bluuebunny/crossref_metadata_2025 huggingface dataset:
Espaces disputés en Afrique noire
Authors: Baro Soulimane , Ouattara Ardjourma
Published: September 2024

La plaine de Banfora, située dans le bassin supérieur de la Comoé au sud-ouest du Burkina Faso était l’objet d’une exploitation rizicole et arboricole ayant généré un système foncier fort complexe mais bien structuré. Ces structures agraires et foncières ont été totalement bouleversées, malgré leur remarquable capacité interne de reproduction et d’adaptation, par l’intervention de l’État voltaïque. Celui-ci désirait, en 1970, concéder 10 000 hectares à la SOMDIAA pour constituer une société d’économie mixte, la SOSUHV, dont l’objet principal était l’aménagement d’un complexe sucrier. Dans des conditions juridiques discutables, les populations de dix quartiers ou villages ont dû déguerpir en perdant un abondant patrimoine constitué durant des générations. Les indemnisations ont été sans commune mesure avec les pertes subies et beaucoup de paysans ont dû devenir les ouvriers agricoles de leurs anciennes terres pour le compte de la SOSUHV. Diverses modifications en ont résulté (renforcement du pouvoir des chefs de village, perturbation des cycles agricoles). Quels que soient les avantages sociaux accordés aux salariés, c’est le processus de la prolétarisation qui caractérise l’impact du complexe sucrier de Banfora.
Espaces disputés en Afrique noire
Authors: Gruénais Marc-Éric
Published: September 2024

Le territoire qui procède de l’établissement d’un lien privilégié entre un groupe et une portion d’espace, est un des éléments essentiels dans la production et la reproduction de l’espace des communautés africaines. Dans la logique traditionnelle, l’accès à la terre dépend des droits sur le territoire détenu par les autorités locales. Cette logique du territoire se voit confrontée à une logique capitaliste qui s’articule notamment autour de la notion de « mise en valeur ». La « mise en valeur » modifie fondamentalement le rapport des hommes à l’espace de la logique traditionnelle : en ne considérant l’espace que comme un ensemble de terrains à utiliser, elle remet en cause l’intégrité territoriale du groupe et les autorités traditionnelles.
Le Vieillissement cérébral
Authors: Gage Fred H. , Bjorklund Anders , Abel C.
Published: September 2024

Résumé Le domaine des greffes de tissu nerveux a connu une expansion considérable au cours des dernières années. Bien que leur application chez l’homme dans le contexte du vieillissement cérébral paraisse peu vraisemblable dans l’immédiat, on a pu montrer que des déficits observés chez l’animal âgé pouvaient être corrigés par la greffe de populations neuronales particulières.
Trauma-Informed Development and Education: Turning the TIDE on Transition to Practice
Authors: Gilroy Heidi , Kobina Audrey , Bhaloo Tajudaullah
Published: September 2024

Background

Transition to practice (TTP), the first year of a nurse's career postlicensure, is widely recognized as a stressful time. Previous trauma exposure and additional workplace trauma exacerbate the stress of this transitional period. Trauma-informed environments are associated with clinician wellness and engagement. Because workforce training for leaders is a necessary precursor to developing supportive environments, we studied changes in trauma knowledge, awareness, and attitudes among TTP leaders.

Method

Our mixed methods study included administering the Attitudes Related to Trauma-Informed Care Scale (ARTIC) pre- and post-training, with additional open-ended questions about the impact of training.

Results

Paired data from participants showed overall mean improvement that was statistically significant, with a large effect size. Statistically significant knowledge gains related to trauma recognition and safety, how to respond to trauma, and how to promote healthy behaviors.

Conclusion

Our study underscores the importance of trauma education, which not only increased awareness but also prompted nurse leaders to reflect on enhanced support for early nursing professionals.

[
J Contin Educ Nurs.
2024;55(10):501–508.]
Caring for Veterans With Depression and Cancer: An Overview for Civilian Nurse Clinicians
Authors: Decker Veronica
Published: September 2024

Purpose

Veterans put their lives on the line to serve our country, but their well-being is often threatened by multifaceted health issues related to military service, including elevated rates of lung cancer and depression. A significant percentage of Veterans have lost faith in mental health care or are unable to breach stigma-related barriers to seek and engage in this care. Veterans' lack of trust can be exacerbated by community mental health clinicians who have had little experience with Veterans and feel inadequately prepared to address their complex needs.

Method

The following databases were searched: PubMed, CINAHL Plus with Full Text, and Google Scholar; as well as the U.S. Department of Veterans Affairs website.

Results

Results indicated that 50% of Veterans use civilian health care and perceive that civilian nurses lack knowledge of military culture and related trauma.

