bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strategies for Bridging the Theory-Practice Gap in Nursing Education from the Perspective of Nursing Teachers, Clinical Nurses, and Nursing Students
Authors: Adha Yuvraj Singh , Thomas Chris 
Published: June 2023

Background:
Nurses are the integral part of the health-care team who focus on the well-being of the patient and quality patient care. With wide range of roles and responsibility, nurses should have proper knowledge of the subject along with the necessary competent skills to perform their duties. The gap between education and the clinical practice has always been challenge for educational experts in the field.

Objectives:
The objectives were to explore the factors causing the theory-practice gap in nursing education in India and to identify the strategies for bridging the theory-practice gap in nursing education.

Methods:
The research design was descriptive qualitative design. The data were collected from 30 participants including 10 clinical nurses, 10 nursing teachers and 10 nursing students from selected hospitals and nursing colleges of Northern India. Non-probability purposive sampling technique was used to collect the data. Semi-structured telephonic interview with self-administered questionnaire was used to collect the data. The collected data were analysed by using Coloizzi's method and the data were organised and transcribed.

Results:
The five emergent themes were clinical practice and clinical nurse-related factors, curriculum-related factors, student-related factors, nurse faculty-related factors and administration-related factors. Findings for the strategies to bridge the theory practice gap were organised into 12 subcluster themes, 7 cluster themes and 5 emergent themes which are collaborative health care approach, reforms in teaching styles and evaluation system, system change and integrative approach of nursing curriculum.

Conclusion:
Nursing practice is closely associated with the theory taught in the class. Hence, the theory should be wisely applied in the clinical areas to deliver the quality nursing care to the patients.
Perspective of Nursing Officers towards their Preferred Profession in India
Authors: Mohanasundari S. K. , Raghu V. A. 
Published: June 2023

Introduction:
The performance of nurses has a substantial impact on patient outcomes and professional development. The perspective towards the job and the nursing profession has a direct impact on professional commitment. The aim of this study was to explore the perspectives of nurses towards their preferred profession.

Methods:
A total of 572 nursing officers from all four of India's regions – the East, West, North and South–were included in a cross-sectional descriptive study. The samples were contacted by WhatsApp, e-mail and telegram by sharing the SurveyMonkey app-created survey link. The questionnaire includes a 5-point Likert scale to assess the nursing officers' perspectives on a total of 20 statements regarding their perception. The subjects were asked to fill out the informed consent before the study started.

Results:
The majority of the nursing officers (69.1%) had favourable perspectives and only 1/3rd of the subjects (30.9%) had unfavourable perspectives towards their preferred profession. The years of experience had a significant association with levels of perspective (P = 0.016) tested by Chi-square. Multiple logistic regression showed geographic region had a significant influence on the level of perspective (P = 0.027; 95% confidence interval: 1.059–2.622).

Conclusion:
The nursing officers had favourable perspectives towards the chosen profession and geographic region is the influencing factor on levels of perspective. To increase personal and professional development, efforts must be taken to reduce the influencing factor and barriers that affect the nursing officer's perspectives.
Primary epithelioid trophoblastic tumor of the lung: A case report
Authors: Zhang Qiongying , Sun Wenwen , Zhang Zhen , Li Jianmin 
Published: June 2023

ABSTRACT
Primary epithelioid trophoblastic tumor (ETT) of the lung is exceedingly rare. Only about three cases have been reported in Pubmed and worldwide literature. We presented a case of multiple primary ETT of the lung occurring in a 33-year-old Chinese female patient. Comprehensive physical examinations revealed no evidence of a primary lesion on the uterus or cervix uteri. Microscopic examination of the tumor demonstrated ETT of the lung, which was confirmed by immunohistochemical staining and declining level of beta-human choriogonadotropin (β-HCG) after the operation. Our case revealed that the ETT can occur in the lung and should be considered when a female had a tumor of lung with increasing β-HCG.
The Taq 1 polymorphism of Vitamin D receptor gene is associated with oral cancer and preoral cancer in North Indian population
Authors: Nigam Kumud , Singh Navin , Yadav Suresh Kumar , Sanyal Somali 
Published: June 2023

ABSTRACT

Background:
Oral cancer is known as one of the most common cancers, with a poor prognosis, related to delayed clinical diagnosis, either due to the lack of particular biomarkers related to the disease or costly therapeutic alternatives.

