bluuebunny/crossref_metadata_2025 huggingface dataset:
Qui fait la fête ?
Authors: Buslacchi Maria Elena
Published: February 2024

À partir d’une étude ethnographique réalisée dans le Nord-Ouest italien, cet article présente le cas des reconstitutions historiques comme une forme d’événement qui hybride les caractéristiques de la fête populaire et du festival. Les évolutions qui caractérisent ce genre de manifestations ne sont pas circonscrites à ce secteur, mais peuvent décrire des tendances qui intéressent plus largement l’industrie culturelle, du loisir et du tourisme. Le cas du Tournoi historique des bourgs de Suse, à la frontière italo-française, ici présenté, permet de dégager par comparaison une réflexion plus large sur les mutations que traverse le secteur de l’événementiel aujourd’hui et sur la continuité entre les pratiques d’amateurs et celles des professionnels qui sont mobilisées dans une pluralité de contextes. Le rôle des institutions est aussi observé pour comprendre la part qu’elles ont, par leurs politiques culturelles, dans l’orientation du phénomène festif.
Le Mas des gwoup-a-po dans le carnaval guadeloupéen : une pratique de résistance ?
Authors: Pavy Flore
Published: February 2024

C’est dans le cadre d’un rapport de force d’ordre politique que le carnaval guadeloupéen, qui était sur le déclin, est réinvesti à la fin des années 1970. Face à des dissidents qui appellent pour la première fois à manifester pendant les Jours gras, les institutions régionales commencent, quant à elles, à travailler à la construction d’un carnaval économiquement rentable et politiquement inoffensif, offrant aux touristes le spectacle d’une Guadeloupe unie. En réaction à ce qui est perçu comme la confiscation d’une culture populaire, représentée surtout par les anciens gwoup-a-mas (groupes de masques), dont les derniers représentants sont en train de disparaître, de petits groupes se forment pour tenter de sauvegarder et redynamiser certaines pratiques associées au carnaval du peuple guadeloupéen, mais aussi aux anciennes fêtes serviles et à leur potentiel subversif, toujours étroitement encadrées : les gwoup-a-po . Cet article repose sur une enquête ethnographique en immersion de deux ans dans l’un de ces groupes, Voukoum, et sur de nombreux entretiens menés en créole. Il propose de montrer comment le rituel propre aux gwoup-a-po – le Mas –, qui est d’abord l’expression d’une résistance contre la disparition de pratiques culturelles ouvrières, se construit progressivement à travers le récit de la réitération rituelle d’une forme de résistance quotidienne de leurs ancêtres réduits en esclavage.
S’adapter aux conditions de l’anonymisation pour la diffusion de données spatiales sur les marchés immobiliers
Authors: Le Corre Thibault
Published: February 2024

Cet article décrit l’expérience de la diffusion d’une base de données constituée à partir de données individuelles. CASSMIR (Contribution à l’analyse spatiale et sociale des marchés immobiliers résidentiels) est une base de données sur le marché du logement en Île-de-France couvrant la période de 1996 à 2018. Les indicateurs de la base de données caractérisent des unités spatiales à trois échelles (communes, carroyage 1 km et carroyage 200 m) et des groupes de population d’acquéreurs et de vendeurs déclinés selon un critère social, de génération et de genre. La livraison de la base fait suite à une série d’opérations de généralisation et de falsification des données dans un objectif de préserver des informations de localisation. Cet article restitue les enjeux et les étapes de cette anonymisation.
Protéger ou invisibiliser ses interlocuteurs : peut-on ouvrir les données ethnographiques ?
Authors: Heintz Monica
Published: February 2024

Le souci de protection de ses interlocuteurs est un des devoirs éthiques fondamentaux qui travaille tout ethnographe et qui l’a conduit traditionnellement à opter pour une anonymisation des interlocuteurs dans tout écrit ethnographique. Cependant, le contexte éthique du métier d’ethnographe a évolué vers une reconnaissance de ses interlocuteurs comme co-producteurs des données. Cette évolution rencontre depuis 2018 les nouveaux cadrages donnés par le Règlement général pour la protection des données (RGPD), puis par l’incitation à l’ouverture des données anthropologiques, deux directions perçues comme contradictoires. L’enquête que nous avons menée sur les pratiques des anthropologues chercheurs dans un laboratoire d’anthropologie sociale pendant la période 2018-2022 montre la diversité des stratégies d’anonymisation qui doivent se mettre en place lors du traitement des données collectées sur le terrain, le rôle du temps qui passe après l’enquête sur la question de la protection des informateurs, ainsi que celui que l’enquêteur peut dédier à la protection attentive de ces données et donc implicitement de ses interlocuteurs dans le processus d’anonymisation des données.
Research on incentive mechanisms for anti-heterogeneous federated learning based on reputation and contribution
Authors: Jiang Xiaoyu , Gu Ruichun , Zhan Huan
Published: February 2024

An optimization algorithm for federated learning, equipped with an incentive mechanism, is introduced to tackle the challenges of excessive iterations, prolonged training durations, and suboptimal efficiency encountered during model training within the federated learning framework. Initially, the algorithm establishes reputation values that are tied to both time and model loss metrics. This foundation enables the creation of incentive mechanisms aimed at rewarding honest nodes while penalizing malicious ones. Subsequently, a bidirectional selection mechanism anchored in blockchain technology is developed, allowing smart contracts to enroll nodes with high reputations in training sessions, thus filtering out malicious clients and enhancing local training efficiency. Furthermore, the integration of the Earth Mover's Distance (EMD) mechanism serves to lessen the impact of non-IID (non-Independent and Identically Distributed) data on the global model, leading to a reduction in the frequency of model training cycles and an improvement in model accuracy. Experimental results confirm that this approach maintains high model accuracy in non-IID data settings, outperforming traditional federated learning algorithms.
A critical review of the impact of uncertainties on green bonds
Authors: Gyamerah Samuel Asante , Asare Clement
Published: February 2024