Conclusion

The current review offers civilian mental health professionals an overview of Veterans' unique issues and provides resources and practical suggestions for helping them overcome barriers to mental health care. [
Journal of Psychosocial Nursing and Mental Health Services, 63
(1), 13–22.]
Ceylon cinnamon (Cinnamomum zeylanicum): Unveiling the health potential
Authors: Madhushika K. T. S. , Bulugahapitiya Vajira P. , Wijayarathne W. M. D. G. B.
Published: September 2024

Cinnamomum zeylanicum provides numerous health benefits linked to its phytochemical composition, which varies by maturity, storage conditions, and genotypes. As previous studies have not examined how these factors affect the antioxidant, antimicrobial, and anticancer properties of C. zeylanicum, this study aims to address this gap and explore its broader applications. Both leaves and bark of seed-propagated (N) and vegetatively propagated varieties, Sri Gemunu (G) and Sri Vijaya (V) were used in the study. Three maturity stages, i.e.: 1-3 years (M3), 3-5 years (M2), and >5 years (M1) were subjected to the analysis in each case. Antioxidant activity was assessed using DPPH and FRAP assays, considering storage conditions (room temperature, 4°C) and storage duration of 1 week to 12 months. The most promising samples were then evaluated for antimicrobial and anticancer activity against MCF-7 and Hep-G2 cells. The results showed that NM1 leaves displayed heightened RSA [IC50: 0.27 ± 0.04 mgmL-1] whereas NM1 bark gave varied radical scavenging activity (RSA) values exhibiting the highest RSA (0.60 ± 0.09 mgmL-1). Maturity-influenced antioxidant activity of GM1 leaves exhibited the highest FRAP values at 2358.8 μmol FeSO4/g dry weight (DW). Bark of GM1 recorded FRAP value of 2770.0 ± 3.19 μmol FeSO4/g DW. Enhanced methanolic extracts (MeOH-Ex) from NM1 leaves and the bark demonstrated potent antimicrobial effects, inhibiting Staphylococcus aureus (MIC: 2.5 mgmL-1) and displaying robust anti-fungal activity against Candida albicans (MIC: 0.078 μgmL-1). In addition, MeOH-Ex of leaves showed the most potent cytotoxicity against cancer cells, Hep-G2 (cell viability: 11.53 ± 0.63%) after 48 hours. The research underscores the remarkable antioxidant, antimicrobial, and anticancer properties in C. zeylanicum leaves and bark, in NM1. This highlights the health benefits of seed-propagated C. zeylanicum over G and V varieties, offering valuable insights for future research and product development.
Performance of a negative binomial-GLM in spatial scan statistic: a case study of low-birth weights in Pakistan
Authors: Ullah Sami , Barakzai Mushtaq Ahmad Khan , Xie Tianfa
Published: September 2024

Spatial cluster analyses of health events are useful for enabling targeted interventions. Spatial scan statistic is the stateof- the-art method for this kind of analysis and the Poisson Generalized Linear Model (GLM) approach to the spatial scan statistic can be used for count data for spatial cluster detection with covariate adjustment. However, its use for modelling is limited die to data over-dispersion. A Generalized Linear Mixed Model (GLMM) has recently been proposed for modelling this kind of over-dispersion by incorporating random effects to model area-specific intrinsic variation not explained by other covariates in the model. However, these random effects may exhibit a geographical correlation, which may lead to a potential spatial cluster being undetected. To handle the over-dispersion in the count data, this study aimed to evaluate the performance of a negative binomial- GLM in spatial scan statistic on real-world data of low birth weights in Khyber-Pakhtunkhwa Province, Pakistan, 2019. The results were compared with the Poisson-GLM and GLMM, showing that the negative binomial-GLM is an ideal choice for spatial scan statistic in the presence of over-dispersed data. With a covariate (maternal anaemia) adjustment, the negative binomial-GLMbased spatial scan statistic detected one significant cluster covering Dir lower district. Without the covariate adjustment, it detected two clusters, each covering one district. The district of Peshawar was seen as the most likely cluster and Battagram as the secondary cluster. However, none of the clusters were detected by GLMM spatial scan statistic, which might be due to the spatial correlation of the random effects in GLMM.
Anti-inflammatory effect of melatonin therapy in sepsis
Authors: Ibrahim Ahmed E.H. , El Sallab Shadia M. , Hamed Abeer M.A. , El Ghareeb Amira H.s
Published: September 2024

Background

The biggest cause of illness and death in children across the globe is sepsis. Melatonin, which is an endogenous lipophilic indoleamine that is primarily made from serotonin inside the pineal gland, has been shown in clinical research to be useful as an adjuvant treatment in septic newborns, improving outcomes and reducing complications, because of its strong antioxidant and immunological activities.

Aim

The goal of the present study is to evaluate the anti-inflammatory effects of melatonin as an additional treatment to antibiotics in children with sepsis, on laboratory markers and inflammatory cytokines: interleukin 6 (IL-6) and IL-8 as well as to study its impact on the outcome of these children.

Patients and methods

Our research is a prospective randomized controlled double-blinded trial from February 2017 to February 2018 at Mansoura University Children’s Hospital. This was accomplished by examining 30 children who were diagnosed with sepsis according to the Third International Consensus Definitions for Sepsis and Septic Shock. The study’s subjects were divided into two groups: group A (cases group) 15 children with sepsis in which antibiotics as well as a total oral dosage of 20 mg melatonin were given. Group B (control group) 15 matched septic children who received antibiotics as well as a cumulative oral dosage of 20 mg of a placebo.

Results

The research showed that melatonin administration as an adjuvant treatment was associated with a significant decrease in the C-reactive protein after treatment in group A than in group B (P=0.031). While there was a statistically insignificant decrease in white blood cells and an increase in hemoglobin as well as in platelets. Furthermore, serum IL-6 and IL-8 levels were significantly lower in the melatonin receiving group when matched with the control group 72 h after treatment (P=<0.001, 0.021, respectively). Melatonin administration improved the outcome in melatonin-treated group better than the control group (P=0.01).

