bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristic of Western and Kannada Absurd Dramas
Authors: . Anantakumar , .Bettakote Nagesh.V
Published: April 2024

In the literary heritage of modern Kannada theatre, innovative methods of writing such as stories, poetry, novels, etc., which are limited only to plays, should be taken into consideration. After the 19th century, modern Kannada theatre under the influence of Western theatre took a path of innovation and expanded its range of features. Along with the Kannada Renaissance literature, the modern Kannada dramas that came to light are mostly imitations of Western and Indian Sanskrit dramas. Apart from that, important Western plays like Samuel Beckett, Eugène Ionesco, Jean Genet, Arthur Adamov, Harold Pinter, Sart, Albert Camus, Brecht, are found to have built upon modern dramas on a satvika basis. Following this Kannada Absurd dramatists can be divided into two groups. The material portrays incongruous things through a coherent technique using coherent language. Playwrights like Kirtinath Kurta Koti, G.B. Joshi, Girish Karnad can be identified. The second group includes Chandrasekhar Patil, P. Lankesh, Chandrasekhar Kambar can be named. Kalyan Karnataka dramatist Chandrakant Kusunur is popular among Absurd dramatists. He wrote the most plays among the Absurd plays. We did not see any western influence in many of his plays. He has written Ani Bantani, Dindi, Mane, Rekke, Vidushaka. Ratto Ratto Rayana Magale etc. play an important role in the development of Kannada anomaly. Western Kannada Absurd plays can thus be observed in a geographically adequate traditional setting. This article attempts to analyse the different types of dramas, and dramatists, who contributed to the field of Absurd dramas in Kannada theatre due to the influence of western Absurd dramas in Kannada drama literary tradition.
Enhancing Workplace Efficiency and Security Through Intelligent Employee Surveillance
Authors: Das Asit Kumar , Kamthane Vaanishree , Purwar Umang , Chandan Mohanty Deba , Kumar Depuru Bharani
Published: April 2024

This project aims to develop an innovative system for accurately tracking employees' working hours based on their presence within designated workspace areas, particularly their work cabins. Leveraging advanced technologies such as image annotation, preprocessing, and augmentation, as well as robust object detection models, this study addresses the need for efficient employee surveillance and time management solutions in contemporary workplaces. The methodology involved detailed annotation and enhancement of image data, enabling precise representation of cabin areas and identification of individual employees within images. Subsequently, a state-of-the-art object detection model, YOLOv8, was utilized to train using this annotated dataset, achieving an impressive accuracy of more than 90% in recognizing and tracking employee presence within the specified cabin regions. Through small incremental changes based on previous insights and optimization, the project achieved high levels of accuracy in inferring employees' working hours based on their occupancy within the designated workspace. By differentiating between time spent inside cabins (considered as working time) and time spent outside these areas (considered as non-working time), the system offers an automated and objective approach to time tracking, eliminating the need for manual input or subjective assessments. Future scopes for this research include exploring the integration of additional sensors or data sources to further enhance the accuracy and granularity of employee activity tracking. Additionally, advancements in machine learning algorithms and hardware may enable real-time processing and analysis of surveillance data, leading to more proactive management of employee productivity and well-being. Moreover, the application of this technology could extend beyond traditional office settings to various industries, such as manufacturing, retail, and healthcare, where precise monitoring of employee activities is crucial for optimizing operations and ensuring compliance with regulations. This research underscores the potential of advanced computer vision techniques, particularly YOLOv8, in revolutionizing employee surveillance and time management practices. By providing real-time monitoring capabilities and ensuring compliance with work regulations, this approach holds promise for enhancing workplace productivity, transparency, and accountability.
États-Unis. Les nouvelles conventions collectives chez les trois grands de l’automobile : une victoire syndicale historique
Authors: Sauviat Catherine
Published: April 2024

L’UAW, dont la direction a été renouvelée, a mené six semaines de grève conduites de façon inédite chez General Motors, Ford et Stellantis, à l’occasion du renouvellement de leurs conventions collectives. Les gains obtenus lors de la négociation, tant en matière salariale que de garantie et de sécurité des emplois, sont historiques pour le secteur, notamment pour les catégories les moins bien positionnées dans l’échelle des salaires (intérimaires et ouvriers du Tier 2) et pour les ouvriers syndiqués des futures usines d’assemblage de véhicules et de batteries électriques.
Régulation des stablecoins : l’Europe comme compétiteur stratégique ?
Authors: Bouffaron Pierrick , Barrier Cédric
Published: April 2024

Cet article examine le contexte technico-financier, l’écosystème d’innovation et les politiques monétaires qui informent l’émergence des crypto-actifs, revenant sur la publication récente du premier cadre régulatoire européen sur le sujet.
Quand l’informatique vient en aide aux compliance officers : l’analyse criminelle comme support dans les enquêtes en criminalité financière
Authors: Lenfant Frédéric
Published: April 2024

habituellement connus dans le monde régalien, il est intéressant d’étudier comment les techniques et outils d’analyse criminelle peuvent apporter une aide pertinente dans les établissements financiers et entreprises du secteur privé. Au-delà des applications dans les domaines de la cybersécurité ( Threat Intelligence , réponse à incident, OSINT 1 …), il apparaît également que les métiers de la conformité ( compliance ) liés à la LCB-FT et à la lutte contre la corruption, pourraient y trouver un intérêt certain.
Devoir de diligence et données personnelles : une proximite annoncée ?
Authors: Mortier Stéphane
Published: April 2024

