bluuebunny/crossref_metadata_2025 huggingface dataset:
Criação de conteúdos educacionais com algoritmos de inteligência artificial
Authors: Brandalise Leandromar , Malta Daniela Paula de Lima Nunes , Melo Júnior Hermócrates Gomes , Torres Priscilla de Jesus Leão , Fontoura Victor Martins , Costa Wilson Aires
Published: June 2024

O estudo abordou como a Inteligência Artificial pode se tornar uma aliada no desenvolvimento de recursos educacionais. O objetivo geral foi investigar as contribuições práticas da IA na educação, identificando suas vantagens e desafios. Utilizou-se uma metodologia baseada em uma revisão de literatura, analisando fontes acadêmicas e estudos de caso relevantes. Durante o desenvolvimento, discutiu-se a personalização do aprendizado proporcionada pela IA destacando-se a capacidade de ajustar o nível de dificuldade das tarefas de acordo com o desempenho dos alunos. A automação de tarefas administrativas, como correção de provas e gestão de notas, foi outro ponto explorado, evidenciando o alívio proporcionado aos professores e a melhoria da eficiência administrativa. Também foi abordado o desenvolvimento de recursos educacionais inovadores, como jogos educativos adaptativos, que mantêm os alunos engajados e motivados. Além disso, foram discutidas as implicações éticas do uso da IA na educação, enfatizando a necessidade de diretrizes para garantir a proteção de dados e a transparência nas decisões tomadas pelos algoritmos. Nas considerações finais, o estudo concluiu que a IA possui um potencial significativo para transformar a educação, desde que implementada de maneira planejada e monitorada. Destacou-se a importância de superar desafios como a infraestrutura tecnológica, a formação de professores e os custos iniciais de implementação. Sugere-se a necessidade de estudos adicionais para explorar os impactos a longo prazo e desenvolver estratégias para a adoção eficaz da IA em diversos contextos educacionais.
Ubuntu Precepts and the Coverage of Xenophobic Discourses in South African Community Newspapers: An Afrocentric Systematic Critique
Authors: Makananise Fulufhelo Oscar
Published: June 2024

In post-apartheid South Africa, community newspapers that publish in native languages were established to promote the values and principles of the new constitutional democracy. This paper critiques how the epistemic dominance and coverage of the xenophobic attack discourses in South African community newspapers in a way contradict the values and principles of Ubuntu as an African philosophy. The paper focuses on how such depictions, coverage and dominance could have the potential to perpetuate the legacy of colonialism and neocolonialism in the post-apartheid era and intensify divisions, devalue dignity, and undermine the unity of African societies. It argues that these colonial legacies of the past conflict with the values and principles of ubuntu, compromise social cohesion, and continue the ongoing neo-colonial discourses that separate and insinuate attacks on other African nationals. Reinforced by the framing theory of representation, this Afrocentric systematic review employed a purposive sampling technique to select at least twenty secondary research articles and theses published between 2015 and 2023 by searching various repositories. The selection of these texts was based on their online availability and accessibility. The paper used thematic analysis to explore the selected materials to develop the related themes and subthemes that informed the entire conversation. Moreover, the findings highlight how the perpetual discourses on xenophobic stereotypes, linguistic features, and expressions used in community newspapers to signify other African nationals could in a way, contradict significant values of ubuntu, communal living, and social cohesion that define the African dignity and unity.

Keywords: Community Newspaper, Immigrants’ Stereotypes, Social Cohesion, Ubuntu, Xenophobic Discourses
Transporto elektroninio bilieto sistemų diegimo ir palaikymo procesų patirtis, iššūkiai ir problemos
Authors: Samuilovas Andrius , Ušpalytė-Vitkūnienė Rasa
Published: June 2024

2024 metais transporto e. bilieto sprendiniai veikė 11 Lietuvos miestuose / savivaldybėse. Visus vienija tie patys tikslai – apmokėjimo už kelionę patogumas, lanksti kainodara, esamų keleivių išlaikymas ir naujų keleivių pritraukimas, duomenų apie keliones rinkimas, analizė bei sprendimai remiantis jais. Skiriasi patirtis, diegiamų sistemų funkcionalumo gylis, integracijos galimybės, sistemos palaikymo ir priežiūros organizavimas, sistemos savininko statusas (miestas, VT organizatorius, vežėjas). Visus analizuotus pavyzdžius vienija tai, jog diegiami naujausi sprendimai, orientuoti į keleivio poreikius, o ne į paslaugos organizatorių ir vežėją. Pagrindinis straipsnio tyrimo tikslas – įvertinti sistemų diegimo patirtį, funkcionalumą ir iššūkius. Tyrimas darytas vertinant patirtį Lietuvos savivaldybėse, kurios jau įsidiegė elektroninį bilietą.
Rationing of medical care: how medical care to be distributed in conditions of limited resources
Authors: Vlassov Vasily V. , Shishkin Sergey V. , Chirikova Alla E. , Khazan Petr L. , Vlasova Anna V.
Published: June 2024

Background. Rationing of health care—restricting patients’ access to potentially beneficial health care interventions through non-market instruments—is a natural feature of all health care systems as they operate under resource constraints. The purpose of this study is to characterize rationing practices and the attitude of doctors themselves to it, with an emphasis on comparing Russia and the United States and on changes in the perception of rationing during the COVID-19 pandemic.

