bluuebunny/crossref_metadata_2025 huggingface dataset:
Le neurofeedback au service de la maîtrise du stress
Authors: Verdonk Charles
Published: April 2023

Le neurofeedback est une technique moderne avec laquelle un individu apprend à contrôler l’activité d’une région de son cerveau en s’aidant du signal généré par sa propre activité cérébrale. Dans le cadre de la gestion du stress, le neurofeedback pourrait permettre d’entraîner les individus à mieux réguler l’activité des régions cérébrales impliquées dans une réponse de stress excessive. Le développement d’un dispositif de neurofeedback comporte plusieurs défis scientifiques et techniques qu’il convient de relever, préalable indispensable avant d’envisager son déploiement à grande échelle au profit des militaires. Le neurofeedback représente un nouveau domaine d’intérêt pour la recherche biomédicale de défense et un enjeu de recherche transdisciplinaire pour les chercheurs des différentes armées.
« Mon camion, c’est ma maison ». Quand le véhicule-habitation vient questionner la norme d’habitat
Authors: Auger Émilie
Published: April 2023

Les jeunes nomades et saisonniers viticoles sont peu étudiés par les chercheurs et peu connus des politiques publiques. Quand ils circulent dans les espaces ruraux, leur présence interroge la norme d’habitat établie par les codes de l’urbanisme et les politiques sociales liées au logement. En effet, les jeunes saisonniers nomades vivant en tente, voiture et principalement en camion aménagé transgressent la norme de l’habitat par leur mode de vie mobile. Les entretiens que nous avons réalisés avec ces jeunes, souvent vus comme des déviants dans les espaces ruraux qu’ils traversent, ont permis de comprendre leur monde social et, ce faisant, les valeurs mises en avant par ces nomades pour justifier leur maintien dans ce mode de vie.
Entre aides et entraides. Enquête sur les expédients alimentaires de trois personnes immigrées sans-domicile
Authors: Renoux Paolo
Published: April 2023

Cet article s’appuie sur une enquête de l’Observatoire du Samusocial de Paris, « Hors-Service », portant sur les manifestations socio-économiques de la crise sanitaire de Covid-19 sur les personnels du secteur de l’hôtellerie-restauration, et menée en 2020 et 2021. Les budgets de trois personnes sans domicile y sont étudiés dans une perspective ethnocomptable sous l’angle spécifique de l’alimentation. La description des économies domestiques met en lumière tout un panel d’activités, de ressources et de relations sociales qui s’articulent pour former un équilibre budgétaire. Au sein de ces portefeuilles de subsistance, le recours à l’aide alimentaire côtoie de multiples façons de se nourrir à moindre coût. L’aide d’urgence ne remplit pas toujours le même rôle, pouvant paradoxalement devenir vectrice d’indépendance et d’émancipation alimentaire. L’enquête met en évidence les usages et les enjeux multiples de l’alimentation qui, loin de se réduire à son intérêt nutritionnel et à ses implications économiques, s’inscrit dans la recherche d’une vie, sociale et domestique, qui vaut la peine d’être vécue. L’étude des budgets, ici ceux de l’alimentation, déborde largement la question économique pour permettre une compréhension fine du vécu des personnes sans domicile, de leurs évaluations quotidiennes et de leurs horizons biographiques.
L’hébergement d’urgence à l’épreuve de la pandémie. Enquête sur les reconfigurations d’un dispositif de mise à l’abri hivernal
Authors: Maurin Marine , Uribelarrea Gabriel , Verbeck Cédric
Published: April 2023

Cet article analyse les transformations de l’hébergement d’urgence dans le cadre de la pandémie du Covid-19 et les épreuves qu’elles ont engendrées pour les professionnels et les personnes qui y sont hébergées. À partir d’une enquête de terrain conduite dès le premier confinement en mars 2020 et prolongée jusqu’en mars 2022, nous documentons comment un dispositif de « mise à l’abri hivernal » a fait l’objet de reconfigurations afin de mettre en application les mesures de « confinement » et de « distanciation sociale ». Alors que la promiscuité de ce type d’hébergement est déjà connue, nous montrons que celle-ci est désormais cadrée comme un problème sanitaire. Ce nouveau cadrage engendre des pratiques d’espacements et de déplacements de personnes vers d’autres habitats précaires, dont l’internat d’un lycée. En décrivant ces espacements et déplacements des personnes hébergées, l’enquête montre comment la crise sanitaire a finalement contribué à renforcer l’intensité de deux épreuves typiques de l’urgence sociale : celle du déplacement contraint des individus considérés sans attaches et celle du caractère temporaire et précaire des habitats proposés.
Do consumers care about environmentally sustainable attributes along the food supply chain? —A systematic literature review
Authors: Yang Wei , Anh Bryan , Le Phuc
Published: April 2023