Devoir de vigilance, devoir de diligence, sécurité, protection, données personnelles… Si cette sémantique a fait couler beaucoup d’encre ces dernières années, elle a surtout fait en sorte que le règlement général sur la protection des données personnelles (RGPD) soit considéré aujourd’hui comme une référence, si ce n’est une norme mondiale. L’Union doit donc profiter de cet élan positif, et c’est ainsi que doivent être accueillis les projets de législation européenne relatifs au devoir de diligence 1 . À titre d’illustration, les principes directeurs de l’OCDE à l’intention des entreprises multinationales 2 , la loi française relative au devoir de vigilance 3 , mais également la loi néerlandaise relative à l’introduction d’un devoir de vigilance pour empêcher la fourniture de biens et de services provenant du travail d’enfants 4 , sont autant d’ inputs au projet de directive européenne sur le devoir de diligence. Tout cela concerne la protection et la sécurité des personnes physiques et place l’être humain au cœur des dispositifs, qu’il s’agisse de sa personne (au sens physiologique du terme) ou de ses données (au sens virtuel d’identité numérique). C’est là le premier point commun de ces deux législations, effective pour l’une et à venir pour l’autre. Un second point commun est leur dimension extraterritoriale. Pourrait-on rapprocher les deux textes ? La protection des données personnelles ne constitue-t-elle pas un devoir de diligence ? L’idéal européen de protection, de sécurité constitue un tout qu’il serait dommage de rendre sécable.
Le facteur émotionnel de l’activité : Analyser les « angles morts » pour améliorer la QVCT. Bilan d’une recherche immersive en Police Judiciaire française
Authors: Monier Hélène
Published: April 2024

Cette recherche, s’inscrivant dans un projet scientifique élaboré en partenariat entre notre Centre de Recherche et le CR ENSP 1 , vise à évaluer les risques émotionnels inhérents aux métiers de la police, et les processus de (dys)régulations des émotions mis en place par les policiers/ières et les collectifs policiers, dans un objectif de Qualité de Vie et Conditions de Travail (QVCT). De nombreuses études abordent la question des émotions dans les organisations ces dernières décennies. Mais la composante émotionnelle au travail, dans les pratiques ayant trait à la Gestion des Ressources Humaines (GRH) et au management publics, est un sujet assez récent au sein de milieux professionnels « extrêmes », à haute fiabilité, comme celui de la Police Nationale. Une étude ethnographique et qualitative a été menée par l’auteure au sein de la Direction Territoriale de la Police Judiciaire (DTPJ) d’une métropole française, au cours du printemps 2021. Plusieurs brigades ont été observées : police technique et scientifique, investigation opérationnelle du numérique, division financière, division criminelle, répression du banditisme, office anti-stupéfiants, groupe anti-terroriste. Cette recherche, fondée sur l’immersion de la chercheuse dans des services policiers pendant 26,5 jours et nuits de mai à juin 2021, ainsi que sur 20 entretiens individuels et collectifs, analyse : les émotions vécues par les policiers, leurs pratiques de (dys)régulations émotionnelles aux niveaux individuel, collectif et organisationnel, et révèle leur rapport au sens au travail. Cette recherche fait apparaître l’importance de deux émotions-clefs constituant des « angles morts » du travail : l’intérêt et la frustration, conduisant les policiers à fournir un travail « invisible », et non discuté, sur les affects relatifs à l’activité dans son ensemble. Cette recherche interdisciplinaire mobilise auteure et praticiens autour d’un double objectif : la prévention des risques psychosociaux (RPS), et la QVCT.
Communication publique stratégique sur le Covid-19 : Le cas des élections municipales françaises de 2020
Authors: Ravenda Diego , Voeller Dennis
Published: April 2024

La pandémie de Covid-19 a mis en évidence l’importance de la communication publique des communes. Cette étude examine comment les incitations politiques façonnent le contenu et la forme de cette communication au moment des élections locales. Sur la base de la théorie de l’ agenda-setting et de la théorie du traitement des informations, une communication plus complète sur le Covid-19 et un ton plus positif peuvent être attendus dans les communes dans lesquelles les élections donnent lieu à un second tour. Nous procédons à une modélisation thématique et à une analyse des sentiments sur un riche ensemble de données comprenant les publications Facebook de toutes les communes de France métropolitaine au moment du premier et du second tour des élections municipales françaises de 2020. Nous utilisons un modèle des doubles différences pour contrôler les caractéristiques invariantes des communes. Nos résultats suggèrent que dans les communes où un second tour de scrutin a lieu, la quantité absolue et la prévalence des informations relatives au Covid-19 sur Facebook sont plus élevées. Ces communes adoptent également un ton plus positif dans leur communication relative au Covid-19 que celui des communes dont le maire a déjà été élu lors du premier tour. Les résultats suggèrent une utilisation stratégique de la communication publique sur le Covid-19, pour promouvoir l’efficacité de la réponse du maire sortant face à la pandémie.
Manifestations psychiatriques en fin de vie, quel accompagnement ?
Authors: Reich Georges Michel
Published: April 2024