Aims and Objectives:
In this study association of single nucleotide polymorphism (Taq1, T>C) in Vitamin D receptor gene with oral cancer and pre oral cancer was studied.

Materials and Methods:
Total 230 patients of precancerous oral lesions (Leukoplakia 70, Oral Sub mucous fibrosis 90, Lichen Planus 70), 72 oral cancer patients and 300 healthy control subjects were genotyped by PCR-RFLP methods. Chi-square test was used for calculation of genotype and allele frequencies.

Results:
Mutant genotype CC as well as C allele were found to significantly decrease the risk of oral disease (P value=0.04, OR=0.60 and P value=0.02, OR=0.75 respectively). In particular, compared to non smokers, smokers with TC & CC genotypes were at decrease risk of oral diseases (P value=0.0001, OR=0.04). The mutant allele genotype CC as well as the mutant allele C showed protective association with leukoplakia (P value=0.01, OR=0.39 & P value=0.009, OR=0.59 respectively). However, individual with CC genotype had developed high cell differentiated grade at diagnosis (OR= 3.78, P value= 0.008).

Conclusions:
This study concludes that VDR (Taq1) polymorphism is associated with oral cancer and pre oral cancer susceptibility in North Indian population.
Epithelioid leiomyosarcoma: An unusual presentation
Authors: Kalantri Suman H. , Joseph Leena Dennis , Priyathersini N. , Elangovan Babu 
Published: June 2023

ABSTRACT
Uterine mesenchymal tumors are a heterogeneous group of neoplasms that can be diagnostically challenging. Thorough investigations and histopathological findings are highly significant to arrive at the correct diagnosis, thus ensuring appropriate and prompt treatment to the patient. Leiomyosarcoma (LMS) is an uncommon uterine malignancy, which arises from the smooth muscle of the uterine wall. They usually present in postmenopausal women with abnormal uterine bleeding. It follows an aggressive clinical course with an extremely poor prognosis. Surgical management followed by adjuvant chemotherapy is usually the treatment for such cases. Here, we report the case of a 57-year-old menopausal female who presented with a large abdominal swelling that was seen infiltrating the adjacent structures. On resection and histopathological evaluation, a diagnosis of epithelioid LMS was made, which was confirmed by immunohistochemistry.
Severe persistent marrow aplasia in chronic myeloid leukemia (CML): An unusual complication of imatinib
Authors: Madabhavi Irappa , Patel Apurva , Anand Asha , Panchal Harsha 
Published: June 2023

ABSTRACT

Background:
Imatinib has changed the treatment of chronic myeloid leukemia (CML) drastically since 15 years. It is usually well tolerated, but severe persistent marrow aplasia is an unusual complication of imatinib while using it in CML. The aim of this study is to describe our experience confronting this rare side effect and review the available data worldwide.

Patients and Methods:
It was a retrospective analysis conducted at a center from February 2002 to February 2015. This study was endorsed by our Institutional Review Board (IRB) and written consent was taken from all patients. Patients diagnosed as Philadelphia (Ph) chromosome-positive CML either in chronic phase (CP), accelerated phase (AP), or blastic crisis (BC) were included. There were a total of 1,576 patients with CML treated with imatinib during this period. Karyotyping and quantitative reverse transcriptase polymerase chain reaction (RT-qPCR) were done at the time of pancytopenia for all patients.

Results:
In total, 11 (males = 5, females = 6) patients met our inclusion criteria from 1,576 patients of CML. The median age was 58 years (range 32–76). Out of 11 patients 8, 2, and 1 patients were in CP, AP, and BC phases, respectively. The median time of administration of imatinib was 3.3 months (range 1.5–6). The average time of marrow recovery was 10.4 months (range 5–15). Two patients expired (one from septicemia and the other from intracranial hemorrhage). BCR-ABL transcripts level by RT-PCR revealed the existence of the disease in all patients.

Conclusion:
Imatinib is a very well-tolerated tyrosine kinase inhibitor (TKI), but is associated with persistent myelosuppression when used in older age, advanced phase of the disease, and treated previously. After confirming persistent marrow aplasia, the treatment is mainly supportive. It is striking that the disease is still persistent, which is confirmed by RT-PCR. There is no consensus regarding recalling imatinib at lower doses or the use of second-generation TKI (nilotinib, dasatinib) in these patients.
Intra-operative partial breast irradiation versus external whole breast irradiation for early breast cancer
Authors: Güzle Adaş Yasemin , Uyar Serab , Yazıcı Ömer 
Published: June 2023

ABSTRACT

Aims:
Intra-operative radiotherapy (IORT) is a new alternative way to give radiation therapy. During surgery to remove breast cancer, radiation is given as a single dose directly to the area where the tumor used to be. The aim of the study was to compare the results of IORT as partial breast irradiation and external whole breast irradiation (EBRT) for early breast cancer in elderly patients after breast-conserving surgery. The results were retrospectively analyzed from a single institution. We report 7-year results for local control.

