bluuebunny/crossref_metadata_2025 huggingface dataset:
Procurer des prodiges dans les provinces : les décemvirs en Sicile en 133 av. J.-C.
Authors: Lietz Beatrice
Published: October 2024

Le système de la procuration des prodiges est le mécanisme essentiel par lequel les autorités religieuses républicaines répondaient aux signes divins. Malgré de nombreuses études, son fonctionnement reste encore largement inconnu, notamment dans son évolution, au gré de l’expansion de Rome, pour prendre en compte l’agentivité des puissances divines actives dans les territoires conquis. Un cas d’étude concernant la Sicile permet de saisir les enjeux du problème : en 133 av. J.-C., répondant à des prodiges dont la nature n’est pas précisée, une délégation du collège sacerdotal des décemvirs se rendit à Henna pour s’attirer la bienveillance de Cérès. En passant en revue la documentation et les précédentes interprétations proposées de cet épisode, on tâchera de montrer que la compréhension du langage des prodiges nécessite une réévaluation plus générale des nouveaux réseaux, assemblages et hiérarchies divines mis en œuvre à l’époque des conquêtes.
L’émigration des médecins, en particulier vers la France, et la desserte médicale au Maghreb
Authors: Zehnati Ahcène
Published: October 2024

Cet article tente de décrypter la réalité de l’émigration des médecins maghrébins vers la France. Il rend également compte des capacités de formation dans ces trois pays et des intentions d’émigration des jeunes médecins. Les résultats mettent en évidence des disparités dans les capacités de formation médicale et confirment la tendance générale à la féminisation des professions médicales dans les pays du Maghreb. L’Algérie forme quatre fois plus de médecins que le Maroc et huit fois plus que la Tunisie, ce qui influence les densités médicales locales et le nombre de médecins migrants. Nos estimations des taux d’émigration suivant le pays d’obtention du diplôme et le lieu de naissance montrent que l’émigration, bien qu’importante, ne peut pas être qualifiée de massive. Certaines spécialités sont particulièrement touchées par l’émigration, telles que l’anesthésie-réanimation, le radiodiagnostic-imagerie médicale, la néphrologie, et surtout la psychiatrie, qui pourraient connaître de graves pénuries surtout dans les pays où les capacités de formation n’ont pas beaucoup évolué. Par ailleurs, les intentions d’émigration des jeunes médecins demeurent fortes, avec la France comme destination privilégiée, suivie par l’Allemagne, le Canada et les pays du Golfe. Cette tendance à l’expatriation pourrait exacerber les inégalités de répartition géographique des médecins dans les pays du Maghreb, ce qui impacte directement l’accès aux soins des populations vivant dans les régions mal couvertes.
Locazione finanziaria immobiliare: contabilizzazione e riflessi fiscali
Authors: Saponaro Fabio
Published: October 2024

Con l’adozione degli International Accounting Standard il principio di prevalenza della sostanza sulla forma diventa regola generale in materia di contabilizzazione del leasing immobiliare, favorendosi, nell’ottica di una crescente globalizzazione, una uniformazione delle regole di contabilità e, quindi, la comparabilità dei bilanci. La consacrazione del principio in esame nel diritto contabile italiano è riconducibile al recepimento della Direttiva 2013/34/UE, favorita anche dalla recente riforma del diritto societario.
L’Autore mette in evidenza come la descritta convergenza in direzione dell’affermazione del principio della substance over form contabile non ha significato, però, la maturazione di un perfetto allineamento tra principi contabili nazionali e quelli internazionali, già a partire dalla nozione di “locazione finanziaria”, prevista dal legislatore (contabile), sono emerse significative divergenze con il concetto di leasing di cui al principio contabile IFRS 16 Leases. L’attenzione è rivolta, in particolare, ai riflessi di carattere tributario che tali disallineamenti contabili possono ingenerare sulle imprese.
CONTINUOUS SCORING OF AUTISM SPECTRUM DISORDER PATIENTS BY ANALYZING THEIR EEG SIGNALS
Authors: Afrooz Erfan , Taghavi Mahsa , Ghavasieh Arsham , Asayesh Vahid , Boostani Reza
Published: October 2024

Clinical manifestations and standard psychological tests have been widely used to diagnose autism spectrum disorder (ASD) patients and evaluate their severity level. The gold-standard criterion to diagnose ASD patients is the childhood autism rating scale (CARS), which is a qualitative questionnaire that is filled out through a systematic interview while no physiological test/record is performed to determine this score. To make the diagnosis process quantitative, electroencephalography (EEG) signals have been repeatedly analyzed to differentiate healthy subjects from ASD patients. However, the precise relationship between the abnormal behavior of EEG signals and different ASD severity levels is not well investigated. Here, we use CARS to qualitatively determine the severity level of 14 autistic children, who voluntarily enrolled in our study. We recorded their EEG signals from 19 scalp channels when they were awake in the idle state and elicited three informative features including approximation entropy, multiscale entropy and sample entropy in successive time frames. Among the three measures of entropy, the last one exhibits the highest sensitivity, where its correlation coefficient (CC) exceeds 0.7, on the electrode positions T6 (CC [Formula: see text] 0.74), P4 (CC [Formula: see text] 0.76) and Cz (CC [Formula: see text] 0.75). Results of sample entropy in channels Cz-versus-Pz and P4-versus-FP2 show that a simple K-nearest neighbor classifier can provide 93% classification accuracy among patients with mild, moderate and severe ASD levels. Comparing the proposed method to the conventional ones, we also extracted power spectral density features from the channels but they failed to identify the ASD severity level with an acceptable accuracy.
Financial Behaviors and Money Beliefs in Educational Sector
Authors: Arias Ardila Albert Dario , Hernandez Hernandez Adolfo Hernando , Gutierrez Almendarez Irma Neli
Published: October 2024