The agri-food market has shown a clear signal of "green" consumption that drives an increasing interest in studying consumers' willingness to pay (WTP) for food products with environmentally sustainable attributes, such as eco-friendly and carbon neutral. Whilst many existing studies have focused on a general idea of green attributes or on-farm practices that are regarded to be most relevant to the attributes, the agri-food industry has started to address consumers' concerns about the negative environmental impacts of agri-food production across the whole supply chain, including the processing, transportation, and consumption process. It is therefore the purpose of this study to conduct a systematic review of the existing literature on consumers' intentions of purchasing and WTP for food products with environmentally sustainable attributes, with a special interest in understanding the connections between consumer behaviours and different stages of the food supply chain. Results of the study revealed three main research gaps: the lack of clear definitions of environmentally sustainable attributes; ignorance of connections between the characteristics of environmentally sustainable attributes and different stages of the food supply chain; and lacking effective information processing among the key players along the supply chain, leading to inefficient communication between the supply and demand side. The findings of the study help form a conceptual framework for future studies to associate environmentally sustainable attributes to the whole food supply chain that helps the agri-food industry to effectively process market information, communicate with consumers, and satisfy the market demand.
Analytical solutions to a class of fractional coupled nonlinear Schrödinger equations via Laplace-HPM technique
Authors: Hong Baojian , Wang Jinghan , Li Chen
Published: April 2023

In this article, a class of fractional coupled nonlinear Schrödinger equations (FCNLS) is suggested to describe the traveling waves in a fractal medium arising in ocean engineering, plasma physics and nonlinear optics. First, the modified Kudryashov method is adopted to solve exactly for solitary wave solutions. Second, an efficient and promising method is proposed for the FCNLS by coupling the Laplace transform and the Adomian polynomials with the homotopy perturbation method, and the convergence is proved. Finally, the Laplace-HPM technique is proved to be effective and reliable. Some 3D plots, 2D plots and contour plots of these exact and approximate solutions are simulated to uncover the critically important mechanism of the fractal solitary traveling waves, which shows that the efficient methods are much powerful for seeking explicit solutions of the nonlinear partial differential models arising in mathematical physics.
Existence and stability results for nonlinear coupled singular fractional-order differential equations with time delay
Authors: Hammad Hasanen A. , Işık Hüseyin , Sen Manuel De la
Published: April 2023

The objective of the manuscript is to build coupled singular fractional-order differential equations with time delay. To study the underline problem, an integral representation is initially discussed and the operator form of the solution is investigated using various supplementary hypotheses. Also, the existence and uniqueness of the considered problem are investigated by using the Lebesgue-dominated convergence theorem and some analysis results. Moreover, the stability analysis to determine the nature of the proposed model's solution is examined. Finally, two supportive examples are provided to demonstrate our analysis as applications.
Positive ground state solutions for a class of fractional coupled Choquard systems
Authors: Ouyang Kexin , Wei Yu , Lu Huiqin
Published: April 2023

In this paper, we combine the critical point theory and variational method to investigate the following a class of coupled fractional systems of Choquard type

   \begin{document}$ \begin{equation*} \left\{ \begin{array}{l} (-\Delta)^{s}u+\lambda_{1}u& = (I_{\alpha}*|u|^{p})|u|^{p-2}u+\beta v \quad &&\text{in}\\ \mathbb{R}^{N}, \ (-\Delta)^{s}v+\lambda_{2}v& = (I_{\alpha}*|v|^{p})|v|^{p-2}v+\beta u \quad &&\text{in}\ \mathbb{R}^{N}, \end{array} \right. \end{equation*} $\end{document}

with $ s\in(0, 1), \ N\geq 3, \ \alpha\in(0, N), \ p > 1 $, $ \lambda_{i} > 0 $ are constants for $ i = 1, \ 2 $, $ \beta > 0 $ is a parameter, and $ I_{\alpha}(x) $ is the Riesz Potential. We prove the existence and asymptotic behaviour of positive ground state solutions of the systems by using constrained minimization method and Hardy-Littlewood-Sobolev inequality. Moreover, nonexistence of nontrivial solutions is also obtained.
Le val de Blois, du IIIe siècle avant notre ère à l'an Mil. Des territoires à la ville, des confins aux réseaux
Authors: Josset Didier , Aubourg Viviane
Published: April 2023

Les relations entre les transformations des paysages du val de Blois et le développement de la ville de Blois ne sauraient être comprises sans être étudiées avec les regards croisés d’archéologues, géoarchéologues, géophysiciens et historiens. Une telle démarche interdisciplinaire a été entreprise depuis 2013 dans le cadre d’un Projet collectif de recherche, en examinant la vaste plaine alluviale blésoise et le lit mineur, la Loire. C’est donc à la connaissance du milieu, pleinement transformé par les sociétés et l’action de l’eau, que l’on accède sur une grande surface. Les travaux ont permis d’identifier plusieurs franchissements de la Loire. Or, franchir la Loire à Blois est un enjeu stratégique, économique et politique qui dépasse bien souvent les seuls intérêts locaux. L’archéologie préventive a montré que le val de Blois est un territoire occupé sans interruption depuis au moins le IIIe siècle avant notre ère. C’est un espace caractérisé par ses croisements d’axes de communication, voie fluviale et carrefour de voies terrestres. Ainsi, le franchissement, quelle que soit sa forme (gué ou pont), est un point de rencontre très important qui pourrait avoir été à l’origine de la fixation de l’habitat et avoir favorisé l’émergence du phénomène urbain dans ce lieu. Dès la création de l’agglomération vers la fin du Ier siècle avant notre ou au tout début du Ier siècle de notre ère, cette configuration lui confère une place spécifique, et par nature singulière, dans le réseau urbain local et régional.
Un carrefour naturel et commercial. L’agglomération secondaire antique des Olivoux et la plaine du Chambon
Authors: Elizagoyen Vanessa
Published: April 2023

