bluuebunny/crossref_metadata_2025 huggingface dataset:
Les terres rares d’Afrique, un potentiel recours pour l’Union européenne dans le respect du droit international
Authors: Ngom Abdoulaye
Published: November 2022

Pour sa transition énergétique et écologique à l’ère du numérique, l’Union européenne (UE), face au monopole chinois et aux limites de ses capacités de recyclage et de substitution, doit sécuriser son approvisionnement en terres rares. L’Afrique peut quant à elle s’ériger en producteur et fournisseur de l’UE. Pour cela, les pays d’Afrique producteurs de terres rares doivent s’appuyer sur le droit international pour maîtriser les enjeux liés à la pollution délocalisée. Émerge ainsi un besoin face aux enjeux géo-économiques, aux défis géopolitiques ou aux dangers écologiques liés à l’exploitation des terres rares africaines : celui d’une conscience écologique globale et d’un encadrement juridique international, qui sont toujours en gestation.
L’évolution normative de la CEDEAO en matière d’investissement : une analyse des règles substantielles de l’ECOWIC
Authors: Tossa Mawuto
Published: November 2022

La Communauté Économique des États de l’Afrique de l’Ouest (CEDEAO) a toujours nourri l’ambition de construire un marché commun des investissements susceptible de stimuler le flux des investissements dans la région. Or, l’édification d’un tel marché commande la production de normes communautaires d’investissement. Cette communauté économique régionale s’est alors engagée dans un processus d’harmonisation des règles et politiques d’investissement de ses États membres, lequel s’est soldé par l’adoption, en 2008, de l’Acte additionnel portant sur les règles communautaires d’investissement et leurs modalités d’application. Une décennie plus tard, attentive aux évolutions économiques et socio-politiques dans ses États membres, la CEDEAO va adopter un Code communautaire des investissements : l’ECOWIC. La présente étude ambitionne de décrypter les aspects substantiels des nouveautés apportées par ce nouvel instrument juridique d’investissement. De par ses dispositions novatrices, l’ECOWIC marque une rupture avec les accords internationaux d’investissement « à l’ancienne » et mérite dès lors une attention particulière.
La sagesse philosophique à l’épreuve des incertitudes contemporaines
Authors: Greisch Jean
Published: November 2022

En ces temps d’incertitude généralisée, la sagesse, pratique ou théorique, est une denrée rare. La formule « sagesse de l’incertitude », par laquelle Milan Kundera caractérise l’art du roman, peut recevoir un sens philosophique qui ne se limite pas à un scepticisme ravageur, si la philosophie, qui affronte les multiples formes de la violence, se donne pour tâche de « devenir raisonnablement raisonnable » (E. Weil).
De la certitude et de l’incertitude de la foi
Authors: Askani Hans-Christoph
Published: November 2022

L’être humain cherche une sécurité dans son rapport au monde et dans sa relation avec lui-même. Il cherche une sécurité aussi face à Dieu. Une vraie sécurité serait donnée par un savoir qui couvre tout, telle est la conviction de l’homme moderne. La certitude est autre chose que la sécurité. Devant Dieu toute sécurité risque d’aboutir à l’idolâtrie. La foi ose un autre rapport à Dieu. Et Dieu ose un autre rapport à l’être humain. C’est en découvrant cette dimension du rapport entre Dieu et l’homme que des théologiens aussi différents que Martin Luther et Saint Ignace de Loyola se rapprochent pour un moment.
L’absurde idéal de certitude
Authors: Riquier Camille
Published: November 2022

Il serait peut-être temps d’en finir avec l’idéal de certitude qui, à bien y penser, doit révéler l’absurdité de sa quête. Il s’agit du moins de donner les quelques raisons que nous avons de soupçonner l’effet de mirage qu’il a longtemps pu susciter chez ceux qui courent après lui. Car, hommes de savoir ou hommes de foi, pour peu qu’on s’attache à ce qu’ils font plutôt qu’à ce qu’ils disent faire ou à ce qu’ils disent plutôt qu’à ce qu’ils disent dire, force sera alors de conclure que dans les faits ils n’ont jamais érigé la certitude absolue au rang de fin suprême.
Du « service rebelle » aux rebelles « de service »
Authors: Crunel Bérénice
Published: November 2022

Au sein d’une prestigieuse institution culturelle se déroule une longue lutte de (dis)qualification de l’image ouvrière et contestataire des techniciens, notamment des machinistes. Aux côtés des porte-parole syndicaux de ces personnels subalternes, cet article questionne particulièrement le poids des routines institutionnelles, syndicales et managériales sur la mise en forme et les possibilités d’expression d’une critique à la fois professionnelle et sociale. Source de fierté collective et emblème d’une certaine autonomie culturelle, cette image rebelle entretient des logiques pratiques de politisation et de contestation d’un ordre institutionnel teinté de mépris de classe. Ces représentations, auxquelles les techniciens adhèrent plus ou moins selon leur trajectoire, soutiennent un syndicalisme de lutte délégitimé par les dirigeants de l’établissement qui retournent cette image contestataire en posture d’opposition systématique, traditionnelle et dépassée. Ce point de vue est renforcé dans les réunions de négociation, codifiées par les politiques d’incitation au « dialogue social » qui, jusque dans leur configuration matérielle, contribuent à encadrer, contourner ou disqualifier les revendications portées par ces syndicalistes hétérodoxes. À rebours de « l’horizontalité entre partenaires sociaux » affichée, ces dispositifs concourent surtout au rappel à l’ordre, indissociablement institutionnel et social, des travailleurs subalternes de cette « Maison ».
Juger la traite des êtres humains en France et en Allemagne
Authors: Darley Mathilde
Published: November 2022