Methods. We conducted a bibliometric analysis of publications in the medical scientific literature since 1989 on the issue of rationing of medical care. To characterize rationing practices in Russia and the United States and the attitudes of doctors towards them, we used data from published studies and data from semi-structured in-depth interviews with 28 Russian doctors.

Results. Despite the increasing frequency of publications related to the topic of resource allocation over the past 20 years, studies using the term “rationing” are rare. Both Russia and the USA have practices of explicit and implicit rationing. In Russia they are more diverse and widespread. In both countries, doctors prefer implicit rationing and do not want open discussion of these issues. The practice of rationing is institutionalized. In Russian medical organizations its most common form is a chain of permissions for the use of resources. But most doctors believe they are not rationing care. The pandemic briefly brought the topic of rationing into the public sphere, but then its discussion was limited. The probable reason is that medical practice during the pandemic was carried out within the previous legal framework. Professional organizations have developed several recommendations for rationing, but their usefulness and level of acceptance by professionals and the public is unclear.

Conclusions The transition from implicit to explicit rationing is extremely difficult, but is necessary to ensure equitable patient access to scarce medical resources and the effective functioning of health care systems. A major barrier to the explicit and informed use of rationing instrument is the limited public acceptance of it and the reluctance of professional communities to make public decisions that maximize public benefit by prioritizing access to effective interventions.
Poxyaibamberus Andersen & Dantas, gen. nov. (Diptera, Chironomidae, Orthocladiinae) from Brazil
Authors: Andersen Trond , Dantas Galileu P. S. , Baranov Viktor , Sanz-laParra Annui M. , Mendes Humberto F. , Hamada Neusa
Published: June 2024

PoxyaibamberusAndersen & Dantas,gen. nov.is erected based on the males of two species,P. jamanximensisAndersen & Dantas,sp. nov.from Jamanxim National Park, Pará State, Brazil, andP. ubajarensisAndersen & Dantas,sp. nov.from Ubajara National Park, Ceará State, Brazil. Both species have a comparatively short and wide head, with large eyes and short, five-segmented palps; a strong subapical seta on the ultimate flagellomere; scalpellate acrostichals; no setae on the wing veins except for one seta on the brachiolum; a long costal extension; and a large triangular anal point and a very long heel on the gonostylus. The systematic position of the new genus is briefly discussed.
Historique des travaux de PRÉAUT, de la recherche à ses applications sur le terrain : le radap , l’ udap , les adp et les app
Authors: Crespin Graciela C. , Trouvé Jean-Noël
Published: June 2024

Cet article retrace l’ensemble des travaux que l’association PRÉAUT mène depuis vingt-cinq ans, que ce soit en matière de recherche, de formation professionnelle ou de modalités innovantes d’accompagnement des enfants tsa et de guidance pour leurs familles. Il envisage les perspectives de remaniements nécessaires à la continuité de l’ensemble de ses activités.
Outils d’identification de signes de souffrance psychique dans la clinique avec des bébés dans nos programmes associés
Authors: Lunardelli-Jacintho Ana , Kupfer Cristina
Published: June 2024

Ce travail a cherché à vérifier la valeur d’accompagnement des outils d’identification de signes de souffrance précoce suivants : le protocole irdi , le questionnaire PRÉAUT et les ssp . Il fait valoir que leur utilisation complémentaire, dans le cadre d’interventions auprès de bébés, permet de soutenir une lecture clinique des problématiques subjectives de chaque enfant dans son lien avec les adultes et de montrer leur évolution tout au long des séances. Il aborde également certaines spécificités des outils à la lumière de leurs références théoriques. Enfin, il commente la question de l’utilisation de signes cliniques dans la promotion des soins à la petite enfance et considère que leur attribuer un statut de parole correspond à l’engagement éthique d’écouter le corps du bébé et de lui donner une voix.
Mise à disposition des travaux de PRÉAUT aux professionnels
Authors: Schojed-Ortiz Débora , Chavarria Analia
Published: June 2024

Cet article retrace des années d’échange entre deux associations, préaut et funadip , entre deux pays, France et l’Argentine. Des visites, de nombreux séminaires portant sur la guidance parentale, la clinique du bébé et les tnd - tsa , des publications, et davantage, l’envie de continuer à travailler ensemble.
La pré-appropriation capacitante d’un outil de contrôle de la qualité : le cas d’une accréditation à l’université
Authors: Hertzog Marion , Bollecker Marc
Published: June 2024

De nombreux travaux en sciences de gestion sont consacrés à l’appropriation des outils de gestion dans les organisations publiques. En revanche, rares sont ceux qui traitent d’une de ses phases, la pré-appropriation, et ceux qui portent sur l’appropriation des outils de contrôle de la qualité. Dans le contexte des universités françaises, les études consacrées à ces deux points sont peu nombreuses. Or, des constats de rejet de certains outils dans ces organisations méritent que l’on s’intéresse aux modalités de leur déploiement et, en particulier, à la pré-appropriation que nous caractérisons comme les premières représentations qu’ont les acteurs d’un outil. Certains auteurs soulignent l’importance d’engager un pilotage actif de ces dernières en associant les acteurs afin qu’ils puissent mieux maîtriser leur utilisation future. L’ancrage théorique retenu dans cet article est celui du contrôle capacitant. Dès lors, cet article se structure autour de la problématique suivante : la pré-appropriation d’un outil de contrôle est-elle capacitante ? Pour répondre à la problématique, nous avons mené une étude exploratoire sur une composante d’une université française ayant le projet de déployer une accréditation internationale. 18 interviews ont été menées à partir d’un guide d’entretien. Ils ont été complétés par une analyse documentaire pour cerner les spécificités de la composante universitaire et de la certification. Les résultats montrent une pré-appropriation différenciée tant sur les impacts de cette dernière que sur ses modalités de fonctionnement et les marges de manœuvre qu’elles procurent aux acteurs. Ils permettent de tirer des enseignements provisoires sur la mise en œuvre des caractéristiques du contrôle capacitant dans la phase de pré-appropriation.
Faut-il craindre la dissidence ?
Authors: Venne Jean-François
Published: June 2024

