bluuebunny/crossref_metadata_2025_split huggingface dataset:
Initial Experience with the Contour Device in the Treatment of Ruptured Intracranial Wide-necked Bifurcation Aneurysms
Authors: Dange Nitin Narayan , Roy Joanna Mary 
Published: November 2022

Background:
Intrasaccular flow diverters are a new modality in the treatment of intracranial aneurysms. The Contour device has been designed to offer a variety of advantages over existing endovascular treatment options for wide-necked bifurcation aneurysms. There is no available literature describing its use in treating ruptured aneurysms.

Objective:
To assess the safety, outcome, and efficacy of the Contour device as a primary modality in treating ruptured intracranial aneurysms.

Materials And Methods:
A retrospective analysis of 14 aneurysms in 13 patients treated with the Contour device was studied. Data pertaining to demographics, clinical presentation on arrival, aneurysmal characteristics, and follow-up outcome was collected. The Hunt–Hess scale and modified Rankin scale were used to grade severity of clinical presentation.

Results:
Of the 14 aneurysms treated, one was unruptured and 13 were ruptured. Six middle cerebral artery aneurysms, six anterior communicating artery, one basilar top and one distal anterior cerebral artery aneurysm were treated. Coiling was required in two patients due to the large size of their aneurysms. No thromboembolic complications or intraoperative rupture was reported following device placement. Two patients required antiplatelet therapy for 6 weeks. A median follow-up at 3 months revealed stable placement of the device within the aneurysm and no sign of residual aneurysm or rebleed.

Conclusion:
Initial experience with Contour in treating ruptured aneurysms has shown favorable immediate and short-term follow-up outcome. However, long-term follow-up studies are required to assess its safety and long-term efficacy.
Analysing Correlation Between the Facial Nerve Notch at the Root Exit Zone and Long-term Effect in Patients with Hemifacial Spasm After Microvascular Decompression
Authors: Fang Li , Haidong Song , Jianfeng Liang , Ruen Liu 
Published: November 2022

Background:
Microvascular decompression (MVD) has become widely accepted for hemifacial spasm (HFS). The significance of facial nerve notch (FNN) for the outcome after MVD is still unknown.

Objective:
To investigate the correlative analysis between the FNN at the root exit zone (REZ) and the curative effect of MVD for HFS.

Method:
A prospective study was performed, which included 232 patients with Cohen score ≥2 who had undergone MVD. The patients were divided into two groups: the group with facial nerve notch (FNN) and the group without FNN, according to whether there is FNN caused by the offending vessels during the MVD operation. All the patients were followed up for 24 months.

Results:
The group with FNN caused by offending vessels at the REZ area was confirmed in 119 patients, of which 117 patients were immediately cured and two patients received partial relief on the 1st day of postoperation. The group without FNN at the REZ area was confirmed in 113 patients, of which 43 patients were immediately completely cured while 70 patients were not immediately completely cured after MVD operation. After 24 months of follow-up, 119 patients with FNN were all completely cured, 71 patients without FNN were completely cured, and 42 patients without FNN were not completely cured. Multivariate logistic regression analysis shows that compared with without FNN group, the FNN group had statistical significance for the clinical results both on the-1st -day (P < 0.01) and 2 years of follow-up (P < 0.05) after MVD operation.

Conclusions:
FNN is an important reference factor to evaluate both the short-term and long-term curative effect of microvascular decompression for hemifacial spasm. The postoperative effect of patients with FNN is much better than that of patients without FNN.
Contrast Enhancement of Scintigraphic Image Using Fuzzy Intensification
Authors: Pandey Anil Kumar , Dogra Sakshi , Sharma Param Dev , Jaleel Jasim , Patel Chetan , Kumar Rakesh 
Published: November 2022

Introduction:
The objective of this study was to see the effect of fuzzy intensification (INT) operator on enhancement of scintigraphic image.