Différents travaux ont déjà analysé les politiques de contrôle de la traite des êtres humains et d’accompagnement de ses victimes à partir de leur mise en œuvre policière et associative. Le procès pour traite à des fins d’exploitation sexuelle, instance ultime de qualification des faits, est cependant resté relativement sousexploré, en dépit de son caractère central dans la production d’une « vérité judiciaire » et l’identification des victimes et auteur·es. À partir d’une ethnographie conduite dans des tribunaux français et allemands, il s’agit ici d’interroger la production pénale de la figure de victime d’exploitation sexuelle au sein de deux modèles législatifs que l’on oppose couramment en matière de régulation de la prostitution et du proxénétisme. Par-delà les contrastes, on développera l’idée que la figure de la victime de traite à des fins d’exploitation sexuelle, en raison des projections sexualisées et racialisées dont elle fait l’objet, révèle avant tout une certaine conception de la femme et de son rapport à la nation.
Alteration of the faecal microbiota composition in patients with constipation: evidence of American Gut Project
Authors: Xu Y.S. , Wang Y.H. , Liu Y. , Sun X. , Xu J.S. , Song Y. , Jiang X. , Xiong Z.F. , Tian Z.B. , Zhang C.P.
Published: November 2022

There is limited information is known about the composition difference of the gut microbiota in patients with constipation and healthy controls. Here, the faecal 16S rRNA fastq sequence data of microbiota from the publicly available American Gut Project (AGP) were analysed. The tendency score matching (PSM) method was used to match in a 1:1 manner to control for confounding factors age, gender, body mass index (BMI), and country. A total of 524 participants including 262 patients with constipation and 262 healthy controls were included in this analysis. The richness and evenness of the gut microbiota in the constipation group were significantly lower than those in the control group. The dominant genera in the constipation group include Escherichia_Shigella, Pseudomonas, and Citrobacter. The dominant genera in the control group include Faecalibacterium, Prevotella, Roseburia, Clostridium_XlVa, and Blautia. The abundance of three butyrate production-related pathways were significantly higher in the constipation group than in the control groups. There was no significant difference in the diversity and gut microbiota composition in patients with constipation at different ages. In conclusion, patients with constipation showed gut microbiota and butyrate metabolism dysbiosis. This dysbiosis might provide a reference for the diagnosis and clinical therapy of diseases.
Ingestion of Lactobacillus helveticus WHH1889 improves depressive and anxiety symptoms induced by chronic unpredictable mild stress in mice
Authors: Gao K. , Chen C.-L. , Ke X.-Q. , Yu Y.-X , Chen S. , Liu G.-C. , Wang H.-F. , Li Y.-J.
Published: November 2022

Emerging evidence indicates that the alterations in the gut microbiota-brain axis (GBA), which is the bilateral connection between the gut microbial communities and brain function, are involved in several mental illnesses, including depression. Certain probiotic strains have been revealed to improve depressive behaviours and the dysregulation of 5-hydroxytryptamine (5-HT) metabolism in depression. Here we evaluated the potential antidepressant effects of Lactobacillus helveticus strains using an in vitro enterochromaffin cell model (RIN14B). The L. helveticus strain WHH1889 was shown to significantly promote the level of 5-hydroxytryptamine (5-HTP, 5-HT precursor) and the gene expression of tryptophan hydroxylase 1 (Tph1), which is the key synthetase in the 5-HT biosynthesis in RIN14B cells. Ingestion of 0.2 ml WHH1889 (1´109 cfu/ml) in a chronic unpredictable mild stress (CUMS) mouse model of depression for five weeks normalised depressive and anxiety-like behaviours in the forced swim test, tail suspension test, sucrose preference test, and open field test. Meanwhile, the CUMS-induced elevated level of serum corticosterone and declined levels of hippocampal 5-HT and 5-HTP were reversed by WHH1889. Furthermore, the disturbances of the gut microbiome composition with reduced microbial diversity were also improved by WHH1889, accompanied by the increased colonic 5-HTP level and Tph1 gene expression. In summary, these findings indicate that WHH1889 exerts antidepressant-like effects on CUMS mice, which is associated with the modulations of the 5-HT/5-HTP metabolism and gut microbiome composition. Therefore, ingestion of the L. helveticus strain WHH1889 with antidepressant potentials may become an encouraging therapeutic option in the treatment of depression.
Virtual Tours as Emerging Technologies to Engage Children and Youth with their Country’s Historical Conflicts
Authors: Nicolaidou Iolie , Zupančič Rok , Fiedler Anke , Andresen Kenneth , Hoxha Abit , Ntaltagianni Christina , Aivalioti Maria , Kasapovic Mak , Milioni Dimitra
Published: November 2022

