bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact du microcrédit sur le développement des TPE au Brésil
Authors: Saliba Fabio , Rouveure Thomas
Published: August 2024

Les petites entreprises en phase de post-naissance au Brésil ont trois voies différentes pour accéder aux ressources financières nécessaires à leur développement : les banques, les usuriers et les sociétés de microcrédit. En nous appuyant sur une étude menée auprès de 22 dirigeants de microentreprises brésiliennes, nous analysons l’impact du microcrédit sur leur performance globale et durable.
Capital marque employeur et rétention des managers en EHPAD : Rôle du soutien organisationnel perçu
Authors: Benraïss-Noailles Laïla , Saboune Khaled , Viot Catherine
Published: August 2024

Le besoin de fidéliser les salariés est particulièrement fort dans le secteur de la dépendance. Les résultats d’une étude auprès de 404 managers d’un groupe d’EHPAD privé confirment l’impact significatif du capital marque employeur (CME) sur le soutien organisationnel perçu (SOP) et l’impact négatif de ce dernier sur l’intention de quitter. Ils font aussi ressortir un effet indirect du CME sur l’intention de quitter via le SOP. Cette recherche enrichit la connaissance sur les effets du CME sur l’intention de quitter des salariés occupant des fonctions managériales. Elle apporte des réponses aux problématiques de fidélisation que rencontrent les EHPAD.
Gouvernance d’entreprise et création de valeur partagée : une étude empirique
Authors: Hirigoyen Gérard , Poulain-Rehm Thierry
Published: August 2024

La recherche examine, en s’appuyant sur le référentiel théorique proposé par Porter et Kramer (2011), l’impact de la qualité de la gouvernance sur la création de valeur de l’entreprise, envisagée du point de vue non pas seulement des actionnaires, mais aussi des autres parties prenantes. L’étude s’appuie sur un échantillon de 204 sociétés cotées à l’échelle internationale, dont les scores de gouvernance et de création de valeur ont été analysés sur la période 2010-2014. Les résultats mettent en évidence une influence positive de la qualité de la gouvernance sur la création de valeur partagée, mais avec des nuances selon la conception de la valeur retenue et la nature des variables de gouvernance considérées.
Inégalités de revenu et de patrimoine : modèles, données et perspectives croisées
Authors: Auray Stéphane , Eyquem Aurélien , Garbinti Bertrand , Goupille-Lebret Jonathan
Published: August 2024

Bien que liées par l’étude d’un objet commun, les approches empiriques permettant de mesurer les inégalités de revenu et de patrimoine et les approches macroéconomiques semblent s’être développées de manière relativement disjointe. Dans cet article, nous revenons sur les origines et développements de ces deux littératures. Nous montrons comment leurs évolutions récentes ouvrent la possibilité d’un dialogue fructueux, et l’illustrons par les travaux d’Auray et al. [2022], qui étudient les facteurs explicatifs des inégalités de revenu et de patrimoine en France depuis 1984. A l’aide d’un modèle à agents hétérogènes et d’analyses contrefactuelles, ces travaux mettent en lumière le rôle clé de l’augmentation du pouvoir de marché des entreprises, des réformes du système socio-fiscal et des variations différenciées du prix des actifs sur la dynamique des inégalités.
Le prix de l’adhésion : l’Irlande, la Politique commune de la pêche et l’intégration européenne au début des années 1970
Authors: Geary Michael J. , Nicault Catherine
Published: August 2024

Cet article analyse les négociations pour l’adhésion de l’Irlande à la Communauté Économique Européenne (CEE) au début des années 1970 et le problème qui en est venu à dominer les discussions entre Dublin et Bruxelles, à savoir la Politique commune de la pêche (PCP). Désireuse d’intégrer le Marché Commun, Dublin est contrainte d’accepter une politique profondément erronée et précipitée qui aurait un impact négatif sur l’industrie de la pêche du pays. Fondé sur des archives irlandaises et de la CEE, l’article explore la stratégie de négociation de l’Irlande, les origines de la PCP et les négociations tendues entre l’Irlande et la Communauté au sujet de la pêche. Son argument central est que l’empressement de l’Irlande à rejoindre la CEE, presque à n’importe quel prix, signifiait qu’elle n’avait pas d’autre choix que d’accepter une politique dont Dublin savait qu’elle profiterait davantage à d’autres États. En outre, l’article souligne comment, alors que le premier élargissement était voué au succès, les candidats n’avaient qu’une capacité limitée à modifier l’ acquis communautaire.
Gérer des stocks halieutiques communs : un défi entre la Norvège et la CEE (1977-1989)
Authors: Andersson Magnus
Published: August 2024