Conclusion

Melatonin can be used as an adjuvant treatment for children with sepsis as it significantly reduced the C-reactive protein, serum IL-6, and IL-8 levels as well as it improves the outcome of sepsis in these children.
Insulin resistance and glucose homeostasis in Egyptian children with sickle cell anemia
Authors: Abdelsalam Marwa A. , Mabrouk Maaly M. , Badraia Ibrahim M. , Hassan Ahmed M.
Published: September 2024

Background

A single gene mutation produces sickle cell anemia (SCA), an autosomal recessive illness. The body can keep the glycemic state in normal range via various mechanisms depending mainly on pancreatic hormones.

Aim

Evaluation of glucose homeostasis and insulin resistance in a group of Egyptian sickle cell children.

Patients and methods

This cross-sectional comparative study was carried out on 80 participants aged from 5 to 16 years old of both sexes, 40 patients with sickle cell hemoglobinopathies and in a steady state (case group), and 40 healthy individuals as control (control group). Fasting blood glucose, fasting serum insulin, glycosylated hemoglobin were measured in all participants, and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) was calculated. Serum fructosamine (SF) was measured in the cases group.

Results

Glucose homeostasis was kept normal in most patients with only 10% of them showed abnormal glycemia. HOMA–IR was significantly different between the two groups with 15% of patients had pathological HOMA-IR. The study found a strong positive correlation (r=0.479, <0.001) between the HOMA-IR and the frequency of vaso-occlusive crisis per year before participants were recruited and between SF and fasting blood glucose (r=0.772, <0.001). On comparing glycosylated hemoglobin between both groups there was no statistically significant difference between both groups (P value = 0.874)

Conclusions and recommendations

Normal glucose homeostasis was proved in the majority of patients. Insulin resistance was detected in a limited number of sickle cell anemia patients. Follow-up of glucose homeostasis is indicated in sickle cell cases.
Assessment of pain in children with juvenile idiopathic arthritis using the pediatric pain questionnaire
Authors: El Deriny Ghada F. , Aref Galal H. , Eissa Maged M. , Abo-Elanin Shaimaa G.A.
Published: September 2024

Background

Juvenile idiopathic arthritis (JIA) is a chronic autoinflammatory disease of unknown etiology and is the most common cause of autoimmune musculoskeletal disease in children. Pain is a commonly reported symptom in JIA. There are levels of pain that interfere with physical, educational, emotional, and social activity, even when disease activity is controlled. Assessment of pain at each office visit is the cornerstone of effective pain management. Pediatric Pain Questionnaire (PPQ) uses a 100-mm horizontal visual analog score (VAS) anchored with happy and sad faces to assess the present pain intensity and the worst pain intensity in the past week. Patients are also asked to choose from a list of 46 word descriptors to express sensory (e.g., cutting), affective (e.g., horrible), and evaluative (e.g., sad) qualities of their pain.

Aim

The aim of the study was to assess pain in children with JIA attending the Rheumatology Clinic in Alexandria University Children’s Hospital and to determine its relation to disease activity.

Patients and methods

Fifty-eight patients and their parents who attended the Pediatric Rheumatology Clinic of Alexandria University Children Hospital were asked to fill out the questionnaire. Of the patients 58.6% were females and 41.4% patients were males; the mean age of the patients was 10.36±3.34 (months).

Results

According to pain and emotion, most parents in this study answered that the pain seemed worse when their children are tired. Distribution of the studied cases for present pain on VAS in this study showed that no significant differences were found between the children and parent scorings of present pain on VAS. All correlations were highly significant for present pain (P<0.001*). The distribution of the studied cases for worst pain last week on the VAS showed no significant differences between the children and parents scorings of worst pain on the VAS. All correlations were highly significant for worst pain (P<0.001*). Distribution of the studied cases according to the relationship between pain intensity on VAS and disease activity score showed no significant difference between pain intensity reported by children, parents, and physicians on VAS and disease activity score.

Conclusion

This work should be viewed in the light of some potential limitations. The results of this study revealed that the PPQ questionnaire was valid, reliable, and sensitive to the assessment of pain. Integrating patient-reported outcome measures of pain severity and responsiveness to standard clinical practice is feasible and applicable in the follow-up of patients and monitoring the treatment effectiveness.
A child with anti-N-methyl-D-aspartate autoimmune encephalitis presenting with frank psychosis: a case report
Authors: Khalifa Maher A. , Abou Heikal Mai M. , Swidan Mohamed , El Kholy Nehal
Published: September 2024

Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is the most common autoimmune encephalitis in children. The clinical manifestations and disease course of pediatric anti-NMDA receptor encephalitis have been comprehensively desibed in the literature and showed some differences compared with adult patients in tumor association, neurological presentation, and frequency of symptoms. In general, neurological symptoms were more common than psychiatric symptoms as the initial signs of presentation in children in most of the previous cohorts. They also tend to present with behavior changes, temper tantrums, hyperactivity, and irritability, instead of overt psychotic symptoms. In this article, we report a 12 years old boy with Anti NMDA encephalitis, showing a rare initial presentation of pure psychosis, after obtaining the consent of his parents.
Attitudes of Indian Undergraduate Occupational Therapy Students Toward Mental Health and Psychiatry
Authors: Dave Nidhi N. , Praveen S. G.
Published: September 2024

Background:

In India, the number of occupational therapy practitioners currently working in mental health settings is lower than most other specialties. The attitudes of students influence their interest in any field and their desire for working in it.