Virtual Reality (VR) is increasingly used for visiting historic places. Research on VR experiences in dark tourism (that focuses on mortality) focuses almost exclusively on adults. No studies were found that used virtual tours to engage children with their own country’s conflicts. The present study addresses this gap by designing and developing virtual tours in four cities of Europe with a troubled past. Virtual tours engage children and youth in historical conflicts using multi-perspective storytelling. The aim of this pre-test post-test comparative case study is to examine the change on students’ perceptions of their country’s troubled past after their interaction with a virtual tour of their capital. A secondary aim is to document students’ evaluation of the virtual tour. A questionnaire examining students’ perceptions was completed before and after students’ individual interaction with a virtual tour. Participants included 360 students (212 from Cyprus, 42 from Germany, 63 from Bosnia-Herzegovina, and 44 from Kosovo). Findings indicate a statistically significant positive change in perceptions of troubled pasts for primary/secondary students from Cyprus, Bosnia-Herzegovina, and Germany. Preliminary results are promising and indicate the effectiveness of virtual tours as tools that can have an effect on students’ perceptions of troubled pasts, particularly for children rather than young adults. Students’ evaluation of the virtual tours was positive, irrespectively of participants’ age, indicating high acceptability.
Learning Game with Stroke Paralysis Rehabilitation for Virtual Reality
Authors: Ketcham Mahasak , Ganokratanaa Thittaporn , Pramkeaw Patiyuth
Published: November 2022

The work is presented for arm paresis patients in rehabilitation phase, consisting of an arm movement but slower than normal ones. Since most patients with lacking motivation affect the physical therapy, they are not willing to follow program of rehabilitation. This work aims to design a game for arm paresis patients in rehabilitation phase with virtual reality. The control system is designed using unity, oculus rift and oculus touch. For the system, the game contains three different levels. A goal of level 1 is to drag and drop an object in X radius. Level 2 is to pick up books to bookshelf in Y radius, and level 3 is to pick ingredients to cauldron in X and Y radius. As a results, the satisfaction survey on usage is satisfied. Besides, the game's development should be more varied to make patients have more fun and motivated in physical therapy.
A Model for Scripting and Designing a Digital Textbook
Authors: Moundy Kamal , Chafiq Nadia , Talbi Mohammed
Published: November 2022

The digital transformation of institutions renovates universities to strengthen the integration of educational technologies with a focus on the quality of learning. Our objective is to analyze the needs of students to determine the essential indicators to be used in the design of a digital textbook of soft skills, to measure the approval of the textbook by specialists and to measure the concordance of the criteria of the textbook with the expectations of students. The sample consisted of 60 university students and 8 educational and technical specialists. A digital textbook scripting and design model is designed to assist in the design of the textbook. The results showed that the identification of students' needs led to the conclusion that they are interested in learning through active teaching and learning methods, through the integration of ICT tools and using a textbook. In addition, students and pedagogical and technical specialists were satisfied with the digital textbook designed and to be used.
A Study on Data-Driven Teaching Decision Optimization of Distance Education Platforms
Authors: Zhao Lili
Published: November 2022

Distance education requires the teachers’ teaching decisions to be innovative, thus it’s very meaningful to optimize the distance education elements, upgrade the teaching activity quality, and realize sustainable development. Existing studies generally make selections on distance education schemes based on empirical knowledge, however, since the decision parameters are often of poor time-efficient and prone to human caused errors, the efficiency and accuracy of the output decisions can hardly meet requirements. Therefore, to overcome these shortcomings, this paper aims to study the optimization of teaching decisions based on the teaching data of distance education platforms. At first, a hybrid neural network integrating the Bi-directional Long and Short Term Memory (Bi-LSTM) model and the Convolution Neural Network (CNN) was introduced into the Teaching Decision-making Optimization (TDO) model to capture the features of bi-directional time series of teaching decisions and build feature space with stronger expression ability. Then, a multi-objective TDO model was built based on fuzzy logic reasoning, which was then used to solve the problem during teaching decision-making that it’s difficult for multiple decision element combinations in distance education to meet standards at the same time. At last, experiments verified the validity and superiority of the proposed model.
An Intelligent Autonomous Document Mobile Delivery Robot Using Deep Learning
Authors: Ganokratanaa Thittaporn , Ketcham Mahasak
Published: November 2022

This paper presents an intelligent autonomous document mobile delivery robot using a deep learning approach. The robot is built as a prototype for document delivery service for use in offices in which it can adaptively move across different surfaces, such as terrazzo, canvas, and wooden. In this work, we introduce a convolutional neural network (CNN) to recognize the traffic lanes and the stop signs with the assumption that all surfaces have identical traffic lanes. We train the model using a custom indoor traffic lane and stop sign dataset with the label of motion directions. CNN extracts a direction-of-motion feature to estimate the robot's direction and to stop the robot based on an input image monocular camera view. These predictions are used to adjust the robot's direction and speed. The experimental results show that this robot can move across different surfaces along with the same structured traffic lanes, achieving the model accuracy of 96.31%. The proposed robot helps to facilitate document delivery for office workers, allowing them to work on other tasks more efficiently.
Mobile Application Design: Caries Health Care for Children
Authors: Leon-Ayala Ricardo , Andrade-Arenas Laberiano
Published: November 2022

