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Glomus tumors are rare, usually benign, lesions that arise most often in the extremities. They are derived from the glomus body and have a propensity to be found in the fingers and toes, and often in the subungual area [1]. They typically demonstrate pinprick sensitivity, cold hypersensitivity and paroxysmal pain [2]. Only two glomus tumors of the scrotum have been reported and we report a third case of this rare tumor.

The discipline of Hassidic Philosophy, which emanates from a particular movement in Orthodox Judaism called Hassidism, begins with the premise that all of creation is a dichotomous world of opposites with both sides in a perpetual conflict with one another. The human construct is therefore a dichotomous spiritual entity manifested in the physical world through a mind-body. One side of this soul is the Godly intellect giving rise to the human identity or self-awareness and the other side is the animal soul whose purpose is to galvanize the body. Having learned that this discipline provides its followers with tools for behavioral transformation through inner conflict resolution, I find that it offers a clearer understanding of the spiritual component of holistic health and nursing theory as well as a tool for behavioral transformation that has practical application in nursing practice. Therefore, the purpose of this paper is to present the basic constructs of Hassidism as it pertains to human behavior, demonstrate its compatibility with existing nursing theory and offer a new methodology for advanced practice nurses (APN’s) to assist their clients in achieving behavioral transformation through inner conflict resolution.

A new technique for the use of Artificial Neural Networks (ANN) for the generalization and visual presentation of the results of experimental studies is proposed. The possibility of using ANN for cases for which their use was previously considered impossible is shown. ANN calculators have been created that summarize the results of experimental studies on the effect of trans-polynorbornene and basalt fiber on the characteristics of a rubber compound based on general-purpose rubbers (isoprene SKI-3, butadiene-methylstyrene SKMS-30ARK and butadiene SKD), which also contained vulcanizing agents (N, N′-dithiodimorpholine, thiuram D), vulcanization accelerators (sulfenamide C, 2-mercapto-benzothiazole), vulcanization activators (zinc white, stearic acid), emollients (industrial oil I-12A, rosin) and antioxidants (acetonanil H, diaphene FP). The rubber mixture was prepared on laboratory rollers LB 320 160/160. Subsequently, the rubber mixture was vulcanized in a P-V-100-3RT-2-PCD press. For the resulting vulcanizates, the physical and mechanical properties and their changes were determined after daily exposure to air and in a standard SZhR-1 hydrocarbon liquid at a temperature of 100 °C. We also studied the change in the mass of vulcanizates after exposure to industrial oil I-20A and water. The dynamic parameters (modulus of elasticity and mechanical loss tangent) of vulcanizates, which characterize their noise and vibration-absorbing properties, were studied on a Metravib VHF 104 dynamic mechanical analyzer. The created ANN calculators allow solving a direct problem - interpolating the dependences of all rubber characteristics on the content of basalt fiber, as well as solving inverse problems - to determine the required content of basalt fiber to create rubber with the required performance properties. The autonomous executable modules of the calculators developed by ANN were made and can be passed to everyone.

Conventionally, concrete strength depends on the bonding interface, especially in hydrated products such as calcium silicate hydrate (CSH). As a result, concrete is sensitive under tensile load. With its unique properties, a low fraction of carboxylated nitro-oxidized cellulose nanofibrils (NOCNF) from the banana rachis is employed to improve the mechanical performance of the concrete nano structurally. Compressive and flexural strength using the NOCNF content at 0, 0.05, and 0.1 wt. % cured in 7 and 28 days were evaluated. Notably, the compressive strength increased by 16% and flexural strength by 13% at 0.1% NOCNF compared to plain concrete after the 28 curing days. A low NOCNF fraction achieved a good, albeit impossible, performance with the microscale fibers. The nanostructured effect was discussed twofold: an excellent interaction between the NOCNF and the hydrated products and the carboxylic groups on the NOCNF surface enhanced the cement hydration. These data are better than the literature based on the small-diameter cellulose nanofibrils without the carboxyl groups. As a sustainable nanocomponent, NOCNF could be a perfect candidate to improve concrete performance under mechanical load.

