults, 19.2% had a score of 1, 27.9% had a score of 2, 31.3% had a score of 3, and 21.5% had a score of 4 on the Mallampati scoring system. Using the STOP-BANG score for risk stratification of OSA, 29.2% had an intermediate risk and 5.8% had a high risk for OSA. Higher Mallampati Grades (3 and 4) were a significant risk factor for OSA (61.8% vs. 38.2%, P = 0.001).

Conclusion:
A higher Mallampati class (3 or 4) is significantly associated with an intermediate-to high risk for OSA as assessed using STOP-BANG score criteria. Therefore, we suggest using the MMS not only as an airway screening tool but also as a predictor of OSA, in view of the rising obesity rates in India.
Clinical Profile, Outcome, and Cost of Care in Snakebite Patients Requiring Admissions in a Single Medical Unit: A Retrospective Study from a Tertiary Care Center in South India
Authors: Mandal Amit , Chakraborty Madhumita , Iyyadurai Ramya , Gunasekaran Karthik 
Published: October 2023

Background and Aim:
Snakebite is an important occupational and rural hazard. It is one of the most common causes of morbidity and mortality in tropical countries. Even though snakebite is an imminently treatable condition, it is a common life-threatening emergency. We aim to study the clinical profile, complications, as length of stay in the hospital, outcome and cost of care in snakebite patients requiring admission under a medicine unit.

Materials and Methods:
This retrospective study was conducted carried out from May 01, 2014, to May 01, 2019. The data were extracted from the inpatient medical records, and it was analyzed. All adult patients requiring admission in medicine unit V with a diagnosis of snake envenomation were included in the study. Descriptive statistics were obtained for all variables in the study, and appropriate statistical tests were employed to ascertain the significance.

Results:
The cohort consists of 80 patients with 45 (56.3%) males and aged 40.06 ± 15.24 years (mean, standard deviation [SD]). The majority of the snake species identification was not available 38 (47.5%). Viper bite was the most common bite 32 (40%). The most common clinical presentation was hemotoxic 33 (31.3%) followed by neurotoxic 16 (20%). Sixty-eight (85%) patients were treated outside before presentation. The median antisnake venom (ASV) given was 10 vials, and 12 (15%) patients had allergic reaction to ASV. Sixty-nine (86%) patients had cellulitis and 16 (20%) had acute kidney injury (AKI). Twenty-four (30%) patients required intensive care monitoring, 22 (27.5%) required mechanical ventilation, and 7 (8.8%) required hemodialysis. The mean ± SD duration of hospital stay was 5.56 ± 3.76 days. The median direct cost was Rs. 19,714.5 and cost of medicine was Rs. 10,798. The mortality in this cohort was 4 (5%).

Conclusion:
Snakebite causes significant morbidity. Viper bite was the most common bite in our study. ASV reaction was seen in 15%, and cellulitis and AKI were the common complications. The median direct cost was Rs. 19,714.5 and cost of medicine was Rs. 10,798. The mortality in this cohort was 4 (5%).
A Comparative Study of Picolinic Acid Levels in Patients of Severe Depression with and without Suicidality
Authors: Savita Vijay , Pal Virendra Singh , Bagul Koustubh , Mudgal Varchasvi 
Published: October 2023

Background and Aim:
Picolinic acid (PIC) is a metabolite of the kynurenine pathway, which is involved in the degradation of tryptophan, an essential amino acid. PIC has been suggested to have neuroprotective effects by inhibiting the production of quinolinic acid, a neurotoxic agent that can induce inflammation and oxidative stress in the brain. Several studies have reported the altered levels of PIC and other kynurenine metabolites in patients with suicidal behavior, indicating a possible link between PIC and suicide risk. However, the exact role of PIC in the pathophysiology of suicide is not fully understood and requires further investigation. We aim to assess the levels of PIC in patients with severe depression with and without suicidal attempts.

Materials and Methods:
A cross-sectional, observation study was conducted at MGM Medical College, Indore. The study consisted of two groups: Group A including patients of depression with suicidal attempt(s) and Group B including patients of depression without any suicidal attempt. After obtaining written informed consent, recruitment of the subjects was done as per strict inclusion criteria and exclusion criteria. Sociodemographic parameters such as age, gender, residence, and marital status were collected along with the clinical parameters such as Hamilton depression rating scale (HAM-D), Suicidal Behavior Questionnaire Revised (SBQ-R) score, and Beck Scale for suicidal ideation (BSSI). Blood samples of both the groups were measured for serum PIC using an auto analyzer.

Results:
Serum PIC levels were significantly lower (124.33 ± 51.15 ng/L) in the depression with suicidal attempt group than depression without suicide attempt which was 163 ± 41.28 ng/L (P < 0.01). SBQ-R, BSSI score, and number of suicide attempts correlated negatively with serum PIC levels.

