bluuebunny/crossref_metadata_2025 huggingface dataset:
Intelligence artificielle : la compétition internationale
Authors: Pajot Benjamin
Published: September 2024

Si les États-Unis dominent le domaine de l’Intelligence artificielle, ils sont toutefois talonnés par la Chine. Derrière ce duopole sino-américain, l’Europe est souvent présentée comme une puissance normative, mais elle dispose aussi d’atouts industriels. Sur le continent européen, le Royaume-Uni et l’Allemagne se placent devant la France. Au-delà des États, c’est surtout au niveau des grandes entreprises technologiques que se situe la capacité à investir et à innover.
L’Intelligence artificielle, onde de choc géopolitique et diplomatique
Authors: Fagart Sébastien
Published: September 2024

La mise à la disposition d’un public élargi des instruments de l’Intelligence artificielle générative et prédictive bouleverse la scène internationale, d’abord au profit des acteurs asymétriques et des grandes entreprises du numérique. L’IA dote aussi les États de nouveaux moyens, militaires, de renseignement, de manipulation de l’information ou de diplomatie publique. Les dangers de l’IA sont cependant multiples et appellent une régulation internationale très complexe à mettre en place.
Intelligence artificielle et cybersécurité : poisons et/ou remèdes ?
Authors: Arpagian Nicolas
Published: September 2024

Les usages de l’Intelligence artificielle (IA) ont connu un développement extrêmement rapide depuis la mise en ligne de ChatGPT. Des acteurs malveillants n’ont pas tardé à se saisir de cette technologie susceptible de faciliter le hameçonnage, la désinformation et le piratage, mais l’IA peut aussi multiplier les capacités en matière de cybersécurité. À ce stade, on ne peut dire si l’avantage ira à l’attaque ou à la défense. Quoi qu’il en soit, de nouvelles formes de régulation s’imposent.
Quelle politique étrangère démocrate après Biden ?
Authors: Quessard Maud
Published: September 2024

La diplomatie d’une nouvelle administration démocrate s’inscrirait sans doute dans l’héritage de Joe Biden : retour au multilatéralisme et choix d’une « politique étrangère pour les classes moyennes », lutte contre le changement climatique et la concurrence technologique. À cet égard, la rivalité avec la Chine demeurera centrale. On pourrait assister à un réengagement vis-à-vis du Sud global, alors que le « retour en Europe » dû à la guerre d’Ukraine pourrait, à terme, se montrer relatif.
Après les élections européennes : vers une Europe post-populiste ?
Authors: Muzergues Thibault
Published: September 2024

Les élections européennes de 2024 sont marquées par une triple tendance : une domination du Parti populaire européen, un morcellement du spectre politique et une droitisation de l’hémicycle avec la montée en puissance de partis d’extrême droite. À l’exception de la France et de l’Allemagne, où les formations populistes progressent, l’Union européenne voit se développer une nouvelle tendance – le post-populisme –, marquée notamment par un effacement du clivage entre le peuple et les élites.
Tarification du carbone en économie ouverte : l’exemple de l’ajustement carbone aux frontières
Authors: Trotignon Raphaël
Published: September 2024

Le « prix du carbone » est une incitation économique puissante à la décarbonation du capital économique existant et à la réorientation des flux financiers vers le développement et le déploiement des technologies « bas-carbone ». Mais un tel prix du carbone n’existe pas de manière uniforme au niveau mondial, alors que la plupart des capitaux, des biens et des services transitent facilement tout autour du globe. En Europe, où le prix du carbone est élevé, un nouveau système d’ajustement carbone à la frontière va progressivement être mis en place pour tenter de neutraliser les effets pervers de cette tarification incomplète. Mais, si l’intention de protéger l’Europe face à une concurrence déloyale qui serait néfaste à l’industrie et au climat est bienvenue, l’architecture envisagée pour ce système risque en réalité d’accroître le déficit de compétitivité de l’industrie européenne.
Le label ISR, un outil en évolution pour aider les investisseurs et les épargnants à participer à la finance durable
Authors: Pappalardo Michèle
Published: September 2024

Le label ISR, créé en 2016 par le ministère des Finances, est destiné à encourager les gestionnaires de fonds à adopter des démarches de finance durable et à assurer les investisseurs et les épargnants de la réalité de celles-ci. À l’origine ambitieux, il a séduit de plus en plus de fonds, mais il a été progressivement dépassé par les progrès de la finance durable, ce qui a affaibli la confiance des utilisateurs. La refonte du référentiel adoptée fin 2023 vise donc à renforcer l’exigence du label pour lui redonner toute sa crédibilité. Désormais, les 1 200 fonds environ labellisés au 1er janvier 2024 doivent évoluer pour s’adapter à cette modification, ce qui nécessite un effort important de la part des sociétés de gestion et conduira probablement à l’abandon du label pour certaines d’entre elles. Mais c’est le prix de la crédibilité !
Dix ans de réglementation de finance durable en Europe : de la mesure du risque financier à l’évaluation de l’impact environnemental
Authors: Siry Gabrielle
Published: September 2024