Background: In health care systems nursing care documentation is a vital and powerful tool that ensures continuity of care and communication between health personnel for better patient outcomes. Knowledge, attitude and practice of nurses’ towards nursing care documentation affect the quality and coordination of patients’ care. Hence, this study aimed to assess knowledge, attitude, practice and associated factors towards nursing care documentation among nurses in West Gojjam Zone public hospitals, Amhara Ethiopia. Method: Institutional based cross sectional study was conducted among 246 nurses in West Gojjam Zone public hospitals from February to March 8, 2018. The study participants were selected by simple random sampling technique. Data were collected by using pre-tested and validated self-administered structured questionnaire with internal reliability of Cronbach’s Alpha values 0.912, 0.784 and 0.713 for knowledge, attitude and practice questions respectively. Epi data version 3.1 and SPSS version 20 was used for data entry and analysis respectively. Descriptive statistics and binary logistic regression model were used. Result: The overall response rate was 97.56%. Among 240 respondents 54.6% of them had good knowledge, 50% of study participants had favorable attitude and 47.5% of study participants had good nursing care documentation practice. Sex and monthly salary were found to be statistically significant with knowledge of nurses. Work setting, work experiences and knowledge of nurses had significant association with nurses’ attitude towards nursing care documentation. Availability of operational standards, knowledge and attitude of nurses had significant association with nursing care documentation practice. Conclusions and Recommendation: Results of this study showed that knowledge, attitude and practice of West Gojjam zone public hospital nurses on nursing care documentation were poor. Therefore; in order to solve this problem each hospital should recruit nurses until hospitals are saturated enough. It is recommended to avail nursing care documentation standards/guidelines in each hospital and to give training about it and also it is recommended to conduct multisite studies especially qualitative type to increase its quality.

Fox, et al. [1] reported on the relevant cardiopulmonary findings in a series of autopsies of patients deceased from SARS-CoV-2 infection. In particular, regarding the histologic examination of the lungs, they observed bilateral diffuse alveolar damage with a lymphocytic infiltrate, thickened alveolar capillaries, fibrin thrombi within the capillaries and small vessels, and entrapment of neutrophils, without any significant neutrophilic, infiltrate within airways or the interstitium. 

Background: A structured multidisciplinary team is very important during every phase of the amputation process and a good communicative team guarantees a greater tranquility for the patient, thanks to more homogenous information, that is already discussed between the clinicians. Aim: The aim of this study was to define the efficacy and outcome value of an innovative procedure tool (TRIA-MF protocol) in the treatment of lower limb amputees before and after prosthesis use with the purpose to quantify the quality of the procedure and its economic impact on the clinical patients’ recovery. Setting: A rehabilitation institute for the treatment of neurological and orthopaedic gait disorders. Methods: 12 patients (4 women and 8 males) subjected to lower limb amputation and admitted according to the principles of inclusion criteria of the TRIA-MF protocol at the Rehabilitation Department of the Clinical Institute Città di Brescia were recruited in this study. All patients were included in an integrated and task-specific management protocol of the amputee, which allowed to follow the rehabilitation process from amputation to the final restoration, for a period of 6 months for each patient. Patients were evaluated 5 times during the study, collecting their degree of pain (VAS), their independence profile (Barthel Index) and the cirtometry of their amputation stump. Data on the duration of their admission to the rehabilitation unit, the inter-time between the amputation and acquisition of the temporary prosthesis, and between temporary prosthesis acquisition and the final prosthesis acquisition were also reported. Results: Patients of our sample, at the end of their hospitalization, highlight a significant modification of the temporal data at 1 month and 6 months from their hospital discharge. A statistical significant increase of the Barthel Index value was observed in all patients recruited in this study proceeding from time T0 to time T4; in the same way, a statistical significant decrease of the VAS scale was observed in all patients recruited proceeding from time T0 to time T4; the cirtometry of the amputation stump (expressed in cm) showed a statistical significant decrease in all patients recruited proceeding from time T0 to time T4. We haven’t observed a statistical significant correlation between the duration of the rehabilitative hospitalization and our clinical data; no statistical significant correlation was observed between the amputation stump cirtometry time-related modification and our intertime data. Conclusions: The protocol was found to be a clear and relevant tool with the definition of the operational profile for each single professional figure involved; it could also be considered as an optimal tool for coding the management and evaluation of the effectiveness of amputee treatment, with a related high reproducibility, sensitivity and specificity profile. In line with the literature, the TRIA-MF protocol has allowed us not to exceed a period of hospitalization in rehabilitation units of more than 23 days, thus showing that it is an excellent tool for optimizing the management costs of the amputee over time.