This research mainly aims to identify the financial behaviors and money beliefs in a business and military context. These analyses may lead to a partial reduction in the stress experienced by these households, thereby facilitating their focus on military activities and preparing them as entrepreneurs in the civil context. A survey was conducted to gather data about students' preferences and beliefs about money, using Klontz Money Script Inventory. The main findings explained students' attitudes on money that help to accomplish the personal financial goals, that are important to the SME´s success.
Knowledge Management and Innovation for Enhancing SME Competitiveness
Authors: Baporikar Neeta
Published: October 2024

SMEs are recognized as engines of growth and economic development worldwide. Yet they seem to be not contributing to their full potential. Many of them do not even survive for longer time and even if they do, they are not as competitive as they could be with proper resources and strategies. Adopting a qualitative approach the aim of this chapter is to explore how knowledge management and innovation in SMEs can enhance their competitiveness and aid in optimization of their potential and contribution to economic and sustainable development.
Research on the Promotion and Fostering of Entrepreneurship in SMEs
Authors: Espinoza-Benavides Jorge , Andrade-Valbuena Nelson Andres , Arias-Ramírez Amanda , Leon-Castro Delia
Published: October 2024

The study delves into the realm of Promotion and Fostering of Entrepreneurship (PFE) research, a domain of scholarly interest due to its potential to shape a future where economic growth aligns with societal well-being. This article presents the first-ever bibliometric analysis of academic research dedicated to PFE, spanning from 1956 to 2021. Utilizing bibliometric techniques as performance analysis and graphical mapping, the research examines academic output using the Scopus database, categorizing articles, authors, and institutions. Noteworthy journals like Journal of Business Venturing feature prominently. Crucial articles by authors like Walter, Auer, and Ritter gain attention, while influential institutions like the University of Toronto are emphasized. Graphical mapping of Keywords highlights the growing importance of PFE research, with a notable surge in studies over the last decade. Entrepreneurship ecosystems and the integration of PFE with sustainability and social responsibility issues stand out as new and prominent perspectives.
Equity, Transparency, and Privacy in Renewable Energy Integration
Authors: Waykar Yashwant Arjunrao , Yambal Sucheta
Published: October 2024

This chapter explores the social implications of integrating renewable energy, focusing on equity, transparency, privacy concerns, and their intersection with policy frameworks and technological innovations. It examines how renewable energy initiatives can perpetuate or alleviate social inequities, stressing the importance of inclusive practices that address disparities. The chapter discusses the necessity of transparency in project planning and implementation, emphasizing stakeholder engagement and clear communication. Privacy concerns related to advanced energy technologies are analyzed, alongside regulatory frameworks that aim to safeguard rights while promoting sustainability. Technological advancements are reviewed for their social impact, offering insights into how innovation can drive equitable and transparent energy transitions.
Solar Energy Integration
Authors: Trivedi Senali Umeshkumar , Nayar Suja
Published: October 2024

India's solar energy sector is rapidly evolving, driven by around 300 sunny days a year and substantial government investment. Solar capacity has surged from 2.8 GW in 2014 to 82.6 GW by April 2024, thanks to falling panel costs. However, challenges such as land acquisition, grid integration, and reliance on imported equipment remain. Innovative solutions like rooftop solar, solar-wind hybrids, and advancements in green hydrogen and energy storage are vital for overcoming these hurdles. Addressing land acquisition in a densely populated, agriculture-dependent nation and modernizing the grid to handle solar variability are crucial. Additionally, reducing import dependency and adopting low-water cleaning technologies are essential for sustainable growth. By leveraging its geographic advantages and embracing these innovations, India is well-positioned to enhance its global role in renewable energy. This chapter examines India's solar growth, challenges, and strategies for a sustainable future.
Sustainable Development
Authors: Rattanasirivilai Samanan , Rotjanawasuthorn Sippaphat , Sirinapatpokin Sirinapattha , Namdech Puthisat , Jermsittiparsert Kittisak
Published: October 2024

Sustainable development is a global agenda set together a century ago that countries will follow and achieve in the first half of this century. The answer to the big question “What are the conditions that will make a country successful or unsuccessful in sustainable development?” has arisen and continues today. To answer these questions with empirical data, this paper synthesizes documents in the Scopus database published from 2013 to the present and highlights how current knowledge answers these questions: 1) What is sustainable development? 2) Why is it necessary for the country to develop sustainably? 3) What is the current situation of sustainable development in the world? 4) What are the conditions and methods that will enable the country to move away from unsustainable development? 5) What are the conditions and methods for achieving sustainable development in a country? And lastly, 6) What are the conditions and methods for maintaining a sustainable level of development? The answer to each question is explained and discussed accordingly.
Business Information Systems, Importance of Information, Business Intelligence, Corporate Excellence, and ICTs Within the Development of Organizations
Authors: Gökmen Aytaç , Temiz Dilek
Published: October 2024