Qu’est-ce qui compte le plus dans une équipe : le consensus ou la dissidence ? Les gestionnaires souhaitent à la fois favoriser une culture harmonieuse et profiter des avantages de perspectives différentes. Un équilibre qui n’est pas toujours facile à maintenir.
L’humour pour apaiser la discorde
Authors: Rioux François
Published: June 2024

Dans le dynamique monde des affaires, où les interactions professionnelles sont souvent empreintes de stress et de pression, les conflits peuvent surgir à tout moment. Pour prévenir et désamorcer les tensions, une arme souvent sous-estimée et pourtant puissante existe : l’humour. Comment faire de cette forme d’esprit un véritable outil stratégique ?
De sérieux freins à la carrière des femmes
Authors: Ethier Claudia , Gosselin Alain
Published: June 2024

Malgré les progrès accomplis ces dernières années, beaucoup de chemin reste à parcourir pour que les femmes puissent briser le fameux plafond de verre qui se dresse au-dessus de leur tête. Aujourd’hui encore, elles occupent seulement 35 % des postes de direction, gagnent 17 % de moins que les hommes, et leur proportion au sein des CA plafonne à 21 % 1 . Comment les principales intéressées perçoivent-elles leur progression de carrière et comment affrontent-elles tous les obstacles qui entravent leur ascension ?
Créer un climat relationnel sécurisant au travail, de Marion Malaussena-Drosson
Authors: Jézéquel Myriam
Published: June 2024

Les situations qui peuvent nuire à la performance des travailleurs et à leur santé sont nombreuses : conflits entre collègues, tensions et plaintes explicites, manque de reconnaissance ou de cohésion… Comment créer alors un climat relationnel sécurisant, propice à apaiser les tempêtes autant qu’à stimuler les esprits ? Outils et conseils de la facilitatrice relationnelle française Marion Malaussena-Drosson.
La transparence dans l’espace numérique, de Vincent Mabillard et Jean-Patrick Villeneuve
Authors: Jézéquel Myriam
Published: June 2024

La prolifération des contenus en ligne s’ajoute à l’obligation légale de transparence et modifie en profondeur les pratiques de bonne gouvernance et la gestion des organisations publiques. Faut-il toujours plus de transparence ou doit-on tout simplement mieux l’encadrer ? Voici quelques clés pour alimenter notre réflexion.
Effect of Split and Timing Injection Techniques on Diesel-Biodiesel Blends Fueled RCCI Engines
Authors: Al-Abboodi Nhad K. Frhan , Al-Badri Alaa R. , Abdulsaeed Ali A.
Published: June 2024

On reactivity-controlled compression ignition engines, numerical simulations approach were conducted to study the combined effect of the 2nd pulse fraction and dwell time on combustion and emissions characteristics powered by the diesel-biodiesel blends. The Diesel-RK commercial software carried out the simulation the engine was chosen. Meanwhile, the fuel is directly injected through engine cylinder, four stroke, and single cylinder. Simulations were conducted with different dwell times between start of injections of the 1st and 2nd pulses, while the start of injections times of 1st pulse keeping at -40o CA ATDC. Besides, the fuel fraction ratio of the 2nd pulse was changed at 90, 80,70, and 70%, accordingly. In this current study, the peak cylinder pressure and peak cylinder temperature were compared at various boundary conditions. The extracted results extracted from simulation showed that, in contrast to the dwell time 5o CA, a slightly reduction in peak cylinder pressure by 8.9, 7.8, 6.7, and 9.1% for 10, 15. 20, 25o CA respectively. Peak cylinder temperature showed identical trend, its decreased by 9.0, 6.8, 7.8, and 8.8% . Moreover, the results showed that by decreased fuel fraction ratio from 90 to 60%, the peak cylinder pressure increased by 10.1%, while peak cylinder temperature decreased by 7.9%. As a result of the current study, and based on the results of the experimental work published in the literature, it has been consistently demonstrated that the predictive numerical model is reliable..
Employing Clean Energies in the Design of Contemporary Buildings, Review
Authors: Alobaidi Maysaa Moffeq , Yahya Luma Mohemmed
Published: June 2024

Energy problems and the search for effective solutions to solve its various crises represent one of the most important problems facing societies and countries, and the consequent economic problems represented in costs and resources, in addition to its negative effects and accompanying environmental effects. And health problems for humans and their environmental surroundings. Therefore, architecture has tended over the years to search for self-sufficiency in its buildings as one of the solutions that can contribute to saving energy. With its external environment on the other hand, and to achieve these goals, the designers resorted to employing a set of mechanisms and strategies in the designs of its buildings and within the stages of designing and operating the buildings, as the paper aims to (discover and clarify the mechanisms and strategies that designers adopt to employ clean energies in the design of contemporary buildings). In its theoretical framework, a group of studies dealt with defining the possibilities of employing clean energies and reviewing the possibilities of employing them in traditional architecture, up to contemporary architecture. Its applied side also deals with a group of contemporary and modern architectural projects and analyzes the design mechanisms adopted by the designers to reach a more healthy and less polluted environment, which are the mechanisms through which we can employ them in the construction of our buildings in our local communities and reach healthier and more prosperous cities and reduce economic costs.
A New Main Matrix to Find the Principal Stresses, Strains and the Max - Shear Stress, Strain by MATLAB Simulation
Authors: Dhayea Assi Abdullah
Published: June 2024