La finance durable a émergé à la suite de l’Accord de Paris il y a près de dix ans aujourd’hui. Depuis, la règlementation financière relative à la finance durable évolue notamment sous l’influence d’un échange entre droits nationaux, en particulier français, et droit de l’Union européenne (UE). D’une stricte prise en compte du risque pour les institutions financières, l’approche s’est élargie à l’impact des activités financières, notamment des investissements, sur l’environnement. L’évaluation et la classification de ces impacts s’est ensuite étendu à la sphère publique. De nouveaux enjeux qui marqueront demain l’évolution du droit de la finance durable se font jour, parmi lesquels l’influence de la perte de biodiversité sur la stabilité financière, et le déficit d’assurance des catastrophes climatiques dans l’UE.
Mobiliser les investisseurs en faveur du développement durable : l’exemple européen des marchés obligataires verts, sociaux et durables
Authors: Victor Maruta Tomomitsu , Rousseau Cyril
Published: September 2024

Lancées par la Banque européenne d’investissement (BEI) en 2007, les obligations vertes sont émises aujourd’hui dans le monde entier, à hauteur d’environ 600 milliards d’euros par an aujourd’hui. L’essor du marché s’est accompagné d’une évolution de la gouvernance, allant de l’auto-régulation vers l’instauration de cadres réglementaires officiels. Celui de l’Union européenne est le plus ambitieux avec la classification de la finance durable la plus avancée (« la taxinomie européenne »). Cette classification doit contribuer à la transparence et au bon fonctionnement du marché, et favoriser le développement de l’union des marchés de capitaux. Toutefois, la difficulté d’application de la taxinomie risque de mener à l’inaction. La Commission européenne et la plateforme européenne sur la finance durable encouragent donc une approche proactive et graduelle. En tant que banque européenne du climat, la BEI s’efforce d’être un fer de lance de la mise en oeuvre graduelle des normes européennes pour la finance durable.
Pratiques à risques ou erreurs de communication : toutes les nuances de greenwashing ne se valent pas !
Authors: Husson-Traoré Anne-Catherine
Published: September 2024

En finance, les allégations environnementales passent plutôt par le marketing où, en illustration de placements sur les marchés financiers et les grands indices boursiers, sont placées des images de nature luxuriante. Ceci peut être considéré comme du greenwashing à cause du décalage entre la promesse et l’offre. La finance durable a de nombreuses nuances de greenwashing dont certaines sont surtout des erreurs de communication. Cet article permet de faire la différence avec d’autres actions qui consistent à prendre des engagements forts comme le financement de la neutralité carbone mais à afficher des portefeuilles à forte teneur en énergies fossiles, ce qui semble incompatible.
Deep Grassmannian multiview subspace clustering with contrastive learning
Authors: Wang Rui , Li Haiqiang , Hu Chen , Wu Xiao-Jun , Bao Yingfang
Published: September 2024

This paper investigated the problem of multiview subspace clustering, focusing on feature learning with submanifold structure and exploring the invariant representations of multiple views. A novel approach was proposed in this study, termed deep Grassmannian multiview subspace clustering with contrastive learning (DGMVCL). The proposed algorithm initially utilized a feature extraction module (FEM) to map the original input samples into a feature subspace. Subsequently, the manifold modeling module (MMM) was employed to map the aforementioned subspace features onto a Grassmannian manifold. Afterward, the designed Grassmannian manifold network was utilized for deep subspace learning. Finally, discriminative cluster assignments were achieved utilizing a contrastive learning mechanism. Extensive experiments conducted on five benchmarking datasets demonstrate the effectiveness of the proposed method. The source code is available at https://github.com/Zoo-LLi/DGMVCL.
Existence of nodal solutions of nonlinear Lidstone boundary value problems
Authors: Yan Meng , Zhang Tingting
Published: September 2024

We investigate the existence of nodal solutions for the nonlinear Lidstone boundary value problem

   \begin{document}$ \begin{align} \left\{\begin{array}{ll} (-1)^m (u^{(2m)}(t)+c u^{(2m-2)}(t)) = \lambda a(t)f(u), \; \; \ \ \ t\in (0, r), \\ u^{(2i)}(0) = u^{(2i)}(r) = 0, \ \ i = 0, 1, \cdots, m-1, \end{array} \right.~~(P) \end{align} $\end{document}

where $ \lambda > 0 $ is a parameter, $ c $ is a constant, $ m\geq1 $ is an integer, $ a :[0, r]\rightarrow [0, \infty) $ is continuous with $ a\not\equiv0 $ on the subinterval within $ [0, r] $, and $ f: \mathbb{R}\rightarrow \mathbb{R} $ is a continuous function. We analyze the spectrum structure of the corresponding linear eigenvalue problem via the disconjugacy theory and Elias's spectrum theory. As applications of our spectrum results, we show that problem $ (P) $ has nodal solutions under some suitable conditions. The bifurcation technique is used to obtain the main results of this paper.
The connection between the magical coloring of trees
Authors: Su Jing , Zhang Qiyue , Yao Bing
Published: September 2024

Let $ f $ be a set-ordered edge-magic labeling of a graph $ G $ from $ V(G) $ and $ E(G) $ to $ [0, p-1] $ and $ [1, p-1] $, respectively; it also satisfies the following conditions: $ |f(V(G))| = p $, $ \max f(X) < \min f(Y) $, and $ f(x)+f(y)+f(xy) = C $ for each edge $ xy\in E(G) $. In this paper, we removed the restriction that the labeling of vertices could not be repeated, and presented the concept of magical colorings including edge-magic coloring, edge-difference coloring, felicitous-difference coloring, and graceful-difference coloring. We studied the magical colorings on the tree and proved the existence of four kinds of magical colorings on the tree from a set-ordered edge-magic labeling. Further, we revealed the transformation relationship between these kinds of colorings.
The signature of a monomial ideal
Authors: Ibarguen Jovanny , Moran Daniel S. , Valencia Carlos E. , Villarreal Rafael H.
Published: September 2024