Settings and Design:
Cross-sectional study.

Methods and Material:
Between November 2012 and December 2019, 21 Gy partial breast irradiation was applied intra-operatively to 40 selected patients. Two of these patients were excluded from the study, and 38 patients were evaluated. Also, 38 patients who had EBRT and had similar properties to that of IORT patients were selected to compare the treatment results in terms of local control.

Statistical Analysis Used:
SPSS version 21 was used for statistical analysis. Patient groups undergoing IORT and EBRT were analyzed with the Kolmogorov–Smirnov test. The groups were examined in terms of demographic features using t-test, and P < 0.05 was considered as statistically significant. Local recurrence rates were calculated by Kaplan–Meier analysis.

Results:
The median follow-up time was 58 months (range 20–95 months). The local control was 100% in both groups, and no local recurrences were observed.

Conclusion:
IORT seems to be a safe and effective alternative to EBRT for early breast cancer in elderly patients.
Evaluating the effects of variation in CT scanning parameters on the image quality and Hounsfield units for optimization of dose in radiotherapy treatment planning: A semi-anthropomorphic thorax phantom study
Authors: Sorooshfard Elahe , Tahmasbi Marziyeh , Chegeni Nahid , Birgani Mohammad Javad Tahmasebi 
Published: June 2023

ABSTRACT

Aim:
The diagnosis accuracy of computed tomography (CT) systems and the reliability of calculated Hounsfield Units (HUs) are critical in tumor detection and cancer patients’ treatment planning. This study evaluated the effects of scan parameters (Kilovoltage peak or kVp, milli-Ampere-second or mAS reconstruction kernels and algorithms, reconstruction field of view, and slice thickness) on image quality, HUs, and the calculated dose in the treatment planning system (TPS).

Materials and Methods:
A quality dose verification phantom was scanned several times by a 16-slice Siemens CT scanner. The DOSIsoft ISO gray TPS was applied for dose calculations. The SPSS.24 software was used to analyze the results and the P-value <0.05 was considered significant.

Results:
Reconstruction kernels and algorithms significantly affected noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). The noise increased and CNR decreased by raising the sharpness of reconstruction kernels. SNR and CNR had considerable increments at iterative reconstruction compared with the filtered back-projection algorithm. The noise decreased by raising mAS in soft tissues. Also, KVp had a significant effect on HUs. TPS--calculated dose variations were less than 2% for mediastinum and backbone and less than 8% for rib.

Conclusions:
Although HU variation depends on image acquisition parameters across a clinically feasible range, its dosimetric impact on the calculated dose in TPS can be neglected. Hence, it can be concluded that the optimized values of scan parameters can be applied to obtain the maximum diagnostic accuracy and calculate HUs more precisely without affecting the calculated dose in the treatment planning of cancer patients.
Feature selection algorithm based on binary BAT algorithm and optimum path forest classifier for breast cancer detection using both echographic and elastographic mode ultrasound images
Authors: Sasikala S , Ezhilarasi M , Arunkumar S 
Published: June 2023

ABSTRACT

Context:
Breast cancer is one of the fatal diseases among women. Every year, its incidence and mortality rate increase globally. Mammography and sonography are widely used in breast cancer detection. Because mammography misses many cancers and shows false negatives in the denser tissues, sonography is preferred to give some extra information in addition to that available from mammography.

Aims:
To improve the performance of breast cancer detection by reducing false positives.

Settings and Design:
The local binary pattern (LBP) texture features must be extracted from ultrasound elastographic and echographic images of the same patients and then fused to form a single feature vector.

Methods and Materials:
Local Binary Pattern (LBP) texture features of elastographic and echographic images are extracted, and reduced individually through a hybrid feature selection technique based on binary BAT algorithm (BBA) and optimum path forest (OPF) classifier and then fused serially. Finally, the support vector machine classifier is used to classify the final fused feature set.