An important shift takes places in organizations which is the shift in priorities to strategic management and increasing human demand for reliable information to run the business competitively in the global context. Nevertheless, executives and managers are exposed to a considerable amount of information which is both invaluable, as well as difficult to acquire, process, store, disseminate and utilize. Therefore, the objective of this study is to focus on the subjects as business information systems, information systems, business intelligence, corporate excellence, business intelligence, ICTs and other topics related to these issues in order to emphasize the importance of information and knowledge in the 21st century.
Role of Diversity and Inclusion in Employee Engagement Among Different Sectors of India
Authors: Sinha Vinita
Published: October 2024

Diversity and inclusion have become one of the main challenges and top priority for recruitment and other HR departments. Different sectors have different workforce diversity and organizational inclusion practices. It helps an organization to attract talented employees and drive the engagement of employees. The concept of diversity management and inclusion policies have been a focus for many companies for years now, and they have become more and more of a trending research topic. Although the literature on diversity and inclusion has been increasing in quantity, there remained a gap in the explaining the importance of diversity management and inclusion policies in the engagement of employees in the different Indian sector. The main aim of carrying out this research study is to investigate the association of various diversity and inclusion practices with an important aspect of the workplace, i.e. employee engagement among different sectors in India.
Kuakata Reimagined
Authors: Talukder Mohammad Badruddoza , Swarna Dil Afrin , Khan Musfiqur Rahoman
Published: October 2024

Kuakata is a naturally gifted tourist spot in the Patuakhali district in the southern region of Bangladesh. It is particularly famous for its beautiful sunrise and sunset view over the Bay of Bengal. We aim to predict Kuakata's economic performance and prospects as the best tourist destination, as indicated in the literature review. The main aspects cover natural resources, archeological and historical points of interest, and current construction and improvements to tourist attractions and amenities. The outcome of our chapter on the elements of decision-making in the choice of strategies for theme park business reveals long-term planning, new attraction, partnership with the private sector, active community involvement, and technological innovation as fundamental strategies for economic growth. It is suggested that more focus must be given to sustainability, promotion, training, and extensive study. Thus, addressing these aspects, Kuakata can go for balanced development with economic upliftment and set its place as one of the most significant tourist spots in the face of Bangladesh.
Global Resilience in Transport and Logistics
Authors: Khare Praveen
Published: October 2024

This study aims to develop the Global Resilience In Transport-and-Logistics (GRIT) framework designed to reinforce the resilience of global supply chains against a variety of disruptions, from pandemics to geopolitical tensions and environmental challenges. It facilitates devising robust, adaptable logistics and transportation strategies that help mitigate the challenges of supply chain disruptions. The research adopts a mixed-methods approach, combining a literature review with the conceptual foundation of the Stress and Strain model and the Theory of Graceful Extensibility. It adapts these concepts to the global transportation and logistics sector to develop the GRIT framework. The findings reveal the GRIT's potential in identifying critical areas for strategic intervention and thus enabling logistics managers to adeptly navigate disruptions. Through its application in a real-world scenario, the framework demonstrates its applicability and effectiveness in mitigating the impact of supply chain disruptions.
Assessment of Computer-Aided Translation Quality Based on Large-Scale Corpora
Authors: Xu Huimin
Published: October 2024

CAT technology, utilizing translation memory and quality control tools, boosts translation efficiency and consistency. Yet, it faces challenges with cultural nuances, context, and creativity, requiring human intervention. This study explores leveraging large-scale corpora to enhance machine translation quality assessment accuracy and efficiency. Automated evaluation models surpass manual limitations, enhancing translation system performance and decision-making. Supervised and unsupervised machine translation quality assessment methods, coupled with data augmentation strategies, reduce model bias by reinforcing the connection between source and target languages. The proposed model achieves 94.8% and 92.6% correctness on Google Translate and Wikipedia datasets, slightly surpassing manual rates. Data augmentation and cascade evaluation notably improve translation evaluation accuracy, especially with large-scale corpora. Future research targets higher-quality pseudo-labeled data, refined evaluation models, and advanced assessment methods for diverse translation needs.
Examining Factor Analysis Results of Customers' Experiences With the Banking Electronic Services (CEBES) Scale
Authors: Alharthi Sager
Published: October 2024

This article examines the validity of a newly developed research instrument, the Customers' Experience of Banking e-Services (CEBES) scale. The study was conducted in Saudi Arabia during the COVID‐19 pandemic; it used both exploratory and confirmatory factor analysis to measure the original 75-item scale. A convenience sampling technique was used to select 555 electronic banking services customers. Exploratory factor analysis yielded a four-factor, 54-item scale, which was run with a cutoff point of .5 to ensure high proportional contribution of each scale item. The four factors were: reflections on bank processing of complaints; recovery of e-banking services; bank webpages; and perceived safety and confidentiality of information. The newly developed scale could be used to measure customers' experience of banking e-service and identify areas requiring improvement. Despite achieving an acceptable level of statistical strength, the 54-item CEBES requires further testing on other populations.
Research on the Evaluation of College English Teaching Based on Data Mining Technology From the Perspective of “Internet Plus Education”
Authors: Jie Yu , Zhou Xinyun
Published: October 2024