Tooth decay is a problem that occurs in every person. However, children are the most vulnerable due to their diet, the consumption of foods high in sugar and poor oral hygiene. Due to this problem, the design of a mobile application was developed with the objective of preventing tooth decay in children, encouraging good oral hygiene habits in children. The mobile application basically teaches the child with the help of 3D modeling the correct way to brush his or her teeth. In addition, of using the smartphone camera to capture a photograph of the teeth. In this way it performs the analysis applying artificial intelligence to diagnose if the patient presents symptoms of caries. Also, creates a dependency of the child on the application each time he/she brushes correctly. The application provides bonuses for progressing and unlocking new interactive features; this way, attention is captured and a good habit is maintained. The agile Scrum methodology was used because it presents an orderly structure and allows adaptability. Also, offers a wide variety of graphical tools and strategies capable of displaying information in a structured way.
Using Machine Learning to Analyze the Learning Process for Solving Mathematical Problems
Authors: Bauyrzhan Nauryzbayev , Sakysh Baygamitova , Zhanar Akhmetova , Nikolay Pak , Ardak Karipzhanova , Kumys Urazbaeva
Published: November 2022

The relevance of the research under consideration is due to the need to improve the efficiency of the analysis of the quality, and completeness of the knowledge obtained by students when solving computational problems, the example problems in mathematics. The theoretical argumentation is proposed and the practical implementation of an intelligent automated analytical system for analyzing the quality and forecasting the content of educational material and the trajectories of the student's learning direction is described. The relevance of the research is the creation of neural network algorithms that allow analyzing the dynamics of changes in the student's level of formation of skills to solve arithmetic problems. The methods of analyzing the assimilation of educational information and methods of personalized construction of the curriculum for each student are substantiated.
Diurnal and Nocturnal Cityscapes in Miami Vice
Authors: Du Verger Jean
Published: November 2022

Amid intense inter-network rivalry and the proliferation of cable, pay television and a nascent and competitive video industry, the major American Networks in the 1980s were faced with major challenges if they wished to continue attracting audiences and profits as they had during the 1970s. Miami Vice, which ran for five seasons on NBC between 1984 and 1989, was probably one of the most influential and innovative episodic series of the decade. Following Julia Kristeva’s assumption that urban space can be understood and analysed as a text, the present paper will therefore examine the role of the city of Miami as the show’s main character, before deciphering the possible readings of the diurnal and nocturnal cityscape in relation to the influence of noir and neo-noir films, which are traditionally associated with a city’s “mean streets”. Consequently, the present study will attempt to demonstrate how the show offers a vision of the post-modern city during the Reagan years, while pinpointing the crucial influence the series had on the networks’ future primetime episodic crime series as well as – more surprisingly – its impact on the city’s urban renovation.
The Importance of the Central Role of the Brand Experience
Authors: Mesfar Sahar , Ltifi Moez
Published: November 2022

With economic advancement, technological development, and the emergence of new trends related to brands, consumer behavior has been transformed as a result of several factors that influence their decision making towards a product, service, or brand. For this, it is necessary to know the importance of the brand experience in determining consumer behavior and intentions. The authors mobilize two theories on which to base their model and to formulate their research hypotheses. The investigation is one of the first empirical investigations of the determinants and consequences and the central role of brand experience. The purpose of this chapter is to propose a new model in the marketing literature. This model proposes (1) to test the central role of brand experience; (2) to measure its effects on customer loyalty, brand love, and emotional value brand; and (3) to measure the effects of customer engagement, sensory marketing, and customer loyalty as antecedents of brand experience. These three contributions make the research original.
E-Word of Mouth and Purchase Intention
Authors: Mishra Manoj Kumar , Sharma Nidhi , Kumar Sunil
Published: November 2022

The aim of the study is to investigate the effect of e word of mouth, consumer engagement, and attitude towards social media advertising on purchase intention of consumers towards organic food products. Analysis of data includes descriptive statistics, correlation, regression using SPSS version 22. CFA and structural equation modeling were conducted using AMOS 22 on the sample of 251 which was collected from Delhi and NCR using convenience sampling method. The result of the study suggests that e word of mouth, consumer engagement, and attitude towards social media advertising have a significant positive relationship with consumer purchase intention towards organic food products. Organic products are getting momentum in the world market as well as in the Indian market. Therefore, the study helps to accelerate this momentum for the organic food industry to execute and help them to align their marketing strategies.
Emotionally Engaging Customers Through Storytelling
Authors: Patwa Nitin , Hamelin Nicolas , Tarabasz Anna
Published: November 2022

Businesses are considered to have reached the zenith of progression once they are able to value and create emotionally engaging customer experiences. Its importance relies on creating strong customer-business relationships in order to increment brand value, customer loyalty, and business growth. Emotional marketing is well acclaimed for introducing storytelling as a tool that facilitates establishing emotional connections. As described by the 5 C model, care for customers, content creation, communication, connection, and customer interaction are essential customer experience elements that when applied to storytelling can create significant relationships. Applying these can create three main types of customer-business relationships: functional, emotional, and symbolic relationships. Through ADANCO 2.1.1, the authors were able to test the goodness of model fit. The indicator SRMR (standardized root mean squared residual) provided information that corroborates that adding emotional elements to customer experience can strengthen the way a business is perceived by the customer.
Customer Engagement Through Emotional Branding
Authors: Jindal Ansh , Jindal Priya , Chavan Lochan
Published: November 2022