The irreducible decomposition of a monomial ideal has played an important role in combinatorial commutative algebra, with applications beyond pure mathematics, such as biology. Given a monomial ideal $ I $ of a polynomial ring $ S = k[{\bf x}] $ over a field $ k $ and variables $ {\bf x} = \{x_1, \ldots, x_n\} $, its incidence matrix, is the matrix whose rows are indexed by the variables $ {\bf x} $ and whose columns are indexed by its minimal generators. The main contribution of this paper is the introduction of a novel invariant of a monomial ideal $ I $, termed its signature, which could be thought of as a type of canonical form of its incidence matrix, and the proof that two monomial ideals with the same signature have essentially the same irreducible decomposition.
Neurogranin in Alzheimer's Disease: Roles in synaptic function, pathology, and potential as a diagnostic biomarker
Authors: Bavaharini Rajkumar , Somala Chaitanya Sree , Saravanan Konda Mani , Anand Thirunavukarasou
Published: September 2024

Postsynaptic protein neurogranin (Ng), which plays a role in synaptic plasticity, learning, and memory, has been identified as the candidate biomarker of Alzheimer's disease (AD). Cortical Amyloid β pathology seems to accelerate the onset of clinical symptoms; therefore, it is potentially valuable for early diagnosis of AD and therapeutic intervention. Synaptic pathology was shown to be an early feature of AD. Thus, proteins involved in synaptic function, such as Ng, are of great interest in studying the disease. Some prior human studies have found that Ng, a protein involved in the regulation of synaptic function, is present at greater levels in the cerebrospinal fluid of people with AD compared with those without the disease. High levels of neurogranin are associated with increased levels of synaptic vulnerability and decreased cognitive function in AD patients. This review, therefore, looked at the functionality of Ng in the brain, its association with other synaptic proteins, and its applicability as a diagnostic marker in AD. This study, therefore, sought to expand the knowledge on Ng changes in AD as it relates to synaptic dysfunction and enhanced the search for a better diagnostic and therapeutic approach.
The Term Latinx
Authors: Villarreal Elsa Garcia , Arrambide Melissa , Parra Jose
Published: September 2024

The term Latinx is relatively new, as it emerged in mainstream media around the year 2017. This term became a source of identity to those individuals who have perceived themselves as outsiders or left out of social and cultural realms. The use of Latinx has propelled different arguments among research scholars. Scholars in favor of using the term Latinx focus on the notion of inclusivity and establishing a voice for traditionally underserved populations. Conversely, the term Latinx is not embraced by all who identify with the Latin culture. Other scholars argue attempting to change a word in the Spanish language in the spirit of inclusion can have unintended grammatical and verbal communication implications. Implications for cultural and social norms indicate that Latinx has gradually shifted and expanded into intersections of society such as media, politics, and academia.
Psychological Barriers and Facilitators to Sustainable Tourism
Authors: Bhartiya Shivam , Prasad Megha D. , Bhatt Vaibhav
Published: September 2024

This research investigates the psychological barriers and facilitators that impact sustainable tourism, employing a behavioral insights framework to understand and influence environmentally responsible travel behaviors. The primary objective is to identify the cognitive and emotional factors that either hinder or promote sustainable tourism practices. The study utilizes a mixed-methods approach, combining qualitative and quantitative data collection through in-depth interviews, focus groups, and surveys. These methods allow for a comprehensive exploration of the psychological constructs, such as cognitive dissonance, perceived behavioral control, and the influence of habitual behaviors on travel decisions. The outcomes reveal significant barriers to sustainable tourism, including entrenched habits and a lack of perceived efficacy, while also highlighting the role of environmental identity, social norms, and altruism as key facilitators. The findings offer practical recommendations for policymakers and industry stakeholders to design interventions that mitigate psychological barriers and enhance facilitators, thereby promoting sustainable tourism practices.
The Relationship Between Air Pollution and Severity of Schizophrenia Symptoms
Authors: Uludag Kadir
Published: September 2024

The chapter uses previous research to demonstrate a connection between air pollution and the severity of psychiatric conditions such as psychosis, depression, bipolar disorder, mood disorders, drug addiction, and anxiety. This link may explain the higher occurrence of psychosis in urban areas. The chapter aims to explore this relationship by examining air pollution factors such as particulate matter (PM) 2.5, nitrogen oxides (NO), and PM 10. However, the exact nature and extent of the relationship between air pollution and symptom severity in patients with schizophrenia (SCZ) is still not well understood and requires further investigation.
Education, Health, and Life Expectancy Across Ethnic Groups
Authors: Kobra Khadezatul , Uddin Md. Emaj , Kulsum Ummay H.
Published: September 2024