Résumé Les manifestations psychiatriques sont souvent mal diagnostiquées et mal prises en charge. En plus des traitements pharmacologiques traditionnels, les approches psychosociales des soins de fin de vie entraînent une amélioration des symptômes. Ces interventions globales, centrées sur la personne permettent d’obtenir une souffrance moindre et une meilleure communication entre patients, familles et équipes soignantes.
Le delirium de fin de vie : une tentative d’échapper à la mort
Authors: Alric Jérôme , Bénézech Jean-Pierre
Published: April 2024

Résumé Sous la forme de manifestations parfois impressionnantes, le delirium palliatif témoigne d’une tentative ultime pour le sujet d’exister. Traumatisé par la survenue de la mort, que la disparition du déni ne lui permet plus d’éluder, le Moi se retrouve comme à bout de forces ; il ne reste alors plus du sujet qu’un désir épars, se raccrochant confusément aux images rassurantes possibles. À quel soin se fier ?
Réflexions au plus près de l’accompagnement
Authors: Marin Catherine , Arnold Cindy , Rochas Bruno
Published: April 2024

Résumé Dans les situations d’angoisse intense on peut essayer de comprendre quelle histoire raconte ce que le patient manifeste au monde et quelle histoire non représentable hante la fin de sa vie. Quand il traverse des épisodes de dépersonnalisation où il se sent perdre pied et perdre la raison, il est possible d’entendre sa peur de l’étrange comme un moment d’extrême solitude où il se sent disparaître à son tour, à ses propres yeux et à ceux des autres.
Quelques particularités cliniques des maladies psychiatriques en fin de vie
Authors: Gomas Jean-Marie
Published: April 2024

Résumé La démarche palliative repose sur une réalité simple et incontournable : savoir composer avec la finitude d’un patient qui parvient à son grand âge ou que l’on ne peut plus guérir de sa maladie. On conçoit facilement que toute perturbation psychique puisse interférer tout particulièrement avec cette dernière étape de la vie. Deux tableaux cliniques méritent une description, le syndrome de Diogène et le syndrome d’Alexandrine.
Les Jeux olympiques modernes : l’avènement d’un spectacle global
Authors: Dufraisse Sylvain
Published: April 2024

Les Jeux olympiques constituent aujourd’hui une manifestation d’ampleur internationale qualifiée de méga-événement. Cet article, qui contextualise leur genèse à la fin du xix e siècle et dans la première moitié du xx e siècle, montre qu’il faut dépasser deux récits mythiques : celui d’un lien évident entre les Jeux panhelléniques qui se tenaient à Olympie ; celui faisant de Pierre de Coubertin un quasi-prophète du sport moderne. Les jo sont le fruit d’un contexte, le développement de l’internationalisme sportif à visée humaniste, et le résultat d’une construction circulaire liant les intérêts d’une multitude d’acteurs qui façonnent le spectacle sportif (dirigeants sportifs, dirigeants politiques, journalistes…) .
L’État et les Jeux olympiques et paralympiques de 2024
Authors: Guillaume Marc
Published: April 2024

L’État joue un rôle particulier dans l’organisation des jop 2024. Si, dès la candidature, il a accordé des garanties financières au comité d’organisation ou assuré qu’il prendrait en charge notamment des missions de sécurité, la part qu’il a prise dans la préparation de cet événement exceptionnel depuis 2017 a été bien au-delà de ces premiers engagements. Indépendamment d’un soutien financier qui demeure maîtrisé, c’est toute l’administration qui est mobilisée pour le succès de ces Jeux, tant en administration centrale que dans la réalisation des actions autour des préfectures, particulièrement en Île-de-France .
Soutenir les couples âgés par le renforcement de leur identité conjugale : ce qu’en dit la littérature
Authors: Couture Nancy , Boucher Kathy , Genest-Roy Marie-Anne
Published: April 2024

Les couples âgés font face à de nombreux défis liés aux changements provoqués par le vieillissement. Ces changements affectent notamment l’identité individuelle mais la littérature explore peu l’impact de ces changements sur l’identité du couple âgé. Or, les personnes âgées, et en particulier les couples qu’elles composent, sont moins propices à avoir recours à des services psychologiques professionnels. L’article explore le concept de l’identité conjugale des aînés dans la littérature ; il en ressort qu’un soutien de l’identité conjugale des couples vieillissants pourrait être une piste intéressante à explorer dans les interventions qui leur sont adressées.
Impact of artificial intelligence technology innovation on total factor productivity: an empirical study based on provincial panel data in China
Authors: Luo Shuang , Lei Wenting , Hou Peng
Published: April 2024

