bluuebunny/crossref_metadata_2025 huggingface dataset:
Archiver, documenter en temps de guerre : Ukraine et Russie aujourd’hui
Authors: Grigorciuk Nathalie , Daucé Françoise , Blum Alain , Lèbre Céline
Published: March 2023

Dans la table ronde « Archiver, documenter en temps de guerre : Ukraine et Russie aujourd’hui », qui s’est tenue à La contemporaine dans le cadre du colloque du projet DISSINVENT, ont été discutées les questions d’accès et de sauvegarde d’archives russes et ukrainiennes (notamment numériques) dans le contexte de propagande, de censure mais aussi de bombardements de la guerre engagée par la Russie contre l’Ukraine.
Probiotic adjuvant treatment in combination with scaling and root planing in chronic periodontitis: a systematic review and meta-analysis
Authors: Li J. , Zhao G. , Zhang H.M. , Zhu F.F.
Published: March 2023

This systematic review and meta-analysis assessed the impact of probiotic supplementation on treating chronic periodontal (CP) disease based on clinical and microbiological findings. Four databases were searched: Medline, Embase, Cochrane Library, and the Web of Science databases. The references to relevant studies were also manually searched. Analyses were conducted using the Review Manager 5.2 software, while the quality of randomised controlled trials was assessed with the Cochrane Risk of Bias tool. In total, 19 studies were included in the meta-analysis. Pooled results revealed that the adjuvant use of probiotics in the treatment of patients with periodontal disease was largely associated with good clinical efficacy. Resulting in statistically significant improvements in plaque index (P<0.05), periodontal probing depth (P<0.05), clinical attachment level (P<0.05), gingival index (P<0.05), bleeding on probing (P<0.05), deep probing depth (P<0.05), and levels of subgingival microbes (P<0.05) following probiotic supplementation. In summary, the results of this meta-analysis suggest that the administration of probiotics together with scaling and root planing can somewhat improve CP patient clinical outcomes and reduce levels of periodontal pathogens. However, more comprehensive experiments are needed to standardise probiotics and maximise their adjuvant therapy.
Agave fructans enhance the effects of fermented milk products on obesity biomarkers: a randomised trial
Authors: Vega-Cárdenas M. , Martínez-Gutierrez F. , Lara-Ramírez E.E. , Reynaga-Hernandez E. , Yañez-Estrada L. , Ratering S. , Schnell S. , Godínez-Hernández C.I. , Vargas-Morales J.M. , Portales-Pérez D.P.
Published: March 2023

Dysbiosis has been implicated in childhood obesity. Oral intake of fermented milk containing Lacticaseibacillus casei strain Shirota preserves gut microbiota (GM) diversity in children and adults. This study was a double-blind trial involving 37 overweight or obese children aged 6-10 years. Children were followed over a 6-week intervention period in which they received different fermented milk products containing L. casei Shirota: 10 in the first group received just L. casei Shirota; 13 received L. casei Shirota with 3 g/day of inulin (L. casei+inulin); and 14 received L. casei Shirota with 3 g/day of fructans from Agave salmiana (L. casei+fructans). Principal component analysis showed the relationship between microbial abundance, GM metabolites, and other obesity-related markers. Supplementation with probiotics and synbiotics improved the HDL-cholesterol levels of overweight and obese children, although no changes in body composition were detected. We observed an increase in butyrate or propionate concentrations in the L. casei+fructans group compared to the end of the intervention (P<0.03). A diminished level of ANGPTL4 within the L. casei+fructans group (P=0.04) was also found, but no differences when lipopolysaccharide-binding protein was evaluated. The FFAR2+ cell frequency decreased between baseline and at the end of 6-week intervention in L. casei+inulin (P=0.02) and L. casei+fructans groups (P=0.04). In contrast, the percentage of CD14+FFAR3+ frequency increased in the same groups (P=0.04). The L. casei Shirota with inulin or fructans modulates GM, which improves the lipid profile and changes at a molecular level, such as expression of FFAR3 and FFAR2, ANGPTL4, propionate, and butyrate. It, therefore, could be considered an interesting therapeutic possibility for treating childhood overweight and obesity.

The study was registered at ClinicalTrials.gov (ID: NCT05423015).
The input of microorganisms to the cultivation of mushrooms on lignocellulosic waste
Authors: Saubenova Margarita , Oleinikova Yelena , Sadanov Amankeldi , Yermekbay Zhanerke , Bokenov Didar , Shorabaev Yerik
Published: March 2023

Lignocellulosic crop waste is the world's most abundant renewable raw material. Its burning leads to the loss of an energy valuable resource and causes enormous environmental damage. An environmentally friendly and promising biotechnological process for such waste utilization is the production of mushrooms for food and medicine. However, the energy intensity of substrate preparation hinders the development of work in this direction. Another significant challenge in this field is to increase the biological efficiency of substrate processing. The purpose of our investigation was to reveal the contribution of microorganisms to solving this and other problems of mushroom cultivation based on a review of the latest scientific research on the topic. The literature from databases of Google Scholar, Scopus, and Web of Science was selected by various combinations of search queries concerning mushrooms, substrates, microbial communities, and their effects. The current state of the issue of mushrooms and microorganisms' interactions is presented. The review considers in detail the contribution of microorganisms to the substrate preparation, describes microbial communities in various phases of the mushroom cultivation process, and identifies the main groups of microorganisms associated with lignocellulose degradation, mushroom growth promotion, and protection against pathogens. The significant contribution of bacteria to mushroom cultivation is shown. The review demonstrates that the contribution of bacteria to lignin degradation in lignocellulosic substrates during mushroom cultivation is largely underestimated. In this process, various genera of the bacterial phyla Bacillota, Pseudomonadota, and Actinomycetota are involved. The correct combinations of microorganisms can provide controllability of the entire cultivation process and increase required indicators. However, expanding research in this direction is necessary to remove gaps in understanding the relationship between microorganisms and mushrooms.
Freezing influence on the histological structure of Mediterranean mussel (Mytilus galloprovincialis)
Authors: Strateva Mariyana , Stratev Deyan , Zhelyazkov Georgi
Published: March 2023