Objectives:

The objective of this study was to examine the attitudes of Indian undergraduate occupational therapy students toward mental health and psychiatry, and to explore the differences in attitudes across different years of study, gender, resulting from personal experiences, and educational coursework, and to examine if the attitudes influence future career choices.

Study Design:

This was a cross-sectional survey.

Methods:

Permission was obtained from heads of institutions of 14 occupational therapy colleges and the survey link was sent. In order to obtain a representative sample, the link was also shared on social groups. The purpose of the study, voluntary participation, and confidentiality were explained on the landing page. The subsequent sections consisted of the demographic questionnaire, the Attitudes toward Psychiatry-30 (ATP-30) Questionnaire, and the Career Preference Questionnaire. A total of 402 responses were obtained within the stipulated period. Statistical analysis was performed, and the odds ratio using logistic regression and Pearson's correlation coefficient were determined.

Results:

Gender and contact with persons with mental illness were significant predictors of positive ATP. Females are 5.387 times more likely to have positive ATP (odds ratio [OR] = 5.387, 95% confidence interval [CI]: 2.101–13.814, P = 0.000). Furthermore, those in contact with persons with mental illness are 2.883 times more likely to have positive ATP (OR = 2.883, 95% CI: 1.076–7.724, P = 0.035). Moderately high positive correlations existed between ATP and career preference in psychiatry.

Conclusions:

Overall, positive attitudes were found. Significant correlations were seen across the domains of the ATP-30 and career preference in psychiatry. Female students are five times more likely to have positive attitudes than male students. Those in contact with persons with mental illness were almost thrice more likely to have positive attitudes than those without any contact.
Falls and its Impact on the Lives of the Rural and Urban South Indian Older Adults using the International Classification of Functioning, Disability, and Health Framework
Authors: Manishanair Murugan , Allenjuda James , Jeromedanypraveenraj Jones , Aruna Ranjan , Samuelprasannavinothkumar James , Samuelkamaleshkumar Selvaraj , George Jacob
Published: September 2024

Background:

A fall is a ubiquitous event experienced by all but, in older adults, it leads to more adverse events. The International Classification of Functioning, Disability, and Health (ICF) framework offers a better understanding of the consequences of falls. Studies concerning the impact of falls on older adults living in rural and urban areas based on the ICF framework are sparse.

Objectives:

We examined the difference in the fall rate, fall characteristics, and the impact of falls based on the ICF framework in rural and urban older adults.

Study Design:

We did a cross-sectional survey among older adults living in rural and urban areas in a South Indian district from November 2017 to April 2018.

Methods:

We included 304 community-dwelling rural (n = 210) and urban (n = 94) older adults in the study. Self-designed data form was used to get the details on age, gender, educational level, visual problems, comorbidities, history, frequency, and fall-related injuries. Based on the ICF framework, we used measures such as the Berg Balance Scale (BBS), modified Barthel Index (MBI), Community Integration Questionnaire (CIQ), and World Health Organization Quality of Life Instrument (WHOQOL-BREF).

Results:

Out of 210 rural older adults, 101 (48%) experienced falls, and out of 94 urban older adults, 52 (55%) experienced falls. The fall rate did not differ significantly between the rural and urban older adults (odds ratio: 0.86, 95% confidence interval [CI]: 0.57–1.31,P= 0.507). The rural and urban older adult fallers differed significantly in gender (male: 95% CI: 0.06–0.39; female: 95% CI: 0.06–0.39;P= 0.007), education (<10 years: 95% CI: 0.31–0.57; >10 years: 95% CI: 0.75–0.94;P= 0.001), comorbidities (diabetes mellitus: 95% CI: 0.03–0.30; hypertension: 95% CI: 0.04–0.26; no comorbidities: 95% CI: 0.05–0.21;P= 0.001), problem in visual acuity (yes: 95% CI: 0.15–0.39; no: 95% CI: 0.15–0.39;P= 0.001), and frequency of falls (once: 95% CI: 0.01–0.33; recurrent: 95% CI: 0.01–0.33;P= 0.001) and did not differ in age, vocational status, and hospitalization. Except in CIQ scores (95% CI: 2.08–5.91;P= 0.001), they did not differ significantly in the fall-related injuries, BBS, MBI, and WHOQOL-BREF scores.

Conclusion:

The rural older women and the urban older adults with higher levels of education who had diabetes, hypertension, and visual problems experienced more falls. Although the urban older adults reported a higher frequency of falls, they showed a higher level of community reintegration than the rural older adults.
Understanding Daily Routine and Schedule of Children with Attention-Deficit Hyperactivity Disorder
Authors: Shikerkar Divesha , Vajaratkar Pooja Vivek
Published: September 2024

Background:

Attention-deficit hyperactivity disorder (ADHD) is characterized by diminished sustained attention, hyperactive and impulsive behavior and is known to have an impact on the daily routine and self-regulation of children. There is a dearth of evidence for understanding the routine of the children with ADHD and their parents, which is necessary for organizing and scheduling the routine for the better management of daily occupations.