Conclusion:
The depression with suicidal attempt(s) group has shown lower mean serum PIC levels than the depression without suicidal attempt(s) group, which was statistically significant. This indicates serum PIC could be a marker in severe depression.
Comparison of micromorphological changes in enamel using SEM analysis after conventional and erbium, chromium:yttrium, scandium, gallium, and garnet hard-tissue laser fissurotomy: An in vitro study
Authors: Aggarwal Priyanka , Anand Pallavi , Singh Kopal , Jhingan Pulkit , Malik Manvi , Mathur Shivani 
Published: October 2023

ABSTRACT

Background:
Well articulated by John Knowles – ”Everything has to evolve or else it perishes.” With the paradigm shift of emphasis toward the prevention of dental caries, it has been proven that laser irradiation protects against both caries initiation and caries progression.

Aim:
The aim of the study was to evaluate and compare the micromorphology of caries-free extracted premolars using a Scanning electron microscope (SEM) after fissurotomy by conventional fissurotomy bur and erbium, chromium: yttrium, scandium, gallium, and garnet (ER, CR: YSGG) hard-tissue laser.

Methodology:
Sixty caries-free premolars extracted atraumatically for orthodontic treatment were included in the study. The samples were divided into two groups randomly (Group 1: fissurotomy by bur, n = 30, and Group 2: fissurotomy by hard-tissue laser, n = 30). Each sample was further divided into halves from the occlusal surface wherein one-half of the occlusal surface received fissurotomy procedure and the other half was control. Samples were analyzed by scanning electron microscopy (SEM) for micromorphological changes.

Results:
Profile image of control samples revealed the disorganization of enamel surface at the junction of fissures forming a heterogeneous tissue and agglomeration of enamel with deep pit and fissure. On the contrary, the image of experimented samples (with laser fissurotomy) showed smooth enamel surface and homogeneous enamel subsurface with wider pit and fissure owing to self-cleansing ability.

Conclusion:
On the grounds of the present study results, it could be concluded that the intervention of ER, CR: YSGG hard-tissue laser possesses self-cleansable pit and fissures for caries prevention and has the potential to irradicate the smear layer entirely for superior attachment of remineralizing agents.
Effectiveness of resin infiltration (ICON) and microabrasion-remineralization technique with two remineralizing agents (Tooth Mousse and Toothmin) on permanent incisor hypoplasia – A randomized clinical trial
Authors: Shah Yash , Deshpande Anshula , Jain Aishwarya , Jaiswal Vidhi , Andharia Mudra 
Published: October 2023

ABSTRACT

Aims:
The study aims to compare the effect of resin infiltration and microabrasion-remineralization (MAb-Re) with Tooth Mousse and Toothmin on permanent incisor hypoplasia.

Materials and Methods:
The study included children with permanent incisor hypoplasia above 9 years of age, 171 teeth divided randomly into four groups: Group A – ICON, Group B – MAb-Re using Tooth Mousse, Group C – MAb-Re using Toothmin, and Group D – control group. Process involved taking standardized photographs at T1 - before intervention, T2 - immediately after treatment, and T3 – 6-month follow-up. Color evaluation, area calculation, participant and expert opinion using a Likert scale, treatment time, and cost-effectiveness were all taken into consideration during the assessment.

Statistical Analysis Used:
Data were collected, entered into a computer, and analyzed; one-way ANOVA was used for intergroup assessment.

Results:
Overall color change was evident immediately after treatment in the ICON group compared to other groups (P < 0.05). However, no significant difference in color change was visible between the groups after 6 months. Reduction in hypoplastic area was seen in all the groups. The mean time was similar for all the groups. Toothmin was found to be the most cost-effective in comparison with the other two interventions.

Conclusions:
ICON proved to be more effective immediately after treatment for masking incisor hypoplasia. However, at 6-month follow-up interval, all the groups gave similar results.
Unusual Complications of Ventriculoperitoneal Shunt Surgery
Authors: Faheem Mohd , Jaiswal Manish , Prajapati Hanuman P. , Kumar Raj , Saba Noor us , Ojha Bal K. 
Published: October 2023

Background:
Ventriculoperitoneal shunt (VP shunt) surgery is one of the most common procedures being performed in the pediatric age group in neurosurgical centers worldwide. Although considered a simple surgery, the complications have made it one of the most difficult procedures to manage in the long term. In this study, we describe our experiences in managing the unusual complications of this common procedure in children.

Materials and Methods:
This retrospective study enrolled 13 pediatric cases having unusual complications related to VP shunt who presented to us from August 2013 to August 2019. All the cases were evaluated for their demographic profile, type of complications, possible pathophysiology, outcome, and management. We had used only spring-valve-based Chhabra VP shunt in all of our cases.