Emotional branding is a marketing strategy that involves appealing to clients' emotions to increase brand loyalty. Consumer behavior has shifted away from a more analytical approach based on product features satisfaction and towards forming an emotional tie with the brand. Consumers are more interested in the brand that depicts their image and understands how the brand makes them feel, resulting in a link, rather than the commodity or goods that meet their needs. Emotions, according to Darwin, are adaptive and help in communication. It's a mental state that develops when a person is exposed to a specific event, thought, or activity, and it's often confused with feelings. Today, emotions are used to influence a customer's reaction to a product. Engagements, such as posting links, clicking through, and buying stuff from the brand, are driven by the emotional attachment that occurs between a customer and a brand. This chapter aims to better understand how emotions play a part in building strong brand ties between customers and brands.
Non-Verbal Communication
Authors: Agnihotri Niharika
Published: November 2022

Communication is the exchange of information with the help of words, speaking, writing, or by using some skills, which can be touch, any sound, body language, posture, etc. Communication is of two types: verbal and non-verbal communication. Verbal communication is that in which information is exchanged by speaking. Non-verbal communication is that in which information is exchanged without speaking but by writing or using skills such as by some sound, touch (handshake, hug), body language, eye contact, physical appearance, etc. It is quite interesting that two or more persons interact among each other without speaking. Some barriers are also there for non-verbal communication such as silence, strange body language, different facial expressions, which create difficulty in understanding.
Impact of Customer Segmentation and Customer Loyalty With Reference to Big Data
Authors: Bathla Devesh , Ahuja Raina , Singh Amandeep
Published: November 2022

Today, the businesses and market are all about data. So, this research work is focusing on performing segmentation analysis on customers and how important it is for a brand to retain their customers in such a competitive market. The background used for the customer segmentation are loyalty programs; they play a major role. All the major brands make best use of data in their loyalty program and target their customers accordingly. Success of every organization depends on the satisfaction of customers, which comes in the picture only when a brand is able to target rightly and retain them. The objective is performing an analysis on the customer segmentation and retention using big data. With the significant resources available, the authors analyse the changing market and how data is helping brands to run their loyalty programs.
Normative Concerns in Neuromarketing
Authors: Bansal Ajit , Bansal Rajni , Bansal Anu , Kumar Manish , Kumar Pankaj
Published: November 2022

A relatively new emerging research field called neuromarketing bridges the conventional gaps between neuroscience, neuroeconomics, and marketing research. An emerging area called neuromarketing uses neuroscience methods in academic and commercial studies to explain customers' preferences, motivating factors, and preconceptions to better understand the consumer's mind. Additionally, those who reject neuromarketing think it is ethically wrong and shouldn't even be inferred to read consumers' minds to improve the company's products and services. The authors discuss prevalent ethical issues with neuromarketing in this research paper. They contend that considering the current capabilities for businesses to stay cautious, the most commonly raised issues are consent, secrecy, privacy, selflessness, and no maliciousness. Nevertheless, the authors point out how the company's largely unique neuromarketing practices may give rise to potentially severe ethical problems. They conclude that businesses can use neuromarketing to remain anxious and reduce the positive effects on society.
Shift in Marketing Trends in the Current Competitive Scenario
Authors: Singla Babita , Shalender Kumar , SHARMA SANDHIR
Published: November 2022

Marketing, the lifeline of businesses, truly gives zest to the corporate and makes a striking difference to the brand and its equity. The ethos of marketing keeps changing with the times. As the customer becomes more knowledgeable, customer contact through marketing plays a vital role in the conversion of businesses. Now, the marketing genre is moving from products to customers to the human spirit. Marketing enjoys a dominant position today as can be seen by the success of the current age businesses.
American College of Radiology Thyroid Imaging Reporting and Data System Score has High Diagnostic Value in the Diagnosis of Malignant Thyroid Nodules
Authors: Biswas Souvik , Sureka Binit , Kaushal Darwin , Elhence Poonam , Goyal Amit , Yadav Taruna , Goel Akhil , Khera Pushpinder Singh
Published: November 2022

Introduction:

A palpable thyroid swelling is a very common finding and is seen in almost 12% of Asian Indian population. Thyroid imaging reporting and data system (TI-RADS) can be used as a risk stratification system to determine malignant or benign thyroid nodules and necessity of further intervention.

Objective:

The objective of this study was to determine the positive predictive value (PPV) of TI-RADS category/ultrasound using TI-RADS categories in the diagnosis of malignancy in clinically suspected thyroid nodule and necessity for further intervention in the case of malignant thyroid nodules.

Materials and Methods:

We conducted a prospective study evaluating 110 patients (140 thyroid nodules) from March 2018 to April 2020 including patients with thyroid swelling. Ultrasound was performed by a radiologist on the patients, and targeted fine-needle aspiration cytology from thyroid nodules was interpreted by an experienced pathologist. Ultrasound features and TI-RADS category were compared with cytology and surgical histopathology. Sensitivity, specificity, PPV, and positive likelihood ratio in different categories of TI-RADS nodules were calculated.