Materials and Methods:
Nuclear medicine physician (NMP) provided 25 scintigraphic images that required enhancement. The image pixels value was converted into fuzzy plane and was subjected to contrast INT operator with parameters of INT operator i.e., cross-over = 0.5 and number of iterations = 1 and 2. The enhanced image was again brought back into spatial domain (de-fuzzification) whose intensity value was in the range 0–255. NMP compared the enhanced image with its input image and labeled it as acceptable or unacceptable. The quality of enhanced image was also accessed objectively using four different image metrics namely: Entropy, edge content, absolute mean brightness error and saturation metrics.

Results:
Most of the enhanced images (18 out of 25 images) obtained at cross-over = 0.5 and number of iterations = 1 are acceptable and found to have overall better contrast compared to the corresponding input image. Four images (two brain positron emission tomography scan and two I-131 scan) obtained at cross-over = 0.5 and with iteration = 2 are acceptable. Three input images (one dimercaptosuccinic acid (DMSA), one I-131 and one I-131- metaiodo-benzyl-guanidine (MIBG) scan) were better than their enhanced images.

Conclusions:
The enhancement produced by fuzzy INT operator was encouraging. Majority of enhanced images were acceptable at cross-over = 0.5 and number iterations = 1.
Job demands and job resources for job satisfaction and quality health outcomes among nurses during COVID-19
Authors: Manchana Varalakshmi 
Published: November 2022

BACKGROUND:
Coronavirus disease 2019 (COVID-19) pandemic has created unprecedented challenges for the Indian health-care system. Nurses, being vital partners of health care, experience tremendous challenges and job stress to deliver quality health care with limited resources. Drastic surge in health-care demands during COVID-19 pandemic amplified the challenges for nurses, yet it remains a neglected area of concern. Job resources like working conditions, team support, and job demands like workload, stress, and ethical dilemmas greatly affect the job satisfaction and health outcomes in nurses. The study aims to identify the job demands and resources among nurses in connection to COVID 19.

MATERIALS AND METHODS:
A quantitative cross-sectional design was adopted to assess the impact of job demands and resources among registered nurses (N = 102). Those in the age group of 21–58 years and working in regular and COVID-19 patient care were included. Semi-structured interview schedule was used, and psychological impact was assessed through DASS-21 scale. Data analysis was done by descriptive and analytical statistical applications using Statistical Package for the Social Sciences (SPSS) 20. The level of significance was P ≤ 0.05.

RESULTS:
The study findings revealed that 66.67% of the nurses frequently experienced work pressure, 72.55%experienced frequent moral distress, and 80.4%were dissatisfied due to being non-participatory inpatient care decision making. Of all, 67.3% agreed that they hadjob dissatisfaction and 79.4% felt conflicting work climate.

CONCLUSION:
Nurses, being key players in the health care, experience constant challenges in the delivery of safe and quality patient care. Addressing the challenges of job stress and promoting job resources can positively impact their job satisfaction, perceived autonomy, job morale, and commitment, which directly influence positive health outcomes.
Do social phobia and depression go hand in hand? A cross-sectional study among school-going adolescents of Northern region of India
Authors: Gupta Kezia , Semwal Jayanti , Sharma Neha , Srivastava Abhay , Vyas Shaili 
Published: November 2022

BACKGROUND:
The preeminent mental health conditions, namely social phobia and depression among adolescents, usually remain incognito. The transition period from childhood to adulthood makes adolescents more liable for low amour-propre, loneliness, and even increases the suicidal tendencies among them. To burgeon the knowledge regarding social phobia and depression among adolescents, the present study was put forward with the objective to assess the prevalence of social anxiety disorders (social phobia) and depression among adolescents.

MATERIALS AND METHODS:
A cross-sectional study was conducted for 2 months on 600 students aged 10–19 years belonging to classes VIII–XII of government and private schools in the Dehradun district recruited through multistage random sampling technique. A pre-tested semi-structured questionnaire having sociodemographic details, validated self-administered tools, Social Phobia Inventory tool, and Kutchers Adolescent Depression Scale (Cronbach's alpha: 0.77 and 0.79) were used. Statistical package for social sciences, version 23 was used for data analysis. Chi-square test, Fisher exact test, and Pearson correlation analysis were used for analysis

RESULTS:
Prevalence of social phobia was found to be 37% among school-going adolescents. Further, 23.7% of the study participants had mild social phobia, while moderate and severe phobia was seen among 11.5% and 2.3%, respectively. Females had more moderate and severe social phobia than males. Adolescents of government schools had more moderate affective distress and somatic distress as compared to adolescents of private schools.