L’agglomération secondaire antique des Olivoux (Montignac, Nouvelle-Aquitaine) a récemment été identifiée par le biais conjoint d’opérations archéologiques préventives et de recherches programmées. Sa localisation, en limite orientale de la cité des Pétrucores, au sein d’une entité territoriale cohérente et sur un point de rupture de charge de la Vézère, lui procure une vocation de carrefour, qu’il soit naturel, routier ou commercial.
Une censure éditoriale : Ravages de Violette Leduc
Authors: Antolin Alexandre
Published: April 2023

En 1948, lorsque Violette Leduc commence à rédiger Ravages, roman autobiographique, elle ne sait pas qu’elle se lance dans l’œuvre de toute une vie. Si les premiers conseils prodigués par Simone de Beauvoir sont exigeants mais bienveillants, les relectures des éditions Gallimard sont bien plus sévères. Dans une société qui refuse certaines réalités et où la Commission de censure exerce un pouvoir fort, les scènes d’amour lesbien, de viol ou d’avortement inquiètent la maison d’édition, qui demande à l’autrice d’effectuer de larges coupes. En 1955, l’ouvrage sort enfin aux éditions Gallimard, mais il est amputé d’une grande partie de ce qui fait son identité. Par la suite, certains extraits du texte censuré paraissent ici et là, mais sans jamais redonner sa force et son entièreté à cette œuvre majeure de la littérature française. À travers l’analyse génétique minutieuse des différentes versions de Ravages – manuscrits, dactylographies, textes publiés –, mais aussi de tous les écrits qui l’accompagnent, Alexandre Antolin retrace le parcours littéraire, psychologique et médiatique de Violette Leduc. Il permet également d’appréhender l’œuvre intégrale non censurée et d’en découvrir toute la richesse.
Research on Power Load Forecasting Using Deep Neural Network and Wavelet Transform
Authors: Tan Xiangyu , Ao Gang , Qian Guochao , Zhou Fangrong , Li Wenyun , Liu Chuanbin
Published: April 2023

In today's rapid economic development, industrial and civil electricity consumption is growing year by year, and how to guarantee stability of power system operation has become the focus of attention of the power sector in each country. Power load forecasting has been closely associated with the modernization of power system management and is a vital guarantee for the safe and stable operation and economic efficiency of the power system. In this article, the authors propose a recurrent neural network (RNN) decision fusion forecasting framework based on the wavelet transform to address the power load forecasting problem. The framework firstly performs the wavelet transform on the power load data and uses Daubechies wavelets to extract the high-frequency and low-frequency parts of the data; then the data with different frequencies are combined with the original data and fed into the RNN model separately, and the decision fusion is performed in the output layer; finally, the prediction results are obtained by superposition of two RNN networks. The results showed that the error of the predicted data in the last nine years decreased by 50%, compared with the traditional method of feeding the data into the RNN model for training, which provides a new idea for future power load forecasting.
A Phenomenological Review of Machiavellianism in Organizations
Authors: Selvarajan P. , Senarathna W. A. N. M.
Published: April 2023

The study intended to investigate the phase of Machiavellianism within Sri Lankan organisations. Previous literature supported to the identification of the characteristics of high Mach people in organizations and societies. The objectives of this study highlight the meaning of Machiavellianism, the qualities of high Mach people in organizations especially in Sri Lanka and find out how to handle them for organizational success. A qualitative research method of Phenomenology has been adopted intentionally in this study. Further past literature from reputed research sites has also been reviewed to enhance the validity of the research. Findings showed that high Mach people manipulate others, and deceive others for their own benefit to build relationships. They often speak about others’ negative qualities or manipulate bad things to build good relationships, especially with the top management. They spread their attributes quickly within the context and achieve their personal goals using others. The attributes of high Mach individuals in society could be observed in the places like schools, universities, government or private organizations, businesses, and families. It is recommended that the education system should be changed in a way that teachers should teach students to create a broad mind with a healthy competition. The government should open career paths by introducing very constructive curricula and regulations to create good governance everywhere.
Proactive Personality and Career Adaptability of Final Year Entrepreneurship Undergraduates in Sri Lanka: A Mediating Effect of Entrepreneurial Self-efficacy
Authors: Bandara W. M. H. K. , Senanayaka S. G. M. S. D.
Published: April 2023