Results:

A total of 113 thyroid nodules were assessed. Out of 113 nodules (right lobe – 64, isthmus – 6, and left lobe – 43), 84 nodules were benign and 29 nodules were malignant. Eleven (10%) patients were found to have metastatic cervical lymphadenopathy. There was no significant difference in the occurrence of malignant nodules according to gender, location of the nodule, or size of the nodule. The mean anteroposterior and transverse diameter of benign nodule was 14.1 ± 6.9 mm and 20.9 ± 9.9 mm, respectively, whereas in the case of malignant nodules, it was 15.6 ± 7.1 mm and 19.5 ± 9.0 mm, respectively. A TI-RADS score of ≥4 had 84% PPV for malignancy. The PPV for malignancy was 32.2%, 49.1%, and 100% for TI-RADS 2, 3, and 5 categories.

Conclusion:

TI-RADS is a simple, practical, and cost-effective tool for assessing the malignancy rates of thyroid nodules. TI-RADS categories 4 and 5 have high PPV for malignancy in thyroid nodules.
Obstructive Sleep Apnea in Hypothyroidism
Authors: Pancholi Chitranshu , Chaudhary Shyam Chand , Gupta Kamlesh Kumar , Sawlani Kamal Kumar , Verma Sudhir Kumar , Singh Abhishek , Verma Ajay Kumar , Usman Kauser , Atam Virendra
Published: November 2022

Introduction:

Obstructive sleep apnea (OSA) and hypothyroidism are closely linked as hypothyroidism has been shown to lead to the development of OSA through multiple mechanisms. With the changing lifestyle patterns worldwide and increased prevalence of obesity, the burden of OSA has substantially increased. The association of OSA with hypothyroidism is essential to establish. If identified early, treatment of OSA and associated hypothyroidism can be done timely to minimize the potential harmful complications of OSA on all aspects of the patient's health.

Aims:

This study was done to find out the prevalence of OSA in hypothyroidism patients.

Setting and Designs:

It was a cross-sectional study, done over a period of 1 year in a tertiary care hospital.

Materials and Methods:

A total of 100 hypothyroidism patients were enrolled after taking written consent. All patients were subjected to STOP-Bang questionnaire and patient falling in intermediate-high risk (score3-8), were taken for overnight polysomnography to confirm the diagnosis of OSA (AHI ≥5).

Statistical Analysis Used:

The Statistical Package for the Social Sciences version 21.0 statistical analysis software.

Results:

Out of 100 patients, who underwent polysomnography, 74 (74%) cases had OSA (AHI ≥5). Out of total 74 OSA cases, 29 (39.2%) cases had mild OSA (AHI 5–14), 15 (20.3%) cases had moderate OSA (AHI 15–30), and 30 (40.5%) cases had severe OSA. The age of the study population ranged between 24 and 78 years and the mean age was 58.28 ± 11.22 years. The mean age of the patients in the OSA group (59.27 ± 11.17 years) was higher than the non-OSA group (55.46 ± 11.09 years). Majority (64%) of our cases were male, and the proportion of males was found to be higher than females in both the groups (OSA/non-OSA). The body mass index (BMI) of the OSA group was found to be statistically higher as compared to that of the non-OSA group (P = 0.040). The BMI was found to be higher in severe OSA, but it was not statistically significant (P = 0.128). The mean value of FT4 was lower and thyroid-stimulating hormone (TSH) was higher in the OSA group as compared with the non-OSA group. However, no significant association was found between FT4 and TSH values in both the groups. Out of 100 cases, 41 patients were treatment naïve with mean TSH value of 13.1 ± 7 and 59 were on treatment with mean TSH of 8.3 ± 4. Treatment-naïve patients had a statistically higher number (85.3%) of OSA cases in comparison to patients on treatment (66.1) (P = 0.030).

Conclusions:

Prevalence of OSA is quite high in hypothyroidism. Patients with hypothyroidism should be screened for OSA for early diagnosis, especially in individuals with higher BMI. Treatment of hypothyroidism reduces the prevalence of OSA.
Perception and Assumptions of Young Waterpipe Smokers in Mumbai, India
Authors: Nimma Vijayalaxmi , Lingam Amara Swapna , Gaffar Aibani Saddik , Kadam Sonali , Ramaswami Easwaran , Ramchandani Amit
Published: November 2022

Background:

Hookah smoking has been on raise all over the world, including India, especially among youngsters. There is growing evidence suggesting the high school children experimenting this form of tobacco.

Objective:

The objective of this study was to investigate the characteristics, behavior, and perceptions related to hookah smoking among the hookah smokers in Mumbai.

Materials and Methods:

A cross-sectional survey was conducted among 200 randomly selected young adults between the age group of 15–35 years in Mumbai who visited different dental clinics. The questionnaire was distributed as Google Forms online in the month of November and December 2019 and those who submitted completed responses were included in the study.

Results:

Only 114 participants returned with the completed forms in the time period of 2 months. The results showed that the majority of participants were between 20 and 24 age, comprising 58% who were having the habit of hookah smoking. Among which 24% females, 76% males had history of hookah habit. Eight percent of males started smoking hookah from very young age. Males (29.89%) shared one hookah pot with four members. Forty percent of the participants stated that they are interested to smoke again because of hookah flavor.