Objectives:

This study aimed to understand the daily routine and schedule of children with ADHD in Goa.

Study Design:

A qualitative, descriptive study design was conducted.

Methods:

This pilot study was conducted in resource rooms and schools in Goa, India. The recruitment of 10 parents of children with ADHD was done by the convenient sampling method and parents were administered a semi-structured questionnaire and in-depth interview was undertaken to understand the children's daily routine.

Results:

Ten parents (mean ± standard deviation [SD] age 45.4 ± 7.97 years) of children with ADHD (mean ± SD age 9.5 ± 1.85 years) participated in this study. The study understood and described in depth the extent of the organized schedule and routine present, child's home and school routine and schedule, how the routine of the child affects the child and the family in terms of their socialization and how important is a routine for the family.

Conclusion:

The study inferred that the parents of children with ADHD have difficulty in managing the daily routine of their child at home as well as in school, including the self-care routine, meal-time, bed-time routine, and study schedule. The study helped understand the importance of an organized routine with a well-defined structure in the daily life to carry out timely meaningful occupations.
Myelofibrosis – A Less Known Complication of Vitamin D Deficiency: A Case Report with Review of Literature
Authors: Mishra Ruchi , Agrawal Mukesh , Nalavade Omkar Gajanan , Hegde Darshan G.
Published: September 2024

Background:

Pediatric myelofibrosis is uncommon and is usually secondary to an underlying hematopoietic or nonhematopoietic condition. Among the nonhematopoietic secondary causes, Vitamin D deficiency is an important but rare cause.

Clinical Description:

An 18-month-old male child with delay in achieving milestones for the past 6 months along with anemia and distention of the abdomen for the past 3 months was referred to our institute. Clinical examination revealed global developmental delay with a developmental quotient of 49%, short stature, rachitic features, and massive splenomegaly.

Management and Outcome:

After ruling out common nutritional and hemolytic causes of anemia, a bone marrow biopsy was done which showed extensive fibrosis, few megakaryocytes, myeloid and erythroid cells with normal maturation, and no storage cells – features consistent with myelofibrosis possibly secondary to Vitamin D deficiency. The clinical and laboratory findings of myelofibrosis improved with Vitamin D therapy and calcium.

Conclusion:

In developing countries like India, nutritional rickets is highly prevalent. However, rarely such children with rickets may show anemia with extramedullary erythropoiesis. If pediatricians are aware of Vitamin D deficiency-induced secondary myelofibrosis, many unnecessary investigations and work-up for storage diseases can be avoided. The condition is easily reversible with Vitamin D therapy.
Transient Hyperleukocytosis in One of the Extreme Preterm Twins: A Case Report with Review of Literature
Authors: Kuriakose Mathews E. , Chandran Shanu , Tawab Abdul
Published: September 2024

Background:

Although physiological leukocytosis is known in premature neonates, hyperleukocytosis (total leukocyte count more than 100 × 103 /µL) is rarely seen. Commonly known disorders leading to hyperleukocytosis include leukemia, leukocyte adhesion defect, and myeloproliferative disorders. Transient hyperleukocytosis of unidentified etiology or attributed to sepsis has been rarely reported.

Clinical Description:

One of the extremely preterm twins (delivered at 26 weeks gestation) developed hyperleukocytosis on day 3 of life, without any evidence of blast cells on the peripheral smear, with normal C-reactive protein levels, while Twin 2 had normal leukocyte counts.

Management and Outcome:

Twin 1 was managed conservatively with mechanical ventilation, supportive care, and broad-spectrum antibiotics. His total leukocyte counts started reducing since day 5 of life and returned to normal after day 18, although he required prolonged respiratory support due to bronchopulmonary dysplasia (BPD). The other twin with a normal leukocyte count had a less difficult course and did not develop BPD. The twins being dichorionic-diamniotic type, and the placental histopathology of Twin 1 showing evidence of chorioamnionitis (the placenta of the other twin was normal), the transient hyperleukocytosis of Twin 1 was attributed to chorioamnionitis.

Conclusion:

The presence of hyperleukocytosis in only one of the neonates of an extremely preterm delivery highlights the fact that some factors such as chorioamnionitis or early-onset sepsis may contribute to this condition, which is transient, and resolves with supportive conservative care.
Infantile Spasms and Developmental Delay: A Case of Miller–Dieker Syndrome
Authors: George Jewel Maria , Cherian Carol Sara , Thomas Reji , Sunnychan Sebin
Published: September 2024

Background:

Miller–Dieker syndrome (MDS) is a rare genetic disorder, due to contiguous gene deletion on chromosome 17p13.3, characterized by classical type I lissencephaly, severe developmental delay, seizures, cardiac defects, and dysmorphisms. West syndrome is a severe form of epilepsy with epileptic spasms, hypsarrhythmia in electroencephalogram (EEG), and neuropsychomotor delay. Herein, we describe the neurophysiological and neuroimaging findings of a patient with MDS with associated West syndrome.