With technological advancements and the increasing nature of complexity and uncertainty in the business world, the development of career adaptation skills is one of the significant factors affecting the success of undergraduates. However, the controversial findings regarding the determinants of career adaptability have triggered this study to question what antecedents would predict undergraduates' career adaptability. Proactive personality on career adaptability in the literature is a hotspot for study in the subject of career adaptability. However, it has been recognized that empirical research on this issue in the context of Sri Lanka is insufficient. Furthermore, the mediating role of this relationship as an intervening mechanism is about to be understood, and there is a knowledge gap in the literature. The major contribution of this research is to expand the knowledge and examine the direct and indirect impact of proactive personality on career adaptability under the mediation role of entrepreneurial self-efficacy. Data is collected using self-administered questionnaires and distributed using the convenience sample technique among 120 undergraduates studying entrepreneurship degree programs at five state universities in Sri Lanka. The results indicate that a proactive personality significantly and positively impacts career adaptability. Furthermore, the findings revealed that the indirect impact of a proactive personality on career adaptability, mediated through entrepreneurial self-efficacy, was significant. The results of this research assist university mentors, coaches, and policymakers in conceptualizing and implementing relevant interventions and projects that incorporate university support for transitioning undergraduates to a more dynamic work world.
Adverse Childhood Experiences and Burnout in Athletic Trainers: An Exploratory Study
Authors: Hedrick Alexander , Lynch Amy , Russ Anne C.
Published: April 2023

Context

Burnout, a state of physical or emotional exhaustion, is a concern within athletic training, as between 17% and 40% of athletic trainers (ATs) report high levels of burnout. Adverse childhood experiences (ACEs) are linked with higher levels of burnout in other health professions.

Objective

To compare burnout with ACEs in ATs.

Design

Cross-sectional study.

Setting

Web-based survey.

Patients or Other Participants

One thousand ATs were selected at random to participate in the study. Of these, 78 ATs started the survey, and 75 ATs completed it.

Main Outcome Measure(s)

Burnout, as measured by the Copenhagen Burnout Inventory (CBI) overall and subscale scores, was compared across groups based on the number of adverse experiences as measured by the ACEs survey. Multiple analysis of variance tests were used to determine the association between ACEs score and overall, personal, work-related, and patient-related burnout.

Results

At least 1 adverse experience was reported by 37 (49.33%) participants. Those with ≥4 ACEs had higher odds of describing overall, personal, and work-related burnout than those with 0 to 3 ACEs. Moderate burnout (CBI score ≥ 50.00) was noted in 27 (36.00%, overall), 44 (58.67%, personal), 34 (45.3%, work related), and 15 (20.00%, patient related) ATs. Participants with 4 ACEs had higher overall burnout (67.11 ± 19.89; F6,68 = 2.59, P = .03) than those with 0 (40.53 ± 17.12, P = .04), 1 (38.42 ± 20.99, P = .04), or 7 (19.08 ± 12.09, P = .03) ACEs. The same pattern existed with personal burnout, as participants with 4 ACEs (76.67 ± 17.33) had higher scores (F6,68 = 3.40, P = .00) than those with 0 (46.60 ± 17.49, P = .02), 1 (42.78 ± 21.48, P = .01), or 7 (27.08 ± 20.62, P = .03) ACEs. No other differences were observed.

Conclusions

Between 20.00% and 58.67% of ATs surveyed reported some form of burnout. Higher levels of overall and personal burnout were found in those with 4 ACEs. Although we expected to see lower levels of burnout in those with fewer ACEs, it was surprising that those with 7 ACEs had some of the lowest CBI scores. Athletic trainers with childhood trauma may find it beneficial to engage in self-regulation exercises to reduce or limit triggers and burnout. Additionally, employers should explore developing trauma-informed workplaces to better support employees.
Anticoagulation in COVID-19
Authors: Taema Khaled M.
Published: April 2023

Coronavirus disease-2019, which was declared by the WHO as a global pandemic in March 2020, was seen to be associated with high incidence of thromboembolic complication. The use of prophylactic anticoagulation was seen to have a survival benefit, especially in high-risk patients. The use of higher than standard-dose prophylaxis anticoagulation in critically ill patients may be warranted. There is no recommendation regarding the use of therapeutic dose anticoagulation, except for very high-risk patients only transiently until proving or disproving the presence of thromboembolic complications.
Infection index
Authors: Ismail Nagwan A. , Abdallah Alshimaa L. , Esawy Marwa M. , Shabana Marwa A.
Published: April 2023

Background

Chronic obstructive pulmonary disease (COPD) is a chronic debilitating disease. Acute exacerbation of COPD (AECOPD) determines the extent of disease morbidity, healthcare utilization, associated costs, and mortality. Patients with COPD who have chronic colonization would not only have greater burden of inflammation and more frequent exacerbations but also a faster decline in pulmonary functions. Hence, our study was conducted.

Patients and methods

A total of 125 patients were enrolled in this cross-section study, which was conducted at Chest Department and Respiratory ICU. Laboratory analysis of the study samples was performed in Medical Microbiology and Clinical Pathology Departments, Faculty of Human Medicine, Zagazig University Hospitals, in the period between May 2018 and July 2019.

Objective

The aim was to examine the value of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) as a promising inflammatory biomarker in detecting chronic bacterial colonization and to settle the cutoff value for the suggested infection index in identifying bacterial colonization. Results Based on sputum culture results, patients were classified into two groups: group A (those with bacterial colonizers) and group B (those with no bacterial colonizers). All assessed laboratory tests were significantly higher in patients with exacerbated COPD with bacterial colonization.