Life expectancy varies by socioeconomic status (SES), ethnicity and religion. Although education positively or negatively influences life expectancy, mechanisms underlying the education-life expectancy link across ethnic groups are not clearly understood. Drawing from human capital theory of learned effectiveness, this chapter systematically reviews relevant literature to understand SES, lifestyle and health as mechanisms by which education transmits different effects on life expectancy between majority and minority ethnic groups, focusing on Bangladesh. The systematic review suggests that lower SES, poor lifestyle and health mediate the association between lower-education and lower life expectancy in the minority groups compared to the majority group. This chapter also discusses future directions for longitudinal research and implications to improve life expectancy in the minority ethnic groups.
Patient-Centric Care in Tuberculosis Management
Authors: Srinivasan S.
Published: September 2024

The WHO's End TB Strategy prioritizes Patient-Centered Care as its primary pillar. This chapter focuses on the Indian Health Care System's implementation of patient-centric care, emphasizing the patient's pivotal role in receiving quality service and quality care. Healthcare workers under this model deliver competent tuberculosis care, aiming to meet patients' needs and provide support throughout their treatment journey. Enhancements in patient-centric care encompass improved TB diagnosis, treatment adherence, and follow-up management. The research findings show enhanced patient-physician relationships and healthcare worker capabilities. Increased medication adherence and reduced patient loss to follow-up contribute to better treatment outcomes. The chapter also addresses arranging nutritional aid for the underprivileged, providing psycho-social and socioeconomic support, and educating affected TB patients about the disease, all within the scope of TB awareness efforts.
The Evolving Landscape of Cytopathology Labs
Authors: Archondakis Stavros K.
Published: September 2024

A modern cytopathology laboratory is offering various examinations with vital clinical significance. The wide application of computers and information systems successfully operates in modern cytopathology laboratories. Over the last decade, clinical cytopathology has been influenced by the broad implementation of telemedicine and cloud-based applications. New innovative information technologies, including e-health and telemedical applications, constitute a valuable tool for interlaboratory collaboration and quality improvement. New applications, especially in cloud computing, have enhanced the opportunities for improvement in cytological data management and sharing. In this chapter, the author presents a thorough research of telemedical and cloud-based applications related to cytopathology and tries to foresee applications that may improve cytopathology laboratories' diagnostic services relating to population health management, pharmacogenomics and patient-centered care.
An Interactive Sign Language Translator
Authors: Rai Bipin Kumar , Sharma Kanan , Malik Harsh
Published: September 2024

The chapter proposes a system that offers a groundbreaking solution to translate sign language into text and speech. This is achieved by implementing a Convolutional Neural Network (CNN) that effectively recognizes hand gestures from images. The process begins with detecting and processing hand movements from the webcam image using the Mediapipe library. Subsequently, the interpreted data is passed through a classifier to predict hand movements accurately. The resulting model has the potential to significantly bridge the communication gap between Deaf/Dumb individuals and the general hearing population. By enabling more effective expression and understanding of sign language, this innovative system prioritizes the perspective and preferences of the patient, bolstering inclusive communication practices.
The Transformative Role of Artificial Intelligence in Healthcare
Authors: Babu C. V. Suresh , Shunmugapriya K.
Published: September 2024

The chapter demonstrates that recent advancements in artificial intelligence (AI) offer promising improvements in healthcare outcomes for patients with Autism Spectrum Disorder (ASD). It examines AI's potential to enhance patient-centered care through a thorough literature review and qualitative interviews with healthcare providers and caregivers. The findings suggest that AI can significantly enhance early diagnosis and personalized treatment plans for ASD patients. However, challenges such as data quality, algorithmic bias, and integration with existing healthcare systems need to be addressed.
A Novel Conceptual Framework for 21st-Century Healthcare Organizations
Authors: Moumtzoglou Anastasius S.
Published: September 2024

The chapter acknowledges that healthcare is a complex and multifaceted field that requires specialized management and ethical considerations. Financial viability, high-quality care, patient well-being, regulatory compliance, healthcare professionals' dedication to ongoing professional development, preventive care, and personalized treatment plans are essential. Collaboration, communication, and patient-centered care in integrated healthcare services are also emphasized. However, the chapter argues that these views, although valid, are outdated mental models for 21st-century healthcare. It advocates that the healthcare industry needs to recognize the complexity of patients, the endogenic nature of medical encounters, nonlinearity, chaos and self-organization as healthcare properties, and embrace new data-driven methodologies and quantum computing, which are crucial to understanding the healthcare system's complexity.
Management Strategies for Advancing Rural Elderly Well-Being
Authors: Gupta Mayanka , Kannur Deepa
Published: September 2024

The phenomenon of population aging is a global challenge, and India is no exception, with projections indicating a significant increase in the elderly population by 2050. Rural locations have limited healthcare and social services, which presents distinct issues. Drawing from empirical evidence and theoretical perspectives, the chapter outlines key issues faced by the elderly. It explores psychosocial and biological theories of aging to comprehend the complexity of aging and its effects on psychological well-being and quality of life. This chapter discusses options to improve rural elderly well-being and quality of life through holistic intervention management strategies, including community engagement, capacity building, access to healthcare services, promotion of healthy lifestyles, and psycho-education and behavioral interventions. These strategies can effectively address the diverse needs of the elderly, ensuring they age with dignity and independence.
Challenges During Adolescence
Authors: Pandey Tripti
Published: September 2024