This paper explores using data mining in English teaching assessment in higher education within the 'Internet + Education' era. Traditional assessment methods struggle to meet modern teaching needs. By collecting diverse data like student performance and learning behavior, and employing data mining, a comprehensive assessment model is built. This model tracks student progress, uncovers data patterns, and offers personalized teaching guidance. Empirical analysis validates the model's feasibility, enabling colleges to better understand English teaching quality and adjust methods accordingly. In essence, this study offers a novel approach to assessment and contributes to education digitization and teaching enhancement.
Spacial Information Improves Modeling Accuracy in Predicting Student Performance
Authors: Yin Mengjiao , Ma Biao , Pan Xianyu , Fan Lanlan
Published: October 2024

The relationship between spatial heterogeneity and students' academic performance is a widely researched topic. This study extends the concept of spatial heterogeneity into two categories - allocatable (acquired after birth) and ascribed (determined before birth) - using seating and hometown information as variables in Spatial Durbin Models for statistical analysis, identifying seating as the salient feature. Subsequently, through 2,000 iterations of random state testing with undergraduate data from two classes (N=282), our research compares six representation learning methods, including an improved, custom version of attention-based Graphic Convolutional Network, affirming the superior efficacy of our enhanced approach in extracting seating features. By doing so, our study broadens the application scenarios of social comparison theory and group dynamics theory, while also providing a feasible best-practice reference for network-based instructional modeling.
Myeloid Cell–Specific Deletion of AMPKα1 Worsens Ocular Bacterial Infection by Skewing Macrophage Phenotypes
Authors: Singh Sukhvinder , Singh Pawan Kumar , Ahmad Zeeshan , Das Susmita , Foretz Marc , Viollet Benoit , Giri Shailendra , Kumar Ashok
Published: October 2024

AMP-activated protein kinase (AMPK) plays a crucial role in governing essential cellular functions such as growth, proliferation, and survival. Previously, we observed increased vulnerability to bacterial (Staphylococcus aureus) endophthalmitis in global AMPKα1 knockout mice. In this study, we investigated the specific involvement of AMPKα1 in myeloid cells using LysMCre;AMPKα1fl mice. Our findings revealed that whereas endophthalmitis resolved in wild-type C57BL/6 mice, the severity of the disease progressively worsened in AMPKα1-deficient mice over time. Moreover, the intraocular bacterial load and inflammatory mediators (e.g., IL-1β, TNF-α, IL-6, and CXCL2) were markedly elevated in the LysMCre;AMPKα1fl mice. Mechanistically, the deletion of AMPKα1 in myeloid cells skewed macrophage polarization toward the inflammatory M1 phenotype and impaired the phagocytic clearance of S. aureus by macrophages. Notably, transferring AMPK-competent bone marrow from wild-type mice to AMPKα1 knockout mice preserved retinal function and mitigated the severity of endophthalmitis. Overall, our study underscores the role of myeloid-specific AMPKα1 in promoting the resolution of inflammation in the eye during bacterial infection. Hence, therapeutic strategies aimed at restoring or enhancing AMPKα1 activity could improve visual outcomes in endophthalmitis and other ocular infections.
The doctor and drugs. Regulatory provisions, medical-legal aspects, deontological problems
Authors: Benciolini Paolo
Published: October 2024

Not available.
The handicapped: forms of intervention
Authors: Ferlauto Luigi
Published: October 2024

Not available.
The contribution of the ecclesial civil community and voluntary spheres
Authors: Sgreccia Elio
Published: October 2024

Not available.
Cardiovascular pathology in the handicapped patient
Authors: Manzoli Ugo , Pennestrì F. , Ferrazza A.
Published: October 2024

As is well known, the clinical definition of a handicapped patient is remarkably complex and extensive, encompassing numerous well-defined aetiological forms but also a wide range of cases in which the handicap is related to non-specific or unknown hereditary factors or to socio-economic and hygienic environmental factors.
Reduction of severe distant handicaps in low-weight infants
Authors: Di Rocco Concezio
Published: October 2024

Not available.
The suffering of the sick
Authors: Cortesi Luigi
Published: October 2024

The French express this anthropological fact with the verb tomber attributed to illness. The sick person is also the one who falls from a vertical to a horizontal position, and this causes him a reversal of perspectives and points of reference (just as happens, on a moral level, with the fall due to sin): the relationship top-bottom, front-back, etc. changes.
Ageing and <>
Authors: Carbonin Pierugo , Antico Leonardo , Cocchi Alberto
Published: October 2024

Not available.
Considerations on 229 cases of V.I.G. in a provincial hospital in Lombardy
Authors: Piccinini Pietro , Meregalli Dino
Published: October 2024

Not available.
Life history of Mexican species of the genus Tlaloc (Cyprinodontiformes, Profundulidae)
Authors: Anzueto-Calvo Manuel d. J. , Valeriano-Cabrera Blanca C. , Aguilar-Decelis Alejandra G. , Velazquez-Velazquez Ernesto , Cerdenares Ladrón de Guevara Genoveva , Ruiz-Campos Gorgonio , Salgado-Maldonado Guillermo
Published: October 2024