Clinical Description:

A 5-month-old boy was brought with new-onset infantile spasms and a history of delay and some regression in milestones. Facial dysmorphism was noted in the form of a prominent forehead, bitemporal hollowing, short nose with upturned nares, thickened upper lip, long philtrum, low-set ears, and hypertelorism. There was hypotonia of all four limbs.

Management and Outcome:

An EEG showed hypsarrhythmia, and the magnetic resonance imaging brain revealed hypoplastic sulci with pachygyria and smooth cortical surface of supratentorial brain parenchyma – features suggestive of lissencephaly type 1. Echocardiography showed atrial septal defect and minimal pericardial effusion. Whole-exome sequencing showed a contiguous large heterozygous deletion on chromosome 17 which was suggestive of Miller–Dieker lissencephaly syndrome. Parents were counseled, and the spasms were treated with an injection adrenocorticotropic hormone and oral vigabatrin.

Conclusion:

Structural brain abnormalities are well-known causes of infantile spasms. MDS is a severe malformative condition, lissencephaly being the hallmark of this disorder. This case report will create awareness among pediatricians regarding this rare condition with a characteristic combination of clinical features, which can be confirmed by brain imaging and genetic analysis.
Malignant Infantile Osteopetrosis: A Rare Cause of Refractory Hypocalcemia
Authors: Dipak Niraj Kumar , Shagufta Nadia
Published: September 2024

Background:

Infantile malignant osteopetrosis (IMO) is a rare autosomal recessive disease characterized by a higher bone density in bone marrow caused by the dysfunction of bone resorption.

Clinical Description:

A 2-month-old baby boy presented with features of lower respiratory tract infection, along with a swollen right upper arm due to fracture of humerus, along with signs of bicytopenia and hepatosplenomegaly. He had a history of hypocalcemic seizures at 8th day of life.

Management and Outcome:

Current hospitalization revealed refractory hypocalcemia and hypophosphatemia with normal to increased Vitamin D and parathormone levels and increased density of bone. Hypocalcemia was particularly refractory in nature needing multiple intravenous calcium corrections. Whole exome sequencing detected compound heterozygous variants in the T-cell immune regulator 1 pathogenic gene of IMO. Simultaneously, a heterozygous nonsense variation in exon 4 of the CHRNA4 gene was detected causing nocturnal frontal lobe epilepsy. As the infant had evidence of bone marrow failure, he was considered and referred for hematopoietic stem cell transplantation.

Conclusion:

Neonatal and early infantile hypocalcemia are commonly seen by pediatricians, but an etiology of IMO is rarely considered. The presence of fracture of long bones with cytopenias and hepatosplenomegaly in a young infant with recurrent hypocalcemia, without Vitamin D deficiency, should raise suspicion of this disorder and genetic analysis should be carried out for the same.
Understanding Self-medication Trends in First-year Medical Students: A Cross-sectional Study
Authors: Adake Prabhakar , Petimani Mahalaxmi S. , Naik Rajesh Vishnu
Published: September 2024

Objectives:

The objective is to explore self-medication perceptions and practices among 1st year undergraduate medical students.

Materials and Methods:

This cross-sectional study was conducted among 1st-year medical students in a private college in North Karnataka. A prevalidated questionnaire assessing self-medication perceptions and practices was administered to 176 participants through Google Forms. Descriptive statistics were used to analyze the data.

Results:

Nearly half of our study participants (52.3%) reported engaging in self-medication. The common sources of information included previous experience/prescriptions (43.8%) and advice from parents/friends (41.5%). Reasons for self-medication included perceiving the illness as nonsevere (82.4%) and time-saving (10.8%). The most common conditions prompting self-medication were the common cold (29%), fever (25.6%), and pain (18.8%). Analgesics (28.4%) and antipyretics (27.3%) were the most commonly used drug classes.

Conclusion:

The relatively lower prevalence of self-medication among 1st-year medical students in this study may be attributed to factors such as the targeted focus on this specific demographic, limited availability of self-medication resources in hostels, and foundational training emphasizing evidence-based medicine principles. However, concerns arise regarding the use of alternative medicine systems like Ayurveda, potentially leading to herb–drug interactions. To address these issues, structured educational initiatives, regulatory enforcement, and improved access to health-care consultations are crucial for promoting rational medication use and mitigating self-medication risks among medical students.
Effective Implementation of Entrustable Professional Activities in Medical Colleges: Faculty Perspective
Authors: Shrivastava Saurabh RamBihariLal , Gade Shubhada , Vagha Sunita
Published: September 2024

Entrustable professional activities (EPAs) refer to the key activities that medical students should be in a position to perform on their own by the time of completion of their training. The process of implementation of EPAs in medical training is a complex and challenging one. In medical colleges, faculty members have been identified as the change agents who will eventually determine the success and effectiveness of planning and implementation. From the faculty perspective, multiple challenges have been identified, including the reluctance to adopt EPAs and preference for traditional assessment methods. In conclusion, the success of EPAs integration into the medical curriculum, as evidenced by improvement in the learning outcomes essentially requires active support from faculty members. Thus, there is an immense need to strengthen faculty development activities to enhance their competency and confidence to implement EPAs.
Facilitating Integration of Interprofessional Education-related Entrustable Professional Activities into the Medical Curriculum
Authors: Shrivastava Saurabh RamBihariLal , Gade Shubhada , Vagha Sunita
Published: September 2024