The chapter explores the complex nature of adolescence amid rapid societal and technological changes. It examines how shifts in work environments and societal expectations impact adolescents' social and emotional development, necessitating adaptability and continuous learning. The chapter highlights the psychological impacts of these pressures, emphasizing the importance of resilience, emotional intelligence, and robust support systems in managing stress and uncertainty. It discusses the crucial roles of families, educators, and mental health professionals in creating supportive environments that promote open communication and emotional well-being. It also addresses the societal pressures on adolescent identity and self-esteem, proposing a balanced approach that prioritizes personal growth alongside academic and career achievements. Finally, the chapter stresses the need for adaptive coping strategies and explores mental health and educational and training approaches that utilize technology for positive outcomes.
Healthcare Marketing and Patient Engagement Strategies
Authors: Ansari Shamsuzzaman , Rahi Pankaj , Ayyub Sheenam , Naik Shreekant G.
Published: September 2024

The healthcare landscape is rapidly evolving, placing increasing emphasis on patient-centric care and integrating marketing strategies to boost patient engagement. This chapter explores the concept of healthcare marketing, detailing the elements of the marketing mix: product, price, place, promotion, people, physical evidence, and process. It highlights the shifts occurring in healthcare, the transformative role of technologies, the importance of patient engagement, and the common strategies used to achieve it. Additionally, the chapter delves into various marketing techniques and patient engagement strategies that healthcare organizations employ to promote wellness, improve patient outcomes, and build lasting relationships with patients.
Characteristics of Crosslinked Gelatin Film with Dialdehyde Cellulose Influenced by Plasticizer Type
Authors: Kirdponpattara Suchata , Muangnamsuk Raktawan , Chuetor Santi
Published: September 2024

The mechanical strength and structural stability of gelatin film were enhanced by crosslinking with dialdehyde cellulose (DC), having an aldehyde content of 65%. However, the elasticity of the film was improved by plasticizers. The recent work aims to examine the effect of plasticizer type on the characteristics of the gelatin film crosslinked with DC (GDC). The results demonstrated that the weight loss of the films increased after 24 hours of immersion in distilled water, resulting in diminished structural stability compared to the GDC film without adding a plasticizer. Insignificant differences in mechanical properties were observed among the GDC-plasticizer films. The GDC film with glycerol had the most vivid yellow hue, followed by the ones with PEG and sorbitol, respectively. Following a better appearance, the GDC film supplemented with sorbitol could be a potential candidate for packaging application.
Migration and Healthcare services
Authors: Francis G.R.
Published: September 2024

No abstract available.
Primary Mediastinal Diffuse Large B-Cell Lymphoma presenting with pyrexia of unknown origin in a 13-year-old boy
Authors: Pathiraja Hashan , Dayasiri Kavinda
Published: September 2024

Primary mediastinal large B-cell lymphoma is a rare aggressive mature B-cell lymphoma which most commonly affects adolescents and young adults. Adverse outcomes correlate with higher LDH levels (>500) and mass size over 10 cm. In this report, the authors report a teenage boy presented initially with intromittent fevers with normal haematological findings and subsequently, diagnosed to have primary mediastinal Diffuse Large B-Cell Lymphoma. This report highlights the importance of having a high index suspicion and a low threshold for further studies for haematological malignancies despite normal baseline haematological investigations so that it will prevent the diagnosis being made with delay.
Two cases of “Rusty pipe syndrome”; a potential barrier for establishment of breastfeeding
Authors: Vijayakumar Vijayakanth , Dayasiri Kavinda , Thadchanamoorthy V. , Gunathilake M.D.A.S.
Published: September 2024

Rusty Pipe syndrome is a rare, benign, self-limiting condition which presents with blood-stained nipple discharge during the period of establishment of breastfeeding. Since the presentation can cause a significant anxiety in the mother, establishment of breastfeeding can be adversely affected. We report mothers of two newborn babies who had brownish breast milk in the absence of a known predisposing factor such as cracked nipples, mastitis or breast infection. Both mothers were managed with lactation support and breastfeeding counselling and were able the establish breastfeeding successfully. This report highlights the importance of accurate recognition of this benign condition and assisting mothers to overcome anxieties and establish breastfeeding successfully.
Assessment of quality of life among end stage renal disease patients undergoing hemodialysis at Teaching Hospital Batticaloa, Sri Lanka
Authors: Thilagapravin T. , Nadarajah S. , Sundaresan K.T. , Sanooz A.R.M.
Published: September 2024

Introduction: End Stage Renal Disease (ESRD) patients confront several challenges in their life with the introduction of routine hemodialysis treatment. However, there is limited data on the Quality of Life (QOL) of ESRD patients undergoing hemodialysis in Sri Lanka.
Objective: To assess the QOL among ESRD patients undergoing Hemodialysis in Teaching Hospital Batticaloa (THB), Sri Lanka.
Methods: A descriptive cross-sectional study was conducted on ESRD patients undergoing hemodialysis at THB. Data was collected through an interviewer-administered questionnaire which gathered sociodemographic and clinical information, along with the WHOQOL-BREF questionnaire measuring QOL under the following four domains: physical, psychological, social relationships and, environmental domains. Descriptive statistics were employed for data analysis. Ethical approval was obtained prior to conducting the study.
Results: More than half of the participants experienced poor QOL under each of the four domains. The highest mean QOL score was observed in the social relationships domain (57.36±3.895), while the physical domain (41.78±3.187) had the lowest mean QOL score.
Discussion: The findings indicate that the majority of ESRD patients (75.56%) undergoing hemodialysis at THB, have poor overall QOL. The obtained results highlight the need to address the QOL issues faced by these patients through targeted support and interventions.
Acardius Acephalus - monochorionic twin pregnancy. A rare case presentation
Authors: Prashanth S. , Kumanayaka Sumeda
Published: September 2024