CONCLUSION:
Social phobia and depression among school-going adolescents are on the upsurge. The present study shows that social phobia and depression have a strong correlation among themselves, which needs to be addressed as expeditiously as possible. Coping strategies and social skill therapy and programs are pressing priorities for the fulgent future of adolescents.
Explaining the challenges of hospitals admitting COVID-19 patients from the perspective of managers (a qualitative study)
Authors: Tabatabaee Seyed Saeed , Vatandoost Vahid , Saghi Fatemeh Kokabi , Daghighbin Elahe 
Published: November 2022

BACKGROUND:
Crises are often unavoidable events that occur around the world. Hospitals play an important role in treating patients and preventing extensive injuries in times of crisis, requiring adequate preparedness. In order to design a proper planning system, it is essential to be aware of the challenges of hospitals during a crisis. The purpose of this study was to explain the challenges of hospitals admitting COVID-19 patients in the city of Mashhad, Iran, from the perspective of their managers.

MATERIALS AND METHODS:
This study employed a qualitative approach, using the method of conventional content analysis and was conducted from May to July 2020. A purposive sampling method was used to recruit the senior managers of hospitals admitting COVID-19 patients in Mashhad. The interviews were conducted face to face, with open-ended questions following an interview guide based on semi-structured questions, and continued until data saturation was reached. Data were analyzed using Atlas Ti software.

RESULTS:
After the implementation of the interviews, first 665 initial codes were extracted from the data, and after removing the overlapping sequences, a total of 115 codes were obtained. Three categories (organizational challenges, extra organizational challenges, and challenges related to information domain), 13 sub-categories, and 33 codes were extracted from the content analysis of the interviews. The main themes propounded in the field of challenges of COVID-19 referral hospitals in Mashhad were organizational challenges, extra organizational challenges, and information domain challenges.

DISCUSSION:
The results of this study showed that the hospitals admitting COVID-19 patients in Mashhad faced many challenges. To improve the quality of services in postcrisis phase, replacing hospitals' equipment, revising curriculums at medical universities, staff retraining, recruiting skilled human resources, and creating a supportive community context are necessary.

CONCLUSION:
For sure, the COVID-19 crisis will not be the last one, we have to be prepared for the bigger health crisis.
Beliefs and expectations on digital learning and examinations among adult learners of a tertiary level health-care institution
Authors: Bhaskarapillai Binukumar , Mishra Rajeeb K. , Rao Girish N. , Govindan Radhakrishnan 
Published: November 2022

BACKGROUND:
Coronavirus disease 2019 (COVID-19) constrained the regular teaching in educational institutions and hampered the teaching–learning process across the globe. E-learning method is widely used in higher education in the current situation. the objective is to assess the beliefs and expectations of the students on e-learning among adult learners of a tertiary level health-care institution.

MATERIALS AND METHODS:
A single group pre-post design was adopted. Microsoft Go two-in-one devices were used to find the effectiveness of e-learning, including digital exam solution. Depending on the availability of device, 25 participants were selected for the study from three different steams. A 5-point Likert scale was used for assessing the quality, adoptability, and acceptance of digital education developed by the researchers. Chi-square/Fisher's exact or McNemar's test was used to test the association between independent or related categorical variables. Comparison of the average score between different courses was performed using the Kruskal–Wallis test.

RESULTS:
Twenty-two participants who completed the final assessment were retained for the analysis. Majority of the participants believed that e-learning helps to achieve personal learning goals or objectives and bridge skill or knowledge gaps and caters to learning preferences. However, the overall quality score across the study groups was found to be statistically insignificant (Kruskal–Wallis statistic: 1.26; P value: 0.533).