As the focus of the new round of technological revolution, it is crucial to explore the role of artificial intelligence (AI) technology innovation in improving total factor productivity (TFP). Based on the data from 30 Chinese provinces from 2003 to 2021, this article measured AI innovation using the number of patent applications and empirically investigated the effects of AI technology innovation on TFP. The results demonstrated that AI technology innovation exerts significantly positive influences on the TFP. The mechanism analyses revealed that AI technology innovation improves TFP by upgrading industrial structures and promoting human capital. The subsample results indicated that the promotion effect of AI technology innovation on TFP is significant only in areas with high levels of marketization, financial development, and digital infrastructure. The panel quantile regression results indicated that as the TFP increases, the promoting effect of AI technology innovation on TFP gradually strengthens. This study offers comprehensive empirical evidence for understanding the impacts of AI technology innovation on TFP, giving a reference for further enhancing the level of AI development and promoting a sustainable economic development.
Measuring pandemic change: Analyzing syllabi for student-centeredness over time
Authors: Mumpower Lori A. , Rohrbacher Chad , Caulkins Joshua , Korentsides Jenna
Published: April 2024

Researchers seek to measure the extent to which faculty increased their student-centered practices in response to COVID-19 by analyzing course syllabi across three semesters. Faculty were randomly selected from two campuses of a STEM-focused institution (n = 110), each of whom had taught the same course during Fall 2019, Fall 2020, and Fall 2022. Scorers used an abbreviated version of the Student-Centered Syllabus Rubric (Palmer et al., 2014) to identify shifts in student-centeredness over time. Results revealed that 85% of measured syllabi changed over time, with over one-third of measured syllabi reverting to pre-pandemic status. The researchers discuss their methods, results, limitations, and future research opportunities.
Digital Transformation and Business Intelligence (BI) in the Industry 4.0 (I 4.0) Age
Authors: Sever Mune Moğol
Published: April 2024

It is crucial to investigate novel methods for handling the rapidly growing volume of data produced by Industry 4.0 (I4.0), Society 5.0 (S5.0), and IoTs (internet of things). Digital solutions are becoming essential for ensuring that the process continues unhindered and for giving prompt responses. To evaluate and conclude the vast amounts of data generated in this intelligent society, newer information technologies are required. Consisting of optimization, modeling, and data mining, BI is a bundle of technology for multi-dimensional analysis to obtain meaningful data and information from big data without the need for business analysts, professionals, or any trained experts. It consists of optimization, modeling, and data mining. This chapter aims to provide an overview of business intelligence, including its components, varieties, and practical uses in the context of the digital ecosystem. Following an explanation of the BI theoretical framework, four case studies from various industries will be covered, followed by empirical research.
Employees and Robots in Amazon's Robotic Mobile Fulfillment Systems
Authors: Bentalha Badr
Published: April 2024

Amazon is a world leader in e-commerce and robotization. Its robotic mobile fulfillment systems (RMFS) aim to speed up product delivery by using robots to move shelves. In terms of speed, precision, and profitability, the RMFS solution seems to guarantee economic and commercial success. Nevertheless, the integration of robotization is accompanied by an increase in workload, daily tasks, and accident risks. The aim of the present study is to provide an in-depth analysis of Amazon RFMS employees' perceptions of current robotization. Through a netnographic study of the comments and opinions of Amazon employees working in robotized warehouses, the empirical study will gather argumentative thinking around the effect of digital transformation in RFMS in terms of employability, working conditions, and quality of work life. The results of the study show a consolidation of working conditions accompanied by stress and a risk of job loss. Certain risks and doubts are also present, notably around the possibility of work-related accidents and the man-machine interactions.
From Consultation to Implementation
Authors: Gatcho Al Ryanne Gabonada
Published: April 2024

Exploring the intersection of technology and community literacy, this reflection chronicles the design and implementation of technology-mediated community literacy (TMCL) programs. It scrutinizes the symbiosis of digital tools and literacy enhancement, addressing challenges like the digital divide and educator resistance. Successes, challenges, and insights from two principal TMCL programs—one for children during COVID-19 and another for adult literacy—are analyzed. Emphasizing core principles such as community engagement and continuous improvement, the chapter outlines future TMCL trajectories influenced by technological advancements and educational policy shifts. Personal reflections offer a vision for TMCL's impact on community literacy.
Operational Efficiency and Competitiveness in the Global Logistics Industry
Authors: Akkartal Gonca Reyhan , Mızrak Filiz
Published: April 2024

The logistics industry, with its inherent complexities and dynamic challenges, relies heavily on strategic human resources management (HRM) practices to optimize workforce potential and navigate the multifaceted demands of the global market. Utilizing the fuzzy analytic hierarchy process (Fuzzy AHP) as a decision-making tool, the research aims to unravel the intricate relationship between these strategies and the dynamic logistics sector. Employing a hybrid methodology that integrates an extensive literature review, insights from expert interviews with HR specialists in the Turkish logistics sector, the study examines how logistics companies optimize efficiency and competitiveness while navigating uncertainties. The findings highlight the foundational importance of talent acquisition, emphasizing innovative recruitment, targeted training, and empowerment. performance management takes center stage, emphasizing the critical role of aligning key performance indicators, maintaining a continuous feedback loop, and implementing recognition and rewards programs.
Digital Twin in Logistics and Supply Chain Management
Authors: Cebir Yaren , Akkartal Erkut
Published: April 2024

