bluuebunny/crossref_metadata_2025 huggingface dataset:
La fin des sanctuaires païens en Île-de-France. Chronologie et modalités d’une disparition protéiforme
Authors: Apruzzese Vincent
Published: November 2024

Cet article propose, à partir d’une relecture des sources archéologiques, un état des lieux des sanctuaires franciliens passé la seconde moitié du iiie s. Il apparaît qu’après la Tétrarchie, seul un tiers d’entre eux fonctionnaient encore normalement malgré une fréquentation massive (70 %) largement indexée sur le rythme de l’occupation rurale. La disparition des cultes publics, qui s’échelonne jusqu’à la fin du ive s., semble avoir provoqué une déstabilisation générale par l’absence de cadres et conduit à une dégradation des pratiques cultuelles. Malgré un délabrement des conditions de cultes, l’analyse minutieuse d’une dizaine de phases tardives confirme la persistance de sacrifices ou de rites communautaires durant la totalité du ive s., et ce malgré l’hostilité des décrets impériaux. Elle révèle également une relative permanence de la restauration des bâtiments sous les Constantiniens, et pose la question de la nature des commanditaires, comme du statut des sanctuaires concernés, dans un contexte de déclin apparent de la religion civique. L’étude démontre enfin la soudaineté de certaines fermetures, amenant à s’interroger quant aux conséquences sur les communautés païennes.
La céramique de l’Antiquité tardive en Pays de Loire (ive-vie siècles ap. J.-C.) : aperçu des principales catégories de céramiques
Authors: Le Boulaire Christian , Mortreau Maxime , Thébaud Sébastien , Trin-Lacombe Lola
Published: November 2024

Un PCR en cours sur la céramique antique a permis la reprise de la documentation portant sur l’Antiquité tardive dans les Pays de Loire. Cette période chronologique reste mal connue dans la région et cet article constitue un premier aperçu d’un sujet qui n’avait pas encore fait l’objet d’une synthèse au niveau régional. Il s’appuie sur la présentation de quelques ensembles de céramique significatifs issus de villae, de nécropoles et de contextes urbains. Malgré les lacunes de la documentation, l’étude fait émerger quelques constats. Le ive s. semble se caractériser par une certaine continuité avec le siècle précédent concernant les productions locales et une intégration aux circuits commerciaux de Gaule interne marquée par le rôle important de la vallée de la Loire. Concernant les ve et vie s., il n’est pas, pour l’heure, possible de dessiner des faciès précis, mais quelques particularismes locaux émergent et semblent annoncer le haut Moyen Âge.
Mutations religieuses et dynamiques territoriales dans la civitas des Bituriges Cubes, de la seconde moitié du IIIe siècle à la fin du VIIe siècle
Authors: Gandini Cristina , Girond Simon
Published: November 2024

Cette contribution s’intéresse aux mutations religieuses qui s’amorcent dans la seconde moitié du iiie s. dans la cité des Bituriges Cubes. Notre objectif est de cerner leurs conséquences sur l’organisation et l’occupation de ce territoire à la fin de l’Antiquité. Les données archéologiques récemment rassemblées sur les lieux de culte permettent de montrer que, comme ailleurs en Gaule, l’abandon d’au moins une partie des sanctuaires est effective bien avant les premiers actes officiels de la législation antipaïenne du ive s. On a l’impression d’un phénomène d’étiolement progressif, en plusieurs étapes, qui s’étale du milieu du iiie s. jusqu’au début du ve s. Toutefois, la disparition assez coordonnée des derniers sanctuaires dans la seconde moitié du ive s., ou au tout début du ve s., est aussi révélatrice de l’impact des politiques impériales et de profonds changements dans la société en cours de christianisation. Le déploiement des premières églises se fixe en priorité sur le réseau antique et résulte d’initiatives de natures variées, prises tantôt par la hiérarchie ecclésiastique pour faciliter la conversion des populations, tantôt par les riches laïcs soucieux de posséder leur propre oratoire. En revanche, les exemples de continuité entre temples païens et églises restent rares.
Les constructions privées en milieu rural et dans les agglomérations secondaires de la seconde moitié du iiie siècle au vie siècle dans la cité des Turons
Authors: Salé Philippe , Chimier Jean-Philippe
Published: November 2024

Dans la cité des Turons, les opérations archéologiques de diagnostics et de fouilles récentes ne livrent que très peu d’exemples de constructions nouvelles de l’Antiquité tardive, que ce soit en milieu rural ou dans le cadre des agglomérations secondaires. Alors que les sources écrites suggèrent un dynamisme certain, l’indigence de la documentation archéologique ne permet pas de caractériser l’architecture de cette période, soulevant dès lors de nombreuses questions.
Les résidences aristocratiques rurales de l’Antiquité tardive dans les provinces de Lyonnaise IIIe et IVe (sud du Bassin parisien, Val de Loire)
Authors: Kasprzyk Michel
Published: November 2024

Dans les provinces romaines tardives de Lyonnaise IIIe et IVe, plusieurs établissements ruraux ont livré des éléments de décor ou de plan qui suggèrent la présence d’états de la fin de l’Antiquité. La documentation, très dispersée, est réunie ici et confrontée à celle de régions plus éloignées de l’Empire. Il apparaît que la chronologie des états de l’Antiquité tardive doit être révisée et que des parallèles, notamment pour les pavements de mosaïque, doivent être recherchées dans les provinces tardives de la Britannia romaine.
La nécropole de Vouillé dans son environnement. Bornage et structuration de l’espace pour éviter les conflits de voisinage
Authors: Glad Damien
Published: November 2024