Cet article se concentre sur l’octroi du premier fonds européen dont le Portugal a été bénéficiaire – le fonds d’aide de pré-adhésion – et plus particulièrement sur sa mise en œuvre dans le secteur de la pêche. Il analyse les projets approuvés et réalisés, leur raison d’être et leurs objectifs, ainsi que l’impact et la contribution que le secteur en attendait. Cette étude de cas montre qu’en dépit de l’importance du secteur de la pêche pour l’économie et la société portugaises, les fonds alloués aux projets d’aide de pré-adhésion ont été assez limités dans ce domaine et n’ont concerné que trois projets sur un total de plus de 70.
Un relâchement introuvable. Marges et applications de la « non-intervention » française durant la guerre d’Espagne (1936-1939)
Authors: Salmon Pierre
Published: August 2024

La posture de la France du Front populaire à l’égard de la guerre d’Espagne (1936-1939) peut être interrogée à nouveaux frais. Si le gouvernement a bien infléchi sa politique de « non-intervention » dans le conflit en laissant transiter nombre de matériels de guerre étrangers, à partir de l’été 1937, cette politique n’est en aucun cas durable, inconditionnelle, ni totale. Agissant, le gouvernement n’a pas hésité à transformer la question espagnole en objet de tractation diplomatique. Des résistances se font sentir aussi bien à l’échelle locale qu’au sein des ministères pour des ouvertures frontalières qui, somme toute, se signalent par leur intermittence. Dans l’absolu, le « relâchement » du contrôle demeure introuvable.
Les connexions aériennes entre Cuba et le Chili sous l’Unité Populaire : antécédents, synchronies et ruptures (1970-1973)
Authors: Moralès Étienne
Published: August 2024

La compagnie privée chilienne ALA-CINTA relia brièvement et sans grand succès commercial le Chili et Cuba en 1957-1959 jusqu’à sa faillite. À partir de 1959, ce fut pour des fins politiques que la compagnie nationale cubaine, Cubana de aviación, contrôlée par le gouvernement de Fidel Castro, chercha à organiser des vols spéciaux vers le Chili. Presque complètement isolé du continent américain sur le plan aérien par une politique de blocus défendue par l’Organisation des États américains (OEA), Cuba établit des relations aériennes avec le Chili d’Allende pendant la période de l’Unité Populaire. Alors que la ligne de Cubana de aviación fut un vecteur essentiel des rapports cubano-chiliens pendant la période du gouvernement d’Allende, jusqu’au 11 septembre 1973, la compagnie chilienne LAN n’inaugura jamais la ligne de La Havane tant de fois annoncée à cause de logiques commerciales et politiques, mais également de pressions extérieures.
Droit pénal
Authors: Perrier Jean-Baptiste , Rousseau François
Published: August 2024

Alors que l’activité du législateur en matière pénale s’annonce assez dense au cours des mois à venir, compte tenu des annonces faites concernant la délinquance des mineurs et du plan de lutte contre la criminalité organisée, les mois passés semblent relativement calmes. Ils ont néanmoins été l’occasion d’adopter quelques réformes, souvent pour répondre à l’émotion provoquée par des faits de violences. Si certaines d’entre elles sont anciennes, on se souvient des agressions subies par différents élus et (plus fréquemment encore) des menaces dont ils font l’objet ; l’actualité la plus récente témoigne du fait qu’il ne s’agissait sans doute pas d’un épiphénomène et, de ce point de vue, le renforcement de la répression des atteintes envers les élus peut apparaître comme une préoccupation légitime dans un contexte, par ailleurs, de « crise des vocations ». De même, et les faits sont parfois plus anciens encore, la dénonciation de violences sexuelles dans le sport a mis en évidence la nécessité de mieux protéger les enfants pratiquant ces activités. Bien au-delà, différents rapports rendus sur les violences intrafamiliales ont à nouveau mis en évidence la très grande vulnérabilité des enfants exposés à ces situations et les carences des dispositifs existant, pour relancer le mouvement plus général de renforcement de la protection des enfants victimes de violences.
Le rôle professionnel des conseillers « RSA » (Revenu de Solidarité Active) : entre conflits perçus et sentiment de reconnaissance
Authors: Gohin Audrey , Cazals Marie-Pierre , Croity-Belz Sandrine
Published: August 2024