In competency-based education, entrustable professional activities (EPAs) play a defining role in developing the competence of students by providing contextual relevance. EPAs aid in the assessment of both cognitive and noncognitive (namely teamwork, leadership, communication skills, professionalism, etc.) attributes of the student. In fact, the inclusion of EPAs targeting interprofessional education (IPE) in the curriculum strengthens collaborative learning. The process of integration of EPAs related to IPE in the medical curriculum requires systematic planning and implementation to encourage collaborative learning and prepare students for medical practice. Assessment of IPE-related competencies using EPAs can be carried out with the help of different methods. In conclusion, EPAs can significantly strengthen the delivery of IPE by promoting collaboration and teamwork. There is an immense need to integrate IPE-related EPAs into the medical curriculum to improve the quality of care and patient-related outcomes.
Retraction Notice: Study on Dynamic Response Characteristics of Offshore Floating Wind Turbine Pitch System
Authors: Guan Xin , Wu Shiwei , Li Mingyang , Xie Yuqi
Published: September 2024

The article Study on Dynamic Response Characteristics of Offshore Floating Wind Turbine Pitch System has been retracted at the request of EAI's Research Integrity Committee on the grounds of plagiarism.
Analytical Sensitivity Analysis and Clinical Impact Modeling of Rapigen Rapid Diagnostic Tests for Malaria
Authors: Golden Allison , Slater Hannah C. , Jang Ihn Kyung , Walke Sayali , Phan Thanh T. , Bizilj Greg T. , Rashid Andrew , Barney Rebecca , Das Smita , Rist Melissa J. , McCarthy James S. , Nosten Francois , Landier Jordi , Imwong Mallika , Hume Jennifer C. C. , Sagara Issaka , Healy Sara A. , Duffy Patrick E. , Ntuku Henry , Mumbengegwi Davis , Hsiang Michelle S. , Murphy Sean C. , Rek John , Torres Katherine , Gamboa Dionicia , Domingo Gonzalo J.
Published: September 2024

Laboratory benchmarking allows objective analysis of the analytical performance of malaria rapid diagnostic tests (RDTs). We present the analytical detection limits of the Rapigen BIOCREDIT Malaria Ag Pf/Pv (pLDH/pLDH), the Rapigen BIOCREDIT Malaria Ag Pf (pLDH/HRPII), and two best-in-class WHO-prequalified comparator RDTs, generated using standardized panels containing recombinant antigen, in vitro cultured parasites, international standards, and clinical samples. Detection limit antigen concentrations of HRP2, PfLDH, and PvLDH were determined for the Rapigen and comparator RDTs. Detection of antigens in international units (IU)/mL was also evaluated. The Rapigen Ag Pf (pLDH/HRPII) detected 3.9 and 3.9 IU/mL for PfLDH and HRP2, respectively, and the Ag Pf/Pv (pLDH/pLDH) detected 3.9 and 5.0 IU/mL for PfLDH and PvLDH, respectively. The comparator HRP2/PfLDH and HRP2/PvLDH detected 15.6 and 31.3 IU/mL for HRP2 and PfLDH and 15.6 and 50.0 IU/mL for HRP2 and PvLDH, respectively. The RDT clinical sensitivity was predicted through application of analytical detection limits to antigen concentration distributions from clinical symptomatic and asymptomatic cases. Febrile cases would be detected in a majority by both standard and Rapigen RDTs, but incremental increases in sensitivity in the Rapigen RDTs may be important for clinical cases currently missed by microscopy. Rapigen RDTs were predicted to have improved detection of asymptomatic cases and infections with parasites carrying hrp2 deletions through more sensitive PfLDH detection. Through the benchmarking and simulation of clinical sensitivity, a method for rapidly assessing the ability of new RDTs to meet clinical needs using high-sensitivity antigen distribution data is presented.
Disseminated Macrolide-Resistant Mycobacterium intracellulare Infection in a Child with Autoimmune Lymphoproliferative Disorder: A Case Report and Literature Review
Authors: Nithirungruang Phuwakrit , Tanpowpong Pornthep , Getsuwan Songpon , Boonsathorn Sophida
Published: September 2024

A 4-year-old girl, previously treated with prednisolone and cyclosporin A due to autoimmune lymphoproliferative syndrome, presented with acute fever, progressive pancytopenia, intermittent abdominal pain, and acute episode of hematemesis. Esophagogastroduodenoscopy revealed diffuse erythematous gastric mucosa and blunt duodenal villi. Histopathology of the duodenal mucosa was notable for numerous acid-fast bacilli within foamy macrophages in the lamina propria, and nontuberculous Mycobacterium DNA was detected by polymerase chain reaction of duodenal tissue. Azithromycin, rifampicin, and ethambutol were started while waiting for species identification and drug susceptibility testing. Macrolide-resistant Mycobacterium intracellulare was demonstrated from blood culture, indicating disseminated infection. The patient died of overwhelming infection, despite receiving newly adjusted regimen (rifampicin, ethambutol, clofazimine, and amikacin). This case highlights the importance of considering disseminated Mycobacterium avium complex (MAC) in the differential diagnosis of immunocompromised, non-HIV patients presenting with gastrointestinal manifestations. Early identification of macrolide-resistant MAC is crucial for guiding appropriate treatment and potentially improve patient outcomes.
Antibiotic Use Characteristics and Patterns in Humans and Poultry in Wakiso District, Uganda
Authors: Wagaba David , Waiswa Peter , Kalule John Bosco
Published: September 2024