Les résultats d’un diagnostic archéologique mené à Vouillé (Vienne, France), en 2014 et en 2015, sont l’opportunité de s’interroger sur la participation des nécropoles aux bornages des territoires dès l’époque romaine tardive. Présumée mérovingienne, en raison de la bataille de 507, l’origine de la nécropole est pourtant plus ancienne. Après une succincte présentation des résultats des fouilles, nous étudions la manière dont s’intègre cette nécropole dans son environnement afin de comprendre les raisons de son isolement relatif des principaux lieux d’habitats des environs.
Un établissement rural de l’Antiquité tardive et du haut Moyen Âge sur le site de la Médiathèque à Lezoux (Puy-de-Dôme)
Authors: Driard Cyril
Published: November 2024

Une fouille archéologique préventive réalisée préalablement à la construction d’une médiathèque à Lezoux a permis d’étudier une occupation rurale datée du ive au viie s. Il s’agit d’un établissement implanté sur les ruines d’un ancien complexe artisanal spécialisé notamment dans la production de céramiques durant le Haut-Empire et appartenant au groupe des ateliers de potiers “des Saint Jean”. Les données archéologiques, bien que lacunaires, documentent l’évolution et les transformations d’un des sites de fabrication des céramiques sigillées après l’âge d’or des productions de Lezoux.
La villa gallo-romaine de Saint-Saturnin-du-Bois (Charente-Maritime) : évolution architecturale, économique et sociale d’un établissement rural du ier au ixe siècle
Authors: Maurel Léopold , Richard Lucile
Published: November 2024

La fouille d’un établissement rural antique occupé dès le ier s. de notre ère, dans la commune de Saint-Saturnin-du-Bois en Charente-Maritime, a permis de mettre en évidence une longue durée d’occupation qui perdure jusqu’aux premiers siècles du Moyen Âge. Ainsi, les aménagements médiévaux qui succèdent, dès le vie s., à une villa gallo-romaine, s’articulent autour de constructions en matériaux périssables sur mur solin de pierre particulièrement bien préservés dans le secteur du bâtiment résidentiel antique. L’opportunité nous est offerte d’étudier les relations complexes entre une occupation rurale antique et sur la surimposition d’une nouvelle occupation durant le haut Moyen Âge.
Refining fire history in the Upper Rhine Graben region - Challenges and opportunities highlighted from a case study at Wildseemoor (northern Black Forest, Germany)
Authors: Steiner Martin , Rambeau Claire , May Jan-Hendrik , Marx Samuel K. , Wolters Steffen , Rösch Manfred , Preusser Frank
Published: November 2024

A 600 cm peat succession covering the last ca. 10,000 years from Wildseemoor, a perilacustrine ombrotrophic peat bog in the northern Black Forest, offers the opportunity to study Holocene environmental evolution and fire history in the Upper Rhine region. More particularly it is used here for a pilot study 1) dealing with the influence of potential peat growth disturbance on charcoal influx interpretation, and 2) proposing a new approach to disentangle regional from local influences on charcoal influx, based on the internal variability of charcoal particle size variations. The latter suggests a fluctuating local to regional main source of charcoal influx to Wildseemoor. Two plausible age-depth models were established based on seven identified radiocarbon-dated macrofossils, showing either reduced depositional rates or breaks in deposition during the early- to mid-Holocene and (less extensively) the Middle Ages, that are not visible to the naked eye in the sediment sequence. The Holocene Climatic Optimum, a time interval of particular interest with its climate conditions analogue to future projections, falls directly into an extensive period of reduced accretion or depositional hiatus. This severely impacts the interpretation of the charcoal record for that period but highlights potential impacts of climate variations on peat growth. Regardless which age-depth model is used, phases of high charcoal influx were identified after ca. 5,000 cal BP and can most likely be linked to anthropogenic pressure on the region. The findings of this study may be used in future Holocene fire dynamics reconstructions, as they stress the necessity for high-resolution age control, but also the opportunity to exploit periods of disturbed/halting peat growth as a proxy to detect past periods of climate change. Using the internal variability of charcoal particle size to estimate local versus regional charcoal transport tendency showed promising results and may help push forward charcoal record interpretations in the future.
Acquired haemophilia A in a patient with pemphigus vulgaris: A case report on a rare coexistence
Authors: Shafana Fathima , Gunawardena Vishaka Panditha
Published: November 2024

Acquired haemophilia A is a rare disease, occurs in patients with no family history of haemophilia. In contrast to congenital haemophilia, acquired haemophilia A is mediated by antibodies causing inactivation or increased clearance of factor VIII leading to abnormal bleeding manifestation. It can be associated with many underlying conditions including autoimmune diseases. Herein we report a case of a 64 year old male with underlying pemphigus vulgaris presented with a psoas haematoma. Coagulation profile, factor assay and inhibitor assay were confirmed the diagnosis of acquired haemophilia A. The patient was not responding to first line therapy, later started on rituximab and achieved remission successfully. This is a rare coexistence of acquired haemophilia A with pemphigus vulgaris with few reported cases worldwide. We believe this case report highlights the importance of suspecting an acquired bleeding disorder in a patient with underlying autoimmune disease, present with a recent onset of abnormal bleeding. Even though the bleeding in acquired haemophilia A could be life threatening, early intervention with haemostatic agents and eradication therapy would be lifesaving.
Patient satisfaction and perceptions regarding obstetrics ultrasound scan services in a tertiary care hospital in Sri Lanka
Authors: Wijayapala MHWMN , Wanigasiri IDUK , Rajapakse RKJS , Amarasinghe WDMG
Published: November 2024