In this research, a main matrix has been derived from the stress components in the inclined plane with an angle θ that calculates the normal stresses and shear stress in the inclined plane to be used in calculating the main stresses and the maximum shear stress in one step, this is done using the principal stress angle which is calculated from known stress compounds. As well as calculating the maximum shear stress after using the correction factor. The inverse of this derived matrix can be used to calculate the stress compounds through the known principal stresses and this applies to the components of the principal strain and strain, and the maximum shear strain. All this is done through MATLAB simulation Keywords: Normal Stresses and Strains, Shear, Principal Stresses, max. Shear Stress
Behavior of Reactive Powder Concrete Covering Quartz Powder Strengthened by Electrical Waste Copper Wire Fiber
Authors: Hendi Saif Ibrahim , Aljalawi Nada Mahdi Fawzi
Published: June 2024

In order to maintain long-term environmental quality, sustainable environmental practices are defined as a system that prevents the exhaustion or degradation of natural assets. By pursuing environmental sustainability, we might assure that the necessary criteria for the present the general populace is content without endangering the potential of upcoming generations to satisfy their private desires. Engineers working in the concrete industry are becoming more and more interested in sustainable development, which includes using locally accessible resources as well as industrial and agricultural left-over in the structure sector being among the probable remedies for the issues with the economy and the environment. After establishing the ideal replacement ratio, this study examined the impact of partial cement replacement with quartz residue (0, 10, 20, and 30%) by weight at several ages on (compressive strength). By means of steam curing for five hours at 90°C after the sample has already hardened, this ideal proportion is utilized to discover its impact on a few properties (like dry density, flexural, and compressive strength) of reactive powder concrete covering 1% recycled copper fibers (RCF). To acquire a compressive strength of 95 MPa next 28 days, reactive powder concrete (RPC) been produced using resident cement, superplasticizer, and silica fume through a W/C proportion of 0.2. The outcomes exhibited that using quartz powder replacing (20%) increased the RPC's compressive strength in 8.5%, flexural strength by means of 9%, dry density in 0.61% at 28 days following comparison of the test grades to the reference mixture.
Effect of Sustainable Fibres on Properties of Structural Perlite Concrete Containing Local, Sustainable Materials
Authors: Qassem Ahmed Jasim , Aljalawi Nada Mahdi Fawzi
Published: June 2024

For sustainability in the construction field, finding a substitute for cement and recycling the waste in concrete is important. This paper shows the effect of sustainable copper fibres on some properties of perlite structural lightweight concrete containing sustainable materials. Research includes slump, density, compressive strength, flexural strength and thermal conductivity tests. The materials used to cast the specimen are ordinary Portland cement, local ash, metakaolin, combined coarse and fine perlite aggregate, and super-plasticizer. The concrete is reinforced with 1% copper fibres by volume of concrete. The results show that adding sustainable material to the concrete increased compressive strength by a percentage of 2.79% for 28 days and improved flexural and tensile strength by 40% and 8.36%, respectively, at 28 days. The density was within the limits of structural lightweight concrete, while the thermal conductivity was within the limits of insulation concrete, in addition to economic benefits and reducing world waste.
The relation between CircRNA0056618 and type 2 diabetes mellitus and insulin resistance through miRNA-206/PTPn-1 pathway
Authors: Abdelgwad Marwa M. , Rashed Maysa H. , Helmy Mona Y. , Eldemery Ahmed B. , Fattah Dina S.A.
Published: June 2024

Background

Diabetes mellitus (DM) is a well-known metabolic syndrome characterized by hyperglycemia produced by a defect in insulin synthesis, insulin action, or a combination of the two.

Objective

The aim of this work was to find out how circular RNA 0056618 (circRNA 0056618) interacts with miRNA-206 to control blood sugar levels in type-2 diabetes mellitus (T2DM), as well as to test the role of PTPN-1 gene expression and protein phosphatase-2 (PP2A), insulin receptor substrate (IRS) protein level in diabetes. Also, whether circRNA 0056618, miRNA-206, PTPN-1, IRS, and PP2A protein could be used as biomarkers for T2DM diagnosis and prognosis.

Patients and methods

This cross-sectional analytic study was carried out on 110 patients. Participants were divided into two equal groups: patients’ group (T2DM) and control group (normal participants). All participants were subjected to quantitative real-time PCR for assessed RNAs (circRNA 0056618, miRNA-206, and PTPn-1 gene expression), enzyme-linked immunosorbent assay technique for IRS, and PP2A protein levels.

Statistical analysis used

The Statistical Package for the Social Sciences (SPSS), version 28 was used to code and enter the data. All data will be presented as means and SDs. Correlations between quantitative variables will be done using Pearson correlation coefficient. Receiver operating characteristic (ROC) curve was constructed with area under the curve (AUC) analysis performed to detect the best cutoff value of significant parameters for detection of cases. P value will be considered significant less than 0.05.