Introduction: Bacterial resistance is a threat to public health, as it is estimated that 37,000 people die due to hospital infections, most of them due to multidrug-resistant bacteria. In part, this resistance is due to the inappropriate use of antibiotics, with ceftriaxone being one of the most used. Therefore, this article aims to analyze the consequences of using ceftriaxone in the hospital environment. Methodology: This is an integrative qualitative review, following the PICO strategy, using the Embase, BVS, and Pubmed databases, with the guiding question being: “In patients admitted to a hospital environment (P), is ceftriaxone used appropriately (I) for the treatment of infections (CO)?” and the time frame from 2013 to 2023. Results: 272 articles were found in total, 46 obtained from the VHL, 62 from PubMed, and 164 from Embase. Of these, 66 were duplicates, leaving 206 works for title and summary reading. After reading, 79 were selected for full reading, with 7 articles ultimately being selected for the study. An average of 62.3% of inappropriate use was found, with the minimum value found being 19% and the maximum being 87.9%. The main reasons for this use were: indication, dose, frequency, and duration. Conclusion: From reading the articles, it is concluded that the inappropriate use of ceftriaxone is mainly due to: indication, dose, frequency, and duration of treatment. These elements must be monitored, as their inappropriate use increases the length of hospital stay and may be associated with the emergence of bacterial resistance.

Background: Cochlear implants (CI) are nowadays a widely accepted treatment for sensorineural hearing loss SNHL. Aim: This study aimed to describe the epidemiological characteristics and the surgical approach and to evaluate the outcomes of our experience in cochlear implantation. Setting: Department of Otolaryngology-Head and Neck Surgery of University Hospital Mohammed VI Marrakech Morocco. Methods: A retrospective chart review was conducted on 113 patients with severe to profound hearing loss who underwent a cochlear implantation between 2007-2018. Results: There were 65 females and 48 males with severe to profound bilateral deafness, of whom 103 had prelingual deafness. The mean age of pediatric cochlear implantation was 5.25 years. Implantation was unilateral in all patients. The procedure was followed by regular adjustments and speech therapy. The evaluation was carried out by the same team each month during the first 6 months, then every 6 months. The average duration of follow-up was 37.54 months. All patients benefited from their implants with inter individual variability. The good results were correlated with early implantation, significant parental investment and a steady follow-up of speech therapy. Conclusion: Cochlear implantation has revolutionized the management of severe to profound deafness. It is a safe and effective technique when it is aimed at correctly selected populations.

The ciliated hepatic cyst of the anterior intestine is a less frequent benign entity that arises from the alteration in the migration of embryological remains. Most of them are found in the left lobe of the liver, especially in segment IV. Its wall is covered by a pseudostratified ciliated columnar epithelium, a layer of connective tissue, smooth muscle, and a surrounding fibrous outer layer. We present the case of a 61-year-old man who, in the context of a scheduled admission for drainage of an intraabdominal abscess, was incidentally discovered to have a hepatic lesion of cystic aspect. The anatomopathological diagnosis was that of a ciliated hepatic cyst. Due to its low frequency in clinical practice (in part due to its incidental character), a review of the case and a review in the literature of the peculiarities of said entity are proposed.