Introduction
Obstetric USS has become integral to global antenatal care. Ensuring better obstetric care and achieving a high level of patient satisfaction are key priorities. Patient satisfaction serves as a crucial index for evaluating and enhancing healthcare services. We aimed to assess pregnant women's views on their care and satisfaction during obstetrics USS and to explore the correlation between demographic factors and level of satisfaction.
Methodology
A cross-sectional descriptive study was conducted at De Soysa Hospital for Women (DMH), Colombo, Sri Lanka. All pregnant women referred to the Radiology Department for antenatal USS in February 2021 were enrolled. Pre-validated self-administered questionnaires encompassing patient demographics and ordinal satisfaction scales for obstetric USS, were distributed to pregnant women prior to their USS appointments, with completed questionnaires collected post-USS. Kendall’s tau-b correlation was used to compare the relationship between patient’s demographic factors and their level of satisfaction.
Results
The analytical sample included 278 females, with 60.5% having secondary education or a university degree. Ages ranged from 14 to 44, with an average of 30.3 years. Overall satisfaction reached 84.6 % and satisfaction ratings above 80% were noted for all the indices of perception of care. 95.7% would recommend it to third parties, and 98.6 % considered their expectations were fulfilled. Level of education and age showed positive correlation with the satisfaction with p<0.05. Ethnicity was independent of satisfaction.
Conclusion
Satisfaction with obstetric ultrasound scan services among pregnant women was high at 84.6%. Positive correlations were found between satisfaction and level of education and age. The study informs health policy and care improvements, emphasizing education and age's influence on satisfaction, suggesting targeted enhancements.
Cyberslacking and psychological distress in school-going adolescents and its impact on their mothers’ mental health
Authors: Kumar P. C. Pradeep , Chako Sithara M. , Manohar Shivanand , Kishor M.
Published: November 2024

Background:

Smartphone use has significantly increased among adolescents for nonacademic purposes. The study aimed to assess cyberslacking and psychological distress among male and female school-going adolescents and its effects on mothers’ mental health.

Methods:

This cross-sectional study involved 532 school-going adolescents and their mothers through purposive sampling. A sociodemographic data sheet, academic cyberslacking scale, K10 psychological distress scale, and general health questionnaire were used to collect data from adolescents and mothers.

Results:

The study showed that accessing online content and sharing are the most common online activities among participants, at 61.84% and 44.55%, respectively. The mean score of domains of cyberslacking, including sharing (P = 0.001), shopping (P = 0.001), real-time updating (P = 0.001), accessing online content (P = 0.001), and gaming (P = 0.001), were significantly higher among male adolescents than female. In contrast, psychological distress was slightly higher among female adolescents. Concerning mothers’ mental health, adolescents’ psychological distress was positively associated with mothers’ somatic symptoms (r = 0.117*, P = 0.007), anxiety (r = 0.183*, P = 0.005), and depression (r = 0.102*, P = 0.018). Shopping (r = 0.113*, P = 0.003) and updating content on social media (r = 0.185*, P = 0.005) also increased depression in mothers. Logistic regression exhibited that age (P = 0.011, odds ratio [OR]: 1.346), online gaming (P = 0.001, OR: 0.890), and shopping in adolescents (P = 0.001, OR: 0.946) predicted somatic symptoms, anxiety, and depression in mothers.

Conclusion:

Cyberslacking is associated with increased psychological distress and depression. Cyberslacking in adolescents correlated with depression, anxiety, and somatic symptoms in mother.
The Politics of Visibility in Community-based Conservation: Insights from a Village Forest in West Kalimantan, Indonesia
Authors: Thung Paul Hasan
Published: November 2024

Conservation organisations play a key role in portraying rural people and places to external audiences, driven by sectoral, political, and technological developments. While aiming to improve social and ecological outcomes, these policies and practices have been criticised for oversimplifying local realities to make them legible, ultimately exacerbating social inequality. However, critiques of legibility often focus on how conservation represents places to outsiders, neglecting the local power dynamics entangled with these representations. This paper shows how conservationist representations are co-produced by and, to varying extents, become visible to local communities. Through ethnographic engagement with the Manjau Village Forest in West Kalimantan, Indonesia, I elaborate on a political understanding of visibility. The politics of visibility is not just an imposition but the product of collaboration and contestation between local and external actors. As such, critiques of visibility can help illustrate the ambivalent relationships that exist between conservation and local communities, clarifying the micro-political risks and opportunities associated with community-based conservation.
Clinico-dermoscopic and Histopathological Evaluation of Benign Skin, Soft Tissue and Appendageal Tumours of Skin: A Cross-sectional Study from a Tertiary Care Hospital
Authors: Reyaz Saika , Rather Shagufta , Bilal Sheikh , Trumboo Taiba , Hussain Mateen
Published: November 2024

Background:

Benign skin, soft tissue and appendageal tumours of skin are one of the most frequently encountered skin disorders. An organised systematic approach along with dermoscopic and histopathological examination can aid in the diagnosis of these diverse disorders.

Objective:

To evaluate clinico-dermoscopic and histopathological findings of benign skin, soft tissue and appendageal tumours of skin in patients attending a tertiary care hospital.