Results and conclusion

There was a significant increase in circRNA 0056618 (P<0.001), PTPN-1 gene expression (P=0.002), and PP2A protein levels (P<0.001) and a significant decrease in miRNA-206 gene expression and IRS protein levels in diabetic cases (P<0.001) when compared with normal controls. There was a negative correlation between circRNA 0056618 and miRNA-206 and a positive correlation between circRNA 0056618 and PTPN-1. IRS at 0.840 showed 94.5% sensitivity and 90.9% specificity and AUC 0.905. PP2A at 0.868, sensitivity 96.4% and specificity 81.8%, and AUC 0.919. ROC curve for circRNA 0056618, at 0.882, sensitivity 89.1% and specificity 87.3%, and AUC 0.932, miRNA-206 at 0.785, sensitivity 85.5% and specificity 85.5%, and AUC 0.869. ROC curve for PTPN-1 at 0.556, sensitivity 67.3% and specificity 67.3%, and AUC 0.669.

We concluded that circRNA 0056618, PTPN-1, PP2A, miRNA-206 and IRS are considered diagnostic, predictive biomarkers in T2DM. Future RNA-based therapy approaches may benefit from an understanding of such new pathways.
Husband’s involvement in utilization of maternal health services by their spouse in district Rohtak, Haryana
Authors: Chayal Vinod , Sagar Vidya , Verma Ramesh , Kalhan Meenakshi , Agrawal Ginni , Sasidharan Shravan K , Satija Jitesh , Jangra Annpurna , Punyani Priya , Arora Himani , Singh Yogender , Sharma Divya , Singmar Achchhesh
Published: June 2024

ABSTRACT

Introduction:

Husband and wife as a couple are fully responsible for their current and future. In our society, the husband is mostly responsible for making the decision regarding any expenses. In India, there is a need to reduce the maternal mortality rate, and Husband’s involvement in antenatal care could be a key to success as it will enable them to support their partner in adequate preparation for birth and to utilize emergency obstetric care early if complications arise.

Aim and Objectives:

To find out about male involvement in the utilization of maternal healthcare services by their spouse and various factors affecting male involvement in the utilization of maternal healthcare services.

Methods:

This study was conducted in urban and rural field practice areas attached to the Department of Community Medicine, PGIMS, Rohtak. The study included 400 couples where 200 each were recruited from rural and urban areas. Out of 17 subcenters under CHC Chiri eight, subcenters were selected randomly by lottery method. A line list of these couples was prepared at each subcenter using ANC and birth register. Couples were enrolled from this line list till a sample size of 25 was reached at each of these eight subcenters. In this way, a total of 200 couples were enrolled from rural areas in which women delivered and availed maternal health services in the last 6 months. In urban areas, an equal number of couples were enrolled from each of these three urban health posts till the sample size of 200 was reached in an urban area.

Results:

The majority of the husbands (73%) reported that they participated in their wives’ utilization of maternal health services. Twenty-seven percent did not participate in their wives’ utilization of maternal health services. It also showed that 71.0% of the husbands did not know about the investigations that needed to be performed during a woman’s pregnancy. Only 29% were aware of it. On analysis, it was observed that 73% of the husbands had good participation in their spouses’ maternal and child health (MCH) care, while the rest had poor participation (27%). It also showed that as the education level of the participants’ husbands increased, their participation in their spouses’ MCH care increased, with the highest being observed among graduates (91.3%) and the lowest among those with primary schooling level education (66.7%) which were statistically significant.
Efficacy of cartridge-based nucleic acid amplification test (CBNAAT) in comparison with line probe assay and liquid culture in the evaluation of tubercular lymph node abscess
Authors: Vankayala Veena Reddy , Sutrave Sumeeth , Kumari B Swapna , Gaddam Ramulu , Mandapakala Gopala Krishna Murthy
Published: June 2024

ABSTRACT

Background:

Tuberculosis (TB) remains the number one cause of adult deaths by a curable infectious disease. Mycobacterium tuberculosis bacilli (MTB) is the most common causative organism isolated from mycobacterial lymphadenitis. Accurate and speedy diagnosis is required, especially in paucibacillary extrapulmonary TB. In this study, we compared the efficacy of CBNAAT with line probe assay and liquid culture in the evaluation of tubercular lymph node abscesses.

Materials and Methods:

This is a hospital-based observational cross-sectional study conducted at Gandhi Medical College and Hospital, Secunderabad, TS, in patients who presented with lymph node abscesses over a period of 18 months after obtaining clearance from the ethics committee and obtaining informed consent. Each sample was evaluated and analyzed in association with the clinical findings, AFB staining, CBNAAT, LPA, and AFB culture, and the results were compared.

Results:

Fifty patients with TB lymph node abscess diagnosed through FNAC were included in the present study. AFB smear was positive in 29 samples, CBNAAT was positive in 43 samples, LPA was positive in 44 samples, and liquid culture was positive in 39 samples. CBNAAT could detect TB in 16 smear-negative cases, 10 liquid culture-negative cases, and one LPA-negative case. In our study, CBNAAT was more effective in diagnosing TB lymph node abscess than AFB smear. No significant results were obtained when comparing CBNAAT with LPA and liquid culture.