The objective of this study was to establish the morphological changes in the structure of Mediterranean mussel (Mytilus galloprovincialis) after frozen storage. Two hundred Mediterranean mussels (M. galloprovincialis) were collected from the Black Sea coastal waters. Forty mussels were subjected to histological analysis in fresh state. The remaining 160 mussels were divided into 4 groups and slowly frozen in a conventional freezer at −18 ℃ and subsequently stored at the same temperature for 3, 6, 9 and 12 months, respectively. The histological assessment of posterior adductor muscle and foot found a change in their morphological profile and overall structure. The fewest changes in the histostructure were recorded after a 3-month period and the most after a 12-month period of storage in frozen state. The results from that study can be used as an unambiguous marker in selecting optimum conditions for storage of mussels in frozen state.
Bifurcation and one-sign solutions for semilinear elliptic problems in $ \mathbb{R}^{N} $
Authors: Shen Wenguo
Published: March 2023

In this work, we study the existence of one-sign solutions without signum condition for the following problem:

   \begin{document}$ \begin{eqnarray} \left\{ \begin{array}{ll} -\Delta u = \lambda a(x)f(u), \, \, x\in\mathbb{R}^{N}, & {\rm{}}\ u(x)\rightarrow0, \, \, \, \, \, \, \, \, \, \, \, \, \, \, \, \, \, \, \, \, \, \, {\mathrm{as}}\, \, |x|\rightarrow +\infty, & {\rm{}} \end{array} \right. \end{eqnarray} $\end{document}

where $ N\geq3 $, $ \lambda $ is a real parameter and $ a\in C^{\alpha}_{loc}(\mathbb{R}^{N}, \mathbb{R}) $ for some $ \alpha\in(0, 1) $ is a weighted function, $ f\in C^{\alpha}(\mathbb{R}, \mathbb{R}) $, and there exist two constants $ s_{2} < 0 < s_{1}, $ such that $ f(s_{1}) = f(s_{2}) = f(0) = 0 $ and $ sf(s) > 0 $ for $ s\in\mathbb{R}\backslash\{s_{1}, 0, s_{2}\}. $ Furthermore, we consider the exact multiplicity of one-sign solutions for above problem under more strict hypotheses. We use bifurcation techniques and the approximation of connected components to prove our main results.
La partie de cache-cache la plus longue du monde. Auteurs médiévaux contre critiques modernes
Authors: Martina Piero Andrea , Trachsler Richard
Published: March 2023

C’est en partant de la considération qu’une bonne partie de la production littéraire médiévale nous est parvenue dans des textes sans nom d’auteur que s’est imposé le cliché du Moyen Âge aux écrivains humbles, qui hésitent à signer leurs œuvres, cliché auquel on oppose traditionnellement l’autre cliché, celui de la Renaissance aux artistes désormais conscients et fiers de leur individualité, qui apposent à leurs créations originelles une signature. Dans cet article, nous nous proposons de revenir sur la question du nom de l’auteur médiéval, pour rappeler que tout, ou presque, est affaire de critique : qu’il s’agisse de sortir un texte de l’anonymat pour le placer sous l’autorité d’un écrivain célèbre ou de déclarer qu’un patronyme est en réalité un pseudonyme, ou encore de faire émerger un nom à partir d’une nuée de lettres en les organisant en anagramme, c’est le médiéviste qui tranche. En nous arrêtant sur les cas de Marie de France et, surtout, de Jean Renart, nous nous proposons de parcourir une partie de l’histoire de la critique, pour voir comment l’histoire de la discipline pèse toujours sur l’approche de nos études médiévales.
Les sols dégradés révélateurs de la solidarité écologique
Authors: Desrousseaux Maylis , Heckenroth Alma
Published: March 2023

En droit français, le principe de solidarité écologique a vocation à être mis en œuvre lorsqu’une décision prise par une autorité publique aurait une incidence notable sur l’environnement. C’est-à-dire lorsque l’incidence n’aurait pas encore eu lieu. Cette interprétation réduit d’emblée son champ d’application et laisse entendre qu’elle ne s’appliquerait qu’aux espaces non encore dégradés. Prenant le contrepied du principe, cet article démontre que le concept de solidarité écologique pourrait être un élément moteur dans la mise en œuvre de mesures de restauration écologique des milieux dégradés et en particulier des sols. Ce faisant, il se fonde sur une étude de terrain située dans le cœur du Parc national des Calanques (projet SynTerCalM, 2014-2016) pour souligner comment l’inaction face à une dégradation parfois invisible, en l’occurrence la contamination des sols, nuit aux objectifs de conservation et de restauration des milieux avec lesquels il est en relation.
La solidarité écologique, lien de droit d’une interdépendance au vivant
Authors: Barrière Olivier
Published: March 2023