No abstract available.
Knowledge and attitude on leprosy among healthcare workers
Authors: Shaffni F.F. , Dharmasena W.Y.K.S. , Wijesundara W.L.G.N. , Perera G.A.Y.L. , Arulpragasam A.N.
Published: September 2024

Introduction: Leprosy is a chronic progressive bacterial infection leading to grave disabilities, if left untreated. In 2019, Batticaloa District reported 126 new cases, which was the fourth highest in the country. Caseload-wise, the eastern province comes second only to the western province. Adequate knowledge and favourable attitudes among healthcare workers are quintessential for the early detection and treatment of affected persons. Therefore, we decided to assess the knowledge and attitude towards leprosy in healthcare workers.
Objective: The purpose of this study was to assess the knowledge and describe the attitude towards leprosy among healthcare workers in Teaching Hospital Batticaloa.
Method: A descriptive study was carried out among 348 health-care workers, in Teaching Hospital Batticaloa. Stratified random sampling was done and a pre-tested, self-administered questionnaire was used to collect data. Collected data were analyzed using SPSS version 26.
Results: A total of 348 healthcare workers participated. Overall, half of the participants had adequate (51.1%) knowledge while 15.5% had poor knowledge. Almost 100% of the doctors and 70% of the nurses had good knowledge while 60% of the midwives and 56% of the health assistants had inadequate knowledge. Two-thirds (60.9%) knew that leprosy is transmitted through inhalation. Just over a third (37.9%) believed brief interaction can lead to transmission. Two-thirds knew that a patient on treatment could no longer transmit the disease. Although inclusively 64% showed positive attitudes, doctors and nurses were overrepresented. Almost 40% reported that they were scared of leprosy, they would not want to shake hands with patients, they would not sit next to them and would not reveal to a friend if they were diagnosed with leprosy, respectively. All participants agreed that they would seek medical care if they were diagnosed with leprosy.
Conclusion: A notable difference in knowledge level and attitude was noted between the doctors, paramedics and nurses, and the rest of the categories. This knowledge gap and poor attitude among the first-line health workers could lead to a delay in diagnosis and hinder timely treatment, leading to an increased risk of disease transmission.
The diagnosis and management of spontaneous bacterial peritonitis
Authors: Yathukulan S. , Mayurathan P. , Francis V.R. , Francis G.R.
Published: September 2024

Spontaneous bacterial peritonitis (SBP) is a bacterial infection of ascitic fluid in patients with decompensated cirrhosis. The infecting organisms are usually enteric gram-negatives which have translocated from the bowel. Most common symptoms of SBP are fever, abdominal pain, mental status changes, and ileus. It is also observed that SBP could present as hepatic encephalopathy without any other symptoms. Therefore, high index of suspicion should exist for SBP in patients with cirrhosis and ascites. Diagnostic abdominal paracentesis can be undertaken with minimal risk and should be performed in all patients admitted to the hospital, during times of worsening clinical appearance, or when gastrointestinal bleeding occurs. The ascitic fluid polymorphonuclear cell count is the most sensitive test in evaluating for infection. Cultures of the ascitic fluid are helpful in identifying the organism and are best performed at the bedside by simply collecting ascitic fluid into culture bottles. Distinguishing SBP from secondary bacterial peritonitis is essential because the conditions require different therapeutic strategies.
The standard treatment for SBP is prompt broad-spectrum antibiotic administration and should be tailored according to community-acquired SBP, healthcare associated or nosocomial SBP infections and local resistance profile. Albumin supplementation, especially in patients with renal impairment, is also beneficial. Prophylaxis should be limited to high-risk settings. Mortality rates in SBP have declined dramatically, largely due to earlier detection and improved therapy.
The impact of menopausal symptoms on female healthcare workers
Authors: Jayasinghe J.A.S.T. , Lokubalasuriya S.P. , Madhuwanthi S.D.S. , Sadhana A.F.G.S. , Arulpragasam A.N.
Published: September 2024

Menopause is a natural biological process that affects a woman's physiological, psychological and social well-being. This study is focused on assessing the knowledge and perception of menopause among women and the impact of menopausal symptoms on a woman's life.
The purpose of this study was to describe the impact of menopausal symptoms on the routine life among female healthcare workers over 40 years in Teaching Hospital Batticaloa.
A Descriptive Cross-Sectional study was conducted from October 2020 to September 2021 among 170 female healthcare workers over 40 years in Teaching Hospital Batticaloa. Complete enumeration was used as a sampling method and a pre-tested, self-administered questionnaire was used to collect data. Statistical Package for the Socia l Sciences 25 (SPSS V.25) was used to enter and analyze the data.
A total of 170 healthcare workers completed the questionnaire. Of the sample, 32.9% were between 45 and 49 years and 30% of the total population was in post-menopausal stage. The negative and positive attitudes regarding menopause were almost equal. Although 79.4% of women complained of suffering from menopausal symptoms, the study did not show that it affected their work and life significantly. It was noted that more women reported menopausal symptoms affecting their personal lives compared to their professional lives.
Although the majority of women over 40 years suffered from menopausal symptoms, they did not report discomfort or interference of their symptoms with their profession. Creating awareness of menopausal symptoms and their management among women and, providing physical and psychological support for menopausal women are recommended.
A case of surgically and medically managed bilateral idiopathic masseter hypertrophy
Authors: Pararajasingham S. , Dias D.K.
Published: September 2024