Conclusion:

This study demonstrates excellent diagnostic accuracy of the Xpert MTB/RIF test in patients with tuberculous lymphadenitis, with a sensitivity of 86%, specificity of 83.33%, negative predictive value of 95.56%, and positive predictive value of 58.82%. Thus, it can be a rule in testing for lymph node TB. These efforts will contribute to the attainment of the TB elimination goal.
Health-related quality of life in gout patients in Madinah Region, Saudi Arabia
Authors: Alhammadi Nouf A. , Jan Raghad Abdulmohsen , Alrohaily Lujain Sami , Aljohani Sulafah Mohammed , Alharthi Nada Nawaf , Almalki Abdulwahab Egal
Published: June 2024

ABSTRACT

Background:

Gout can significantly impact health-related quality of life (HRQoL) due to excruciating pain, chronic arthropathy, and associated comorbidities. The objective of our study was to evaluate HRQoL among patients diagnosed with gout in the Madinah region of Saudi Arabia.

Materials and Methods:

The research took place in the Madinah Region, where eligible adult participants aged 18 years or older, having a confirmed history, or present diagnosis of gout were enrolled using medical records from 2016 to 2022. To gather data, patients were invited to participate in telephone-based interviews and complete the Short Form-36 (SF-36) questionnaire.

Results:

The majority of participants were male (81.5%), and 31–39 years form the largest group (37.0%). Most participants were married (86.4%), and the majority possess university and postgraduate education (70.4%). The respondents’ self-reported assessments were as follows: physical function (69.9), limitation due to physical health (74.1), emotional problem (75.8), energy or fatigue (61.6), emotional well-being (68.9), social functioning (76.6), pain (78.9), and general health (63.8).

Conclusions:

HRQoL among patients with gout was not significantly affected.
Clopidogrel resistance and its relevance: Current concepts
Authors: Pradhan Akshyaya , Bhandari Monika , Vishwakarma Pravesh , Sethi Rishi
Published: June 2024

ABSTRACT

Clopidogrel is the most widely used P2Y12 receptor inhibitor (P2Y12i) as a part of dual antiplatelet therapy along with aspirin. Clopidogrel is a pro-drug and is metabolized to its active metabolite by the hepatic enzyme cytochrome P4502C19 (CYP2C19). This active metabolite is responsible for the antiplatelet action of clopidogrel. Recent studies have demonstrated that single nucleotide polymorphisms in the CYP2C19 gene, including CYP2C19*2,*3,*4, and *5 alleles, result in reduced production of the active metabolite of clopidogrel, and hence reduced inhibition of platelet aggregation. This in turn enhances the incidence of stent thrombosis and recurrent cardiovascular (CV) events. We report a case of coronary stent thrombosis due to clopidogrel resistance proven by CYP2C19 genotyping. We then review the literature on clopidogrel resistance and its impact on CV outcomes. Subsequently, we discuss the methods of diagnosis of resistance, evidence from clinical trials for tailoring clopidogrel therapy, the role of potent P2Y12 inhibitors, the current guidelines, and future directions.
Contraceptive use, unmet need and its determinants among tribal married reproductive women: A community based observational study in a district of West Bengal
Authors: Basu Gandhari , Chakraborty Upasana , Halder Indranil
Published: June 2024

ABSTRACT

Context:

Reported literatures revealed the problems of access and misconceptions, low contraceptive usage and high unmet need for family planning among the tribes.

Aims:

Our aim was to find out the prevalence of contraceptive usage, unmet need and their determinants among tribal married reproductive women.

Settings and Design:

A community-based, observational, analytical research using cross-sectional design was conducted among 290 tribal women of the Nadia district of West Bengal.

Subjects and Methods:

After obtaining ethical clearance, an interviewer-administered pre-designed, structured proforma was used to collect information on socio-demographic attributes, marital history, contraceptives and fertility status, unmet needs and the reasons for not using contraceptives.

Statistical Analysis Used:

Bi-variate analysis was used to know the differences and a two-tailed significance test with a P value of 0.05 or less was considered statistically significant.

Results:

The present study revealed a high prevalence of teenage marriage (60.7%) and pregnancy (27.6%). Every one in six tribal women was illiterate. The contraceptive prevalence rate was 43.8%. Tubectomy (38.6%) was the most common method (38.6%) and unfelt need (19.6%) was the most common reason for non-use. Age, occupation of women, social class, living status, marital duration, number of living children and desire to have a future child were found to be associated with the current contraceptive use. Social class, number of living children, contraceptive awareness, source and place of availability, abortion history, opposition from family and husband, and husband participation all were significantly associated with the unmet need for family planning.

Conclusion:

In-depth counselling focusing on achieving a satisfactory level of awareness and acceptance of family planning methods may help to achieve reproductive health by reducing unmet needs.
Toll-Like receptor 3 genetic polymorphism in dengue encephalitis
Authors: Verma Rajesh , Pandey Atul K. , Chakraborty Rajarshi , Prakash Shantanu , Jain Amita
Published: June 2024

ABSTRACT

Context:

Dengue is one of the important vector-borne viral diseases affecting humans with diverse manifestations. Toll-like receptors (TLR) are pattern recognition receptors and play an important role in innate immunity against microbes. TLR3 plays a critical role in controlling the innate immune response mediated by flaviviruses such as dengue.

Aim:

We attempted to study the susceptibility of single nucleotide polymorphism of the TLR3 gene in dengue encephalitis (DE) patients and determine the association in terms of genotype, allele, and haplotype distribution along with the clinical outcome.

Settings and Design:

It was a case-controlled observational study in a tertiary care hospital.

Methods and Material:

We investigated the single nucleotide polymorphism in the TLR3 Leu412Phe gene using real-time polymerase chain reaction in 29 cases of DE and compared them with equal number of age- and sex-matched dengue patients without neurological features.