Conclusion

sTREM-1 is a valid and reliable inflammatory biomarker and can determine the presence of chronic bacterial colonizers. Infection index (procalcitonin+sTREM-1) should be applied and measured for admitted AECOPD with exacerbations of noninfective type, and this would guide antibiotic usage and limit overutilization of antibiotics in noninfective patients with AECOPD.
Chylopneumothorax with an unusual cause in an Indian patient
Authors: Gupta Krishan B. , Kumar Vipul , Garg Nitika , Shetty Adarsha , Yadav Jyoti
Published: April 2023

Chylothorax is an unusual cause of pleural effusion that is formed when chyle enters the pleural space owing to disruption of lymphatic duct. Tuberculosis, especially multidrug-resistant tuberculosis, is an uncommon cause of chylothorax. Here, we present a case of pleural effusion, which on thoracocentesis showed milky white fluid. The pleural fluid had triglyceride content of 75 mg/dl, and lipoprotein electrophoresis showed chylomicrons, confirming the diagnosis of chylothorax. Bacteriological examination of sputum yielded acid‐fast bacilli which were resistant to rifampicin by Gene-Xpert. The patient was started on appropriate drug-resistant antituberculosis regimen. She improved clinically and had complete resolution of chylothorax.
Arthroscopic-assisted mini-open rotator cuff repair outcome measures
Authors: Saleh Mohamed R A
Published: April 2023

Background

Mini-open repair seems to be equivalent to all-arthroscopic repair in multiple nonrandomized comparative studies, and a randomized trial is underway to formally address this question.

Objectives

These include the ability to perform diagnostic arthroscopy, preservation of the origin of the deltoid, rapid hospital discharge, less postoperative pain, and accelerated rehabilitation.

Patients and Methods

A case series study was performed on 20 patients from May 2017 to May 2019. The technique is not technically demanding than all-arthroscopic repair while still having the advantages of arthroscopic repair. A total of 20 patients, 11 (55%) men and nine (45%) women, were included in this study with a mean age of 58.00 Å} 9.17 years.

Results

There was high significant gradual improvement in the modified University of California, Los Angeles (UCLA) shoulder scale among the studied patients at 1, 3, and 6 months postoperative follow-up compared with preoperative. Postoperative complications were found in six patients. Three (15%) cases had stiffness, and the other three (15%) cases had superficial wound infections. There were significant correlations between the modified UCLA shoulder scale with age, operative time, and postoperative complications, while there were no significant correlations with sex or side.

Conclusion

Our study concluded that surgery for rotator cuff tears improves self-reported patient outcomes and has a lasting and durable result at an average of 15 years after surgery. There was a high statistically significant gradual improvement in the modified UCLA shoulder scale among the studied patients at 1, 3, and 6 months postoperative follow-up compared with preoperative. Further studies including a larger sample are required to enhance the current findings.
Comparison of treatment of unstable intertrochanteric fractures by intramedullary and extramedullary implants
Authors: Khairy Mahmoud , Nzayikorera Gratien
Published: April 2023

Background

To achieve union and restore the normal biomechanics of the hip region after unstable trochanteric fractures, surgical intervention is necessary. There are two options for internal fixation: extramedullary and intramedullary. Dynamic hip screw (DHS) as extramedullary fixation was and is still widely used to surgically treat intertrochanteric fractures. However, it sometimes fails to give good results. Intramedullary fixation methods include gamma nail placement, which is considered by some surgeons to be a better choice as it can avoid complications occurring with extramedullary fixation. Our study aimed to conclude which is better to be used to manage unstable intertrochanteric fractures by either DHS or gamma nail regarding the operation requirements (hospital stay, need for blood transfusion, wound complications, and soft tissue damage) and later on evaluate which is better regarding the fracture healing radiologically and functionally.

Patients and methods

This is a retrospective study of 52 patients with recent unstable intertrochanteric fractures between January 2020 and December 2020. A total of 40 patients continued the study till the last follow-up, where 20 of them were fixed by intramedullary gamma nails as a group I and the other 20 patients were fixed by extramedullary DHS as a group II. The mean age for the group I was 50.05 (20–83) years and the mean age for group II was 60.5 (22–91) years. A total of 14 patients from group I were males and 12 from group II were males. All fractures were classified according to Evan’s classification to be unstable (Evan’s types III, IV, and V).

Results

Overall, 19 (95%) patients of group I achieved full union and one patient had nonunion with nail breakage. No patients in group I had malunion. A total of 17 (85%) patients of group II achieved good union with one patient having nonunion with implant failure. Moreover, two (10%) patients of group II had femoral shaft medialization and varus malunion.

Conclusion

This study supported the previous series in the literature, which proved that unstable intertrochanteric fractures can be fixed by intramedullary gamma nails or extramedullary DHS but intramedullary fixation gives better results than extramedullary fixation.
Biological plating for diaphyseal humeral fractures
Authors: Hegazy Mohamed O , Hosny Gamal A , Elbegawi Hossam E A , El-Attar Hesham A , Elnakkadi Nagui S E
Published: April 2023

Background

Diaphyseal humeral fracture is one of the common injuries in orthopedic surgery. The biological plating technique or minimally invasive plate osteosynthesis (MIPO) is the fixation of the fracture with minimal opening, preserving the soft tissue attachment and blood supply to the bone.

Aim

To evaluate the biological plating technique in the management of diaphyseal humeral fractures by comparing MIPO with open reduction and internal fixation (ORIF) techniques.