Le législateur français introduit le concept de solidarité écologique dans le droit en 2006 comme une relation bioécologique entre espaces, puis ce concept est érigé en principe général en 2016 dans le code de l’environnement en appelant à prendre en compte dans les prises de décisions « les interactions des écosystèmes, des êtres vivants et des milieux naturels ou aménagés ». Même avec une définition restrictive de la solidarité écologique, évitant de mentionner toute interdépendance, son introduction dans la loi est un pas majeur vers un dépassement qui va permettre une transformation indispensable de la société moderne occidentale face à l’urgence écologique (climatique, sanitaire, de biodiversité). L’analyse de l’apport de cette solidarité des êtres vivants doit être perçue comme un cheval de Troie dans l’antre du naturalisme. Le droit étatique va devoir se réinventer en se dégageant d’un schéma de développement. Il doit opérer une mutation articulée autour d’une ontologie relationnelle commune, dite « coviabiliste », inscrite dans le cadre d’un pluralisme juridique. Cette réinvention du droit ne peut se réaliser qu’en rapprochant les sociétés du vivant, humains et autres qu’humains, faisant socio-écosystème. La solidarité écologique ouvre les perspectives d’un droit de la coviabilité en formalisant les interactions au sein des êtres vivants et des milieux par le biais du lien de viabilité, comme lien de droit.
The realising of religion moderation in Tareqa Al-Yusriyyah As-Siddiqiyyah Ash-Shadhiliyyah
Authors: Khotimah Khusnul , Sukron Mokhamad
Published: March 2023

This study aims to clarify certain ideas regarding Al-Yusriyyah Ash-Shdhiliyyah Siddqiyyah Tariqa and its function in religious moderation. Tareqa can be a new formula in realising harmony in religious diversity, in which the teaching principle of Tariqa is the spirit of improving moral and character. This is very important in living in diversity. By implementing Tariqa, a person understands religion not only from the outward side but also from the inner part of religion, so that it is expected to be able to find the substance, namely, the true truth that is universal. From this point of view, the Sufism paradigm seems to have advantages that the person is more tolerant of differences, both internal and external. A field study was conducted to achieve the objective of this research. Particularly, this study used an interdisciplinary approach, that is, a combination of religious and social approaches. A participatory observation, deep interviews and documentations were employed to collect the data of this study. The subjects of this research were adherents of the Tariqa in Cairo, Egypt and Indonesia. This study reveals that Tariqa has teachings and values in realising religious moderation in a plural society. This Tariqa could be an agency of religious moderation. The significance of this study is to prove the power of Tariqa and Sufism as agents of change in plural societies against extremist and intolerable attitudes both between devotees of particular religions and between adherents of different religions. Accordingly, it can promote a peaceful and tolerant way of life and reduce violence. This study supports earlier research that suggested Sufism as an option for governmental action in a plural society to counteract radicalism and intolerance.Contributions: The results of this study are expected to contribute to providing suggestions to the stakeholders in dealing with the rise of religious intolerance and radicalism both globally and locally. Moreover, the ritual, doctrinal and social interaction of Tareqa Al-Yusriyyah As-Siddiqiyyah Ash-Shadhiliyyah can be a source of reference and inspiration for the policy of stakeholders in deradicalising religion and creating religious moderation.
A critical study of Pentecostal understanding of the baptism of the Holy Spirit in Acts
Authors: Stevanus Kalis , Weismann Ivan Th. J. , Luthy Christopher J. , Ronda Daniel , Rouw Randy F.
Published: March 2023

In faith and practice, Pentecostals put emphasis on practical issues as well as spiritual experience in their theological understanding and doctrinal teachings. The Pentecostals take their doctrine from certain empirical events. One of the spiritual experiences often underlined is the baptism of the Holy Spirit. In interpreting the Book of Acts, Pentecostals tend to emphasise the theological character of the narratives and seldom their historical uniqueness. That is why Pentecostals stress the normative theological intent of the historical record for contemporary Christian experience. This article therefore examines critically Pentecostal paradigm of the baptism of the Holy Spirit, deriving examples from the Acts of the Apostles. It is concluded that the practice of the baptism of the Holy Spirit carried out by Christians today, arguably, has no biblical basis. This is because, there is nowhere the Bible commands people to seek baptism in the Holy Spirit. The observation is that, all the events or experiences of Christians baptised in the Holy Spirit in Acts are not necessarily universal normative for every Christian and for this reason, there is no need to be dogmatic.Contribution: This article challenges the practice of the baptism of the Holy Spirit in church today. This study supports the fact that the baptism of the Holy Spirit is not a universal experience for every Christians and there is no need to be dogmatised.
Description of Culicoides truuskae sp. n. (Diptera: Ceratopogonidae) from southern Africa
Authors: Labuschagne Karien , Meiswinkel† Rudolf , Liebenberg Danica , Van Zyl Carissa , Van Schalkwyk Antoinette , Scholtz Clarke
Published: March 2023