CONCLUSION:
The findings show that the adult learners in higher education, irrespective of their age differences, believe that intense e-learning support with Microsoft Go two-in-one device has a complementary effect on their learning outcome.
Bronchiectasis associated with severe COPD
Authors: Doria da Silva Silvia Maria , Moreira Marcos Mello , Paschoal Ilma Aparecida , Pereira Monica Corso 
Published: November 2022

Background:
Bronchiectasis is frequently identified in patients with COPD, especially in severe patients, but the relevance of this finding remains unclear. We aimed to investigate the factors that would increase the chance of having bronchiectasis in patients with severe COPD.

Methods:
This is an analytical, observational, cross-sectional study. Patients with severe COPD with (BC group) and without bronchiectasis (NBC group) were clinically evaluated and performed spirometry, 6-minute walk test (6MWT), volumetric capnography (VCap) and high resolution computed tomography (CT). CT was scored for the findings, and multiple linear regression was performed to identify variables related to the score's severity and logistic regression in order to identify factors that could be associated with the presence of bronchiectasis.

Results:
There was no significant difference between BC and NBC groups regarding clinical variables, except in the smoking load, which was lower in the BC group. In functional evaluation, NBC patients walked shorter distances in 6MWT (P < 0.005). In the BC group the distribution of CT findings was mostly bilateral and in lower lobes. Using the multiple linear regression analysis within the BC group, we found that the higher the bronchiectasis score, the higher ?SpO2 during the 6MWT and the lower the FVC. The chance of having bronchiectasis was 4.78 times higher in the presence of positive isolates (sputum) (CI 1.35-16.865; P = 0.023). The higher the distance covered (6MWT) and Slp3 (VCap), (OR 1.01, CI 1.004; 1.0202, P = 0.0036; OR 1.04, CI 1.003; 1.077; P = 0.036), the greater are likelihood of bronchiectasis.

Conclusions:
In patients with COPD and bronchiectasis, higher CT scores were associated with worse lung function and a greater drop in oxygenation during exercise.
Clinical profile of small-cell lung cancer in North India
Authors: Iyer Hariharan , Ghosh Tamoghna , Agarwal Harsh , Garg Avneet , Pandey Rambha , Jain Deepali , Tiwari Pawan , Mittal Saurabh , Hadda Vijay , Madan Karan , Guleria Randeep , Mohan Anant 
Published: November 2022

Introduction:
The small cell variant is a relatively uncommon but aggressive form of lung cancer. The present study aims to analyse the clinical characteristics, treatment outcomes and prognostic factors of an ambispectively enrolled large cohort of small cell lung cancer (SCLC) in the Indian population over a decade-long period.

Materials and Methods:
All patients diagnosed with SCLC between 2008 and 2020 at a tertiary care lung cancer clinic were included. The clinical details, demographics, details of investigations, treatment and survival outcomes were recorded and analysed.

Results:
A total of 361 patients were included. The majority were males (86.4%) with a mean (SD) age of 57.3 (12.3) years. Further, 34.9% were current smokers, with the median smoking index being 520 (interquartile range [IQR]: 260–1000). The majority had good performance status, that is, the Eastern Cooperative Oncology Group scale (ECOG) 0 or 1 (65%), and Karnofsky Performance Scale (KPS) ≥70 (85.9%). Also, 73.3% had extensive stage disease. The median time from symptom onset to definitive diagnosis was 91 days. Treatment details were available for 179 patients: chemotherapy only (n = 128), combined chemo-radiotherapy (n = 41) and radiotherapy only (n = 10). The median (IQR) progression-free survival (PFS) was 182 (94 to 306) days and the median (IQR) overall survival (OS) was 205 (94 to 429) days. On univariate analysis, factors that significantly affected survival included smoking index and performance status. However, on multivariate analysis, only the performance status significantly affected PFS, whereas none of these factors were significant for OS.