Patients and methods

This study is a randomized controlled trial. It was performed on 40 adult patients with a humeral diaphyseal fracture. The patients were randomly divided into two groups: 20 MIPO cases and 20 ORIF controls. We compared the two groups.

Results

MIPO is superior to ORIF, as it has a shorter duration of surgery, shorter incision length, and less blood loss. It may minimize to some extent the duration of fracture healing and the risk of deep infection. MIPO and ORIF have excellent shoulder and elbow functional outcomes.

Conclusion

MIPO offers many advantages over the ORIF, but it has some disadvantages.
Clinical outcome of ambulatory anterior cruciate ligament reconstruction compared with the standard in-patient surgery
Authors: Sharaby Mohamed M F , El-Deeb Younes M , Abuheif Mohamed
Published: April 2023

Purpose

There is a current trend toward performing anterior cruciate ligament reconstruction (ACLR) as a day surgery procedure. However, the full evaluation of this process compared with the traditional inpatient ACLR was not accomplished particularly from the perspective of patient satisfaction, pain improvement, and final outcome. Furthermore, several centers described refusal of patients to pass through the day surgery protocol with more preference to admission.

The aim of this study is the evaluation of early/late results of short-term hospital stay following arthroscopic ACLR with regard to patient recovery, complications, patient satisfaction, and return to daily activities through our algorithm.

Patients and methods

Through a prospective randomized study, 284 patients were operated for ACLR through two pathways; G1 is the day surgery pathway and G2 is the traditional inpatient pathway. Patients were evaluated postoperatively for pain severity, satisfaction, the need for additional analgesia, any readmission, complications, and final outcome.

Results

Patients in both groups showed similar pain and satisfaction levels with no difference regarding the amount of extra-analgesia needed and with no readmission from the day surgery group. However, seven patients were recorded as reattending the hospital seeking for pain medication which was given in ER and the patient was satisfied to return home with no need for readmission.

Conclusions

In conclusion, day surgery can be considered as the protocol of choice for patients undergoing ACLR with no difference from the former standard in-patient ACLR.
The prevalence of tuberculosis infection in India: A systematic review and meta-analysis
Authors: Chauhan Arohi , Parmar Malik , Dash Girish Chandra , Solanki Hardik , Chauhan Sandeep , Sharma Jessica , Sahoo Krushna Chandra , Mahapatra Pranab , Rao Raghuram , Kumar Ravinder , Rade Kirankumar , Pati Sanghamitra
Published: April 2023

Background & objectives:

The National Prevalence Survey of India (2019-2021) estimated 31 per cent tuberculosis infection (TBI) burden among individuals above 15 years of age. However, so far little is known about the TBI burden among the different risk groups in India. Thus, this systematic review and meta-analysis, aimed to estimate the prevalence of TBI in India based on geographies, sociodemographic profile, and risk groups.

Methods:

To identify the prevalence of TBI in India, data sources such as MEDLINE, EMBASE, CINAHL, and Scopus were searched for articles reporting data between 2013-2022, irrespective of the language and study setting. TBI data were extracted from 77 publications and pooled prevalence was estimated from the 15 community-based cohort studies. Articles were reviewed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and were sourced using a predefined search strategy from different databases.

Results:

Out of 10,521 records, 77 studies (46 cross-sectional and 31 cohort studies) were included. The pooled TBI prevalence for India based on the community-based cohort studies was estimated as 41 per cent [95% confidence interval (CI) 29.5-52.6%] irrespective of the risk of acquiring it, while the estimation was 36 per cent (95% CI 28-45%) prevalence observed among the general population excluding high-risk groups. Regions with high active TB burden were found to have a high TBI prevalence such as Delhi and Tamil Nadu. An increasing trend of TBI was observed with increasing age in India.

Interpretation & conclusions:

This review demonstrated a high prevalence of TBI in India. The burden of TBI was commensurate with active TB prevalence suggesting possible conversion of TBI to active TB. A high burden was recorded among people residing in the northern and southern regions of the country. Such local epidemiologic variation need to be considered to reprioritize and implement-tailored strategies for managing TBI in India.
Heteroresistance to rifampicin & isoniazid in clinical samples of patients with presumptive drug-resistant tuberculosis in Central India
Authors: Desikan Prabha , Panwalkar Nikita , Punde Ram Prakash , Khan Zeba , Pauranik Ankur , Mirza Shaina Beg , Chourey Manju , Anand Sridhar , Sachdeva K.S.
Published: April 2023

Background & objectives:

A combination of resistant and susceptible Mycobacterium tuberculosis (MTB) isolated from clinical specimens is referred to as heteroresistance. Heteroresistance leads to difficulties in drug resistance testing and may adversely affect treatment outcomes. The present study estimated the proportion of heteroresistance among MTB in clinical samples of presumptive drug-resistant tuberculosis (TB) patients in Central India.

Methods:

A retrospective analysis of data generated from line probe assay (LPA) at a tertiary care hospital in Central India between January 2013 and December 2018 was carried out. A heteroresistant MTB in a sample was indicated by the presence of both wild-type and mutant-type patterns on an LPA strip.

Results:

Data analysis was carried out on interpretable 11,788 LPA results. Heteroresistance in MTB was detected in 637 (5.4%) samples. Of these, heteroresistance in MTB was detected in 413 (64.8%), 163 (25.5%) and 61 (9.5%) samples with respect to rpoB, katG and inhA genes, respectively.