The advancement of technology has reshaped the pathway for products to reach end consumers, with disruptive technologies emerging as a key factor in streamlining operations and appealing to users. Digital twin technology stands out among these innovations, offering a virtual model of physical items, processes, or systems, allowing for testing and monitoring without the physical object. This chapter examines the role and impact of digital twin technology as a form of disruptive technology, especially focusing on its transformative influence on the logistics sector. This technology addresses the logistics industry's need for smarter, quicker, and more efficient solutions amidst ever-changing consumer demands and competitive pressures. It highlights how digital twin technology contributes to increased efficiency, cost savings, and the optimization of logistical processes, making it essential for companies to stay competitive and adapt to market shifts.
Future Perspectives and Challenges
Authors: Bhattacharya Sumanta , Sachdev Bhavneet Kaur
Published: April 2024

Focusing on the effects on long-term economic and social development, the chapter investigates the potential future directions and obstacles of human rights and corporate social responsibility (CSR). Possibilities to effect good change arise when CSR and human rights issues become more central to company plans. Nevertheless, there are still major obstacles to overcome, such as cultural resistance to change, greenwashing, and victims' lack of access to remedies. In order to overcome these obstacles and fully utilise CSR and human rights to promote sustainable development, it is vital that governments, corporations, civil society, and people work together. By resolving these issues, stakeholders can pave the way for a future in which companies put ethics first, uphold human rights, and help bring about social and economic progress while also protecting the environment for the sake of generations to come.
Hospital Management Practice of Combined Prediction Method Based on Neural Network
Authors: Yang Qi
Published: April 2024

In this article, the outpatient volume, hospitalization income and drug demand in hospital management are taken as the research objects, and a neural network combined prediction model is established to predict the outpatient volume with the fitting prediction results of cubic polynomial regression model and grey model as the input of the network and the actual statistical outpatient volume as the output. Lasso variable selection method is used to determine the main indexes affecting the income of inpatients in hospital, and a prediction model combining grey prediction and artificial neural network is established to predict the income of inpatients in hospital. By studying the key characteristics of hospital drug demand, BP neural network, RBF neural network and GRNN generalized regression neural network are selected to predict the drug demand. By solving the quadratic programming problem and according to the weight rules, a combination forecasting model based on neural network is established to predict the drug demand, and the accuracy and stability of the model are evaluated.
A Novel Hybrid Binary Bat Algorithm for Global Optimization
Authors: Liang Huijun , Pang Aokang , Lin Chenhao , Zhong Jianwei
Published: April 2024

In this article, a novel hybrid binary bat algorithm named HBBA is proposed for global optimization problems. First, to avoid simultaneous updating of bat velocity's dimensional components, i.e., elements of velocity vector, a random black hole model is modified to adapt to binary algorithm for updating in unknown spaces for each dimensional component individually. Through this way, the search ability of bats around the current group best is increased greatly. Second, a time-varying v-shaped transfer function, rather than a time-invariant one as in closely related works, is proposed to map velocity in continuous search space to a binary one. This accelerates the speed to switch individuals' positions, i.e., solutions in binary space. Third, a chaotic map is utilized to replace monotonous parameters in original binary bat algorithm, which is beneficial for avoiding premature convergence. Simulation results demonstrate the effectiveness of the proposed algorithm by three types of benchmark functions and unit commitment problem.
Analyzing E-Commerce Market Data Using Deep Learning Techniques to Predict Industry Trends
Authors: Qian Wei , Wang Yijie
Published: April 2024

Faced with challenges in sales predicting research, this article combines the capabilities of deep learning algorithms in handling complex tasks and unstructured data. Through analyzing consumer behavior, it selects factors influencing sales, including images, prices and discounts, and historical sales, as input variables for the model. Three different types of neural network models-fully connected neural networks, convolutional neural networks, and recurrent neural networks-are employed to process structured data, image data, and sales sequence data, respectively. This forms a deep neural network for feature representation. Subsequently, based on the outputs of these three types of deep neural networks, a fully connected neural network is employed to train the sales prediction model. Ultimately, experimental results demonstrate that the proposed sales prediction method outperforms exponential regression and shallow neural networks in terms of accuracy.
Rotorcraft Flight Control Design for Rotor Noise Abatement
Authors: Buǧday Batın , Saetti Umberto
Published: April 2024

This article presents the development and implementation of active noise abatement flight control laws utilizing redundant control allocation in rotorcraft. The study starts by finding a periodic equilibrium of coupled rotorcraft flight dynamics and acoustics using a modified harmonic
balance trim solution method. Next, the rotorcraft nonlinear time-periodic dynamics are linearized about its periodic equilibrium and transformed into an equivalent higher-order linear time-invariant system in harmonic decomposition form. Composite aeroacoustic measures are formulated as outputs
of this system. To enable faster runtime and tractable control design, a reduced 8‐state model representative of the coupled rigid‐body dynamics and acoustics is obtained through residualization. An explicit model following control law with pseudoinverse allocation to redundant
control surfaces–an active horizontal stabilizer in this study–is synthesized using the 8‐state model. The article further assesses the impact of noise alleviation control on handling qualities of conventional and compound rotorcraft in forward flight. The results demonstrate
that redundant control allocation is an effective method for active reduction of unsteady rotor noise, with increasing effectiveness during aggressive maneuvers. Future-generation rotorcraft, particularly future vertical lift configurations featuring high control redundancy and aggressive
maneuvering capabilities, can significantly benefit from noise abatement through redundant control allocation. Furthermore, the article highlights that while implementing noise abatement control in conventional helicopters can degrade handling qualities, the use of redundant control allocation
in compound configurations offers noise reduction without compromising handling qualities.
Cavernous Haemangioma of the Submandibular Triangle Eluding the Gland – A Case Report
Authors: Shetty Sujeeth Kumar , Kale Revati
Published: April 2024