Methods:

Cross-sectional hospital-based study where patients of all age groups irrespective of gender suspected of having benign skin, soft tissue and appendageal tumours were enrolled. Clinical, dermoscopic and histopathological findings were recorded and the agreements between them were evaluated using the Cohen's Kappa coefficient.

Results:

The study included a total of 415 patients with a mean age of 37.9 ± 15.59 years and a male to female ratio of 1:1.3. The mean duration of the disease was 4.3 ± 2.14 years. Soft tissue tumours were the commonest (60%), followed by benign skin tumours (24.3%) and benign appendageal tumours (17.1%). A good agreement between dermoscopic and clinical diagnosis was found (Cohen's Kappa = 0.879) and between dermoscopic and histopathological diagnosis was also found (Cohen's Kappa = 0.789).

Conclusion:

This study infers that benign tumours of the skin include a heterogeneous group of skin disorders affecting a heterogeneous population. Dermoscopy improved the diagnostic accuracy of this large group of skin disorders and reduced the number of unnecessary excisions; however, histopathology remains the benchmark diagnostic tool to differentiate these tumours from other benign tumours and their malignant counterparts.
A Rare Case of Adrenal Gland Metastasis from Parotid Adenocarcinoma: Unveiling the Potential Augmented Utility of FAPI PET/CT
Authors: Al-Ibraheem Akram , Abdulrahman Marwah , Alrousan Medyan , Haidar Mohamad
Published: November 2024

Conventional imaging techniques, while essential, occasionally fall short in identifying elusive metastatic lesions, leading to delayed diagnoses and compromised patient outcomes. Gallium-68 fibroblast activating protein inhibitor (68Ga-FAPI) positron emission tomography/computed tomography (PET/CT), leveraging the distinct affinity of fibroblast activation protein for cancer-associated fibroblasts, emerges as a promising solution to bridge this diagnostic gap. Parotid gland adenocarcinoma is a relatively rare malignancy with metastasis typically occurring in regional lymph nodes and distant sites such as the lungs and bones. However, there have been limited reported cases of rare metastatic sites such as the adrenal gland. This exceptional case report details the clinical presentation, diagnostic workup, and management steps of a rare case of a 47-year-old female patient diagnosed with parotid gland adenocarcinoma with confusing metastasis to the ipsilateral adrenal gland which was confirmed later with a follow-up 68Ga-FAPI PET/CT scan. We aim to highlight FAPI unique ability to illuminate metastatic foci in challenging anatomical locations.
Disseminated Multiple Organ Lymphoma Presented as Vulvar Lesion Diagnosed by [18F]FDG PET/CT
Authors: Koç Zehra Pınar , Özcan Pınar Pelin , İlhan Tolgay Tuyan , Yaldız Mehmet
Published: November 2024

We would like to present a 49-year-old female patient who was presented with a vulva lesion and palpable inguinal lymph nodes who were diagnosed with disseminated multiorgan involvement of high grade diffuse large B-cell lymphoma. The 18F-fluorodeoxyglucose positron emission tomography computerized tomography imaging showed multiple cervical, axillary, and abdominal lymph nodes, pulmonary nodules as well as gross hypermetabolic vulvar lesion.
Assessment of the Performance of the Dose Calibrator Used in Radioactivity Measurement
Authors: Hoang Dinh Xuan , Vu Truong Dinh , Dan Do Van , Nhan Nguyen Thanh
Published: November 2024

Aims:

This study aimed to evaluate the principal technical characteristics of a well-type gas-filled ionization chamber dose calibrator used in measuring radiopharmaceutical activity, namely accuracy, repeatability, and linearity. Furthermore, this work also explored the correlation between the device’s response and the position and volume of the radiopharmaceutical I-131.

Materials and Methods:

Experimental measurements were conducted on the ATOMLAB 500 dose calibrator using NIST traceable Cs-137 source to determine the accuracy and repeatability. For the linearity test, the Tc-99m solution produced at the Dalat Nuclear Research Institute, Vietnam was utilized to examine the performance of the device over a wide measurement range. Effects resulting from different volumes and measuring positions were also determined by experiments and Monte Carlo simulations.

Results:

Based on acceptance test results, it is revealed that the dose calibrator’s characteristics comply with international standards, where the deviations of accuracy, repeatability, and linearity are all lower than 1.0%. The response of the dose calibrator to different measuring positions and volumes was well controlled. To rectify the discrepancy in the response to the changes in solution volume, correction functions were proposed.

Conclusions:

It is concluded that the dose calibrator is suitable for radioactivity quantification and adheres to standards recommended by international organizations for nuclear medicine activities. The outcome of this work will serve as the foundation for establishing a standard for I-131 radiopharmaceuticals’ radioactivity in Vietnam.
Role of [18F]FDG-PET/CT in Evaluation of Tumor Response to Chemoradiation Therapy for Advanced Colorectal Cancer
Authors: Soni Abhishek , Chandola Stuti , Das Chandan Jyoti , Sharma Raju , Pathy Sushmita , Bhattacharjee Hemanaga Kumar , Chandrashekhara Sheragaru Hanumanthappa , Sharma Atul , Kumar Rakesh
Published: November 2024

Objectives:

The objective is to evaluate the efficacy of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) computed tomography (CT) in the evaluation of tumor response to preoperative/palliative chemoradiotherapy (CRT) for advanced colorectal cancer; including metastatic cancer at primary presentation and recurrent cancers with local and/or distant metastasis.