Fish of the genus Tlaloc are distributed from southern Mexico to Central America and are a distinctive example of the endemic fauna of the Mesoamerican highlands, which has been scarcely studied in Mexico. The present study provides basic life-history data for the species Tlaloc hildebrandi, T. candalarius, and T. labialis, which are native to the headwaters of the Grijalva-Usumacinta basin in southeastern Mexico. We collected 918 specimens to determine their Length-Weight Relationship (LWR), Relative Condition Factor (Kr), sex ratio, Gonadosomatic Index (GSI), fecundity, and size at first sexual maturity. Both sexes of all species had positive allometric growth, except for T. candalarius females (isometric). Mean Kr and sex ratio values differed significantly among species. Females’ GSI values differed significantly among species but were highest during the dry season in all three species. Absolute fecundity was positively correlated with standard length and weight. Sexual maturity was reached at different lengths among species. Based on these results, we suggest that all three species present an opportunistic life strategy, which is very common in fish of the order Cyprinodontiformes. These results represent a first contribution on the life-history of this group of fish and provide basic information that is fundamental to ensuring their conservation.
Combined active and passive isothermic heating leads to similar core temperature compared to exercise alone
Authors: Wardenaar Floris C. , Navarro Sonia , Caballero Rachel , Vento Kaila A. , Kavouras Stavros A. , Vanos Jenni
Published: October 2024

Context

The training stress of heat acclimatization optimizing exercise performance in a hot environment can be demanding.

Objective

This study evaluated the efficiency of different single heating protocols to elevate core temperature.

Design

Not randomized controlled trial.

Setting

Passive heating (PAS), 30-min active heating using a high-intensity bike protocol (HIBP) in a hot environment with 30-min passive heating (EH-PAS), 60-min HIBP in a hot environment (EH), or 60-min HIBP at room temperature (EM).

Participants

Ten male participants (25±3 years) performed four different 60-min heating strategies at least one week apart.

Intervention(s)

Protocols were performed three times per week for six weeks. The single-task group underwent one-leg static balance training with and without vision and hopping balance training. The dual-task group underwent balance and cognitive training (backward counting task).

Main Outcome Measures

Body core temperature and heart rate.

Results

The highest peak gastrointestinal temperature occurred in EH-PAS (39.1±0.4°C), followed by EH (38.9±0.3°C), EM (38.4±0.3°C), and PAS (38.1±0.5°C). The average HR, measured as a control for intensity, was not different between exercise strategies (EH-PAS: 142±12.3, EH: 146±9.7, and EM: 142±13.3, p>0.05), while different from PAS: 98±15.2 bpm, p<0.05.

Conclusions

Adding passive heating to a shorter exercise protocol can be just as effective in keeping core temperature elevated as exercise in the heat alone during a 60-minute session. Therefore, a single-bout combination of exercise and passive heating may result in a similar body temperature induction compared to exercise heat stress alone.
National estimates of nonurgent emergency department utilization for sportsrelated injuries in high school-age population
Authors: Peterson Collin , Li Tao , Norcross Marc , Johnson Sam
Published: October 2024

Context:

Athletic trainers (ATs) can manage nonurgent, musculoskeletal emergency department (ED) visits. Little is known about what populations are most likely to use the ED for nonurgent, sports-related musculoskeletal injuries.

Objectives

Our object is to provide national-level evidence on whether high-school age population with public insurance or lower socioeconomic status were more likely to have ED visits for nonurgent injuries.

Design

Cross-sectional study.

Setting

Secondary data analysis of the 2017-2019 Nationwide Emergency Department Sample (NEDS).

Patients or Other Participants

ED visits for high school-age patients with a sports-related musculoskeletal injury.

Main Outcome Measure

We used a multi-step process and AT scope of care threshold to classify ED visits for musculoskeletal injuries as urgent and nonurgent. National estimates of the proportions of visit, patient, and hospital characteristics by urgent, nonurgent, and total injury ED visits were reported. Survey weighted logistic regression was used to calculate odds ratios of an ED visit being for a nonurgent injury based on a patient's insurance type and socioeconomic status.

Results

For ED visits for musculoskeletal injuries in a high school-age, sports exposed population, 52.93% (95% CI: 51.11, 54.73) were for nonurgent injuries. Patients with public insurance were more likely (OR = 1.39; 95% CI: 1.35, 1.44) to have an ED visit for a nonurgent injury compared to ED visits for patients with private insurance. Patients from the lowest estimated neighborhood income quartiles were more likely (OR = 1.10; 95% CI: 1.02, 1.20) to have an ED visit for a nonurgent injury compared to ED visits for patients in the highest estimated income quartile.