Conclusions:
SCLC predominantly affects males with a heavy smoking index. The diagnosis is usually made late; survival remains poor and is predominantly affected by the performance status.
Lived experience of healthcare professionals providing safe abortion in Rwanda
Authors: Musabwasoni M. G. S. , Ngoga E. , Sitini B. , Muganda J. , Kanyamanza E. , Nyiringango E. , Tengera O. , Uwimana M. C. , Muganwa K. , Bazirere O. , Mukeshimana M. , Uhawenimana T. C. 
Published: November 2022

BACKGROUND: Various countries have ratified the law declaring that safe abortion is a fundamental women’s right. Rwanda has expanded legal grounds for abortion in Law n° 68/2018 of 30/08/2018, determining offenses and penalties in general. This study aimed to gain an in- depth understanding of how physicians, midwives and nurses perceive safe abortion service provision and their experience of providing the service in Rwanda.
METHODS: A qualitative, descriptive phenomenological method with transcendental theory devised by Husserl Edmund was used to guide this study. A non-random purposive sampling recruited twenty-three informants, and a semi-structured interview guide was used to collect data. The data analysis used NVivo pro 12 software to categorize and code ideas, while the eight steps of transcendental descriptive phenomenology were used to generate the final themes. RESULTS: Four themes with ten sub-themes were generated: (1) personal feelings and beliefs (humiliation and stigma, guilty and wonder); (2) resilient mechanisms (Clients’ protection, institutional support, appreciation of the law); (3) training and (4) informants’ recommendations (integrated service, community awareness, psychological support, follow-up).
CONCLUSION: Healthcare providers’ willingness to provide safe abortion services depend on the individual’s beliefs about abortion. Professionalism and resilient mechanisms are key to sustaining the safe abortion service provision in addition to the law determining offenses and penalties in general in Rwanda.
The clinical, functional, and radiological features of hand osteoarthritis: TLAR-osteoarthritis multi-center cohort study
Authors: Tuncay Duruöz Mehmet , Erdem Gürsoy Didem , Tuncer Tiraje , Altan Lale , Ayhan Figen , Bal Ajda , Bilgilisoy Meral , Cerrahoğlu Lale , Çapkın Erhan , Fatih Çay Hasan , Çevik Remzi , Durmaz Berrin , Dülgeroğlu Deniz , Gürer Gülcan , Gürsoy Savaş , Hepgüler Simin , Hizmetli Sami , Kaçar Cahit , Kaptanoğlu Ece , Kaya Taciser , Ecesoy Hilal , Alkan Melikoğlu Meltem , Nas Kemal , Nur Hakan , Özçakır Şüheda , Sarıdoğan Merih , Sarıkaya Selda , Sezer İlhan , Sindel Dilşad , Şahin Nilay , Şahin Özlem , Faruk Şendur Ömer , Taşçı Bozbaş Gülnur , Tıkız Canan , Uğurlu Hatice 
Published: November 2022

Objectives: This study aims to evaluate the clinical, functional, and radiological features of hand osteoarthritis (OA) and to examine their relationships in different geographic samples of the Turkish population.
Patients and methods: Between April 2017 and January 2019, a total of 520 patients (49 males, 471 females; mean age: 63.6±9.8 years) with hand OA were included in the study from 26 centers across Turkey by the Turkish League Against Rheumatism (TLAR). The demographic characteristics, grip strengths with Jamar dynamometer, duration of hand pain (month), the severity of hand pain (Visual Analog Scale [VAS]), and morning stiffness were evaluated. The functional disability was evaluated with Duruöz Hand Index (DHI). The Kellgren-Lawrence (KL) OA scoring system was used to assess the radiological stage of hand OA.
Results: The DHI had significant correlations with VAS-pain (r=0.367, p<0.001), duration of pain (r=0.143, p=0.001) and bilateral handgrip strengths (r=-0.228, p=0.001; r=-0.303, p<0.001). Although DHI scores were similar between the groups in terms of the presence of hand deformity (p=0.125) or Heberden's nodes (p=0.640), the mean DHI scores were significantly higher in patients with Bouchard's nodes (p=0.015). The total number of nodes had no significant correlations with the VAS-pain and DHI score (p>0.05). The differences between the groups of radiological hand OA grades in terms of age (p=0.007), VAS-pain (p<0.001), duration of pain (p<0.001), and DHI (p<0.001) were significant. There were no significant differences between radiological hand OA grades according to the duration of the stiffness, grip strength, and BMI (p>0.05 for all).
Conclusion: In our population, the patients with hand OA had pain, functional disability, and weak grip strength. The functional impairment was significantly correlated with the severity of the pain, and the functional status was worse in high radiological hand OA grades.