Interpretation & conclusions:

Heteroresistance is considered a preliminary step in the development of drug resistance. Delayed or suboptimal anti-tubercular therapy in patients with heteroresistance of MTB may elicit full clinical resistance and negatively impact the National TB Elimination Programme. Further studies are, however, needed to determine the impact of heteroresistance on treatment outcomes in individual patients.
Sociocultural and drug-related factors associated with adherence to iron–folic acid supplementation among pregnant women – A mixed-methods study
Authors: Muthuraj Lakshmi Prabha , Kandasamy Sunitha , Subbiah Padmavathi , Sibqathulla Maryam Jamila , Velappan Lakshmi Kandhan , Gopal Muthu , Ramya Ezhil J , Jayaraman Yuvaraj , Kalyanaraman Shantaraman
Published: April 2023

BACKGROUND:

The National Family Health Survey of India (NFHS-5) revealed a lapse in the advancement of mitigating anemia despite free supplementation of iron–folic acid tablets (IFAT) and improvement in IFAT coverage during pregnancy. The local sociocultural beliefs and community perspective toward IFAT are pivotal in reducing the gap between IFAT coverage and consumption. Hence, we proposed the study to assess adherence to IFAT among rural pregnant women and explore the associated factors.

MATERIALS AND METHODS:

The present study was conducted as a mixed-methods study with a sequential exploratory design in a rural setting of the Model Rural Health Research Unit (MRHRU) from October 2020 to May 2021. Ten focus group discussions (FGDs; 8 – antenatal women, 1 – mother/mother-in-law, and 1 – health care worker) were conducted, and framework analysis was done to identify themes followed by a quantitative survey with a semi-structured questionnaire among antenatal women (n = 236). Logistic regression was used to analyze factors associated with adherence.

RESULTS:

The major themes that emerged from FGDs were the sociocultural factors (gender norms, communal fallacies), lack of awareness, and drug-related factors (unpalatability, misperceptions, and experienced side effects). Around 57% were adherent to IFAT. Side effects experienced on IFAT intake (P = 0.001, OR = 2.33), misconceptions regarding IFAT, like weight gain in IFAT use (P = 0.001, OR = 2.86), a big baby with IFAT use (P = 0.000, OR = 5.93) negatively influenced adherence.

CONCLUSIONS:

The significant gaps between IFAT coverage and consumption surrounded the unpleasant odor and stench of IFAT, side effects, lack of individualized counseling, and misperceptions regarding IFAT use.
Reasons for not getting COVID-19 vaccine in Ardabil, a Northwestern province in Iran: Based on an ecological approach
Authors: Moghaddam Hamed Rezakhani , Khan Fatemeh R. , Bazyar Hadi , Aghamohammadi Vahideh
Published: April 2023

BACKGROUND:

Understanding the reasons for not getting the COVID-19 vaccine can help to increase acceptability and tackle vaccine hesitancy and consequently reach high coverage for this new vaccine. Using an ecological approach, the reasons for not getting the vaccine in the Iranian population was investigated.

METHODS AND MATERIAL:

This study was conducted from October to December 2021 on 426 participants who had not received the COVID-19 vaccine. The following subsets of questions were included in the questionnaire: intrapersonal level factors, interpersonal level factors, group and organization, and society and policy-making. Multivariable logistic regression was used, and the odds ratio (OR) and 95% confidence intervals (CIs) were estimated for vaccine hesitancy (dependent variable) according to the reasons for not getting COVID vaccine scores (independent variable) using multivariable logistic regression in 3 different models, including Model 0: unadjusted, Model 1: adjusted for age, gender, and underlying disease, and Model 2: adjustment for age, gender, underlying disease, education, place of living, income, marital status, and employment.

RESULTS:

A significant difference was found regarding gender between likely and not likely groups (P= 0.016). A significant association was observed between the vaccine hesitancy and interpersonal (unadjusted model: OR = 0.833 (CI: 0.738–0.942),Pfor trend = 0.003; model 1: OR = 0.820 (CI: 0.724–0.930),Pfor trend = 0.002; model 2: OR = 0.799 (CI: 0.703–0.909),Pfor trend = 0.001) and group and organization (unadjusted model: OR = 0.861 (CI: 0.783–0.948),Pfor trend = 0.002; model 1: OR = 0.864 (CI: 0.784–0.952,Pfor trend = 0.003; model 2:OR = 0.862 (CI: 0.781–0.951,Pfor trend = 0.003). There was no significant association between vaccine hesitancy and intrapersonal and society and policy-making (P> 0.05).

CONCLUSIONS:

We found that a high score of “interpersonal” and “group and organization” factors were associated with lower intention to COVID vaccine. Moreover, women had higher vaccination intentions than men.
Attitude of nurses caring critically ill patients admitted in the ICUs of AIIMS Hospital, Jodhpur
Authors: Aktar Shoaib , Pandey Vandna , Kumar Ashok
Published: April 2023

BACKGROUND:

Nurses are internationally recognized to be largest group of registered and regulated practitioner in the health workforce of any country. There is an increase in number of critically ill patients seeking optimal care, and this rapidly increases the demand for the critical care nurses at the end of life. Caring for a critically ill patient creates anxiety and emotional exhaustion and may sometimes lead to burnout. So, it is imperative for the nurses to have an optimistic approach while caring patients in the ICU. The aim of the study was to assess the attitude of the nurses caring critically ill patients and to determine the association of the level of attitude with the selected personal variable. The study was conducted at ICUs of tertiary care hospital by using descriptive research design.