Materials and Methods:

Fifty patients with advanced rectal cancer underwent two point imaging with 18 FDG PET-CT before and after 3 weeks of completion of preoperative/palliative CRT in between 2016 and 2022. Patients with locally recurrent cancer also underwent radical surgery. The assessment consisted of the evaluation of the following metabolic PET parameters: Maximum standardized uptake value (SUVmax), SUVratio, metabolic tumor volume (MTV), and total lesion glycolysis (TLG). Response was assessed among the followed patients using RECIST 1.1 criteria.

Observations and Results:

There was a significant decline in the mean post therapy SUVmax and SUVratio as compared to baseline (P = 0.0001). Twenty-six out of 50 (52%) patients were classified as responders. A significant decrease in all parameters (SUVmax, SUVratio, TLG, and MTV) from baseline was observed in responders of the study when comparing with nonresponders (P < 0.05). Besides SUVmax and SUVratio, the mean posttherapy TLG was significantly reduced in responders than nonresponders (P = 0.0065).

Conclusion:

PET-CT is a useful combined anatomic and functional imaging modality in monitoring tumor response to preoperative/palliative CRT in advanced rectal cancer, whether primary or recurrent, including metastatic cancers at presentation. Posttherapy SUV and TLG in particular are significantly associated with treatment response.
To Sew or Not to Sew: A Case Report
Authors: Hambire Chaitali , Hambire Umesh
Published: November 2024

Introduction-Tongue injuries in children vary from slight lacerations to complete amputations. It could be due to fall, self-mutilation, epilepsy, child abuse, or sport injury. The anterior dorsum is the most common site followed by the mid dorsum and anterior ventral part. These injuries may cause dysfunction of tongue, hemorrhage, and disfigurement. Management of injuries of tongue in young children is challenging. There are no established guidelines for managing tongue lacerations. This is a case report of a three-year-old girl with a laceration on the anterolateral part of the tongue with non-approximating wound edges. The laceration extended from the dorsal to the ventral part. The parents were apprehensive about the surgical management of the injury due to the age of their daughter. Hence, healing of the injury with conservative management without suturing was achieved. Conclusion-The management of traumatic injuries of tongue in children is difficult due to their age and cooperation. The pediatrician has to decide whether to heal the tongue by primary or secondary intention. Our decision to allow the healing by secondary intention was successful. The tongue healed without any complications barring a small scar with satisfactory aesthetic and functional outcome. Both the parents and the child were satisfied with the management of the injury.
Case Report: Congenital Pulmonary Airway Malformation—A Rare Cystic Lung Malformation
Authors: Walia Gurpreet K. , Akal Ramanjit S. , Kinra Prateek
Published: November 2024

Congenital pulmonary airway malformation is a rare congenital malformation of the lower respiratory tract with a worldwide incidence of 1: 11,000 to 1: 33,000 live births. CPAM cases are increasingly being diagnosed antenatally with antenatal anomaly scans having been made compulsory with the availability of improved imaging technologies. Here, we present a case of CPAM in a 14-month-old child who was diagnosed with congenital anomaly during the antenatal scan and was managed with lobectomy to prevent further progression of the disease and preserve the function of normal residual lung parenchyma. Histopathological examination of the lobectomy specimen revealed CPAM type II. During clinical follow-up, the child is asymptomatic and is achieving his developmental goals as per his age.
NUT Midline Carcinoma at the Anterior Skull Base - A Case Report
Authors: Swain Santosh K. , Anwer S. P. A , Pradhan Pradeep , Adhya Amit K.
Published: November 2024

An uncommon and severe form of human malignancy is called NUT midline carcinoma (NMC). The mediastinum or midline of the upper aerodigestive tract contains the majority of NMCs. A chromosomal rearrangement affecting the NUT gene, which produces oncoproteins regarded as a major pathogenic driver of cellular transformation, is the genetic cause of NMC. When a commercial antibody against NUT is available, NMC can be diagnosed, and the diagnosis is confirmed by positive nuclear immunohistochemistry staining. There is no standard treatment for NMC to date. There may be a multimodal approach for NMC such as chemotherapy, surgical intervention, and radiotherapy adopted currently in clinical practice. Despite aggressive radiation therapy and chemotherapy, the typical survival is less than 1 year. The majority of cases with NMC die due to local complications of the tumor or complications due to treatment. Here, we are presenting a case of NMC in young adults with isolated involvement of the anterior skull base with bony erosion and intracranial extension.
An Unusual Presentation of Pulmonary Sequestration - A Case Report
Authors: Kumar Kunal , Sharma Neeraj , Rana Sandeep , Grewal Darshan S. , Chaudhary Robin , Vasan Amit S.
Published: November 2024

Pulmonary sequestration is an uncommon congenital anomaly. It is usually diagnosed at a young age but can present in adults with recurrent episodes of pneumonia and cough. Isolated shortness of breath is an uncommon presentation of pulmonary sequestration and is rarely reported. We describe an adult male who presented with exertional dyspnea at a high altitude and was eventually diagnosed as a case of pulmonary sequestration. It is an uncommon developmental anomaly that can go undetected at a young age. In adults, it can present as isolated dyspnea, and a thorough work-up can lead to an accurate diagnosis.
Multilocular Cystic Renal Neoplasia of Low-grade Malignant Potential: Evolving Diagnostic Criteria: A Case Report with Review of Literature
Authors: Chandanwale Shirish S. , Singh Madhuri , Rajpurohit Sravya , Raj Akshi , Patil Saurabh S.
Published: November 2024