Culicoides truuskae Labuschagne and Meiswinkel sp. n. is described and illustrated in both sexes from material collected in South Africa and Namibia. It is restricted to the xeric western margin of the subcontinent, occurring in Fynbos, Nama-Karoo and Succulent Karoo ecoregions in South Africa and Desert and Savanna ecoregions in Namibia experiencing 600 mm of rainfall annually. Culicoides truuskae sp. n. is part of the Afrotropical ‘plain-wing’ Culicoides in which the wing lacks a distinguishing pattern of light and dark spots; the diagnostic dark smudge that traverses wing cell r3 may result in C. truuskae sp. n. being misidentified as the sympatric but phyletically unrelated Culicoides herero (Enderlein) – (of the Similis group, subgenus Oecacta Poey). Additionally, this study is the first description of the male of C. herero. C. truuskae sp. n. and Culicoides coarctatus Clastrier and Wirth share similar characters in the male genitalia, although the two species are separable on wing pattern and female flagellum sensilla coeloconica (SCo) distribution. The breeding habitat and adult female blood-feeding preferences of C. truuskae sp. n. are not known. A maximum likelihood phylogenetic tree, using mitochondrial cytochrome c oxidase I (COI) sequence data, is provided to further clarify the relationship between C. truuskae sp. n., C. coarctatus and C. herero. Extensive light trap data, collected over 30 years, are used to map the distribution ranges of C. truuskae sp. n., C. coarctatus and C. herero in Southern Africa.Contribution: The description of this new species and the description of the male of C. herero increases our understanding of the diversity and distribution of Culicoides species in southern Africa.
Work engagement and resilience at work: The moderating role of political skill
Authors: Sanhokwe Hamfrey , Chinyamurindi Willie
Published: March 2023

Orientation: Faced with high contextual dynamics, organisational leaders are looking to resilience as a resource to help their employees manage their well-being as they adapt to the changes. Appreciating the complementary resource streams that help employees adapt or transform the context is an urgent priority.Research purpose: Drawing on the conservation of resources theory, the study evaluated the moderating role of political skill in the relationship between work engagement and resilience at work.Motivation for the study: The quality of the employees’ personal and social resources at work could explain the degree to which they move beyond mere adaptation to thriving.Research approach/design and methods: The data collected from a convenient sample of over 200 individuals were used to construct a hierarchical multiple regression model.Main findings: There was a significant association between work engagement and resilience at work. The interaction term between work engagement and political skill accounted for a significant proportion of the variance in resilience at work.Practical/managerial implications: The result suggests that work engagement and political skill act in an integrative way to replenish adaptive resources at work. Organisational leaders must inculcate and nurture cultures that promote these complementary capabilities if they are to enjoy adaptive advantages. These capabilities are learnable and, hence, developable.Contribution/value-add: The study model deepens our understanding of the integrative mechanisms that nourish employee resiliency.
Exploring the methods of salivary analysis in the diagnosis of Alzheimer's disease: A scoping review
Authors: Awais Dania , Sarhan Farah Ayman , Al-Majali Laila Sami , Almuzaien Mariam , Awad Marwan Amjad , Amer Mostafa Nagi , Ali Mohammed Marwan Mansoor
Published: March 2023

Alzheimer's disease is a common type of dementia. It is a progressive neurodegenerative disease that starts with mild memory loss and may progress to loss of ability to convey a conversation and respond to the surrounding. Early detection can help in the management of this disease. In this review, we attempted to find the most accurate method for salivary biomarkers detection, which can aid in the early diagnosis of Alzheimer's disease. For this scoping review; PubMed, Scopus, and Google Scholar online databases were searched to find studies and articles that test the salivary biomarkers for the diagnosis of Alzheimer's disease. Eleven studies were eligible for our research. Ten were case–control, and one was a cohort study. Seven of the studies used the enzyme-linked immunosorbent assay (ELISA) method, five of which showed diagnostic potential. Two studies used Luminex assay and photomultiplier tube, showing similar results to ELISA. AbsoluteIDQ®p150 Kit and faster ultra-performance liquid chromatography-mass spectrometry analysis and pattern recognition techniques tested different metabolites with potential diagnostic significance. Furthermore, another study using an extended gate ion sensitive field effect transistor sensor related salivary trehalose sugar to Alzheimer's disease. Different reliable biomarkers were detected using ELISA kit and appear to be effective in disease detection. Further studies and clinical trials on a large scale are required to determine the most accurate method of detecting Alzheimer's disease.
Levothyroxine Absorption Test – Results and Follow Up of Patients from a Single Center
Authors: Subramaniam Karthik , Babu Tom , Sreevalsan K. C. , Mathew Shemy
Published: March 2023

Introduction:

Treating primary hypothyroidism with appropriate weight-based dosing is usually straightforward. When supraphysiologic doses of thyroxine are required, it is important to know the reason behind the increased requirement. When compliance with medication is assured and when there are no drug interactions resulting in increased thyroxine requirements, a levothyroxine absorption test (LT4AT) could be performed to diagnose the coexistence of malabsorption.

Materials and Methods:

This was a single-center, retrospective chart review. Patients who had undergone LT4AT between 2018 and 2020 with a complete evaluation and follow-up records were reviewed. LT4AT and further evaluation (if necessary) were standardized, and details until the last review were obtained.

Results:

In all, 11 patients had complete records and follow-up details. The median age (range) of the cohort was 24 years (19 to 46), and the duration of hypothyroidism was 8 years (4 to 24). Seven had low absorption (<60%) in LT4AT of which two each had celiac disease and Helicobacter pylori infection; one had autoimmune gastritis, and in two the reasons of malabsorption was not known. The median follow-up duration was 13 months. Nine of 11 (81%) achieved euthyroid state with/without thyroxine dose reduction on follow-up.

Conclusion:

A high proportion of patients requiring supraphysiological doses of levothyroxine had occult malabsorptive states, some of which were curable. Even in those with pseudo-malabsorption, LT4AT helped in reinforcing compliance and thereby thyroxine dose reduction.
Ought to The Changes Within the Immunophenotype of Solid Cell Nests (SCNs) and Follicular Cells in Hashimoto’s Thyroiditis be Considered as Premalignant Lesions?
Authors: Dung Tran Ngoc , Tuyen Nguyen Khac , Tien Truong Dinh , Thinh Pham Van , Hassell Lewis A. , Van Nguyen Khanh , Hung Nguyen Manh , Tra Dang Thai , Ben Nguyen Huu , Linh Nguyen Thuy
Published: March 2023

Background:

Papillary thyroid carcinoma (PTC) is more frequently reported in patients with Hashimoto’s thyroiditis (HT), which may be associated with the presence of solid cell nests (SCNs) and focal PTC-like nuclear alterations in the thyroid gland. The point of this consideration was to assess the morphological and immunohistochemical features of SCNs and follicular epithelial changes in Vietnamese patients with HT.