Green bonds are relatively new in the financial market compared to other financial securities but are useful in financing environmentally friendly projects. Just like other financial securities, green bonds are affected by various factors, such as economic policy uncertainty. Our aim of this paper was to conduct a systematic literature review of the impact of economic policy uncertainty on green bonds. We sought to do a thorough analysis of the existing literature on the assessment of the impact of economic policy uncertainty on green bonds and the techniques used in assessing the impact. Our findings showed that economic policy uncertainty had a strong impact on the green bond, with its intensity varying by location. This impact tended to be more pronounced in periods of heightened uncertainty. Also, our findings highlighted that the assessment of the impact of economic policy uncertainty on green bonds gained popularity in 2019, with China emerging as a prominent contributor. However, other countries, such as Finland, even though they had few published papers, their citations signified the production of quality papers in this field. Additionally, we found that the application of the quantile analysis method was utilized by many recent studies, which signified its importance in this field. Our findings highlighted the importance of considering appropriate techniques in assessing the impact of economic policy uncertainty on green bonds while taking into account the paper quality.
Multiple positive solutions to the fractional Kirchhoff-type problems involving sign-changing weight functions
Authors: Yang Jie , Liu Lintao , Chen Haibo
Published: February 2024

This paper was concerned with the following Kirchhoff type equation involving the fractional Laplace operator $ (-\Delta)^{s} $

   \begin{document}$ \begin{cases} \left(1+\alpha\int_{\mathbb{R}^{3}}|(-\Delta)^{\frac{s}{2}}u|^{2}dx\right)(-\Delta)^{s} u+\mu K(x)u = g(x)|u|^{p-2}u, &{\rm in}\ \mathbb{R}^{3}, \\ u\in H^{s}(\mathbb{R}^{3}), \ \end{cases} $\end{document}

where $ \alpha, \ \mu > 0 $, $ s\in [\frac{3}{4}, 1) $, $ 2 < p < 4 $. By filtration of the Nehari manifold and variational techniques, we obtained the existence of one and two positive solutions under some conditions imposed on $ K $ and $ g $.
Periodic solutions in reversible systems in second order systems with distributed delays
Authors: Duan Yameng , Krawcewicz Wieslaw , Xiao Huafeng
Published: February 2024

In this paper, we study the existence and multiplicity of periodic solutions to a class of second-order nonlinear differential equations with distributed delay. Under assumptions that the nonlinearity is odd, differentiable at zero and satisfies the Nagumo condition, by applying the equivariant degree method, we prove that the delay equation admits multiple periodic solutions. The results are then illustrated by an example.
Modeling disease awareness and variable susceptibility with a structured epidemic model
Authors: Amorim Paulo , Margheri Alessandro , Rebelo Carlota
Published: February 2024

We developed an epidemic model with disease awareness and variable susceptibility, consisting of a two-dimensional, nonlocal, transport equation. From this model, we deduced a 3D ordinary differential equation (ODE) model, which is reminiscent of (but not reducible to) more traditional susceptible-infectious-susceptible (SIS)-type models, where the dynamical variables are the infected population proportion, the mean awareness of the population, and the mean susceptibility to reinfection. We show that a reproduction number $ R_0 $ exists whose threshold value determines the stability of the disease-free equilibrium, alongside the existence of an endemic one. We deduced conditions on the model parameters and ensured the stability and uniqueness of the endemic equilibrium. The transport equation was studied, and we showed some numerical experiments. Our results suggest that disease awareness dynamics can have a major role in epidemiological outcomes: we showed that even for high $ R_0 $, the infection prevalence could be made as small as desired, as long as the awareness decay was small. On the other hand, numerical evidence suggested that the relation between epidemiological outcomes and awareness levels was not straightforward, in the sense that sustained high awareness may not always lead to better outcomes, as compared to time-limited awareness peaks in response to outbreaks.
Tecnologias gerenciais, assistenciais e educacionais da atenção domiciliar utilizadas por enfermeiros e técnicos de enfermagem
Authors: Dias França Bruna , Silva Kênia Lara , Tavares Álvares da Silva João André , Aparecida Barbosa de Castro Edna , Albertina Nietsche Elisabeta
Published: February 2024