Rationale:

Haemangiomas are benign vascular malformations. They are common neoplasms of infancy but seldom manifest at birth. Although common in the head & neck region, they are rare in the submandibular region. Despite being benign, surgical treatment is necessary if it causes significant functional or aesthetic compromise.

Patient Concerns:

The patient’s primary complaint was swelling in the submandibular region.

Diagnosis:

Initial examination and imaging studies were suggestive of sialolithiasis due to the presence of multiple calcifications. Ultrasonographic and magnetic resonance imaging were suggestive of haemangioma with multiple phleboliths.

Treatment:

Excisional biopsy was done without compromising the submandibular gland. A histopathological examination was done post-operatively to confirm the diagnosis.

Outcomes:

Post-operative recovery was uneventful and 6-month follow-up showed no recurrence.

Take-away Lesson:

This case highlights the importance of considering haemangioma in the differential diagnosis of submandibular region masses and emphasises the preservation of the submandibular gland when the extent of the lesion permits.
Geographic information system-aided evaluation of epidemiological trends of dengue serotypes in West Bengal, India
Authors: Baskey Upasana , Verma Priya , Mondal Palash , Dutta Supradip , Biswas Aritra , Bakshi Sagnik , Das Raina , Bhaduri Sudipta , Maji Dipankar , Dutta Shanta , Sadhukhan Provash Chandra
Published: April 2024

Background & objectives:

West Bengal is a dengue-endemic State in India, with all four dengue serotypes in co-circulation. The present study was conceived to determine the changing trends of circulating dengue virus (DENV) serotypes in five consecutive years (2015-2019) using a geographic information system (GIS) during the dengue season in West Bengal, India.

Methods:

Molecular serotyping of dengue NS1 sero-reactive serum samples from individuals with ≤5 days of fever was performed using conventional nested reverse transcriptase-PCR. GIS techniques such as Getis-Ord Gi* hotspot analysis and heatmap were used to elucidate dengue transmission based on the received NS1-positive cases and vector data analysis was used to point out risk-prone areas.

Results:

A total of 3915 dengue NS1 sero-positive samples were processed from most parts of West Bengal and among these, 3249 showed RNA positivity. The major circulating serotypes were DENV 3 (63.54%) in 2015, DENV 1 (52.79%) in 2016 and DENV 2 (73.47, 76.04 and 47.15%) in 2017, 2018 and 2019, respectively. Based on the NS1 positivity, dengue infections were higher in males than females and young adults of 21-30 yr were mostly infected. Getis-Ord Gi* hotspot cluster analysis and heatmap indicate that Kolkata has become a hotspot for dengue outbreaks and serotype plotting on maps confirms a changing trend of predominant serotypes during 2015-2019 in West Bengal.

Interpretation & conclusions:

Co-circulation of all the four dengue serotypes was observed in this study, but only one serotype became prevalent during an outbreak. Representation of NS1-positive cases and serotype distribution in GIS mapping clearly showed serotypic shift in co-circulation. The findings of this study suggest the need for stringent surveillance in dengue-endemic areas to limit the impact of dengue and implement better vector-control strategies.
Recent updates on laboratory diagnosis of rabies
Authors: Ashwini M. A. , Pattanaik Amrita , Mani Reeta S.
Published: April 2024

Rabies is a lethal viral disease transmitted through the bite of rabid animals. India has a high burden of rabies, contributing to a significant proportion of the global deaths. However, under-reporting of the disease is prevalent due to lack of laboratory confirmation. Laboratory diagnosis of rabies plays a crucial role in differentiating the disease from clinical mimics, initiation of appropriate care, implementing infection control measures and informing disease surveillance. This review provides an overview of the recent advancements in laboratory diagnosis of rabies, aimed at updating physicians involved in diagnosis and management of rabies cases in India.
Urinary lipoarabinomannan in individuals with sputum-negative pulmonary tuberculosis
Authors: Ajantha P. , Puri Man Mohan , Tayal Devika , Khalid U.
Published: April 2024

Background & objectives:

Tuberculosis (TB) is a major global cause of ill health. Sputum microscopy for confirmation of presumptive pulmonary TB (PTB) has a reportedly low sensitivity of 22-43 per cent for single smear and up to 60 per cent under optimal conditions. National TB Elimination Programme in India recommends the use of cartridge-based nucleic acid amplification test (CBNAAT) and culture for microbiological confirmation in presumptive PTB individuals with sputum smear negative test. The use of lateral flow urine lipoarabinomannan (LF-LAM) is usually recommended for the diagnosis of TB in HIV-positive individuals with low CD4 counts or those who are seriously ill. The objective of this study was to detect urinary LAM using cage nanotechnology that does not require a physiologic or immunologic consequence of HIV infection for LAM quantification in human urine in 50 HIV-seronegative sputum smear-negative PTB individuals.