Conclusions

Our results suggest opportunities to reduce nonurgent ED use using AT services exist, especially in high school-age athletes from vulnerable populations.
Electoral participation of people with and without disabilities in urban communities in Cameroon and Senegal
Authors: Pente Vladimir Y. , Jeyam Anita , Bechange Stevens , Jolley Emma , Roca Anne , Dossou Sandra R. , Ba Khady , Oye Joseph , Bocoum Salimata , Leclercq Laurene , Schmidt Elena
Published: October 2024

Background: The right to participate in political processes is fundamental to democratic governance, economic development and human rights.Objectives: We assessed participation in political processes and also explored factors associated with voting at the most recent election for people with and without disabilities.Method: We conducted cross-sectional survey in four cities in Senegal and three in Cameroon in 2021. Disability was assessed using the Washington Group Short Set of questions. Univariate and multiple regression analyses were conducted to identify the factors associated with voting at the most recent elections.Results: Among 4180 participants in Cameroon and 4171 in Senegal, disability prevalence was 9.77% and 10.89%, respectively. More than half of the participants had voted at the most recent elections in both Cameroon (52.31%) and Senegal (58.27%). Participants with an interest in politics, having all the key documents or registered with a political party were more likely to have voted in both countries. Adjusting for socio-demographic characteristics, people with disabilities were less likely to have voted compared to those without disabilities in Cameroon (odds ratio [OR] = 0.58 [0.40, 0.84]) and in Senegal (OR = 0.36 [0.26, 0.44]).Conclusion: There is an urgent need to address the socio-political and environmental factors that have been identified so as to close the disability gaps in voting and ensure equitable opportunities and levels of political participation between people with and without disabilities.Contribution: This article contributes to the existing knowledge base on the political participation of people with and without disabilities in Cameroon and Senegal.
Resilience and preparedness of hospitals for pandemics: Lessons learned from COVID-19
Authors: Raphela Tlou D.
Published: October 2024

Amidst the COVID-19 pandemic, health systems around the world took a lot of pressure, and the resilience of these systems has been addressed in thedisaster management and COVID-19 literature. However, little focus has been given to the resilience of hospitals in general. Therefore, the study assessed one hospital in the Free State province of South Africa as a preliminary study for a project that will look at all hospitals in the Free State province. The study assessed the following: (1) the preparedness and actionable strategies that were implemented across the waves of the COVID-19 pandemic; (2) the resilience plans of the hospitals and also determined (3) the resilience of the hospital amid the COVID-19 pandemic; (4) the vulnerabilities exposed by the COVID-19 pandemic in the hospital. Using the R statistical program and modelling, I found that the study hospital was not prepared holistically for the COVID-19 pandemic. The five generalised linear mixed models and the general linear models applied did not show significant differences for the most important variables used to measure resilience. The models showed the hospital to be less resilient to pandemics. Several vulnerabilities were recorded across the hospital.Contribution: This study’s findings suggest that the studied hospital is not resilient to pandemics and will be able to make recommendations to relevant government departments to work together to strengthen the resilience of the country’s healthcare system once the project is completed.
Slow Flow And No-Reflow Phenomenon In The Intervention Of Coronary Arteries At The Viet Nam National Heart Institute - Bach Mai Hospital
Authors: Lam Truong Hoai , Yen Nguyen Thi Bach , Dat Phan Tuan , Hung Nguyen Duc , Minh Tran Duc , Long Nguyen Tuan , Vu Nguyen Hoai , Linh Duong Cong , Thanh Nguyen Cong , Thanh Nguyen Van
Published: October 2024

Background:

Slow or no-reflow can occur in both acute coronary syndrome (ACS) and chronic coronary syndrome (CCS), with an incidence rate of up to 32% in patients with ACS. No-reflow is associated with increased rates of rehospitalization, ventricular remodeling, malignant arrhythmias, and heart failure, and is an independent predictor of myocardial infarction and mortality. Although various treatments and medications, such as Adenosine, Nitroglycerin, Nicardipine, and Adrenaline, have shown effectiveness in improving flow when this phenomenon occurs, not all cases respond to these flow-improving drugs. Additionally, the use of these drugs may be unsuitable due to adverse developments that contraindicate their use

Objective:

A descriptive of the clinical and paraclinical characteristics and slow or no-reflow phenomenon during coronary artery interventions at the Viet Nam National Heart Institute, Bach Mai Hospital.

Method:

This is an observational study describing the clinical and paraclinical characteristics and management methods for slow or no-reflow in 40 patients undergoing coronary artery interventions at the Viet Nam National Heart Institute, Bach Mai Hospital.

Results:

Among the 40 observed patients, 80% were admitted with a diagnosis of STEMI. Males accounted for 57.5%, averaging 71.43 ± 10.97 years. All patients had mildly reduced left ventricular systolic function with an LVEF of 45.75 ± 10.43%. Slow flow primarily occurred in the culprit branch, with the LAD accounting for 50% and the right coronary artery for 32%. There were 14 anemic patients, accounting for 35%, with the lowest hemoglobin level being 80g/L. Blood potassium levels <3.5 mmol/L accounted for 22.5%, with the lowest being 2.9 mmol/L.

Adenosine was used to manage slow flow in 33 patients, with 32 patients (97%) showing improved flow after administration. Six patients were treated with Nitroglycerin, which improved TIMI flow in four patients. Two patients did not respond to Nitroglycerin but responded to Adenosine. Two patients with TIMI flow 0-1 did not respond to Adenosine and were subsequently treated with Adrenaline; however, TIMI flow did not improve, leading to short-term complications during hospitalization

Conclusion:

Slow or no-reflow is commonly observed in patients with acute coronary syndrome, predominantly in older males. These cases are often seen in patients with heart failure and mildly to moderately reduced left ventricular systolic function. The LAD is the most frequently affected coronary artery branch compared to the other two branches. Adenosine is the first-line drug and is more effective in managing slow or no-reflow.
Hysterectomy across Different Occupational Groups of Women in India: A Cross-sectional Study
Authors: Gunnal Gaurav Suresh , Roy Sudeshna
Published: October 2024

Aims and Objective:

The paper aims to examine the prevalence of hysterectomy amongst 451,853 women aged 25–49 years by different occupation groups in India and seek to identify associated factors. It is a cross-sectional study using bivariate and multivariate analyses.