Objetivo: identificar e analisar as tecnologias gerenciais, assistenciais e educacionais que são utilizadas pelos enfermeiros e técnicos de enfermagem no Serviço de Atenção Domiciliar. Método: pesquisa qualitativa, apoiada na dialética marxista, concebendo-se as tecnologias como processos resultantes da experiência humana cotidiana. Realizaram-se, em janeiro de 2019, entrevistas semiestruturadas com 13 enfermeiros e 11 técnicos de enfermagem de Serviços de Atenção Domiciliar de três municípios de Minas Gerais. Com aporte da análise crítica do discurso de Fairclough, analisou-se a ação desses participantes sobre insumos/materiais utilizados no cotidiano do trabalho, obedecendo aos preceitos éticos da Resolução nº 466 de 2012. Resultados: identificaram-se nos discursos 29 tecnologias, sendo 14 gerenciais, ressaltando-se a organização, registro/documentação do trabalho, preparo de materiais/insumos e coordenação de rotas, nove assistenciais, destacando-se a desospitalização e cuidados no domicílio conforme necessidades dos pacientes, e seis atividades educacionais, enfatizando-se a orientação de cuidados para paciente, família, cuidador e capacitação no/para o trabalho. Considerações finais: os trabalhadores de enfermagem do cenário domiciliar utilizam tecnologias comumente aplicadas em distintos cenários de saúde. Destaca-se, no entanto, a classificação dessas tecnologias para o seu reconhecimento, na práxis, das tecnologias inovadoras e específicas do cenário domiciliar.
Perfil de mortalidade de idosos jovens hospitalizados em uma unidade de terapia intensiva
Authors: Moreira dos Santos Jeferson , De Freitas Mussi Ricardo Franklin , Pereira Santos Jessica Lane , Chaves Pedreira  Silva Larissa , Alves de Souza Maria Antônia
Published: February 2024

Objetivo: analisar o perfil de mortalidade dos idosos jovens hospitalizados na unidade de terapia intensiva de um hospital do sudoeste da Bahia. Método: estudo transversal, censitário, retrospectivo, descritivo, com a participação de 128 idosos jovens. Os dados foram coletados do livro de registros da unidade, entre os internados de novembro de 2018 e novembro de 2019. Para análise, utilizou-se o IBM Statistical Package for the Social Sciences SPSS, versão 22. O estudo foi submetido ao Comitê de Ética em Pesquisa, sendo aprovado sob o número de parecer 3.233.411 e CAEE 73792317.3.0000.0057. Resultados: a mortalidade foi maior entre os idosos da raça/cor negra, com tempo de internação maior ou igual a seis dias e na presença de doenças pouco prevalentes. Em contrapartida, ter regulação da emergência para unidade de terapia intensiva reduziu o desfecho de óbito em aproximadamente 50%. Conclusão: o grupo de idosos negros, com maior tempo de internação e acometido por enfermidades pouco prevalentes, morre mais quando hospitalizado em unidades de cuidados intensivos.
Cuidado domiciliar à criança com gastrostomia: produção e validação de tecnologia cuidativo-educacional
Authors: De Melo Sousa Jéssica Nathália , Macedo de Sousa Francisca Georgina , Gonçalves de Oliveira Toso Beatriz Rosâna , Furtado Oliveira Lima Heloísa Rosário , Palácio Fernandes Cabeça Luciana , Stein Backes Dirce
Published: February 2024

Objetivos: Descrever o processo de produção e validação de tecnologia cuidativo-educacional (TCE) em vídeo para suporte ao cuidado domiciliar a crianças com gastrostomia. Métodos: Pesquisa metodológica para produzir e validar TCE em vídeo. Realizou-se uma revisão integrativa seguida pela construção do roteiro, para determinar o conteúdo e a estrutura da tecnologia. O processo de validação ocorreu em duas etapas: validação de conteúdo (15 juízes especialistas) e validação técnica (05 juízes familiares/cuidadores), entre setembro de 2021 e fevereiro de 2022. Nesse processo, utilizou-se escala tipo Likert, com três domínios : objetivo; estrutura e apresentação; relevância. Para evitar vieses subjetivas, calculou-se o Coeficiente de Correlação Intraclasse (ICC), enviando os itens com ICC > 80%. Resultados: Produziu-se vídeo com 12 minutos, que se desenvolve em dois eixos: conhecendo mais sobre gastrostomia e cuidados no domicílio. Engloba orientações como cuidado com a pele periestoma, oferta de alimentos e medicamentos, prevenção e manejo de problemas relacionados à gastrostomia. Obteve ICC > 80% em todos os itens avaliados, nas duas fases de validação. Conclusão: Um TCE produzido e validado permite apoiar o cuidado dos pais às crianças com GTT no domicílio, facilitando a aquisição de conhecimentos técnicos além de reduzir os riscos à criança e prejuízo na família.
Taal, kultuur en ontspanning: Die rol van die AlgemeenNederlands Verbond in Kaapstad, 1995-2008
Authors: De Klerk P.
Published: February 2024

The Algemeen-Nederlands Verbond (“General Dutch Union”), an international society for the promotion of the Dutch language and culture, has been active in South Africa since its foundation in 1895, and a branch of this organisation has existed in Cape Town since 1908. The article discusses the activities of the Algemeen-Nederlands Verbond in Cape Town from 1995 until February 2008. Although some Afrikaans speakers and a few people of Flemish origin belong to the Cape Town branch, most members are Dutch immigrants. The Cape Town branch has always concerned itself with the development of a Dutch library, today the largest collection of Dutch books in the southern hemisphere. In 2004 the Algemeen-Nederlands Verbond transferred the ownership of the library to another organisation, the Huis der Nederlanden (“House of the Netherlands”), mainly because of financial problems. The Algemeen-Nederlands Verbond in Cape Town has been active in promoting Dutch culture in various ways, inter alia, by organising fairs and festivals with a Dutch character, such as the traditional Saint Nicholas festival.
Progress towards legislative transformation: A critical assessment of the 1956 and 1998 water acts regarding municipal water supply
Authors: Nealer Eric , Raga Kishore
Published: February 2024