Multilocular Cystic Renal Neoplasm of Low Malignant Potential (MCRNLMP) is a distinct type of clear cell renal tumor. The diagnostic histological criteria for this entity have evolved, and specific histological features have been modified over the years. The WHO 2022 of Male Urinary System and Male Genital Tumours respecified diagnostic histopathological features. Maximum tumors are asymptomatic and are incidentally detected on radiological examination. Computed tomography using contrast agents is still the gold standard for classifying cystic tumors of kidney. The Bosniak category of renal cystic lesions is crucial for the management of other imaging modalities such as magnetic resonance imaging (MRI) and contrast-enhanced ultrasound, which can be used with the same effectiveness. The prognosis is excellent in MCRNLMP, and there are no reports of cancer progression or metastasis. Minimally invasive nephron-sparing surgery with strict clinical including imaging follow-up with contrast-enhanced computerized tomography and magnetic resonance imaging is a choice of treatment.
High-Resolution Vessel Wall Imaging in Primary CNS Vasculitis: A Case Series
Authors: Rohatgi Shalesh , Rangankar Varsha , Rao Prajwal , Nirhale Satish , Naphade Pravin , Hatekar Khushboo
Published: November 2024

High-resolution vessel wall imaging (HRVWI) is a relatively new technique in which vessel walls can be imaged suppressing the cerebrospinal fluid and blood signals. If there is inflammation of the vessel wall (vasculitis) it will show contrast enhancement. This is the only modality which is available to study vessel walls. All angiography techniques including Magnetic Resonance Angiography(MRA), Contrast computerized tomography angiography (CT -Angiography), and digital subtraction angiography (DSA) shows only the state of the lumen of the blood vessel. Involvement of blood vessels in Central Nervous system (CNS) can occur in systemic vasculitis (like microscopic polyangiitis, Polyarteritis nodosa, etc) where there is evidence of other organ involvement or primary CNS vasculitis (PCNSV) in which only involvement of the brain and spinal cord occurs. PCNSV is a rare disease and till now only the brain biopsy is the gold standard for definitive diagnosis. Brain biopsy is an invasive procedure, not always available, and many patients don’t give consent for the procedure. HRWVI can complement the angiography in the diagnosis of CNS vasculitis, especially PCNSV. Here we describe a case series of 4 cases of CNS vasculitis (3 cases of possible PCNSV and one vasculitic moya- moya syndrome) who had presented with stroke, All had abnormal Cerebrospinal fluid (CSF) and HRVWI showed contrast enhancement of the vessel wall indicating the possibility of vasculitis. In two cases, there was involvement of medium-sized arteries (middle cerebral artery), one patient had unilateral internal carotid artery (ICA) involvement and one had bilateral supra- clinoid stenosis of ICA associated with hyperthyroidism (vasculitic Moyamoya syndrome).
Role of High-Resolution Computed Tomography in Classifying Pneumatization of the Temporal Bone: Typical Patterns, Prevalence, and Implications
Authors: Rohit RC , Chandru Assvath Oobula , Babu Sathish S , Natarajan Kavya Priyadharshini
Published: November 2024

Introduction:

Pneumatization patterns in the temporal bone have been implicated in the prognostic outcomes of various pathological conditions, such as cholesterol granulomas, otitis media, and cholesteatomas. This study investigated how high-resolution computed tomography (HRCT) helps to classify pneumatization patterns in the temporal bone, exploring its impact on the pathogenesis, surgical outcomes of temporal bone diseases, and its association with age and gender.

Methods:

HRCT of temporal bone of fifty patients of age 13 years and more with normal findings were included. The petrous apex, mastoid, and infra-labyrinthine regions’ pneumatization patterns were categorized using previously published grading methods.

Results:

The dominant pattern of pneumatization in the petrous apex was classified as group 2, indicating that less than 50% of the pneumatization was located medially in the labyrinth. Conversely, in the mastoid, the prevailing pattern was group 4, which signifies hyper-pneumatization. In the infra-labyrinthine region, the prevailing pattern was categorized as type B, indicating limited pneumatization. It was found that patients who exhibited augmented pneumatization in one compartment of the temporal bone tended to display similar changes on the opposite side and in other compartments on the same side (P < 0.05). Importantly, it was observed that younger age (P < 0.001) and male gender (P = 0.001) were associated with increased pneumatization in the petrous apex and infra-labyrinthine compartments.

Conclusion:

Different compartments of temporal bone show varying degrees of pneumatization. The level of pneumatization of the temporal bone is highly associated with age and sex.
Challenges and Opportunities in Deceased Organ Donation Program: Insights from a Tertiary Care Hospital in South India
Authors: Sen Mousumi , Johnson Latif R. , James Ranjit I. , Manoj Daniel , Joseph Vivek , Nair Shalini , Abhilash KPP
Published: November 2024

Background:

Organ transplantation is a critical medical intervention for patients with end-stage organ failure. Deceased organ donation plays a pivotal role in meeting the demand for organs. However, there exists a significant disparity between the need for organs and their availability, especially in low-income countries. India, despite its potential donor pool, faces a severe shortage of organs for transplantation.

Materials and Methods:

This retrospective study analyzed hospital records of 116 potential deceased organ donors from 2013 to 2020. Data encompassed demographics, next-of-kin consent for organ transplantation, and circumstances of injury.

Results:

Results revealed that 85.34% of potential donors were men, and 14.66% were women. After counseling, 71.55% (83/116) of the families consented to deceased organ donation. Most potential donors fell within the 21–30 age group (25.88%). The majority of donors (80.17%) died due to road traffic accidents (RTAs), primarily two-wheeler drivers constituted the largest group of deceased (51.72%).