Materials and Methods:

Hematoxylin–eosin and immunohistochemistry were performed on 20 samples of HT patients who underwent thyroidectomy and were diagnosed with Hashimoto’s thyroiditis at Military Medical Hospital 103 from 6/2018 to 6/2019. The expression of five markers (P63, Calcitonin, TTF1, CK19 and HBME-1) in SCNs and follicular epithelial changes were evaluated.

Results:

Ninety per cent of samples had SCNs with an average of 10 SCNs per section. Only type 1 and type 4 SCNs were presented (85% and 55%, respectively) and all SCNs were composed of main cells (p63-positive). Fifteen of the 18 cases having SCNs possessed nuclear features of PTC. C-cell hyperplasia was found in one case with 20 clusters. All SCNs showed strong staining with CK19 and weak staining with HBME-1. Follicular epithelial changes were Hürthle cell metaplasia, PTC-like nuclear alterations, atypical solid nodules, papillary and glomerular-like forms (40%, 100%, 25% and 50%, respectively). Follicular cells of glomerular-like forms (new alteration) especially were positive with CK19 (2+ ~ 3+), HBME-1 (1+) and TTF1, while the components in these follicles were negative with CK19, HBME-1 and TTF1. Among PTC-like nuclear alterations, all the atypical solid nodules related to HT showed markers related to PTC and without SCNs.

Conclusions:

Increasing the number of SCNs, as well as PTC-like nuclear alterations of main cells in SCNs and follicular epithelial changes were co-expressed CK19 and HBME-1. Therefore, the need for HT management should be considered.
Idiopathic Intracranial Hypertension following Levothyroxine Replacement Therapy: Systematic Review and a Case Report
Authors: Datta Sumanas G. , S.L Sagar Reddy , Dhananjaya Melkunte S. , Tamminedi Nitin , Nayak Vittal , Kodapala Suresha , Sarathi Vijaya
Published: March 2023

The data on the characteristics of patients with idiopathic intracranial hypertension (IIH) following levothyroxine (LT4) replacement are limited. Here, we report a case and systematically review published cases of idiopathic intracranial hypertension (IIH) following levothyroxine (LT4) replacement. The systematic review was performed as per the PRISMA guidelines. Our patient is a 46-year-old lady with hypothyroidism (thyrotropin: 319 mIU/L, free thyroxine: 0.04 ng/dl), treated with 100 μg.d of LT4 and presented a month later with headache, visual diminution, bilateral lateral rectus palsies, and papilledema. Cerebrospinal fluid (CSF) pressure was 32 cmH2O. Drainage of CSF, oral acetazolamide, and modification of LT4 dose resulted in prompt symptomatic improvement and complete reversal of IIH. In the systematic review (n = 21), the median age of patients (7 males) was 13 (IQR: 8.8- 26.5) years. The median duration of hypothyroid symptoms was 4 (n = 10, IQR: 0.44-6.25) years whereas that from initiation of LT4 replacement to the diagnosis of IIH was 2 (n = 20, IQR: 1.17-4) months. Initial median serum thyrotropin and thyroxine were 100 (n = 14, IQR: 72.5-421.6) mIU/L, and 1.13 (n = 12, IQR: 1.0-2.45) μg/dl which changed to 2.2 (n = 7; IQR: 0.23-3.40) mIU/L and 8.90 μg/dl (n = 8, IQR: 6.43-14.85 μg/dl), respectively at diagnosis of IIH after LT4 treatment with median daily LT4 doses of 0.89 (n = 8, IQR: 0.60 – 1.17) times the maximum recommended dose for age. To conclude, we report an adult woman with IIH following LT4 replacement for primary hypothyroidism, a rare entity. Pediatric age, prolonged symptom duration, and use of higher LT4 replacement dose may be associated with IIH following LT4 replacement.
Oncological Emergencies
Authors: Jha Avanish , Abraham Sisha Liz , Mathew Anna , Ahmad Areeba , Jacob Jeryl Chellappa , Shandilya Sudipti , Prabhakar Abhilash Kundavaram Paul
Published: March 2023

Background:

Patients with malignancies present to the emergency department (ED) with a varied spectrum of presentations. Data on oncological emergencies are scant; hence, we aimed to determine the profile, outcome, and awareness of their treatment of patients with malignancies presenting to the ED.

Methodology:

This prospective observational study was conducted in the adult ED of a large tertiary care hospital in South India between February and August of 2018. A convenient sample of patients presenting to the ED with a known or newly diagnosed malignancy was included in the study after obtaining written informed consent.

Results:

During the study, we recruited 110 patients presenting to the ED. The mean age of the patients was 48 (15.9) years. There was a female preponderance (56.4%). A quarter of the patients had malignancy of the genitourinary tract while 10% had breast carcinoma and 9% had bronchogenic carcinoma. Vomiting (44%) was the most common symptom at presentation followed by fever (39%) and abdominal pain (38%). Anemia (81%) and hyponatremia (54.5%) were the most common laboratory abnormalities. Antiemetics (61%), antibiotics (32%), and nonsteroidal anti-inflammatory drugs (27%) were the most commonly used medications. Chemotherapy-related complications (35.5%) and mass effects (28%) were the most common reasons for ED visits. The majority (83%) were previously diagnosed with malignancies. Most patients were aware of the duration (86%) and common side effects of chemotherapy (79%). However, most were unaware of the chemotherapy drugs' names (25%) and how to manage side effects (54%). Sixty percent required admission and three patients died during their in-hospital stay.