Inwoners van Suid-Afrika behoort deurlopend herinner te word dat hulle ‘n waterarmland bewoon en dat kennis oor die fisiese omgewing en die aard en omvang van effektiewe openbare bestuur van watervoorsiening van strategiese belang is. Die oppervlakte- en grondwater wat in die rivieropvanggebiede saamvloei is hidrologies en geohidrologies verbind deur die hidrologiese kringloop. Laasgenoemde manifesteer in ‘n natuurlike omgewing wat nie net gekenmerk word deur ‘n toestand van wye diversiteit en kompleksiteit nie, maar ook deur die behoefte aan goed gestruktureerde openbare dienslewering op veral die plaaslike regeringsfeer. Teen die einde van April 1994 was die voorsiening van openbare drinkwater en basiese sanitasiedienste aan al die landsinwoners op al die owerheidsfeeren veral die plaaslike regeringsfeeragendas die hoogste in die openbare diens geskiedenis van Suid-Afrika. Gevolglik is die Regering nie net meer gemoeid met die verskaffing van genoegsame drinkwater alleen nie, maar ook met die fasilitering van die implementering van ‘n holistiese en geïntegreerde benadering aangaande die effektiewe, doeltreffende en ekonomiese bestuur van die ontwikkeling, vervoer, opgaar, behandeling en verspreiding van water. As die enigste bestuurder en bewaarder van die land se waterbronne is die Departement van Waterwese en Bosbou (DWAF) sedert veral die oorgang na ‘n demokratiese bestel in 1994 proaktief in die evaluering van bestaande beleidsdokumente sowel as die voortbring van verbeterde wette en uitvoerbare openbare beleid aangaande waterbestuursaspekte in die land. Dit is ook opmerklik dat primêre nasionale wetgewing aangaande die bestuur van openbare water sedert die 1956 - en die jongste 1998 waterwetgewing transformasie ondergaan het en dat die mees optimale voertuig tot meer effektiewe, doeltreffende en ekonomiese implementering van die nuwe getransformeerde openbare waterverwante wetgewing die 284 munisipaliteite in die land is. Dit is dan ook op hierdie regeringsfeer waar die spreekwoordelike ‘motorkarwiel die teerpad tref’ en die sukses al dan nie, van nuut geïmplementeerde openbare beleid evalueer kan word. Die fokus van die artikel is om vanuit ‘n dissiplinêr geïntegreerde perspektief die toepassing van watergewing in Suid-Afrika op munisipale owerheidsfeer krities in oënskou te neem.
An historical overview of problems associated with the formalization of the South African minibus taxi industry
Authors: Ingle Mark
Published: February 2024

Die minibus taxi bedryf in Suid-Afrika is ’n belangrike afdeling van die vervoerstelsel, en daarom is dit ’n beduidende faktor in die nasionale ekonomie. Sedert die middeltagtiger jare het hierdie bedryf binne ‘n eie stel reëls en regulasies ontwikkel, in dié mate dat dit betrokke geraak het by wetteloosheid. Verskeie gewelddadige ‘taxi oorloë’ het al plaasgevind. In baie dele van die land is daar min alternatiewe openbare vervoerstelsels. Daarom het die eienaars wat die bedryf beheer, die gesamentlike mag ontwikkel om die regering se pogings om kontrole uit te oefen, te ontduik. Baie regeringsamptenare blyk betrokke te wees by taxi-sindikate. Die regering se taxi herkapitaliseringsprogram het ten doel om die swak beeld en veiligheidsrekord van die taxi-bedryf te verbeter, en om opnuut die mag af van die regering te druk op die toekenning van hulpbronne in die sektor. Hierdie inisiatief mag heel moontlik op ’n mislukking afstuur. ’n Meer pragmatiese oplossing sou kon wees om die bedryf te dereguleer, in samehang met effektiewe polisiëring, sodat die mag van die beherende partye in die bedryf aan bande gelê kan word.
Streeksgeskiedskrywing en koloniale verhoudinge: Die WesKaapse platteland en die Karoo
Authors: De Klerk Pieter
Published: February 2024

Scholars who specialize in local or regional history study the characteristics and development of a society on a micro-level. These characteristics include demographic, economic, social, political, juridical, cultural and religious aspects. Historical writing on the relations between the indigenous Khoisan and the Western colonizers in the Cape Colony during the period before 1900 has a strong socio-economic focus. Furthermore, regional differences have received little attention in these texts. Therefore a regional approach may provide a fuller and more nuanced perspective. A provisional examination of historical studies on rural areas in the western part of the Cape Colony and the Karoo was done for the purpose of this article and only seventeen studies were found that contain significant research results regarding the relations betweeen the colonizers and the colonized peoples. In the article these results are evaluated. It appears that, although the seventeen studies provide important information, none of them deal with the whole spectrum of relations between the indigenous peoples and the colonizers. The available source material inevitably puts restrictions on the results that can be achieved. However, in none of the studies optimal use was made of all the relevant sources. There is a strong need for more research in the field of regional history with a focus on colonial relations.
They also served: Ordinary South African women in an extraordinary struggle: The case of Erna de Villiers (Buber)
Authors: Möller Pieter L.
Published: February 2024