Conclusion:

Easy availability of newer forms of smoking at online markets could play a role in promoting the use of hookah among youngsters. Most products are being sold without any warnings, and there is no means to control the selling of the products to minors. Educational intervention is urgently needed to create awareness among youth about the harmful effects of hookah smoking.
Comparative Efficacy of Coronally Advanced Flap with and Without Guided Tissue Regeneration in the Management of Gingival Recession Defects
Authors: Potharaju Santhi Priya , Prathypaty Santha Kumari , Chintala Ravi Kanth , Kumar D. Sunil , Bai Y. Durga , Bolla Vijaya Lakshmi , Koppolu Pradeep , Barakat Ali , Lingam Amara Swapna
Published: November 2022

Background:

The gingival recession causes tooth sensitivity, poor esthetics, and tooth mobility in severe cases. Scientific documentation revealed effective root coverage (RC) and increased keratinized tissue heights acquired with the coronally advanced flap (CAF) for multiple recession defects.

Objectives:

This research evaluates and compares the efficacy of CAF procedures with and without Type I collagen bio-absorbable membrane in guided tissue regeneration (GTR) in the treatment of Miller's Class I and II gingival recession.

Materials and Methods:

A total of 30 sites from 15 patients were selected for the study after fulfilling the presurgical phase of treatment. The chosen sites were randomly allocated into Group A CAF and Group B (CAF + Resorbable GTR membrane). The clinical variables such as plaque index, gingival index, recession depth (RD), recession width (RW), width of keratinized gingiva (WKG), clinical attachment level (CAL), and surface area of the defect were recorded at the baseline and 6 months postoperatively.

Results:

Both therapies resulted in a notable gain in RC with a mean of 73.13% and 71.60%, respectively, but it was not statistically significant when compared between the groups. Both the RD and RW were significantly reduced from baseline to 6 months postoperatively. Although there was a gain in WKG and CAL in both experimental sites, no significant difference was observed between both the groups.

Conclusion:

Although there are several RC procedures, CAF furnishes a foreseeable, straightforward, and appropriate perspective for treating Miller's Class I and II recessions. Integrating this approach with placing a bio-absorbable membrane does not seem to improve the results following surgical treatment of such defects. However, both groups showed the potential advantage of achieving RC.
Pattern of Eye Diseases in Adults at the General Outpatient Clinic of a Tertiary Hospital in Nigeria
Authors: Onyiaorah Adaora Amaoge , Kizor-Akaraiwe Nkiru N. , Nwosu Sebastian N. N.
Published: November 2022

Objective:

To determine the pattern of eye diseases at the general outpatient department (GOPD) of a Nigerian tertiary hospital.

Materials and Methods:

Patients selected by systematic random sampling at the GOPD of a Nigerian tertiary hospital were studied. Information on sociodemographics and ocular complaints were obtained using interviewer-administered questionnaire. Ocular examination included visual acuity measurement and anterior and posterior segments examinations. Data analysis was with Statistical Package for the Social Sciences.

Results:

Three hundred and eighty-two patients, comprising 124 (32.5%) males and 258 (67.5%) females, aged between 18 and 86 years, mean 44.8 ± 15.4 years, were studied; 112 (29.3%) had eye diseases but only 88 (78.6%) patients complained of ocular disorder(s). Common complaints were poor vision 53 (60.4%), red eye and grittiness 15 (17.0%) each. Common eye diseases were lens 52 (13.6%) and conjunctiva 46 (12.0%) disorders. Attaining higher education was protective against eye diseases (P < 0.05).

Conclusion:

Nearly a third of patients at the GOPD have eye diseases. Therefore, primary eye care should be integrated into the GOPD service with provision of relevant manpower and facilities for care of the ophthalmic patients.
Knowledge, Awareness, and Attitude Among Dental Students Regarding Oral Cancer in Saudi Arabia
Authors: Tarakji Bassel
Published: November 2022

Background:

Oral cancer awareness among junior and seniors' dental undergraduate students may have an impact on the early detection and prevention of oral cancer.

Aims and Objectives:

To assess oral cancer awareness, knowledge and attitude among undergraduate dental students in government and private colleges in Saudi Arabia.

Material and Methods:

A cross-sectional survey was undertaken to assess oral cancer knowledge, awareness and attitude among undergraduate dental students in government and private colleges in Saudi Arabia. All junior and senior students enrolled during the 2020– 2021 academic year, were eligible to participate (n=189).

Results:

The study shows that dental Students at private and government colleges in Saudi Arabia are generally knowledgeable regarding Knowledge, awareness, attitude and management of oral cancer. There was no significant difference between knowledge, awareness, attitude, and management of oral cancer between students in either private and government colleges. Results shows that 99 (88.9%) of dental students in government colleges considered human papilloma virus as a risk factor, higher than dental students in private colleges 48 (73.3%). My results indicated that dental students considered (87%) tobacco, and alcohol (83.6%) as main risk to oral cancer, whereas, 100 (53%) identified limited consumption of fruit and vegetables and 124 (65.6%) considered old age as risk factor for oral cancer.