Conclusion:

Gastrointestinal symptoms and fever are the most common causes of presentation to the ED among patients with malignancies. Although most patients were aware of the duration and side effects of treatment, half of them were ignorant of the emergency first aid for side effects of the medications they were on.
An audit of perioperative antibiotic prescriptions in patients undergoing clean surgeries and compliance with antibiotic policy in a tertiary hospital
Authors: Sinha Sharmili , Biswal Sandeep
Published: March 2023

Introduction:

There has been a rise in the use of broad spectrum antibiotics in patients undergoing surgeries in perioperative period including clean surgeries. The use of such antimicrobials is also found to be longer than recommended and is responsible for emregence of multi drug resistant infections. These add to antibiotic related complications and cost as well.

Aim:

To study the type of antibiotic prescription in patients undergoing clean surgeries and assess compliance with antibiotic policy and frame recommendations for improvements if any.

Method:

Fifty five patients were prospectively evaluated for perioperative antibiotics prescriptions and followed up till discharge/1 month for any nosocomial infections or other complications. The kind and duration of antibiotics were noted and assessed for extent of compliance to antibiotic policy.

Results and Discussions:

Compliance to perioperative surgical prophylaxis in time was good (91%) as per the protocol and all patients received prophylaxis. Broad spectrum antibiotics were used in almost 50% cases and duration was prolonged compared to the prescribed protocol. Prescription of oral antibiotics was continued in 72.7% % cases(40/55). There was no increased incidence of health care associated infections(HAI) in these patients.

Conclusion:

Compliance to Surgical antibiotic prophylaxis practices in clean surgeries is good in the hospital Broad spectrum antibiotics were in use in more than half cases and oral antibiotics were prescribed at discharge in most patients which is not in accordance with the protocol. The incidences of HAIs in these cases were not increased. Regular audit and continued training of all stake holders is necessary to raise awareness and improve practices for antimicrobial stewardship.
Evaluation of characteristics, clinical relevance and outcome of ventilator associated pneumonia and ventilator associated events algorithm
Authors: Sahni Neeru , Biswal Manisha , Kaur Kulbeer , Bandyopadhyay Anjishnujit , Saini Vikas , Yaddanapudi Lakshmi Narayana
Published: March 2023

Background:

Surveillance for ventilator-associated pneumonia (VAP) has long been a challenge because of the lack of objective, reliable definitions. Hence, National Healthcare Safety Network (NHSN) has introduced ventilator-associated events (VAEs) as a surveillance definition. While VAE identifies all the possible complications in a mechanically ventilated patient, VAP recognises only the infective complications. There are several retrospective studies reporting no concordance between the occurrence of VAE and VAP. A prospective, observational study in medical intensive care unit (ICU) was conducted over 1 year with the objective of comparing all three tiers of VAE, which are ventilator-associated condition (VAC), infection-related ventilator-associated complication (iVAC) and possible VAP (PVAP), along with VAP in terms of predictive value, characteristics and clinical relevance.

Materials and Methods:

A prospective cohort study was conducted from July 2018 to June 2019 at PGIMER, Chandigarh, in a 12-bedded medical ICU. All patients with more than 48 h of mechanical ventilation (MV) were included. The demographic data, Acute Physiology and Chronic Health Evaluation-II at 24 h of admission, days of MV, length of ICU stay and outcome of patients were recorded. The patients were screened for both VAP and VAE.

Results:

Out of a total of 405 patients, 274 patients were included with 3945 patient days and 3330 MV days. The incidence of VAP, VAC, iVAC and PVAP was 6.91, 8.41, 5.41 and 1.50/1000 ventilator days, respectively. Kendall's W-test showed that there was no concordance between VAP and VAE.

Conclusion:

The study concluded no concordance between cases identified as VAE and VAP.
A case report of pulmonary alveolar microlithiasis with pulmonary tuberculosis
Authors: Sarkar Malay , Sharma Sudarshan K. , Jhobta Anupam , Gulati Anchana
Published: March 2023

Pulmonary alveolar microlithiasis (PAM) is a rare autosomal recessive disease characterised by the deposition of calcium phosphate microliths in the alveoli. PAM has been reported in all continents and there is often a familial history. There is clinical-radiological dissociation as there is often a paucity of symptoms in contrast to the imaging findings. Patients often remain asymptomatic until the third or fourth decade of life, and dyspnea is the most common symptom. PAM is caused by a mutation within the solute carrier family 34 member 2 gene (the SLC34A2 gene) located on chromosome 4p15.2, which encodes a sodium/phosphate co-transporter. The imaging appearance of the disease is quite pathognomic with the high-resolution computed tomography (HRCT) demonstrating a diffuse micronodular appearance. Transbronchial lung biopsy also confirms the diagnosis. There is no effective therapy at present except lung transplantation. We herein, present a case of PAM along with clinical history, imaging study, histopathological study and genetic study of a 43-year-old female adult patient along with genetic analysis.
Factors determining the therapeutic level of positive airway pressure in patients with obstructive sleep apnea syndrome
Authors: Sunnetcioglu Aysel , Cilingir Buket Mermit , Gunbatar Hulya , Yıldız Hanifi , Dogan Hediye Ulker
Published: March 2023

Objectives:

In daily practice, we encounter with obstructive sleep apnoea syndrome (OSAS) patients who require different levels of positive airway pressure (PAP) despite having a similar apnoea-hypopnea index (AHI). We aimed to determine the parameters contributing to the determination of the therapeutic level of PAP.