Statistical Analysis Used:

The genotype and allele frequencies were compared using a two-sided Chi-square or Fisher’s exact test.

Results:

The findings revealed that the genotypic distribution of TLR3 Leu412Phe polymorphism for the mutant genotype Phe/Phe (TT) demonstrated increased association of DE (31.03% vs 6.8%, P 0.019, odds ratio 6.075, 95% confidence interval 1.181–31.245). However, the number of heterozygous (H) genotype (Leu/Phe–CT) and mutant Phe allele (T) did not show any statistically significant association. TLR3 gene polymorphism did not show any correlation with mortality outcome at 1 month.

Conclusion:

The presence of mutant TLR3 Leu412Phe polymorphism may confer the propensity to have DE in patients with dengue infection in the Indian population. TLR3 polymorphism did not affect mortality outcome at 1 month.
Assessment of self-management care and glycated hemoglobin level among diabetes mellitus patients attend diabetic center in armed forces hospital in southern region, Kingdom Saudi Arabia
Authors: Alshahrani Salehah A. , Salem Fatima , Al harbi Sana , Alshahrani Ali , AlAhmari Yasser
Published: June 2024

ABSTRACT

Background:

Diabetes mellitus (DM) requires patients to take on a high level of responsibility for their daily care. Thus, care for people with diabetes is moving toward patients taking an active role in their own health care.

Objective:

To evaluate the impact of self-management care on glycemic control in individuals with DM and determine the correlation between glycated hemoglobin (A1C) levels and self-management practices.

Material and Methods:

A cross-sectional descriptive study was conducted among diabetes patients at a diabetic center in Armed Forces Military hospitals, Southern region. A questionnaire of demographic and clinical information and self-management measured with the Diabetes Self-Management Questionnaire was used. Glycemic control was assessed using HbA1c levels.

Results:

The study involved 255 patients with diabetes, of which 61.2% were females and 81.6% aged ≥41 years. The average diabetic self-management score was 6.49 on a scale of 10. The mean glucose self-management subscale score was 7.83 points, while the mean dietary control (DC) subscale score was 4.89. The patients had a mean physical activity (PA) subscale score of 6.31 and 8.75 for healthcare usage. Patients with higher education were significantly less likely to have poor glycemic control. Diabetes duration was significantly and positively correlated with poorer glycemic control. Mean perceived PA and DC scores were significantly associated with glycemic control.

Conclusion:

Type 2 diabetes patients had satisfactory self-care practices. Many did not achieve the target glycemic control for diabetes.
A comparative study between first three waves of COVID-19 pandemic with respect to risk factors, initial clinic-demographic profile, severity and outcome
Authors: Thakur Indranil , Chatterjee Arabinda , Ghosh Ashis Kumar , Chatterjee Shiv Sekhar , Saha Santanu , Panja Tanmaykanti , Dan Utpal
Published: June 2024

ABSTRACT

Introduction:

During the 2 years and 9 months from March 2020 to December 2022, the SARS-CoV-2 virus raged across the country. Cases occurred in three particular time clusters recognised by World Health Organisation as coronavirus disease 2019 (COVID-19) waves. In this study, we compare the clinical parameters of adult non-obstetric COVID-19 patients admitted to our rural tertiary care hospital during the three distinct waves of the pandemic.

Materials and Methods:

Retrospective chart analysis of 272, 853 and 97 patients admitted with SARS-CoV-2 infection to the only rural medical tertiary care centre in the Sunderbans of West Bengal in the first, second and third waves, respectively, was done after obtaining ethical and scientific clearance. Clinical [vital parameters, oxygen requirement, mental status, risk factor assessment, duration of hospital stay, modified-emergency warning score (m-EWS), quick Sequential Organ Failure Assessment (qSOFA), confusion, uraemia, respiratory rate, blood pressure, age ≥ 65 years (CURB65)], epidemiological variables (age, gender, and vaccination status), laboratory parameters and in-hospital outcome were recorded and analysed statistically.

Results:

Statistically significant (P < 0.05) m-EWS and qSOFA scores were recorded during the second wave of the pandemic. The second wave also recorded the highest mortality (14.89%) compared to the first (12.87%) and third (11.96%) waves, though this was not statistically significant. The highest duration of hospital stay was recorded in the first wave of the pandemic (mean = 9.99 days, P < 0.01). The difference in mortality rates between patients with and without co-morbidity (P < 0.05) was observed during Wave-1, across any pandemic wave, and overall but not in Wave-2 and Wave-3.

Conclusion:

The second wave of the COVID-19 pandemic was the most severe in comparison with the other two waves, while the outcome was poorer in those with co-morbidities, especially in the first wave.
Prevalence of high-risk children and role of maternal factors on these children—findings of cross-sectional community-based study
Authors: Gupta Vivek , Nimonkar Ravi , Hiremath Ravishekar N. , Ahmed Shafique , Sinha Pooja , Huchchannavar Raghavendra
Published: June 2024

ABSTRACT

Background:

Children, being the future of any nation, not only need special attention but also need a suiTable environment to have proper growth and development. They are also vulnerable to various diseases and disabilities. It is observed that certain maternal characteristics are helpful in the development and survival of such high-risk children.

Methodology:

A community-based, cross-sectional, analytic study was undertaken among children under 5 years of age in two slums. The population of both slums was 1550, out of which children under 5 years of age were 196 (12.64%), which constituted the study population. The “high-risk” children were identified based on pre-development criteria of “risk factors.” Data was collected by interview technique, physical examination of the children, and checking of medical documents. The data regarding “high-risk” children were analyzed to determine the association of “high-risk” children with maternal factors like birth order, education, and occupation of the mother and child being looked after as the mother’s substitute. The data obtained was subjected to standard statistical methods to achieve valid comparisons.