Conclusion:

The variation in correct answers indicate to need to reinforce the undergraduate dental curriculum with regards to oral cancer education; particularly in its prevention and early detection. Revision of knowledge senior students in oral cancer is highly recommended.
Diabetes Mellitus Foot Ulcer and Associated Factors Among Type 2 Diabetes Patients in a Tertiary Institution in Southwest Nigeria
Authors: Salawu Adedayo Idris , Ajani Gbadebo Oladimeji , Soje Michael Osisiogu , Ojo Owolabi Dele , Olabinri Eunice Oluremi , Obajolowo Omotola Olawale , Babalola Olakunle Fatai , Ipinnimo Tope Michael , Oguntade Hameed Banjo , Adediran Olufemi Olusola
Published: November 2022

Aim:

This study aims to assess the proportion of diabetic foot ulcer (DMFU) and associated factors among patients with type 2 diabetes in a tertiary hospital in Southwest Nigeria.

Methods:

A pretested semi-structured interviewer-administered questionnaire adapted from the STEPwise Approach to Surveillance of Noncommunicable Disease Risk Factors of WHO.14 was used for data collection from a sample of 181 patients with type 2 diabetes mellitus. Sociodemographic, behavioral, clinical, and laboratory variables were collated from the participants. Chi-square test and logistic regression were used to identify the predictors of DMFU.

Results:

A total of 166 patients had their questionnaires completed. The mean age (standard deviation) of the respondents was 62.6 (14.3) years. The proportion of DMFU was 18.7%. More than two-third (71.1%) of our respondents had clinical symptoms suggestive of peripheral neuropathy while 34.3% of the patients seen in the study had evidence of peripheral vascular disease on duplex Doppler ultrasound. Male patients were about five times more likely to have DMFU than female patients (adjusted odds ratio [AOR] =5.27; 95% confidence interval [CI] = 1.001–27.841). Those with duration of diabetes ≥10 years were more likely to have DMFU than those with disease duration <10 years (AOR = 15.47; 95% CI = 1.201–199.314). Patients with fasting blood glucose (FBG) of ≥ 7.2 mmol/L were about four times more likely to have DMFU than those with FBG of <7.2 mmol/L (AOR = 4.19; 95% CI = 1.618–18.463).

Conclusions:

The proportion of DMFU was 18.7%, and the predictors identified included sex, duration of disease, and FBG level.
Effect of Scalp Infiltration with Bupivacaine on Analgesic Requirement Following Elective Craniotomy
Authors: Abdullahi Abdulkareem A. , Aliyu Abdulrahman
Published: November 2022

Background:

Postcraniotomy pain and perioperative assessment of patients' neurological function are some of the issues associated with craniotomy surgeries. Cost-effective pain control will result in good clinical outcome, decrease the length of hospital stay, and reduce total cost. Infiltration anesthesia is a recognized modality of cost-effective pain control.

Objective:

The study determined the effect of scalp infiltration with 0.25% plain bupivacaine on pain control following craniotomy.

Methods:

A prospective randomized study recruited 50 consenting patients scheduled for craniotomy under general anesthesia into two study groups. All patients received routine general anesthesia as per local protocol and received scalp infiltration after skin closure. Group A received 20 ml of 0.25% plain bupivacaine, while Group B received 20 ml normal saline. Pain scores were assessed using the Visual Analog Scale (VAS) on admission into the intensive care unit (ICU) then at 4, 8, 12, 16, 20, 24, and 48 h after surgery. The interval between the end of surgery and the first request for analgesia, 4 hourly intervals pentazocine and the cumulative doses of pentazocine given for postoperative pain relief.

Results:

The presenting VAS at the ICU and total postoperative analgesic consumption at 48 h were significantly lower in the bupivacaine group compared to the saline group. In addition, the increase in time to the first analgesic request was statistically significant between the two. There was a trend toward the reduced incidence of sedation and postoperative nausea and vomiting in the bupivacaine group compared to the saline group.

Conclusions:

Postoperative scalp infiltration with plain 0.25% bupivacaine reduced pain intensity and opioid analgesic consumption among the studied patients. Resultantly, it can be regarded as an effective technique of pain management after an elective craniotomy.
Right Sided Stellate Ganglion Block before Pneumoperitoneum in Laparoscopic Surgeries. Does it Balance Hemodynamics? A Case Series
Authors: Jepina Prem , Nandhini P , Parthasarathy S
Published: November 2022

The laparoscopic technique is currently used for many types of surgery because it is painless, has less nociceptive stimulus from the skin and tissues, has fewer wound complications, and allows for a faster and smoother postoperative recovery. Institution of capnoperitoneum to visualize the viscera inside is the need in these cases. However, capnoperitoneum can cause many side effects including a significant rise in heart rate and blood pressure. Stellate ganglion block (SGB) is a sympathetic block for the head, neck, chest, and upper limbs. Hence, we hypothesized that blocking the same, especially right-sided, will decrease a sympathetic surge after capnoperitoneum. We conducted three such cases with administration of ultrasound-guided SGB in the right side 10 min before capnoperitoneum and found that there was no surge in hemodynamics. We postulate that right-sided SGB can be added to the armamentarium of countless techniques to blunt the response. We admit that this is a very small primitive report with only three cases. As ultrasound was used in all the cases, the deposition of local anesthetic drug was precise.