No abstract available.
Benefits of meditation on health and for health professionals – A narrative review
Authors: Kayalini P.
Published: September 2024

Meditation has been shown to be associated with better mental health, improved attention, greater emotional regulation, slower cellular aging and better academic performance.
The aim of this review was to provide insight into benefit of meditation on health as an adjuvant therapy, thus enabling health professionals to use this technique in their daily life and promote appropriate patients to practice meditation to experience its benefits.
A literature search was done with inclusion criteria of journals, searched on PubMed, Google scholar and books relating both meditation and health, published up to 28/04/2024.
Fifty-three articles matching the search were identified and studied. The review showed the benefit of meditation in preventive medicine activities, control of non-communicable diseases, slowing cellular aging and improving academic performance. Meditation was also found to be effective as an adjuvant in management of anxiety.
Quiz Answers Vol.18(1)
Authors: Board Editorial
Published: September 2024

No abstract available.
Study of the Billings ovulation method for fertility regulation in Lombardy
Authors: Dedé Achille
Published: September 2024

The Billings Ovulation method is based on the daily analysis of changes in cervical mucus secretion that every woman can verify by studying the sensation perceived in the vulva and observing the appearance and consistency of cervical mucus flowing from the genitals.
Establishment of the Centre for Bioethics at the Catholic University of the Sacred Heart
Authors: Anonimo
Published: September 2024

Not available.
The Elderly Today: Ethical Aspects
Authors: Sgreccia Elio
Published: September 2024

Not available.
Sport in the Magisterium of John Paul II
Authors: Ferrario Luisella
Published: September 2024

Not available.
Brain death Scientific aspects and ethical issues
Authors: Manni Corrado
Published: September 2024

If there is so much talk of ‘brain death’ today, it is mainly due to two main reasons: the continuing advances in resuscitation and organ transplants, which have drawn everyone's attention to the meaning of the term ‘brain death’ in recent years.
The ethical problem of transsexualism
Authors: Cozzoli Mauro
Published: September 2024

The ethical problem of transsexualism provokes our reflection to a global and radical evaluation of human being and action. In fact, it is a problem that involves the profound conception we have of man: the anthropological vision that acts as a frame of reference for our moral evaluations and choices. With transsexualism, the very way of seeing and wanting human existence is at stake. It is therefore a problem that exceeds itself by rebounding on the global conception of the human person, which it itself contributes to changing.
Hygiene between nature and culture in doctor training
Authors: Vanini Giancarlo , Calamo-Specchia Francesco
Published: September 2024

Not available.
Hearing Loss in Diabetes Mellitus – Correlation with Otoacoustic Emissions
Authors: Munjal Manish , Kaur Hardeep , Puri Sanjeev , Mittal Naveen , Munjal Shubham
Published: September 2024

Background:

Patients with diabetes mellitus with hearing loss were analyzed for the effect of diabetes mellitus on the outer hair cells.

Materials and Methods:

Thirty patients with diabetes mellitus who visited to ENT and endocrinology outpatient clinics were analyzed for the effect of diabetes mellitus on hearing, between March 1st, 2021, and August 31st, 2022, in this prospective study.

Statistical Analysis:

On measurement of Mean and Standard Deviation- Pure tone average shows high hearing threshold in higher frequencies with increase in HbA1c levels (P = 0.001). With increase in HbA1C amplitude of recorded waves for OAE in 29 diabetics were significantly lower (P = 0.001) which attributed to disorder in the hair cells of the cochlea Categorical data were presented as percentages and Chi-square test was used to derive comparisons. For all statistical testing, P = 0.05 was considered significant. The incidence of hearing loss was analyzed from the data of otoacoustic emissions (OAE). All the clinic demographic factors were studied and correlations of hearing loss in diabetics were made to various positive risk factors.

Results:

In the present study, only 3.3% of subjects exhibited OAE. With an increase in glycosylated hemoglobin (P = 0.001), the distortion product OAE (DPOAE) amplitude decreased. Majority, i.e., 12 (41.3%) had reduced amplitude of DPOAE at 6 kHz, followed by 9 (31.2%) at 4 kHz, 5 (17.2%) at 2 kHz, and 3 (10.3%) at 8 kHz. Males predominated, i.e., 21 (72.4%) in comparison to the females 9 (27.5%).

Conclusions:

Diabetes has been associated with hearing impairment secondary to alterations in the organ of Corti and the stria vascularis. Hearing deficit is also attributed to the combined effect of hyperglycemia and oxidative stress leading to cochlear microangiopathy and auditory neuropathy. The quality of life improves in diabetics with control of the glycemic index.
Dilated cardiomyopathy subsequent to anabolic-androgenic steroid abuse
Authors: Natarajan Deepak
Published: September 2024

Elite athletes and males frequently use anabolic-androgenic steroids (AAS) to enhance performance and enhance physique. There have been reports of severe cardiovascular adverse effects in AAS users. This report describes the uncommon instance of a 40-year-old male without any other risk factors developing dilated cardiomyopathy, subsequent to AAS abuse for the previous 8 years. The precise mechanism by which AAS causes cardiomyopathy remains unclear. There are as yet no guidelines formulated for the treatment of AAS-induced cardiomyopathy. Anabolic androgenic-induced cardiomyopathy must be familiarized by physicians when confronted with a case of dilated cardiomyopathy.
Does Physiological Intracytoplasmic Sperm Injection Improve Outcome in Men with Abnormal Semen Parameters: A Retrospective Cohort Study
Authors: Shivhare Swati , Karunakaran Sandeep , Bose Ananda Swarup , Goel Rishu , Ananthakrishnan R.
Published: September 2024

Background:

As the male factor in infertility is on rising trend, we need a promising tool for sperm selection to improve the embryo development.