Materials and Methods:

Data available in the public domain from the fourth round of the National Family Health Survey, conducted pan-India including both rural and urban areas during 2015–2016 by the Ministry of Health and Family Welfare, Government of India, are used. Descriptive statistical analyses were performed to investigate hysterectomy prevalence across various states and union territories and other independent variables in India. Further, two binary logistic regression models were run to examine the determinants of hysterectomy where the dependent variable had undergone hysterectomy and not undergone hysterectomy.

Results:

The result revealed that about five in every 100 Indian women had undergone hysterectomy. Excessive menstrual bleeding was the most common underlying condition for undergoing hysterectomy amongst all occupation groups. The prevalence was found to be the highest amongst agricultural women workers who are 32% (odds ratio = 1.320; confidence interval: 1.209–1.440) significantly more likely to undergo hysterectomy compared to other occupation groups.

Conclusion:

These results raise questions about poor access to quality healthcare services particularly for sexual and reproductive health amongst women working in the agricultural sector.
Evaluating the Efficacy of a Polymerase Chain Reaction Assay for Pneumocystis carinii Detection in Respiratory Samples
Authors: Agarwal Sonu Kumari , Thakur Harendra Kumar , Tarai Bansidhar
Published: October 2024

Introduction:

Accurately identifying patients with pneumocystis pneumonia (PCP) presents considerable challenges, primarily relying on clinical suspicion. The manifestations of PCP lack specificity, encompassing symptoms such as cough, dyspnoea, fever, hypoxaemia, malaise and weight loss. Therefore, this study assesses the efficacy of a polymerase chain reaction (PCR) assay intended for use in clinical microbiology laboratories for the identification of Pneumocystis carinii from respiratory specimens.

Materials and Methods:

In this retrospective study, the medical records of patients aged 18 years and above were examined, focusing on those assessed using pneumocystis PCR-based tests. The study spanned from 2019 to 2022 in our tertiary care centre at Max Hospital, Saket. In this study, sputum and bronchoalveolar lavage (BAL) samples were proceeded for both staining and PCR for multi-copy mtLSU gene and single-copy dihydropteroate synthase polymorphisms (DHPS) fas gene of P. jirovecii.

Results:

In the analysis of 112 BAL specimens, 17 were identified as positive for P. carinii through both Grocott-Gomori’s Methenamine Silver Staining (GMS) staining and PCR. In addition, two BAL specimens were negative through GMS staining but showed positive results with PCR. On reviewing the clinical details of the patients associated with these two specimens, it was discovered that both individuals were under systemic steroid treatment, yet neither exhibited clinical signs of pneumocystis pneumonia (PCP). Consequently, these instances were classified as false positives by PCR. In comparison to GMS, the PCR assay demonstrated a sensitivity of 100% and specificity of 98% for detecting P. carinii in BAL specimens.

Conclusions:

The study underscores the necessity for individualised approaches, with each laboratory assessing the positive and negative predictive values based on their specific prevalence rates. In the ongoing pursuit of improving PCP diagnosis, PCR emerges as a promising screening tool that when used judiciously in conjunction with confirmatory measures, can enhance diagnostic precision in immunosuppressed populations.
Altering Trends in Pathological Spectrum of Cholecystectomy Specimen: Time to be More Vigilant
Authors: Gowda Vinay N. , Kumar Arvind , Singh Ashok , Durgapal Prashant , Gupta Amit , Kishore Sanjeev , Phulware Ravi Hari
Published: October 2024

Background:

Gall bladder cancer is a rare, most common and aggressive malignancy of the biliary tree, accounting for 80%–90% of biliary tract cancers. Gallstones are one of the major causes of the development of cholecystitis and long-term malignancy in developing countries. Cholecystectomy specimens have a great value in documenting various entities with clinical significance. Early detection is the most important step in improving the prognosis of gall bladder carcinoma (GBC) screening.

Aim:

Clinico- pathological spectrum of cholecystectomy specimen and Incidence of malignancy and its precursor lesion with gallstones.

Patient and Methods:

We conducted a retrospective analysis of all gall bladder specimens (cholecystectomy, laparoscopic, open or radical) from the period of January 2019–January 2022, including demographic data of the patients such as age and sex. Additional findings, such as the presence of gallstones, cholesterolosis, gastric or intestinal metaplasia, dysplasia and histopathological type of GBC, were documented.

Results:

A total of 1221 gall bladder specimens were received, with a higher female preponderance and a female-to-male ratio of 2.6:1. The mean age of presentation was 45 years. The most common histopathological diagnosis made was chronic cholecystitis (97%), and malignant cases accounted for 3% of the total cases.