Met die ontplooiing en vestiging van die Apartheidsbeleid1 in Suid-Afrika na 1948 het by ‘n groot gedeelte van die Suid-Afrikaanse bevolking teenstand teen die beleid van afsonderlike ontwikkeling ontstaan. Gedurende die tydperk 1948 tot 1960 is ‘n hele reeks wette aanvaar om die skeiding van rassegroepe in Suid-Afrika aan te moedig. Grootskaalse weerstand teen die reeks diskriminerende wette het onder die swartmense ontwikkel. Vroue uit alle kleurgroepe het tydens die “Apartheidsjare” (1960 tot 1990) aan versetaksies in Suid-Afrika deelgeneem om hulle misnoeë met inperkende wetgewing te kenne te gee. Ander het bydraes gelewer om ‘n verskil te maak in die lewens van mense wat onder rassisme gebuk gegaan het. Vroue se betrokkenheid op hierdie fronte was dikwels geminag. Hulle minderwaardige plek in die destydse samelewing was moontlik ‘n faktor. Desnieteenstaande het hierdie vroue se bydraes ‘n verskil help maak. Vir hierdie doel val die kollig op verskeie vroue se bydraes, waaronder enkele bekende asook minder bekende vroue. Erna de Villiers (Buber) is ‘n spesifieke voorbeeld om die rol van ‘n vrou wat tydens die Apartheidsjare ‘n prominente bydrae gelewer het, uit te wys. Haar rol onder swart skoolleerlinge word beklemtoon.
Cloud leakage in higher education in South Africa: A case of University of Technology
Authors: Ntloedibe Tshepiso , Foko Thato , Segooa Mmatshuene A.
Published: February 2024

Background: Users with knowledge of an organisation can pose risks to Cloud Computing, including current and past employees and external stakeholders with access to the organisation’s cloud. These insiders may engage in intentional or unintentional disruptive behaviors, causing significant harm to the organisation. A study focused on insider threats in South African higher education examined the tactics used by cybersecurity leaders to enforce cybersecurity policies.Objectives: The goal of this study was to develop a comprehensive insider mitigation framework for cloud leakage in a South African University.Method: The study employed qualitative methodologies and a case study approach. Open-ended interviews were conducted to collect data from the participants. The collected data was coded and analysed using ATLAS.ti 22.Results: The study’s findings revealed that some of the major sources of cloud leakage are a lack of effective training, ineffective information security (IS) policy regulation, and the implementation of information security awareness workshops that provided advice on how information security should be managed in the university.Conclusion: Insider threats pose a serious risk to organisations. To mitigate this threat, it is crucial for organisations to establish strong security policies and closely monitor employee activities. By conducting a thorough assessment of insider threats, organisations can enhance their understanding of this dynamic threat and strengthen their defenses.Contribution: Although every employee is ultimately responsible for an organisation’s security, the most effective IS programmes demonstrate strong top-level leadership by setting a ‘tone at the top’ and promoting the benefits of IS through careful policy and guidance.
A Retrospective Study on Maternal and Neonatal Outcomes of Adolescent Pregnancies at a Referral Hospital in Bengaluru
Authors: Chethana Ramegowda , Kiruffi Divyarajan Vinitha , Seema K. S. , Shivalingaiah Anwith Huluvadi
Published: February 2024

Background and Aim:

Adolescent pregnancy has become an important health and social issue in both developing and developed countries. According to the National Family Health Survey-5, the prevalence of adolescent pregnancy in India is 6.8%. Adolescent pregnancy has shown association with preterm birth, low birth weight, perinatal death, miscarriage, puerperal sepsis, mental illness, and maternal death. With this background, this study was taken up with the objective to delineate the maternal and neonatal complications seen in teenage pregnant women.

Materials and Methods:

This study was a retrospective case record analysis with descriptive study design of all adolescent pregnancies delivered between October 2021 and September 2022 with mother’s age being ≤19 years, at a first referral hospital in Bengaluru were included in the study. Participants who could not be contacted were excluded from the study.

Results:

Out of the 1005 deliveries during the study period, 55 were adolescent pregnancy with a proportion of 5.47%. The most common maternal complication is pregnancy-induced hypertension (8.5%) and the most common neonatal complication is low birth weight (21.2%).

Conclusions:

Despite continuous and consistent efforts by the health-care administration and health-care personnel under maternal and child national health program, the expected outcomes in terms of usage of contraception and delaying first pregnancy have not been attained.
Seroprevalence Study of Dengue at a Tertiary Care Hospital in Jaipur, Rajasthan
Authors: Singla Ashina , Ali Afreen , Galav Himanshi , Mamoria Ved Prakash
Published: February 2024

Background and Aims:

Dengue is one of the most severe mosquito-borne viral infection. In the absence of specific treatments and vaccines for dengue fever (DF), vector control is the only method by which the spread of dengue can be prevented. This study investigates the seroprevalence of DF cases by detecting NS1 antigen and immunoglobulin (Ig)-G and IgM antibody by enzyme-linked immunosorbent assay (ELISA) test.

Materials and Methods:

This study was carried out in the Department of Microbiology, at a Tertiary Care Hospital, Jaipur (Rajasthan), done between 6 months. Blood samples from clinically suspected cases of dengue were tested immediately for qualitative detection of NS1 Ag, IgM, and IgG antibodies by ELISA.

Results:

One thousand seven hundred and sixty-three serum samples were tested for dengue NS1 antigen, IgM, and IgG, out of which 1066 were positive for one or more serological parameters. Dengue cases for the NS1 infection are 52.53%, for the IgM infection is 33.39%, and for the IgG infection is 14.07%. Sixty-two percentage positive samples were of male patients and 57% of positive samples were from 19 to 40 years of age group (adult population) (59%). The seasonal trend showed a gradual increase in dengue-positive cases that started in September with a peak in October (46.24%).