Statistical Analysis Used:
Various relevant performance metrics such as accuracy, sensitivity, specificity, discriminant power, Mathews correlation coefficient (MCC), F1 score, and Kappa were used to analyze the classification results.

Results:
The use of LBP feature produces 93.2% accuracy, 94.4% sensitivity, 92.3% specificity, 89.5% precision value, 91.88% F1 score, 93.34% balanced classification rate, and Mathews correlation coefficient of 0.861. The performance was compared with gray level co-occurrence matrix (GLCM), gray level difference matrix (GLDM), and LAWs features, and showed that LBP outperformed.

Conclusions:
Because the specificity is better, this method could be useful for detecting breast cancer with minimum false negatives.
Clinico-virological profile of severe acute respiratory infections in children admitted in pediatric ICU/high dependency unit
Authors: Kavil Hasanath Ayyappan , Anand Manjula , Kandath Sathishkumar , Ramachandran Anand Manjeri 
Published: June 2023

Background:
Viral etiologies responsible for acute respiratory infections in our region are poorly understood or studied, particularly among hospitalized children. Lacking etiologic diagnosis is the main reason that most of the cases suffer unnecessary or inappropriate prescription of antibiotics.

Objectives:
This study was done to know clinic-virological profile of severe acute respiratory infections in children admitted to pediatric intensive care unit or high dependency unit in a tertiary care hospital.

Materials and Methods:
Respiratory samples were collected and screened for viruses by utilizing multiplex real-time polymerase chain reaction (PCR) assay.

Results:
Viral PCR detection rate was 82.9%. A total of 69% of isolates were single virus and 31% were coinfection. Among the viral isolates, respiratory syncytial virus (RSV) A, B was the most common viral isolate (27.6%), followed by adenovirus (23.42%) and bocavirus (12.66%). RSV A, B showed an age predilection for 1–5 years. RSV A, B was the predominant isolate in children having acute respiratory distress syndrome, need for invasive ventilation and prolonged intensive care unit stay and it showed a seasonal prevalence in the months of August to December with peak incidence during October.

Conclusion:
Overall positivity was 82.9%. RSV A, B was the most predominant virus.
Rehabilitation of a completely edentulous patient with fixed implant prosthesis on titanium framework
Authors: Kalavathy Natarajan , Anantharaj Nikhil , Ragunath Karthiban , Shetty Mitha M , Kumar P. Roshan , Patil Netra 
Published: June 2023

Rationale:
This article describes step by step procedure for the rehabilitation of a completely edentulous patient with 12 endosseous implants followed by the fabrication of the Malo bridge with CAD-CAM fabricated titanium framework.

Patient Concerns:
The patient with a chief complaint of ill-fitting conventional complete denture reported to the hospital and wanted a fixed rehabilitation.

Diagnosis:
The patient was diagnosed with completely edentulous maxillary and mandibular arches without any systemic illness.

Interventions:
Twelve implants (Neobio tech) were placed in maxillary and mandibular arches (6 in each arch). After osseointegration, healing abutments were placed during the second stage of surgery. A final impression was made using the open tray technique. The accuracy of the impression was verified using jig trial and OPG. This was followed by jaw relation and try-in. A titanium metallic framework was positioned on the implants to check the fit. A Malo bridge with individual cementable zirconium crowns was fabricated. The metallic framework was torqued to 35N and crowns were cemented using Implant Premier cement. The screw holes were packed with Teflon tape and restored using composite.

Outcomes:
The patient was satisfied with the treatment outcome. Follow up were done after 10 years with no significant complications.

Lessons:
Fixed implant prosthesis with titanium framework was found to be a successful treatment protocol for the rehabilitation of the completely edentulous patient.
Evaluate the effectiveness of laparoscopic myomectomy without power morcellator
Authors: Le Si Phuc An , Le Si Phuong , Nguyen Vu Quoc Huy 
Published: June 2023