Methods:

To study the diagnostic value of urinary LAM in sputum smear negative PTB individuals, a cage based nanotechnology ELISA technique was used for urinary LAM in three different groups of participants. Fifty smears negative PTB clinically diagnosed, 15 smear positive PTB and 15 post TB sequel individuals. Sputum was tested by smear, CBNAAT, and culture along with urine LAM before treatment. The results were interpreted by ROC curve in comparison to the standard tests like CBNAAT and culture.

Results:

The mean urinary LAM value was 0.84 ng/ml in 37 culture-positive [Mycobacterium tuberculosis (M.tb)] and 0.49 ng/ml in 13 culture-negative (M.tb) smear-negative individuals with PTB, respectively. In 47 smear-negative PTB cases with microbiologically confirmed TB by CBNAAT, the mean urinary LAM was 0.76 ng/ml. The mean urinary LAM in post-TB sequel individuals was 0.47 ng/ml. As per the receiver operating characteristic curve, cut-off value of urinary LAM in individuals with smear-negative PTB microbiologically confirmed by: (i) CBNAAT was 0.695 ng/ml and (ii) culture was 0.615 ng/ml.

Interpretation & conclusions:

The findings of this study suggest that individuals with smear-negative PTB and a urinary LAM value of >0.615 ng/ml were most likely to have microbiological confirmed TB while those with a LAM value <0.615 ng/ml >0.478 ng/ml are less likely and those with a value <0.478 ng/ml are unlikely to have microbiological confirmed TB.
Does Lake Louise questionnaire interpret high-altitude headache as acute mountain sickness? Experience in the western Himalayas
Authors: Unnikrishnan Abhilash , Shekhar Atul , Kumar Dharmendra , Jaipurkar Raksha , Sikri Gaurav , Singh Krishan , Manral Rahul
Published: April 2024

Background & objectives:

High-altitude headache (HAH) and headache in acute mountain sickness (AMS) are common among lowlanders ascending to the high altitude and are often confused with one another. A pilot study was undertaken to analyze HAH and AMS cases in Indian lowlanders ascending to Leh city (3500 m) in western Himalayas.

Methods:

A total number of 1228 Indian lowlanders, who ascended (fresh and re-inductees) by air and acclimatized, participated in this pilot study. The intensity of headache was assessed by the Visual Analogue Score. The parameters of HAH as per the International Classification of Headache Disorders-3 and 2018 Revised Lake Louise Questionnaire (LLQ) were used to differentiate HAH and AMS.

Results:

Out of 1228 cases, 78 (6.4%) cases had headache, of which 24 (1.95%) cases were HAH only, 40 (3.25%) cases AMS only and 14 (1.14%) cases were defined as both HAH and AMS. There was a significant difference in heart rate [F (2,51) = (4.756), P=0.01] between these groups. It also showed a difference in the correlation between the parameters within the groups. The Odd’s Ratio of AMS in fresh and re-inductees was found to be 4.5 and for HAH it was 4.33.

Interpretation & conclusions:

The findings of this study suggest that LLQ has a tendency of overestimating AMS by including HAH cases. Furthermore differential parameters exhibit differences when AMS and HAH are considered separately. Re-inductees showed a lower incidence of HAH and AMS.
Emerging role of exosomes as a liquid biopsy tool for diagnosis, prognosis & monitoring treatment response of communicable & non-communicable diseases
Authors: Yadav Rajbala , Singh Ajay Vir , Kushwaha Shweta , Chauhan Devendra Singh
Published: April 2024

From an initial thought of being used as a cellular garbage bin to a promising target for liquid biopsies, the role of exosomes has drastically evolved in just a few years of their discovery in 1983. Exosomes are naturally secreted nano-sized vesicles, abundant in all types of body fluids and can be isolated intact even from the stored biological samples. Being stable carriers of genetic material (cellular DNA, mRNA and miRNA) and having specific cargo (signature content of originating cells), exosomes play a crucial role in pathogenesis and have been identified as a novel source of biomarkers in a variety of disease conditions. Recently exosomes have emerged as a promising ‘liquid biopsy tool’and have shown great potential in the field of non-invasive disease diagnostics, prognostics and treatment response monitoring in both communicable as well as non-communicable diseases. However, there are certain limitations to overcome which restrict the use of exosome-based liquid biopsy as a gold standard testing procedure in routine clinical practices. The present review summarizes the current knowledge on the role of exosomes as the liquid biopsy tool in diagnosis, prognosis and treatment response monitoring in communicable and non-communicable diseases and highlights the major limitations, technical advancements and future prospects of the utilization of exosome-based liquid biopsy in clinical interventions.
Genetic diversity of Mycobacterium leprae: Need to move towards genome-wide approaches
Authors: Dwivedi Purna , Sharma Mukul , Ansari Afzal , Singh Pushpendra
Published: April 2024