Methods:

Data on 548 patients who underwent polysomnography and PAP titration were analysed retrospectively. Patients were divided into groups according to OSAS severity (mild, moderate, and severe) and the mean pressure in each group was determined, after which patients were further divided into those who required a PAP below the mean and those who required a PAP above the mean.

Results:

The mean optimal PAP level in the mild, moderate, and severe OSAS groups was 7.4 ± 2.3, 8.6 ± 2.4, and 9.8 ± 2.9 cm H2O, respectively. In the moderate and severe OSAS group, the subgroup that needed high pressure had a higher supine AHI, a longer apnoea time, and a longer SaO2 <90% time as compared with the subgroup that needed low pressure.

Conclusion:

A longer apnoea duration and a higher supine AHI are associated with a higher PAP level in patients with moderate and severe OSAS.
Pneumothorax ex vacuo: Three cases of an uncommon entity
Authors: Venkitakrishnan Rajesh , Augustine Jolsana , Ramachandran Divya , Cleetus Melcy
Published: March 2023

Pneumothorax is a frequently encountered entity in pulmonary practice and can be primary or secondary. Traumatic and iatrogenic causes also account for a minority of cases presenting to the chest physician. The most common therapeutic intervention done is a tube thoracostomy in all but the mildest of cases. Pneumothorax ex vacuo is a distinctly uncommon entity that differs considerably from the rest of the pneumothorax cases in its pathogenesis, clinical manifestations, radiological findings, and management. Pneumothorax in this entity results from the sucking in of air into the pleural space caused by an exaggerated negative intrapleural pressure, which is most frequently secondary to acute lobar collapse. Symptoms attributable to pneumothorax per se are distinctly mild and the vital aspect of treatment is to relieve the bronchial obstruction. Tube thoracostomy fails to relieve the pneumothorax in such cases and should be avoided. We share three cases of pneumothorax ex vacuo encountered in our institution and alert clinicians of the presentation, radiology, and management of this uncommon condition.
Predictive equation for six-minute walk test in Indian children, adolescents, and adults
Authors: Agarwal Bela , Shah Monal , Sawant Bhoomika , Bagwe Hiranmayee , Murkudkar Payal , Mullerpatan Rajani
Published: March 2023

Background:

Post-COVID residual dysfunction has been observed in a majority of people, with reduction in cardiopulmonary endurance emerging as a primary symptom. The Six-Minute Walk Test is a simple, reliable, and valid test that is used routinely on people with chronic respiratory dysfunction. In the current COVID-19 pandemic situation, reference values and a predictive equation developed from a large sample across a large age group, from 6 to 75 years, will enable one to establish goals of treatment for post-COVID rehabilitation.

Methods:

Following institutional ethical clearance, we recruited 1369 participants for the study (685 females and 684 males). Participants were classified according to biological age into group 1 (6–12 years), group 2 (13–17 years), group 3 (18–40 years), group 4 (41–65 years), and group 5 (>65 years). Informed consent was sought and participants were screened using a health history questionnaire. Demographic features, namely, age, height, weight, and body mass index (BMI) were noted. The Six-Minute Walk Test was administered as per ATS guidelines. Clinical parameters, namely, pulse rate, respiratory rate, systolic blood pressure, diastolic blood pressure, and rate of perceived exertion were recorded.

Results:

The Six-Minute Walk Test (6MWT) was significantly influenced by age and gender (r = 0.257, P = 0.00 and r = 0.501, P = 0.00, respectively). Walking distance was longest in 13–17-year-old males, whereas females demonstrated a linear decline after 12 years. In each age group, males walked a greater distance than females. Stepwise linear regression analysis was used to derive the following predictive equation:

6MWT = 491.93 − (2.148 × age) + (107.07 × gender) (females = 0, males = 1).

Conclusion:

The study confirmed variability of the Six-Minute Walk Test, with age and gender being predominant predictors. Reference values, equations, and percentile charts generated from the study can be utilised to guide clinical decision-making while exercise prescription for patients with post COVID dysfunction.
Analgesic Effect of Erector Spinae Plane Block after Cesarean Section: A Randomized Controlled Trial
Authors: Dostbil A , Ince I , Altinpulluk EY , Perez MF , Peksoz U , Cimilli G , Kasali K , Atalay C , Ozmen O , Sahin T , Yilmaz EP
Published: March 2023

ABSTRACT

Background:

Ultrasound-guided bilateral erector spinae plane block is also a technique for providing analgesia after a cesarean section.

Aim:

We hypothesized that bilateral erector spinae plane block applied from the transverse process of T9 who underwent elective cesarean section could provide effective postoperative analgesia.

Patients and Methods:

Fifty parturients who were scheduled to undergo elective cesarean section under spinal anesthesia were included in the study. Group SA (n = 25) was categorized as the group in which spinal anesthesia alone (SA) was performed, and Group SA+ESP (n = 25) was categorized as the group in which SA + ESP block was performed. All patients were given a solution containing 7 mg isobaric bupivacaine + 15 mg fentanyl intrathecally through spinal anesthesia. In the SA + ESP group, the bilateral ESPB was performed at level T9 with 20 ml 0.25% bupivacaine + 2 mg dexamethasone immediately after the operation. Total fentanyl consumption in 24 h, the visual analogue scale for pain, and time to the first analgesic request were evaluated postoperatively.