METHODS AND MATERIAL:

A cross-sectional descriptive study was conducted in ICUs of tertiary care hospital from October to December 2018. The sample was selected by total enumeration technique. Data was collected from 60 critical care nurses with the help of self-structured five-point Likert scale to assess the attitude of nurses. Descriptive statistics and inferential statistics were used for data analysis such as mean, frequency, percentage, standard deviation, and Chi-square test.

RESULTS:

Majority (81.7%) of the nurses were having favorable attitude toward caring the critically ill patients, and there was no significant association of the attitude score with the selected personal variable at P < 0.05.

CONCLUSIONS:

Majority of critical care nurses have favorable attitude. If they have supportive environment at workplace, their willingness to work toward quality care will improve further.
Analysis of cognizance and practices of biomedical waste management principle rules among health professional workers in a teaching hospital with special emphasis on COVID-19 pandemic: A critical appraisal on the current state and way forward
Authors: Sri E. S. Keerthika , Vaithy Anandraj K , Shanmugasamy Kathirvelu , Srinivasan Sowmya
Published: April 2023

BACKGROUND:

Hospital-generated waste materials commonly labeled as “Biomedical waste” (BMW) is a kind of remnant that includes infectious and non-infectious materials and their appropriate disposals are controlled as per the guidelines of Biomedical Waste Management (BMWM) Amendment Rules, 2018, Government of India. Periodic assessment on BMWM among healthcare workers (HCWs) is mandated to ensure quality assurance, which may be helpful during pandemic times.

MATERIALS AND METHODS:

The study was conducted with ethical clearance by using a validated questionnaire (using Cronbach's α) covering knowledge, attitude, and practices (KAP) derived based on recent BMWM 2018 guidelines. The responses in context to KAP were checked by the study conductors, appropriate statistical analysis was done and discussed at end of each session.

RESULTS:

Nearly 279 HCWs participated in the study and cast their responses. Knowledge and attitude domain on BMWM showed statistical significance whereas varied responses were observed with practices among the health professional workers with health professional physicians having an edge over other HCWs involved in the processes with varying attrition factors.

CONCLUSIONS:

The present study proves novelty by extensively analyzing KAP among HCWs on BMWM in general with special emphasis on laboratory biosafety norms. The study emphasizes that BMWM should be a continuous process and that all HCWs handling BMW must undergo regular training and assessment with questionnaire surveys. Multi-tasking and cumulative efforts must be formulated to attain translational synergy in the stream of KAP of BMWM, which could be attained by incorporating BMWM in the health science curriculum.
Validation of a form for assessing the professional performance of residents in cardiology by nurses
Authors: Busch German , Rodríguez Borda María V. , Morales Pablo I. , Weiss Mónica , Ciambrone Graciana , Costabel Juan P. , Durante Eduardo , Gelpi Ricardo , Alves De Lima Alberto E.
Published: April 2023

BACKGROUND:

There is a strong need for transformation in our assessment systems from one that evaluates performance based on levels of training to another that focuses on professional competence to meet the expected requirements for the practice of the profession. The aim of this study is to validate for the first time a Spanish version of a new tool for assessing the professional performance of residents by nurses newly developed in the Ottawa Hospital (O-RON).

MATERIALS AND METHODS:

After the author's written authorization, the original O-RON form was translated and cross-culturally adapted. Then we conducted a prospective observational study in two cardiology centers in the city of Buenos Aires. The validity of the tools was evaluated by the ability of the instrument to discriminate the level of experience of the residents according to their post-graduate year level. Data is expressed as percentages and frequencies of the qualifications obtained in the different questions. The chi-square test was used to assess the significance of the differences obtained. A generalizability test was used to evaluate reliability. Feasibility was defined as a minimum of 4 assessments per resident per evaluation round. Satisfaction of evaluators was assessed using a survey with a 10-point scale designed by the authors.

RESULTS:

A total of 838 evaluations were performed. Regarding validity, the 15-item form could significantly discriminate the experience of the residents according to their postgraduate year level (P < 0,005). Thirty evaluations per resident are required to obtain reliable results. The tool is feasible to implement and an average of 4.55 assessment per resident per evaluation round were achieved throughout the entire experience. This value remained stable during the 8 rounds (1st: 4.65; 2nd: 4.34; 3rd: 4.47; 4th: 6.17; 5th: 4.56; 6th: 4.08; 7th: 4.36; 8th: 3.91). The levels of satisfaction among the evaluators were acceptable.

CONCLUSION:

The Spanish version of the O-RON form can provide residents with a valuable source of feedback from the eyes of nurses on important aspects of their professional training. This tool, positively assessed by the raters, significantly discriminates residents' experience. Its implementation is feasible in our environment, and it is user-friendly, though it requires a considerable number of assessments to achieve high reliability.