Conclusion:

Bridging the gap between organ demand and supply in India necessitates addressing the lack of awareness regarding brain death and organ transplantation. Collaborative efforts involving NGOs, healthcare institutions, media, and government bodies are essential to raise awareness and improve donation rates, especially in public health centers. Establishing guidelines for compassionate discussions with families about organ donation is imperative.
Pulmonary Aspergillosis: An Observation from a Tertiary Care Hospital of Western Uttar Pradesh
Authors: Naj Zeba , Singh Peetam , Pandey Anita
Published: November 2024

Background:

Aspergillus is the most frequently occurring fungal infection in immunocompromised patients with a high mortality rate. Invasive pulmonary aspergillosis is the most serious entity on the spectrum of pulmonary aspergillosis. Limited studies on the occurrence of pulmonary aspergillosis from this geographical area prompted us to carry out this study.

Materials and Methods:

This hospital-based cross-sectional observational study was carried out in the Postgraduate Department of Microbiology of a tertiary care medical teaching hospital in western Uttar Pradesh for one year. A total of 1032 respiratory samples were subjected for isolation and identification of fungal pathogens by direct microscopic examination (KOH mount) and culture on Sabouraud dextrose agar.

Results:

The isolation rate of pulmonary aspergilli was 6.97%. The majority of the respiratory samples received were sputum 900 (87.2%) followed by bronchoalveolar lavage fluid 132 (12.7%). The pulmonary pathology was predominantly seen in the age group of 41–50 years (25%). Male patients (69%) were predominant. The majority of the samples (50%) were from the respiratory medicine ward followed by the respiratory medicine ICU (25%). Aspergillus fumigatus (58%) was the predominant species isolated followed by Aspergillus flavus (25%).

Conclusion:

Isolation of Aspergillus species from patients of pulmonary pathology needs to be correlated clinically to rule out colonization as they may need proper antifungal treatment. Indiscriminate use of antifungals may lead to the emergence of antifungal drug resistance.
Evaluation of Ascitic Fluid Cytology in a Tertiary Hospital in South-Western Nigeria: A 7-year Retrospective Study
Authors: Oguntoye Oluwatosin O. , Oguntoye Oluwafunmilayo A. , Adeniyi Olawale M. , Osasona Oluwadamilola Gideon , Nkereuwem Precious E.
Published: November 2024

Background:

Ascites is the pathological accumulation of fluid within the peritoneal cavity of varied etiology. Various abnormalities can be detected through cytological analysis of ascitic fluid. Ascitic fluid cytology (AFC) is a rapid and cost-effective means of evaluating ascites to establish its nature and cause.

Aim:

To evaluate ascitic fluid cytological findings over a seven-year period and to correlate the cytological features with the clinical profile of the patients.

Materials and Methods:

This was an observational retrospective study conducted in a healthcare facility in south-western Nigeria. The reports of AFC tests performed from January 1, 2016 to December 31, 2022 were retrieved to obtain the following information for analysis: Age, Gender, Tribe, Year of the test, Provisional diagnosis, and Cytological diagnosis.

Results:

The data of a total number of 121 patients were analyzed; 61 males (50.4%) and 60 females (49.6%) with a mean (±SD) age of 51.51 ± 15.22. Decompensated cirrhosis was the commonest clinical diagnosis 65 (53.7%) followed by hepatocellular carcinoma 11 (9.1%). Ascitic fluid cytological findings showed 45 (37.2%) were positive for malignant cells; 46 (38.0%) were negative for malignant cells; 13 (10.7%) were suspicious for malignancy; 9 (7.4%) were acellular smears; and 8 (6.6%) were inflammatory smears. The ascitic fluid of only 4 out of 11 patients with hepatocellular carcinoma tested positive for malignant cells, giving a sensitivity of 36.4%.

Conclusion:

AFC remains very useful in the diagnostic work-up of patients with ascites but should not be completely relied upon in confirming a malignancy, other additional diagnostic investigations should be deployed.
Transect Walk in the Community, a Tool to Understand Community Resources by Medical Undergraduates of an Academic Institution
Authors: Pal Debkumar , Sahoo Bimal Kumar , Taywade Manish , Behera Binod Kumar , Mishra Abhisek , Roychowdhury Arka , Dora Susmita , Das Kajal
Published: November 2024

Introduction:

A transect walk is a methodological walk in a well-defined pathway within a particular community/society while simultaneously drawing attention to the location of the community, distribution of resources, different social problems, and the opinion of local people regarding those problems. It is a well-accepted method related to participatory research action. However, the transect walk should have been utilized in the context of undergraduate medical education. Thus, we conducted this study to understand the feasibility and utilization of transect walks in undergraduate medical education.

Methodology:

We conducted a transect walk activity involving 25 undergraduate students in a village under the rural field practice area of the Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Bhubaneswar. We prepared a checklist before conducting the transect walk based on available literature. The checklist was prepared for conducting a resource type of transect walk. The students were divided into four small groups and finally prepared a common diagram after merging all initial diagrams for better understanding and utilization of the activity.

Results:

The student identified different housing types, various water sources, and places for garbage disposal. They also identified important institutions like banks, local administration offices, and schools. The problem such as the absence of a wastewater disposal system, was identified during this activity.