Results:
The age group ranged between 2 and 18 years, with a male to female ratio of 9:4. Anal extrusion of distal shunt tube was observed in four cases, and two cases each of urethral and oral extrusion were also seen. Two cases developed extrusion of shunt tube through the anterior abdominal wall and one case developed umbilical fistula. Multiple extradural hematoma and intraventricular bleed with partial shunt coil were also seen in each of the cases, respectively. All cases were managed as per need.

Conclusion:
Unusual complications of VP shunt surgery are increasingly being observed nowadays. Prompt diagnosis and treatment of these complications result in an excellent outcome.
Position of Tonsillar Tip in Relation to Foramen Magnum in Children with Structurally Normal MRI Brain Imaging
Authors: Putrevu VenkataPravallika , Thodika Unais Chettian , Raiyani Yatin Vinodray , Mangaleswaran Balamurugan 
Published: October 2023

Introduction:
The position of the tonsillar tip in relation to the foramen magnum varies from individual to individual, even after excluding all predisposing factors that might alter the tonsillar tip position; the mere presence of the tonsillar ectopia should not be misinterpreted as Chiari malformation.

Aim:
Our aim is to establish the normal range of the tonsillar tip position and the incidence of tonsillar ectopia and its relation to age and sex in asymptomatic Indian children with structurally normal MRI brain imaging.

Materials and Methods:
We have conducted a retrospective data collection comprising 301 structurally normal MRI brain images done for children younger than 14 years, in which we measured the level of the tonsillar tip from the foramen magnum by taking the Mc Rae line as constant. Measurements were taken in the right and left parasagittal sections of T1-weighted MRI brain images by using pre-existing software.

Statistical Analysis Used:
Data analysis was done by SPSS v 25.0; all P values <0.05 were considered statistically significant.

Results and Conclusion:
The incidence of tonsillar ectopia in Indian children was about 13.79%, and the median tonsillar position was 3.2 mm above the foramen magnum with a median range of 5.2 mm above to the level of the foramen magnum (0).
ANÁLISE DOS NÍVEIS DE SINTOMAS DEPRESSIVOS E ANSIOSOS EM ACADÊMICOS DOS CURSOS DE MEDICINA E ODONTOLOGIA DE UMA UNIVERSIDADE PÚBLICA NO MUNICÍPIO DE PONTA GROSSA NO PARANÁ
Authors: Chaikoski Andrielle Cristina , Postiglione Mansani Fabiana , Fasolo Laura 
Published: October 2023

Objetivo: Avaliar a correlação de fatores estressores e o desenvolvimento de transtornos mentais, como a depressão e a ansiedade, nos acadêmicos dos cursos de Medicina e Odontologia da Universidade Estadual de Ponta Grossa. Resultados: Observou-se que a maioria das repercussões psicológicas se encontram no em estudantes do sexo feminino, em decorrência da insatisfação do desempenho acadêmico, dos elevados níveis de estresse submetidos ao longo da graduação e do apoio emocional insuficiente. Conclusão: Os achados demonstram a necessidade de repensar sobre as metodológicas pedagógicas e de auxílio psicológico aos acadêmicos, em vista de minimizar o impacto negativo dos eventos estressores na formação acadêmica dos estudantes.
Online Banking and Technical Efficiency of Commercial Banks in Kenya
Authors: Getugi Joyce Chepkoech , Osoro Cliff , Kihara Allan 
Published: October 2023

Purpose: The financial sector is being revolutionized as a direct result of technological progress, with banks and other financial institutions embracing new technologies to better serve their customers online. Technological developments in the financial sector are simplifying access to financial services. The study set out to dissect the effects of Fintech on Kenya's commercial banking sector. The general objective was to establish the effect of online banking on technical efficiency of commercial banks in Kenya. The study was anchored on Theory of Constraint-Induced Innovation.
Methodology: The entire study relied on collecting empirical data and evaluating hypothesis in a positivist way. A causal-comparative research design was used in this research. The study targeted population of Seventeen Kenyan commercial banks from the first and second tiers. The analysis relied on secondary sources of information. The gathered quantitative data was analyzed using both descriptive and inferential statistics. Numbers, medians, and standard deviations were used to characterize the data, and frequency distributions were used to determine the sample size. Models for analyzing correlations and regressions are inferential statistics. STATA was used for the data analysis.
Findings: The study established that online banking has a positive and significant effect on technical efficiency of commercial banks in Kenya.
Unique Contribution to Theory, Policy and Practice: The research showed that commercial banks in Kenya could benefit from investing more in their online banking systems to boost their technological efficiency.
DIMENSÕES SOCIOTERRITORIAIS QUE O TURISMO DE BASE COMUNITÁRIA PODE COPRODUZIR ATRAVÉS DA GOVERNANÇA PÚBLICA / Socio-territorial dimensions that community-based tourism can co-produce through public governance
Authors: Chagas de Almeida Thiago , Luiz Emmendoerfer Magnus 
Published: October 2023