Results:

The total fentanyl consumption in 24 h was statistically significantly lower in the SA + ESP group than the SA group (279 ± 242.99 mg vs. 423.08 ± 212.55 mg, respectively, P = 0.003). The first analgesic requirement time was statistically significantly shorter in the SA group than the SA + ESP group (150.20 ± 51.83 min vs. 197.60 ± 84.49 min, respectively, P = 0.022). Postoperative VAS scores at 4th, 8th, and 12th h at rest were statistically significantly lower in group SA + ESP than in group SA (P = 0.004, P = 0.046, P = 0.044, respectively). VAS scores during the postoperative 4th, 8th, and 12th h cough were statistically significantly lower in group SA + ESP than in group SA (P = 0.002, P = 0.008, P = 0.028, respectively).

Conclusion:

Ultrasound-guided bilateral ESP provided adequate postoperative analgesia and significantly decreased postoperative fentanyl consumption in patients having cesarean section. Also, it has a longer analgesia time than the control group, and it has been shown to delay the first analgesic requirement.
The Impact of Endodontic Workload and Allocated Treatment Time of Dentists in Turkey on Perceived Stress and Complication Frequency and Suggested Solutions
Authors: Ozbay Y , Cirakoglu NY
Published: March 2023

ABSTRACT

Background:

Procedural complications and workload have been reported as sources of stress in dentistry.

Aim:

To investigate the impact of endodontic workload and allocated treatment time of dentists on perceived stress and frequency of complications

Material and Methods:

The online survey included questions to evaluate the average number of root canal treatments per week, stress levels during root canal treatment, frequency of single-visit root canal treatments, time spent on single-visit treatments, frequency of endodontic complications per week, preference for management of complication, and proposed solutions.

Results:

A negative correlation was found between endodontic workload and perceived stress, which was statistically significant at slight and moderate stress levels (P < 0.05). Amongst the clinicians who feel “very stressful” during the treatment, the clinicians who allocate only 20 minutes or less per treatment had the highest frequency, and their numbers were significantly higher than clinicians who spent 20–40 minutes per treatment (P < 0.05). Amongst the clinicians who experience instrument separation 4–6 times/week, the number of clinicians who spent 40–60 minutes or more than 60 minutes per root canal treatment was significantly lower in comparison to the number of clinicians who spent 20–40 minutes (P < 0.05).

Conclusion:

Increasing the quality of dental equipment and reducing the time pressure on dentists might result in lesser stress levels of clinicians and fewer endodontic complications.
Sexual Experiences of Infertile Women: A Qualitative Study
Authors: Demirci H , Sen S
Published: March 2023

ABSTRACT

Background:

It is suggested that stress related to infertility causes marriage conflicts and decreases in the frequency of sexual intercourse.

Aim:

This study aimed to explore the experiences of the sexuality of infertile women.

Patients and Methods:

A phenomenological design was used in this study. We conducted face-to-face, semistructured, in-depth interviews with 11 infertile women. The interviews were audio-recorded, and a thematic approach was used to assess the data.

Results:

The average age of the women was 33.05 ± 3.40 years, and their age of first sexual intercourse was 23.0 ± 2.8 years and all of them are legally married. The durations of experiencing the problem of infertility were as follows; 3-5 years in 33%, 6-10 years in 27%, and 11 years and above in 38%. According to interpretative phenomenological analysis, two main themes emerge. Two main themes were determined: Perception of Sexuality and Sexual Problems. The results show that infertile women have a higher risk for sexual dysfunction than fertile women.

Conclusion:

These findings suggest that the diagnosis of infertility is an important factor in assessing the differences in the sexual satisfaction of women. In infertility counseling, health professionals must explain the gender differences. Also, infertile couples must encourage to share each other’s feelings and this may help couples to cope with the communication problems they may experience.
Is gray-white matter ratio in out-of-hospital cardiac arrest patients' really early predictor of neurological outcome?
Authors: Emektar Emine , Karaarslan Fatmanur , Öztżrk Cansu , Ramadan Selma
Published: March 2023

OBJECTIVE:

This study aimed to evaluate the association between neurological outcome and gray-white ratio (GWR) in brain computed tomography (CT) in patients with return of spontaneous circulation (ROSC) who were brought to the emergency department (ED) due to out-of-hospital cardiac arrest (OHCA).

METHODS:

This study has a retrospective design. Patients with ROSC who were brought to the ED due to OHCA and who underwent brain CT in the first 24 h were included in the study. Demographic data, brain CT results (intensities of gray matter and white matter in Hounsfield units and calculated GWR), and hospital outcome were recorded. The cerebral Performance Categories (CPC) score was used as the outcome of the study.

RESULTS:

A total of 160 patients were included in the study. 55% of the patients were male and the median age was 75.5. The median brain CT time of the patients was 120 min. 16.3% of the patients were in the good neurological outcome group. When attenuation values and GWRs of the patients were compared according to CPC of patients (good-poor), no statistically significant difference was detected in any parameter except MC2 attenuation (P > 0.05 for all values). The patients were separated into groups geriatric and nongeriatric and GWRs were compared. GWRs were lower in the geriatric groups (P < 0.05 for all values).

CONCLUSION:

Although it is emphasized in the literature that detection of low GWR in brain CT can help the clinical decision process in patients surviving comatose arrest, we think that it is not valid for especially in geriatric patients and in patients who underwent early brain CT after ROSC.