Antibiotic use in animals has been identified as a major contributing factor for antibiotic resistance. Given the limited access to veterinary services, the choice of antibiotic and the dosage are determined by the farmers. By analyzing prescription practices and their appropriateness, we can compare performance in antibiotic stewardship across regions to drive change toward national goals and to guide policy interventions. This study used an integrated approach to assess antibiotic use at the grassroots in a rural poultry-keeping community in Wakiso District, Uganda. Medical prescriptions of 347 outpatients were captured between September 2021 and November 2021 via systematic random sampling of patients attending a local health center and were reviewed to decode antibiotic use characteristics and patterns. In the same period, structured questionnaires were issued to 36 poultry farmers in the same area to obtain information on their antibiotic use practices. Of the 347 human outpatient prescriptions reviewed, 250 (72%) recommended at least one antibiotic at a mean of 1.7 antibiotics per prescription. Conversely, all the poultry farms reported antibiotic use. There was significantly more use of macrolides and tetracyclines on poultry farms than at the local health centers and more use of penicillins, nitroimidazoles, and cephalosporins in humans than in poultry. There is unregulated use of critically important antibiotics in poultry and a misuse of antibiotics in the health center due to the lack of adequate diagnostic services. There is a need to improve point-of-care diagnostics of both human and poultry diseases in this community to guide antibiotic use.
Challenges and Approaches to Establishing Multi-Pathogen Serosurveillance: Findings from the 2023 Serosurveillance Summit
Authors: Carcelen Andrea C. , Kong Alex C. , Takahashi Saki , Hegde Sonia , Jaenisch Thomas , Chu May , Rochford Rosemary , Kostandova Natalya , Gurley Emily S. , Wesolowski Amy , Azman Andrew S. , van der Klis Fiona R. M. , den Hartog Gerco , Drakeley Christopher , Heaney Christopher D. , Winter Amy K. , Salje Henrik , Rodriguez-Barraquer Isabel , Leung Daniel T. , Njenga Sammy M. , Kagucia Eunice Wangeci , Jambo Kondwani C. , Wolter Nicole , Charles Richelle C. , Saboyá-Díaz Martha-Idalí , Martin Diana L. , Moss William J.
Published: September 2024

Multiplex-based serological surveillance is a valuable but underutilized tool to understand gaps in population-level exposure, susceptibility, and immunity to infectious diseases. Assays for which blood samples can be tested for antibodies against several pathogens simultaneously, such as multiplex bead immunoassays, can more efficiently integrate public health surveillance in low- and middle-income countries. On March 7–8, 2023 a group of experts representing research institutions, multilateral organizations, private industry, and country partners met to discuss experiences, identify challenges and solutions, and create a community of practice for integrated, multi-pathogen serosurveillance using multiplex bead assay technologies. Participants were divided into six working groups: 1) supply chain; 2) laboratory assays; 3) seroepidemiology; 4) data analytics; 5) sustainable implementation; and 6) use case scenarios. These working groups discussed experiences, challenges, solutions, and research needs to facilitate integrated, multi-pathogen serosurveillance for public health. Several solutions were proposed to address challenges that cut across working groups.
Reimagining the global economic order*
Authors: Rodrik Dani
Published: September 2024

A retreat from the post-1990s model of deep economic integration was inevitable and is not necessarily a bad thing. Today’s worries about de-globalization should not blind us to the possibility that the present crisis may in fact produce a better globalization. This essay describes the frailties of the hyper-globalization model and lays out two key prerequisites for the construction of a better global economic order: the prioritization of the domestic social, economic and environmental objectives to build more inclusive societies and polities; and the avoidance of global primacy by major powers. It then discusses the limits of global governance, emphasizing the need to restrict our ambitions with respect to global cooperation to domains where it is most needed and likely to pay dividends. The normative core of the paper is a proposal for a meta-regime for the global economic order that presumes relatively little agreement among countries on desirable economic policies and focuses on minimizing worst cases of adverse cross-border spillovers while building trust (and increased cooperation) over time.
“America fractured?“ The present and future of democracy, ideology and party system in the United States
Authors: Pechatnov V. O. , Suchkov M. A.
Published: September 2024

The politics of the United States, both internal and external, and the analysis of its historiosophic foundations, topical subjects, trends and prospects of development have occupied a special place in the Russian school of international relations. On the one hand, interest in this topic has always been determined by its applied nature: for most of the 20th century, the USA was the main adversary of the USSR, and today the relations between the two countries are in a state of systemic confrontation, albeit of a different kind. On the other hand, with its history, economics, culture, ideology and politics, the USA as an experimental state and laboratory society has always been a field of scientific research and an object of intellectual reflection for researchers of all socio-humanitarian disciplines. All these works reveal different facets of American reality, but for Russian Americanists among historians and political scientists, those that allow them to find a key to understanding the driving forces of American politics and to forecast its development are especially valuable. The interview with leading Russian Historian-Americanist Dr. V.O. Pechatnov is an attempt to understand these key issues.