Aim:

The present study compares the embryological and clinical parameters between physiological intracytoplasmic sperm injection (PICSI) and conventional intracytoplasmic sperm injection (ICSI) in abnormal semen parameters.

Settings and Design:

This was a retrospective cohort study.

Materials and Methods:

This study was conducted over the duration of 9 months from April to December 2023. One hundred and four patients, who matched the inclusion and exclusion criteria, were enrolled in the study. The adjusted blastulation rate was evaluated as the primary outcome, and the secondary outcomes studied were fertilisation rate, good-quality cleavage stage embryo rate, clinical pregnancy and miscarriage rate.

Statistical Analysis Used:

The outcome measures were calculated using independent Student’s t-test, and P < 0.5 was considered statistically significant.

Results:

The 104 enrolled patients were divided into two groups. In the study population (n = 51), PICSI was used for sperm selection and the controls (n = 53) used conventional ICSI. The adjusted blastulation rate was statistically significant higher in the PICSI group (43.7%) as compared to the controls (34.2%) (P = 0.022). The fertilisation and cleavage rates were not statistically different amongst the groups. The pregnancy rate (37.2% vs. 32%, P = 0.027) and miscarriage rate (5.3% vs. 11.7%, P = 0.005) were statistically better in the PICSI group.

Conclusion:

PICSI may improve treatment outcomes in couples undergoing assisted reproduction for male factor infertility. However, larger randomised controlled trials are needed for validating the current study findings.
Pharmacists’ Counseling and Benzodiazepines Dispensing for Sleep Disorders: A Simulated Patient Study in Iran
Authors: Banitaba Joshaghani Fatemeh , Sarahroodi Shadi
Published: September 2024

ABSTRACT

Objective:

Sleep is critical for good health and quality of life, but many people struggle with sleep disorders. Pharmacists are on the front lines, helping patients manage these problems. However, there is growing concern that some pharmacists are dispensing benzodiazepines over-the-counter and failing to provide proper counseling. This study examined how pharmacists in Iran performed in these areas.

Methods:

Between January and April 2022, we conducted a cross-sectional study in three major Iranian cities, using a “simulated patient” to observe how pharmacists interacted with them. In total, 431 pharmacies participated, and we used detailed forms to record the pharmacists’ behavior. We then analyzed the data using descriptive statistics and the Chi-square tests.

Findings:

Of 549 visits, 78.5% were managed by pharmacists, whereas the remainder were managed by other pharmacy staff. 79.7% of pharmacists evaluated the patient before deciding whether or not to prescribe the medication and 58.9% provided a kind of counseling for their offered medication, but just 10.6% of pharmacies had a private counseling area. Despite regulations that require a valid prescription for benzodiazepines, 9.2% of pharmacies dispensed diazepam, and 13.2% dispensed alprazolam without requesting one, and when counseling was offered, it often lacked critical details.

Conclusion:

These findings raise serious concerns. There are deficiencies in how pharmacists and patients interact, with many pharmacists spending minimal time assessing patient needs. The high rates of benzodiazepine dispensing without valid prescriptions and inadequate counseling point to a need for stricter protocols and more training. To address these issues, health-care professionals and policymakers must collaborate to improve the quality and safety of sleep disorder treatment in community pharmacies.
Recurrent vulvar dysplasia after a prior carcinoma of the cervix: A case of field effect
Authors: Apa Jessa Karyl Rubenecia , Luna Jericho Thaddeus P.
Published: September 2024

Vulvar intraepithelial neoplasia (VIN) is a dysplastic condition of the squamous epithelium of the vulva. There are two types of VIN: high-grade squamous intraepithelial lesion of the vulva and VIN differentiated type (dDVIN). Management includes excision, laser ablation, and topical therapy. An excisional procedure used in VIN is simple local excision and partial or total skinning vulvectomy. Despite treatment, its recurrence is high. A G5P5 (5004) woman in her 60s presented with vulvar pruritus and vulvar pain of 2 years. She was treated for cervical adenocarcinoma Stage IB1 with surgery and complete radiotherapy 27 years prior. She was diagnosed twice with vulvar dysplasia 12 and 21 years after the diagnosis of cervical malignancy, both times presenting as vulvar pruritus. She was subsequently managed with vulvectomy with bilateral groin node dissection and with wide local excision, respectively. A 3 cm × 2 cm well-circumscribed, irregular erythematous plaque at the introitus’s 11–1 o’clock region was noted on physical examination. She was managed as a case of recurrent VIN III and underwent wide local excision and distal urethrectomy with split-thickness skin graft. The final histological examination of the submitted specimen showed human papillomavirus-associated classic VIN II.