Conclusion:

The monsoon and postmonsoon seasons are times of high virus activity and enhanced vector breeding. The population must thus be constantly monitored to prevent the virus from spreading further, and serological tests are crucial for making an early diagnosis. ELISA is advised for all suspected dengue patients to initiate therapy and decrease the morbidity and fatality rate.
Carotid Cavernous Fistula – Radiological Features
Authors: Sheetal S. , Gladson Nikhil , Ram Chandana , Sujan Joel Varghese
Published: February 2024

Carotid cavernous fistula (CCF) is an abnormal vascular shunt from the carotid artery to the cavernous sinus. The characteristic clinical features include chemosis, proptosis, ocular bruit, headache, diplopia, and ophthalmoplegia. The classical radiological features on magnetic resonance imaging (MRI) include proptosis, extraocular muscle enlargement, dilatation of the superior ophthalmic vein, and ipsilateral cavernous sinus enlargement. We report the case of a 66-year-old female who presented with headache, redness of the right eye, and double vision, who had features of CCF on MRI.
Bilateral adrenal histoplasmosis in a Malaysian tertiary hospital: Report of four cases
Authors: WH Kang , Wahab Norasyikin Abdul
Published: February 2024

Rationale:

Adrenal histoplasmosis can present as bilateral adrenal enlargement with constitutional symptoms and/or adrenal insufficiency. Often these patients are initially investigated as secondary adrenal metastases before eventually their diagnosis established by histopathological examination of the adrenal tissues.

Patients concerns:

We report 4 cases of patients aged 55-78 who presented with hypocortisolism and bilateral adrenal masses.

Diagnoses:

Bilateral adrenal histoplasmosis.

Interventions:

Three patients received antifungal treatment for at least one year while 1 patient passed away before the initiation of antifungal treatment.

Outcomes:

Two patients’ adrenal function recovered not requiring any steroid replacement, while 1 patient still requires long-term steroid replacement.

Lessons:

Adrenal histoplasmosis should be excluded in patients from endemic areas presenting with bilateral adrenal masses and adrenal insufficiency. Usually patients have an exposure to bird droppings, bat guano or soil contaminated with histoplasmosis fungi. Histopathological examination of biopsied adrenal tissues is still the gold standard investigation as serology and molecular diagnostic methods are still not widely available in most centers in Malaysia.
Central Channelopathies in Obesity
Authors: Li Athena Hsu , Kuo Yi-Ying , Yang Shi-Bing , Chen Pei-Chun
Published: February 2024

As obesity has raised heightening awareness, researchers have attempted to identify potential targets that can be treated for therapeutic intervention. Focusing on the central nervous system (CNS), the key organ in maintaining energy balance, a plethora of ion channels that are expressed in the CNS have been inspected and determined through manipulation in different hypothalamic neural subpopulations for their roles in fine-tuning neuronal activity on energy state alterations, possibly acting as metabolic sensors. However, a remaining gap persists between human clinical investigations and mouse studies. Despite having delineated the pathways and mechanisms of how the mouse study-identified ion channels modulate energy homeostasis, only a few targets overlap with the obesity-related risk genes extracted from human genome-wide association studies. Here, we present the most recently discovered CNS-specific metabolism-correlated ion channels using reverse and forward genetics approaches in mice and humans, respectively, in the hope of illuminating the prospects for future therapeutic development.
Assessment of Cardiovascular Risk Factors in Women Having Female Pattern Hair Loss
Authors: Verma Damini , Mendiratta Vibhu , Garg Taru , Tripathi Smita , Tomer Shaili
Published: February 2024

Background:

Many studies have associated male androgenetic alopecia with the risk of cardiovascular disorders but very few studies have addressed this association in women with FPHL.

Materials and Methods:

This was a cross-sectional hospital-based study in which a total of 50 women (18-45 years) were recruited. The objective was to measure carotid intima-media thickness (CIMT) by doppler ultrasound, Body mass index (BMI), waist circumference, lipid profile, fasting blood sugar (FBS), insulin, testosterone, Sex hormone binding globulin (SHBG), hs-CRP, ESR and fibrinogen, in pre-menopausal women having FPHL and to correlate these parameters with severity of FPHL. The prevalence of Metabolic syndrome (MetS) and Insulin resistance were evaluated.

Results:

Metabolic syndrome and insulin resistance were found in 12 (24%) and 17 (34%) cases respectively. Hypercholesterolemia, elevated LDL levels and hypertriglyceridemia, low HDL levels and hyperinsulinemia were found in 11 (22%), 31 (62%), 9 (18%), 17 (34%) and 7 (14%) cases respectively. 8 (16%) cases were diabetics. Elevated ESR, increased fibrinogen levels and elevated hs-CRP were found in 43 (86%), 10 (20%) and 21 (42%) cases respectively. CIMT was found to be within its normal range. Correlation of CIMT, anthropometric indices (BMI and WC), biochemical markers (serum cholesterol, triglycerides, FBS, and fibrinogen), and presence of metabolic syndrome with severity of FPHL in terms of Ludwig grade was found to be statistically significant.

Conclusions:

The determination of metabolic syndrome, insulin resistance and acute phase reactants such as hs-CRP and fibrinogen may be useful screening methods to detect increased cardiovascular risk in women with FPHL.
Quality of Life in Psoriasis: A Cross-Sectional Study from North India
Authors: Arora Khushboo , Hazarika Neirita , Kumari Ranjeeta , Chawla Himanshu
Published: February 2024

Background:

Psoriasis is a chronic inflammatory papulo-squamous disease characterized by multiple remissions and relapses. This study aimed to assess the impact of psoriasis on the quality of life of patients.