Leprosy, an ancient disease, continues to be a public health concern as it remains endemic in several countries. After reaching the elimination target (1/10,000) as a public health problem in 2005 in India, around 1.2 lakh cases have been detected every year over the last decade indicating active transmission of leprosy bacillus (Mycobacterium leprae). Single-nucleotide polymorphisms (SNPs), genomic insertions/deletions and variable-number tandem repeats (VNTRs) have been identified as genetic markers for tracking M. leprae transmission. As the leprosy bacilli cannot be cultured in vitro, molecular testing of M. leprae genotypes is done by polymerase chain reaction-based sequencing which provides a practical alternative for the identification of strains as well as drug resistance-associated mutations. Whole-genome sequencing (WGS) of M. leprae directly from clinical samples has also proven to be an effective tool for identifying genetic variations which can further help refine the molecular epidemiological schemes based on SNPs and VNTRs. However, the WGS data of M. leprae strains from India are scarce, being responsible for a gross under-representation of the genetic diversity of M. leprae strains present in India and need to be addressed suitably. Molecular studies of leprosy can provide better insight into phylogeographic markers to monitor the transmission dynamics and emergence of antimicrobial resistance. An improved understanding of M. leprae transmission is essential to guide efficient leprosy control strategies. Therefore, this review compiles and discusses the current status of molecular epidemiology, genotyping and the potential of genome-wide analysis of M. leprae strains in the Indian context.
Pharmacoeconomics of medicines used for geriatric individuals in a tertiary care hospital in Delhi
Authors: Singh Vikram Jit , Roy Vandana , Singhal Shubha , Daga M.K.
Published: April 2024

Background & objectives:

Expenditure on healthcare is a major concern in the geriatric age group. The current study was carried out to assess the expenditure patterns on medicines utilized in geriatric inpatients.

Methods:

An observational study was conducted on 1000 geriatric inpatients, aged ≥60 yr, admitted to the medicine unit. Data were collected regarding demographic characteristics, prescribed medicines, expenditure incurred on medicines, appropriateness of medicines prescribed and adverse drug reactions (ADRs). Appropriateness of the prescribed medicines was determined using the American Geriatrics Society 2015 Updated Beers Criteria.

Results:

Geriatric inpatients comprised 41.3 per cent of the total individuals admitted in the ward during the study period. A total of 8366 medicines were prescribed in 127 formulations. The total expenditure on prescribed medicines was INR 1,087,175 with a per capita expenditure of INR 1087.17. Parenteral medicines accounted for 91 per cent of the expenditure on medicines. Maximum expenditure (70%) was incurred on 11.9 per cent of the medicines prescribed. The per capita expenditure was significantly higher in individuals with comorbidities (P=0.03) and those who had a longer duration of hospital stay (P<0.0001). About 28.1 per cent prescriptions were inappropriate. ADRs (140) were observed in 139 (13.9%) inpatients. Individuals with inappropriate medicines prescriptions and ADRs had a longer duration of hospital stay and more number of medicines prescribed.

Interpretation & conclusions:

Comorbidities, prolonged hospitalization, polypharmacy, inappropriate medicines and parenteral medicines being prescribed contribute to increased expenditure on medicines in geriatric inpatients. In view of the rising number of geriatric inpatients, there is a need to frame a drug policy for them along with surveillance of expenditure on prescribed medicines. This needs to be treated as a priority.
Clinical outcomes of rhabdomyolysis & validation of McMahon Score for risk prediction
Authors: Mathew Manju , Pillai Subhash Chandran Bhaskaran
Published: April 2024

Background & objectives:

Rhabdomyolysis in tropics has a unique aetiology and clinical profile. The objective of this study was to determine the aetiology and clinical outcomes of rhabdomyolysis and validate the McMahon risk prediction score in affected individuals from south India.

Methods:

A retrospective study of affected individuals with rhabdomyolysis admitted to a tertiary care hospital in south India, between January 2015 and June 2020, was undertaken. In-patients who were ≥15 yr in age and had creatinine phosphokinase ≥5000 U/l were included in the study. Cardiac, stroke, chronic muscular diseases and chronic kidney disease on maintenance haemodialysis were excluded. The incidence of acute kidney injury (AKI) in this group was calculated. Other clinical outcomes determined were 28-day mortality, proportion of individuals who required renal replacement therapy (RRT), intensive care unit (ICU) admission, vasopressors, mechanical ventilation (MV), number of days on mechanical ventilator and length of stay in ICU and hospital. Validation of McMahon risk prediction score for the requirement of RRT and mortality was performed.

Results:

Major aetiologies identified in the 75 study participants included were infections, trauma and seizures. Twenty eight-day mortality was 24 per cent (n=18). AKI incidence was 68 per cent, out of which 43.1 per cent had RRT. AKI in all survivors became dialysis independent. Vasopressors, MV and ICU requirement were 30.7, 32 and 77.3 per cent, respectively. Receiver operator characteristic curve for RRT and mortality risk prediction based on the McMahon Score showed a sensitivity of 71.4 per cent and specificity of 77.8 per cent for a cut-off ≥7.8.

Interpretation & conclusions:

Rhabdomyolysis in tropics is associated with significant organ dysfunction and mortality. Although the incidence of AKI and RRT is high, the overall renal outcome is good among survivors. The wide confidence intervals for the area under curve for McMahon Score limit its predictability for RRT and mortality.