Conclusions:

The high propensity of GBC with non-cholelithiasis cases, more than half of cases with metaplasia and increased incidence of adenosquamous carcinoma indicate a high burden of tumours, alerting the clinician as well as the pathologist.
Impact of Multiple-choice and Essay-based Assessments on Academic Performance and Stress Levels among Medical Students: A Cross-sectional Study
Authors: Chauhan Tanya , Hasan Shazia , Vardhan Gyan , Jhanwar Shubham , Negi Gita , Bisht Manisha , Handu Shailendra
Published: October 2024

Background:

Balancing classroom instruction and examinations poses challenges in education, particularly in diverse student populations, necessitating educational reform and assessment strategies to mitigate stress. Medical education, like other fields, requires both knowledge acquisition and practical application, yet reliance on internet resources may exacerbate stress and hinder academic performance. Assessment tools in medical education vary based on the skills being evaluated, with written formats such as multiple-choice questions (MCQs) and essay-based questions (EBQs) used for cognitive assessments. This study compares MBBS students’ performance and stress levels in pharmacology examinations using MCQs and EBQs.

Aim:

To compare the performance and level of stress in the MBBS students after going through multiple choice questions and essay-based examination pattern.

Methods:

A cross-sectional study surveyed 100 third-semester MBBS students at AIIMS Rishikesh using a validated electronic questionnaire to assess various aspects of their experience with MCQs and EBQs in pharmacology assessments. The study collected data on demographics, stress levels, psychological effects, coping skills and student feedback, while excluding students who were not in the third semester, unwilling to participate or absent during the examination.

Results:

The study outcome showed no significant difference in scores between MCQs and EBQs. Stress factors during MCQ preparation included academic performance concerns and sleep issues, while course issues and sleep disturbances were primary stressors during EBQ preparation. Suggestions for examination pattern changes were common, indicating students’ desire for support.

Conclusion:

The study highlights the importance of addressing multifaceted stressors to support student well-being and academic success. Further research is needed to explore effective interventions.
Predicting the Response of Patients Treated with 177Lu-DOTATATE Using Single-photon Emission Computed Tomography–Computed Tomography Image-based Radiomics and Clinical Features
Authors: Behmanesh Baharak , Abdi-Saray Akbar , Deevband Mohammad Reza , Amoui Mahasti , Haghighatkhah Hamid R. , Shalbaf Ahmad
Published: October 2024

Background:

In this study, we want to evaluate the response to Lutetium-177 (177Lu)-DOTATATE treatment in patients with neuroendocrine tumors (NETs) using single-photon emission computed tomography (SPECT) and computed tomography (CT), based on image-based radiomics and clinical features.

Methods:

The total volume of tumor areas was segmented into 61 SPECT and 41 SPECT-CT images from 22 patients with NETs. A total of 871 radiomics and clinical features were extracted from the SPECT and SPECT-CT images. Subsequently, a feature reduction method called maximum relevance minimum redundancy (mRMR) was used to select the best combination of features. These selected features were modeled using a decision tree (DT), random forest (RF), K-nearest neighbor (KNN), and support vector machine (SVM) classifiers to predict the treatment response in patients. For the SPECT and SPECT-CT images, ten and eight features, respectively, were selected using the mRMR algorithm.

Results:

The results revealed that the RF classifier with feature selection algorithms through mRMR had the highest classification accuracies of 64% and 83% for the SPECT and SPECT-CT images, respectively. The accuracy of the classifications of DT, KNN, and SVM for SPECT-CT images is 79%, 74%, and 67%, respectively. The poor accuracy obtained from different classifications in SPECT images (≈64%) showed that these images are not suitable for predicting treatment response.

Conclusions:

Modeling the selected features of SPECT-CT images based on their anatomy and the presence of extensive gray levels makes it possible to predict responses to the treatment of 177Lu-DOTATATE for patients with NETs.
Corneal Epithelial Thickness in Normal Corneas with Low and High Toricity
Authors: Beheshtnejad Amir Houshang , Hani Mohammad , Abdolalizadeh Parya , Alipour Fateme
Published: October 2024

Purpose:

To compare the corneal epithelial thickness along the flat and steep meridians of corneas with low and high toricity.

Methods:

This was a prospective observational comparative study on healthy subjects with normal corneas seeking preoperative evaluation for refractive surgery at a university-based hospital. Subjects with up to 2 diopters (D) of corneal with-the-rule astigmatism were defined as low corneal toricity (CT), whereas cylinder > two-dimensional was considered as high CT. The anterior segment optical coherence tomography was conducted to measure the epithelial thickness along the principle meridians of CT over a diameter of 9 mm. At the eye level, outcome variables (corneal and epithelial thicknesses in low- and high-astigmatism groups) were assessed using generalized estimating equation models.

Results:

Included were 98 eyes (49 subjects): 46 eyes (23 subjects) with low CT and 52 eyes (26 subjects) with high CT. Two groups were similar with respect to the age (P = 0.82), sex (P = 0.49), and spherical equivalent (P = 0.11). Although the corneal thickness at steep and flat meridians was not different between two groups, high-CT group had significantly thinner epithelium at inferior 2.5–3.5 and 3.5–4.5 mm zones (P = 0.01 and 0.04) as well as superior 2.5–3.5 mm zone (P = 0.03) along the steep meridian. Two groups were similar with respect to epithelial thickness of flat meridian (all P > 0.05).

Conclusion:

The epithelium of steep meridian was thinner in the high-CT group compared to the low-CT group.