Materials and Methods:

A hospital-based, cross-sectional study was conducted enrolling 198 adult patients of psoriasis. The STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for observational studies were followed. Clinical severity of psoriasis was measured using Psoriasis Area Severity Index (PASI), and quality of life was measured by EuroQoL 5D (EQ-5D-5L, EQ-VAS) and Psoriasis Quality-Of-Life-12 (PQOL-12) Questionniares.

Results:

Of the 198 patients, 71.7% (n = 142/198) were males with a mean age of 41.65 ± 13.19 years. The mean PASI score was 12.46 ± 11.51, and the mean PQOL-12 score was 50.18 ± 23.36. Up to 22.7% (n = 45) cases had ‘severe’ and 6.1% (n = 12) cases has ‘very severe’ PQOL-12 scores. Statistically significant correlation (P < 0.05) was observed between PASI scores and almost all domains of EQ-5D-5L and PQOL-12.

Conclusion:

Psoriasis affects most psycho-social domains of a patient’s life. Coping with these QOL issues remains a challenge to the patients in everyday life. The goal of management of psoriasis therefore must include measures to improve quality of life along with long-lasting remittance of physical symptoms.
Description of Occupational Contact Dermatitis Related to the Use of Personal Protective Equipment with a History of Atopy in Health Workers at Prof. DR. Chairuddin Panusunan Lubis Universitas Sumatera Utara and H. Adam Malik Hospital
Authors: Hazlianda Cut P. , Nababan Kristo A. , Elvira Yesie , Nahrisyah
Published: February 2024

Introduction:

Coronavirus disease 2019 was declared a pandemic by WHO in March 2020. The Indonesian Ministry of Health has recommended many prevention strategies including the use of hand sanitizers (HSs) and the use of personal protective equipment (PPE), especially for healthcare workers. Previous research reported that the increase in the use of HS and PPE is directly proportional to the increase in the incidence of occupational skin diseases.

Aims:

To find out the prevalence of work-related contact dermatitis patients related to the use of PPE in healthcare workers at Prof. DR. Chairuddin Panusunan Lubis Universitas Sumatera Utara and H. Adam Malik Hospital, Medan, with a history of atopy dermatitis.

Materials and Methods:

This was a descriptive study including 104 healthcare workers. The results of the study were analysed using prevalence and frequency data distribution.

Results:

In this study, we found that the majority of occupational skin diseases in healthcare workers are female (n = 64; 62.5%), and the most common age group was 31–33 years old (44.2%). The incidence of contact dermatitis due to the use of PPE in healthcare workers at Prof. DR. Chairuddin Panusunan Lubis Universitas Sumatera Utara and H. Adam Malik Hospital, Medan, was found only in 15 subjects (14.4%), and only 5 (33.3%) of them had a history of suffering from atopy dermatitis.

Conclusion:

There is high prevalence of contact dermatitis due to PPE at Prof. DR. Chairuddin Panusunan Lubis Universitas Sumatera Utara and H. Adam Malik Hospital, Medan; in 104 research subjects, only 15 people (14.4%) suffered from work-related contact dermatitis with a history of atopy in 5 people (33.3%).
Systemic Sclerosis in Males—Deciphering the Enigma of Erasmus Syndrome
Authors: Sharma Reena K. , Gupta Mudita
Published: February 2024

Background:

Systemic sclerosis is an autoimmune connective tissue disease characterized by fibrosis in skin and internal organs. Chronic exposure to silica may not only lead to silicosis of lungs but also systemic sclerosis. Systemic sclerosis is relatively commoner in females; however, occupational exposure to silica in males makes them vulnerable to silica--associated systemic sclerosis (Erasmus syndrome).

Objective:

To describe the clinico-epidemiological aspects of systemic sclerosis in males in a retrospective cohort study.

Materials and Methods:

The data were analysed retrospectively for demographic profile and clinical characteristics including examination findings, laboratory investigations, and treatments of all male patients diagnosed with systemic sclerosis with or without silica exposure, managed from January 2018 to December 2021.

Results:

Eight out of twelve patients were having silica exposure in the form of stone cutting, cement exposure, and working with concrete. The average age was 55 ± 10.72 years with average smoking exposure of around 24.4 ± 12.8 pack years. Skin thickening was reported by all patients with an average modified Rodnan score of 18.33/51 in diffuse and 7/51 in limited cutaneous systemic sclerosis. Raynaud’s phenomenon and sclerodactyly were universal findings, while 9 (75%) patients had digital pitted scars. Antinuclear antibodies were present in all patients and specific antibodies substantiated the clinical assessment in almost all patients. Interstitial lung disease was the most common systemic finding present in 11 (91%) patients and tuberculosis was diagnosed in 2 (25%) cases with silica exposure. Gastrointestinal and cardiac system involvement was seen in 5 (41.6%) and 4 (33.3%) patients, respectively.