Conclusion:

Students utilized the transect walk to understand the various public health issues and resources. This method was found to be an effective way of understanding different community resources.
Can Fasting Practices Improve Vitamin D Levels?
Authors: Nair Pradeep M.K , Silwal Karishma , Nagarkar Aarti
Published: November 2024

Vitamin D deficiency is emerging as a very serious public health problem. Numerous epidemiological studies link vitamin D deficiency to the pathophysiological process of several acute and chronic diseases. Sun exposure, vitamin D supplementation, and fortification of foods with vitamin D are the present strategies adopted to tackle this epidemic. While this can be effective, recent evidence suggests the need to consider the multifaceted causation of vitamin D deficiency such as impaired liver function, kidney function, hyperparathyroidism, and endocrine dysfunction. Therapeutic fasting, a popular nutritional approach has shown to have a positive association with vitamin D levels. This perspective attempts to provide an overview of literature discussing fasting and vitamin D, the possible mechanisms behind this association, and discusses the future possibilities of using fasting as a public/clinical tool in mitigating vitamin D deficiency.
Interdisciplinary approach in the management of visual loss in giant cell arteritis
Authors: De Simone Luca , Marvisi Chiara , Ricordi Caterina , Gozzi Fabrizio , Bolletta Elena , Gentile Pietro , Muratore Francesco , Cimino Luca , Salvarani Carlo
Published: November 2024

Giant cell arteritis (GCA) is the most common vasculitis among older patients in western countries. A correct diagnosis permits the prompt initiation of glucocorticoids, which still represent the cornerstone of treatment. One of the most feared complications of the disease is sudden visual loss and other ischemic events causing visual disturbances. In these cases, an interdisciplinary approach between ophthalmologists and rheumatologists is crucial to avoiding any diagnostic delays and to permitting correct clinical assessment without subjecting the patient to unnecessary treatment. In this review, we discuss the main causes of visual disturbances in GCA, particularly the causes of sight loss, outlining the red flags that should raise suspicion in ophthalmologists and rheumatologists.
Neuro-Quantum Cyber-Physical Intelligence (NQCPI)
Authors: Perdigão Rui A. P.
Published: November 2024

Neuro-Quantum Cyber-Physical Intelligence (NQCPI) is hereby introduced, entailing a novel framework for nonlinear natural-based neural post-quantum information physics, along with novel advances in far-from-equilibrium thermodynamics and evolutionary cognition in post-quantum neurobiochemistry for next-generation information physical systems intelligence. NQCPI harnesses and operates with the higher-order nonlinear nature of previously elusive quantum behaviour, including in open chaotic dissipative systems in thermodynamically and magneto-electrodynamically disruptive conditions, such as in natural biological and environmental systems, thereby paving new pathways for post-quantum information technologies, including new paradigms for information encoding, encryption, transmission and security elusive to SoA post-quantum approaches. NQCPI further harnesses and operates with novel quantum properties including new classes of high-order emergence and entanglement structures, new neuro-quantum physical properties, with higher-order post-quantum-proof improvements in security, storage and relaying of information. It further empowers new capabilities to disarm security protocols of adversarial powers including those already at SoA quantum and post-quantum levels. This new technology is implemented into a novel coevolutionary system-of-systems seamlessly operating across classical, quantum, post-quantum cryptographic and key distribution approaches, thereby generalising them with added value whilst ensuring backward compatibility for seamless articulation with legacy and SoA protocols. Having demonstrated disruptive added value relative to post-quantum security, NQCPI is also tested and implemented in other quantum technological developments, ranging from sensing to communication and computation, in articulation with QITES (Quantum Information Technologies in the Earth Sciences), QuASI (Quantum Aerospace Systems Intelligence), AIPSI (Augmented Information Physical Systems Intelligence), and Synergistic Nonlinear Quantum Wave Intelligence Networks (SyNQ-WIN), respectively from Perdigão (2020, 2023) and Perdigão and Hall (2023, 2024). Perdigão, R.A.P. (2020): QITES - Quantum Information Technologies in the Earth Sciences. https://doi.org/10.46337/qites.200628 Perdigão, R.A.P. (2023): QuASI - Quantum Aerospace Systems Intelligence. https://doi.org/10.46337/quasi.230901 Perdigão, R.A.P.; Hall, J. (2023): Augmented Information Physical Systems Intelligence (AIPSI). https://doi.org/10.46337/230414 Perdigão, R.A.P.; Hall, J. (2024): Synergistic Nonlinear Quantum Wave Intelligence Networks (SyNQ-WIN). https://doi.org/10.46337/240118
Roles involved in school violence: links with the problematic use of social networking sites, self-esteem, and loneliness in adolescents.
Authors: Moreno-Ruiz David , Montero Montero David , Romero-Abrio Ana , Musitu-Ochoa Gonzalo
Published: November 2024

The objective was to analyse the relationships between multidimensional self-esteem (academic, social, emotional, family, and physical), loneliness, the problematic use of social networking sites (PUSNS) and the different roles involved in school violence - non-involved, aggressors, victims and victim-aggressors-, depending on sex. Participants included 1,930 adolescents (50.2% girls) aged 12 to 18 years, schooled in the province of Seville (Spain). A MANOVA (4x2) was performed. Significant relationships were observed between the different school violence roles, loneliness, multidimensional self-esteem, and PUSNS. Specifically, depending on the dependent variables analysed, victims-aggressors presented a more negative profile than the rest of the roles observed, and the non-involved showed the best adjustment. It is also remarkable that the groups with the lowest scores in PUSNS are the two groups of non-involved individuals, both boys and girls, and the group of male victims. To finish, we describe the practical implications of the study.