Results:

The present study revealed that out of 196 children under 5 years of age surveyed, 88 were “high-risk” children which constituted a prevalence rate of 44.89%. A significant association had been found between the prevalence of “high-risk” children and factors like birth order, education, and occupation of the mother and child being looked after by the mother’s substitute.

Conclusion:

The study showed a significant association between various maternal factors and high-risk children. Thus maternal social and environmental factors along with enhancing pregnancy health go a long way in preventing high-risk children and betterment of child health.
Vision, mission, goals, and objectives of the Academy of Family Physicians of India
Authors: Kumar Raman
Published: June 2024

ABSTRACT

The role of the Academy of Family Physicians of India (AFPI) has been vital in promoting family medicine in India. Through its various initiatives, the AFPI has worked to enhance the quality of healthcare services, support the professional development of family physicians, and advocate for policies that recognize and strengthen the role of primary care in the healthcare system. By fostering education, research, and collaboration, the AFPI is working toward a healthcare system where everyone can access comprehensive and continuous primary care. This paper summarizes the vision, mission, goals, and objectives of AFPI.
On Trudinger-type inequalities in Musielak–Orlicz–Morrey spaces of an integral form over metric measure spaces
Authors: Ohno Takao , Shimomura Tetsu
Published: June 2024

We establish Trudinger-type inequalities for variable Riesz potentials

J_{\alpha(\cdot),\tau}f

of functions

f

in Musielak–Orlicz–Morrey spaces of an integral form over metric measure spaces

X

. As an application and example, we give Trudinger’s inequality for double-phase functionals with variable exponents. Finally, we prove the result for Sobolev functions satisfying a Poincaré inequality in

X

.
Unraveling colorectal cancer prevention: The vitamin D - gut flora - immune system nexus
Authors: Zhan Zhi-Song , Zheng Zu-Shun , Shi Jing , Chen Juan , Wu Si-Yi , Zhang Shi-Yan
Published: June 2024

Colorectal cancer (CRC) is one of the most common cancers diagnosed in the world. Although environmental and genetic factors play a major role in the pathogenesis of CRC, extensive research has suggested that vitamin D may play a pivotal role in the development of CRC. Vitamin D, primarily obtained through sunlight exposure, dietary sources, and supplements, has long been recognized for its essential functions in maintaining health, including immune regulation. This article delves into the intricate relationship between vitamin D, the immune system, gut flora, and the prevention of CRC. It presents a synthesis of epidemiological data, experimental studies, and clinical trials, highlighting the mechanisms by which vitamin D influences immune cell function, cytokine production, and inflammation. By enhancing the immune system’s surveillance and anti-tumor activity, vitamin D may offer a promising avenue for CRC prevention. Furthermore, this comprehensive review delves into the prospective clinical applications of vitamin D supplementation and delineates the forthcoming avenues of research in this dynamic domain. Additionally, the paper tentatively outlines a spectrum of prophylactic impacts of vitamin D on CRC, emphasizing its significant potential in reducing CRC risk through shedding light on its mechanisms, encompassing antineoplastic mechanisms, influences on the immune system, and modulation of the gut microbiome.
Development of a diagnostic nomogram for alpha-fetoprotein-negative hepatocellular carcinoma based on serological biomarkers
Authors: He Li , Zhang Cui , Liu Lan-Lan , Huang Li-Ping , Lu Wen-Jing , Zhang Yuan-Yuan , Zou De-Yong , Wang Yu-Fei , Zhang Qing , Yang Xiao-Li
Published: June 2024

BACKGROUND

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide. Serum biomarkers play an important role in the early diagnosis and prognosis of HCC. Because a certain percentage of HCC patients are negative for alpha-fetoprotein (AFP), the diagnosis of AFP-negative HCC is essential to improve the detection rate of HCC.

AIM

To establish an effective model for diagnosing AFP-negative HCC based on serum tumour biomarkers.

METHODS

A total of 180 HCC patients were enrolled in this study. The expression levels of GP73, des-γ-carboxyprothrombin (DCP), CK18-M65, and CK18-M30 were detected by a fully automated chemiluminescence analyser. The variables were selected by logistic regression analysis. Several models were constructed using stepwise backward logistic regression. The performance of the models was compared using the C statistic, integrated discrimination improvement, net reclassification improvement, and calibration curves. The clinical utility of the nomogram was assessed using decision curve analysis (DCA).

RESULTS

The results showed that the expression levels of GP73, DCP, CK18-M65, and CK18-M30 were significantly greater in AFP-negative HCC patients than in healthy controls (P < 0.001). Multivariate logistic regression analysis revealed that GP73, DCP, and CK18-M65 were independent factors for diagnosing AFP-negative HCC. By comparing the diagnostic performance of multiple models, we included GP73 and CK18-M65 as the model variables, and the model had good discrimination ability (area under the curve = 0.946) and good goodness of fit. The DCA curves indicated the good clinical utility of the nomogram.

CONCLUSION

Our study identified GP73 and CK18-M65 as serum biomarkers with certain application value in the diagnosis of AFP-negative HCC. The diagnostic nomogram based on CK18-M65 combined with GP73 demonstrated good performance and effectively identified high-risk groups of patients with HCC.