Conclusion:

Systemic sclerosis in males against the gender predilection indicates the role of occupational exposure. Silicosis and systemic sclerosis synergistically add to lung damage, and at the same time, these patients are more prone to infections like tuberculosis.
X-linked Dyskeratosis Congenita Case with Mutation 1058C>T(p.Ala353Val) in Dyskerine Gene
Authors: Oktem Ayse , Kocyigit Pelin , Tuncalı Timur , Kahraman Ulviyye , Ozbolat Sumeyra
Published: February 2024

Dyskeratosis congenita (DC) is a rare inherited bone marrow failure syndrome and telomere biology disorder, usullay consisting of a triad of oral leucoplakia, dystrophic nails, reticular skin pigmentation. The diagnosis in the majority of cases can be made following all the clinical findings of this triad are established. Here we report 7 years-old boy who had oral leukoplakia and nail abnormality without skin involvement, associated with bone marrow failure diagnosed with X-linked DC due to dyskerin (DKC1) mutation. Our report emphasizes the fact that clinical suspicion can prevent fatal consequences since all manifestations may not always be seen collectively.
Clinico- Therapeutic Study of Stevens Johnson Syndrome-Toxic Epidermal Necrolysis and Prognostic Significance of SCORTEN in Indian Patients
Authors: Jangid Neha Chetan , Choudhary Ankita Nirmal , Shah Bela Jashwantlal , Shah Shikha Rupalkumar , Vyas Harshita R , Mistry Deval
Published: February 2024

Background:

Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are life-threatening dermatological emergencies. SCORTEN (SCORe of toxic epidermal necrolysis) is a validated score to predict mortality; however, there is a paucity of data to determine its usefulness in the Indian population.

Objective:

To evaluate the accuracy of SCORTEN as a prognostic marker in SJS-TEN.

Methods:

A prospective observational study was conducted at a tertiary care hospital for two years. SCORTEN was calculated on days one and three of admission. The actual death rates were compared to the predicted rates as estimated by the SCORTEN by standardised mortality ratio analysis (SMR).

Results:

Of 40 cases included in the study, the mean age was 36.2 ± 14 years (range 11–65) with the male: female ratio being 1.67:1. Antibiotics (37.5%) were the most common group followed by anticonvulsants (22.5%). Comorbidities were observed in 60% of cases, with epilepsy (17.5%) and HIV (human immunodeficiency virus) infection (12.5%) being common. On univariate analysis, heart rate > 120/min, epidermal detachment > 10% BSA, and Se HCO3 (bicarbonate) <20 mmol/L were associated significantly with the death of the subjects (P < 0.05). The observed mortalities were 4.34%, 0, 0 and 80% for SCORTEN 0–1 (3.2%), 2 (12.1%), 3 (35.8%) and 4 (58.3%) respectively when compared to expected mortality. SMR of SJS was 0.69 and of TEN was 1.49.

Conclusion:

SCORTEN gave an overestimation of mortality in patients with lower scores and an underestimation of mortality in patients with higher scores in our study. Minor refinements based on the study population may increase the predictive accuracy of the original scale.
Zoon’s Balanitis – Update of Clinical Spectrum and Management
Authors: Relhan Vineet , Kumar Abhinav , Kaur Aneet
Published: February 2024

Zoon’s balanitis or balanitis plasmacellularis circumscripta is a chronic inflammatory disorder of the genital mucosa that can affect both males and females (Zoon’s vulvitis). It is not a sexually transmitted disease but can still cause anxiety to the patients because of its chronic nature. Hence, proper diagnosis and early management are necessary. It is a clinical mimicker of other commoner genital dermatoses and is mostly a diagnosis of exclusion when other diseases have been ruled out. It is characterised by a well-demarcated shiny erythematous patch or plaque over the genital mucosa. Histopathological examination becomes necessary when we are unable to differentiate it from premalignant lesions. It reveals lozenge-shaped keratinocytes with siderophages, haemorrhages and variable plasma cell infiltrate in the dermis. Dermoscopy shows spermatozoa-like, convoluted vessels with structureless red orange areas. Response to topical therapy alone is not always satisfactory. However, lasers and surgical management can provide long-term remission.
A Clinico-Epidemiological Study of Cutaneous Adverse Drug Reactions in a Tertiary Care Centre of Eastern India
Authors: Sinha Sujata , Kar Chinamy , Das Sudip , Dutta Arnab , De Abhishek
Published: February 2024

Background:

Adverse drug reactions (ADRs) are major problems in the drug therapy. Cutaneous adverse drug reactions (CADRs) are the most common ADRs. The pattern of CADRs differs among various drugs.

Aims:

To record various morphological patterns of CADRs and their causal relationships among patients attending in a tertiary care centre.

Materials and Methods:

An observational, cross-sectional, clinical study was conducted for a duration of one and a half years in a tertiary care centre in eastern India. Patients presenting with suspected CADRs were included if drug identity could be ascertained. Clinical profiling and drug history were recorded, and causality assessment was carried out as per the Naranjo scale.

Result:

The commonest CADR in our study was fixed drug eruption (FDE) 48.61%, followed by SJS-TEN spectrum 16.66%, maculopapular rash 11.11% and so on. Severe cutaneous adverse drug reactions (SCARs) such as SJS, TEN, SJS-TEN Overlap, AGEP and DRESS accounted for 18 cases (25%). The most common culprit drugs were antimicrobials (54.16%), followed by nonsteroidal anti-inflammatory drugs (15.27%) and anticonvulsants (12.5%). Most of the CADRs were in probable category.

Conclusion:

The pattern of CADRs and the drugs causing them in our study population are similar to some previous studies but somewhat different from most of the previous Indian studies. The incidence of SCARs was significantly higher than in previous other studies in India and abroad.