Aim: To describe characteristics of uterine fibroids and evaluate the effectiveness of laparoscopic myomectomy.
Methods: Cross-sectional observative study in fifty-two patients underwent laparoscopic myomectomy at Department of Obstetrics and Gynecology, Hospital of Hue Medicine and Pharmacy University and Hue Central Hospital from 6/2019 to 6/2021. Inclusion criteria were patients with ≤ 5 fibroids, largest diameter did not exceed 10cm in diameter and no contraindication for laparoscopy. Patients were operated laparoscopically and manually morcellated by vaginal route, without electrical morcellator.
Results: Mean age was 42.3 ± 4.2 years old. The most common symptom was abnormal uterine bleeding (42.3%). The mean diameter was 66.8 ± 16.3 mm. The success rate of laparoscopic myomectomy was 98.1%. The mean operation time was 148.66 ± 51.4 min. Diameter ≥ 80mm, multiple fibroids (>5 fibroids) and operation time ≥ 180 min (p < 0.05) were associated factors of significant Hemoglobin drop and prolonged surgery.
Conclusions: Laparoscopic myomectomy had high success rate and low complication rate, however appropriate indication and experienced surgeon were necessary.
Risk factors of postpartum hemorrhage due to uterine atony: a retrospective cohort study
Authors: Vo Hoang Lam , Truong Quang Vinh 
Published: June 2023

Background: Postpartum hemorrhage (PPH) continues to be a significant global burden leading to high maternal mortality and morbidity rates. Uterine atony is the most prevalent cause of postpartum hemorrhage, accounting for 75% to 90% of cases.
Aim: Research uterine atony related PPH at Hospital of Hue University of Medicine and Pharmacy’s Department of Obstetrics and Gynecology.
Materials and methods: In this study, we conducted a retrospective case-control study to determine the risk factors for PPH among a cohort of women who gave birth between August 2020 and June 2021 at the Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy Hospital. PPH was defined as an estimated blood loss ≥500 mL. Logistic regression analysis was used to identify independent risk factors for PPH.
Results: After the vaginal deliveries, we collected data from 147 patients, including 49 women with PPH caused by uterine atony and 98 without PPH. Maternal characteristics significantly associated with PPH included: pre-delivery anemia (adjusted OR [aOR] 4.0, 95% Confidence interval [CI]: 1.7 - 11.2), macrosomia (aOR = 4.3; 95%CI 1.1 - 16.8) and grand parity (aOR = 4.7; 95%CI: 1.7 - 13.9).
Conclusions: All pregnant women should have their risks associated with postpartum hemorrhage evaluated and monitored during their pregnancies’ prenatal, labor, and postpartum stages.
Correlation of serum biomarkers with treatment result in women with first trimester threatened miscarriage
Authors: Le Uyen Phuong , Ho Tran Tuan Hung , Vo Van Duc 
Published: June 2023

Objectives: To assess the correlation of serum biomarkers with treatment result in women with first trimester threatened miscarriage.
Materials and methods: Cross-sectional observative study in 107 patients which were first trimester threatened miscarriage at Department of Obstetrics and Gynecology, Hue Central Hospital and Hospital of Hue Medicine and Pharmacy University from March 2021 to June 2022. Inclusion criteria included women with threatened miscarriage and gestational age ≤ 13 weeks and 6 days. Participants were measured the levels of biomarkers (PAPP - A, CA 125, β-hCG, progesterone) and divided into two groups: group 1 included 90 women with successful treatment (continued pregnancy), and group 2 included 17 women with failed treatment (miscarriage, stillbirth).
Results: The level of maternal serum PAPP - A, β-hCG and progesterone for the successful treatment group were higher than the failed treatment group (p < 0.05). The median PAPP - A in group 1 and group 2 were 0.59 (0.12 - 2.04) IU/L and 0.02 (0.01-0.04) IU/L, respectively. The cut-off limit of 0.088 IU/L of PAPP - A level achieved sensitivity of 77.8% and specificity of 94.1%. The cut-off limit of 8004.5 mIU/ml of β-hCG level for ≤ 6 weeks gestational age group achieved sensitivity of 92% and specificity of 84.6%. The cut-off β-hCG value of 29162.5 mIU/ml for over 6 weeks to 13 weeks and 6 days group gave a sensitivity of 98.5% and specificity of 100%. The threshold progesterone value of 14.13 ng/dl gave a sensitivity of 93.3%, specificity of 94.1%. The median CA 125 in the group 2 was 74.01 (32.75 - 103.00) U/ml, that was higher than group 2 which was 40.90 (27.28 - 76.76) U/ml, p > 0.05. The cut-off CA 125 value of 68.55 U/ml for miscarriages gave a sensitivity of 58.8% and specificity of 71.1%.
Conclusions: Levels of maternal serum PAPP – A, CA 125, β-hCG and progesterone were early predictors of pregnancy outcome in women with first trimester threatened miscarriage.