O Turismo de Base Comunitária (TBC) é um modo de gestão das atividades de visitação protagonizado e autogerido pela comunidade, podendo ser um vetor para desenvolver endogenamente periferias urbanas e áreas rurais. Considerando o potencial do TBC de esculpir socialmente um determinado território, pela interação com outros atores, o presente trabalho investiga quais dimensões socioterritoriais o TBC pode coproduzir através governança pública. Isso foi feito por uma pesquisa exploratória qualitativa, realizando uma revisão integrativa da literatura. A análise dos dados se baseou na técnica análise de conteúdo do tipo temática. Dessa forma, os resultados da pesquisa indicaram que o TBC pode coproduzir quatro dimensões socioterritoriais pela governança pública: a ambiental; a cultural; a econômica; e a política. Tais resultados contribuem teoricamente para avançar na compreensão das características socioterritoriais que o TBC ajuda a promover por meio da governança. Já como implicação à prática de gestão territorial, este trabalho mostra que a participação de atores do TBC na governança pública gera benefícios para o desenvolvimento e coprodução do território endogenamente.

Abstract: Community-Based Tourism (TBC) is a way of managing visitation activities led and self-managed by the community, and can be a vector to endogenously develop urban peripheries and rural areas. Considering the potential of TBC to socially sculpt a given territory, through interaction with other actors, this paper investigates which socio-territorial dimensions TBC can co-produce through public governance. This was done through a qualitative exploratory research, performing an integrative literature review. Data analysis was based on the thematic content analysis technique. Thus, the research results indicated that the TBC can co-produce four socio-territorial dimensions for public governance: the environmental; the cultural; the economic; and the policy. Such results theoretically contribute to advancing the understanding of the socio-territorial characteristics that TBC helps to promote through governance. Already as an implication to the practice of territorial management, this work shows that the participation of TBC actors in public governance generates benefits for the development and co-production of the territory endogenously.
Participative Art Marketing Communication and Creativity of User-generated Content
Authors: Fichnová Katarína , Spálová Lucia 
Published: October 2023

This paper deals with participatory communication in the field of the promotion of cultural institutions. Creativity is an important factor in the success and effectiveness of marketing communication. This phenomenon has not yet been explored in relation to the creativity of user-generated content. This research addresses the question of whether creativity is a significant factor in the success of UGC (user generated content). Analysis of the outputs generated by the recipients of the communication issued by the Getty Museum in Los Angeles – and their interpretation of the works of art available to the museum. We used a modified method of evaluating creativity developed by Smith et. al. (2007). We used correlation analysis to analyze our data. The findings show that creativity is an important factor in the design of the communication strategy rather than in the success of specific UGC products.
GLOBAL REVIEW OF SOLAR POWER IN EDUCATION: INITIATIVES, CHALLENGES, AND BENEFITS
Authors: Oluwaseun Augustine Lottu  , Vincent Ebhohime Ehiaguina  , Sodrudeen Abolore Ayodeji  , Tina Chinyere Ndiwe  , Uchenna Izuka  
Published: October 2023

This research paper comprehensively reviews the global initiatives, challenges, benefits, and future trends in integrating solar power into education. Educational institutions worldwide increasingly embrace solar energy to reduce carbon emissions, promote sustainability, and enhance educational experiences. From pioneering solar campuses in the United States to innovative programs in India and Australia, solar power integration in education is transforming campuses and curricula. However, this transformation has challenges, including financial constraints, regulatory complexities, and technical intricacies. To overcome these hurdles, institutions must leverage innovative financing models, collaborate with utilities, and prioritize education and outreach. The benefits of solar power integration span environmental, economic, educational, and societal dimensions, making it a compelling proposition for schools, colleges, and universities. Solar installations reduce ecological footprints, generate long-term cost savings, offer hands-on learning opportunities, and engage communities. Future trends indicate a shift toward energy storage solutions, microgrids, smart building integration, scalability, and data analytics. To maximize the potential of solar power in education, institutions must develop clear integration strategies, invest in training and professional development, and engage in policy advocacy. International collaboration and knowledge sharing are essential as educational institutions worldwide strive to lead in the transition to a sustainable and solar-powered future in education.
Keywords: Solar Power, Education, Sustainability, Renewable Energy, Environmental Education, Solar Initiatives.