La loi du Revenu de Solidarité d’Activité (RSA) a succédé au Revenu Minimum d’Insertion (RMI) en 2008. Le RSA poursuit la même logique que le RMI pour les bénéficiaires du RSA : des droits (l’allocation financière) et des devoirs (rechercher un emploi). Les conseils départementaux opérationnalisent la prise en charge des bénéficiaires du RSA par la voie d’accompagnements soit sociaux, soit à visée professionnelle. Au bout de la chaine, les conseillers/référents RSA accompagnent ces bénéficiaires dans leur recherche d’emploi. Comment ces conseillers/référents RSA font-ils pour accompagner les bénéficiaires du RSA, souvent éloignés de l’emploi ? Entre les exigences en matière d’employabilité et les valeurs de l’accompagnement, comment gèrent-ils ces logiques qui peuvent entrer en contradiction, voire mener à des conflits ? Se perçoivent-ils suffisamment reconnus dans l’exercice de leur rôle professionnel ? Pour répondre à ce questionnement, nous avons réalisé une enquête par questionnaire auprès de 211 conseillers/référents RSA. Les réponses au questionnaire ont été analysées par des Analyses Factorielles : des Analyses en Composantes Principales pour créer des indicateurs et une Analyse Factorielle des Données Mixtes (AFDM), correspondant à notre jeu de variables qualitatives et quantitatives, pour étudier les corrélations entre les variables. Les résultats de cette analyse montrent trois types de profils chez les conseillers/référents RSA. Un premier profil de professionnels qui s’inscrivent dans une dynamique conflictuelle dans l’orientation de leur rôle professionnel. Un deuxième profil de conseillers/référents RSA qui s’inscrivent dans un rapport de reconnaissance perçue avec l’institution. L’Analyse Factorielle des Données Mixtes (AFDM) montre un troisième profil plus inattendu : les conseillers/référents RSA qui sont expérimentés sur le poste perçoivent à la fois de la reconnaissance et de la surcharge de travail, ce qui questionne quant à une forme instrumentalisée de la notion de reconnaissance.
Using Debriefing in Professional Development Courses
Authors: Kowalski Karren
Published: August 2024

Debriefing is a valuable tool to use when developing teamwork skills. The skill set can be either a specific outcome talent, such as a class on building teams, or a team skill set needed to successfully complete a team project. Professional development faculty can work to acquire and expand the skills described in this column.

[
J Contin Educ Nurs.
2024;55(8):375–377.]
A novel modeling and prediction approach using Caputo derivative: An economical review via multi-deep assessment methodology
Authors: Önal Tuğrul Nisa Özge , Karaçuha Kamil , Ergün Esra , Tabatadze Vasil , Karaçuha Ertuğrul
Published: August 2024

In this study, we proposed a novel modeling and prediction method employing both fractional calculus and the multi-deep assessment methodology (M-DAM), utilizing multifactor analysis across the entire dataset from 2000 to 2019 for comprehensive data modeling and prediction. We evaluated and reported the performance of M-DAM by modeling various economic factors such as current account balance (% of gross domestic product (GDP)), exports of goods and services (% of GDP), GDP growth (annual %), gross domestic savings (% of GDP), gross fixed capital formation (% of GDP), imports of goods and services (% of GDP), inflation (consumer prices, annual %), overnight interbank rate, and unemployment (total). The dataset used in this study covered the years between 2000 and 2019. The Group of Eight (G-8) countries and Turkey were chosen as the experimental domain. Furthermore, to understand the validity of M-DAM, we compared the modeling performance with multiple linear regression (MLR) and the one-step prediction performance with a recurrent neural network, long short-term memory (LSTM), and MLR. The results showed that in 75.04% of the predictions, M-DAM predicted the factors with less than 10% error. For the order of predictability considering the years 2018 and 2019, Germany was the most predictable country; the second group consisted of Canada, France, the UK, and the USA; the third group included Italy and Japan; and the fourth group comprised Russia. The least predictable country was found to be Turkey. Comparison with LSTM and MLR showed that the three methods behave complementarily.
Real-Time Applications of Ubiquitous Computing on Heterogeneous Next Generation Networks
Authors: Gayathiri A. , Sabitha S. , Sathiya G. , Sumitra P. , Sathiya M. , Ghinea George
Published: August 2024

Pervasive is also acknowledged as ubiquitous computing, which incorporates connecting all objects in the surroundings through its functionalities. When it is connected it will integrate as a single system and all together work as a whole single unit. It is used for computer capacity as an embedded device and is used for communication. It communicates well and achieves the dropping of end users' need to communicate with computer. This pervasive computing is used in various areas in the real world. Today, people have a smart watch which connects with smart phones and receives many notifications from the office employees while not at work. As this, there are many examples in the real world of pervasive computing. In this chapter the authors are going to know about the pervasive computing origin, which are the places where pervasive computing is used and how it is working with heterogeneous network and also with the future generation network.
Artificial Intelligence Techniques in Cognitive Radio Networks Applications
Authors: Pal Kamalendu
Published: August 2024

Cognitive radios (CRs) are intelligent wireless sensor devices that sense, learn, and adapt to real-time operating environments. One of the essential characteristics of a CR-based communication network (also known as cognitive radio networks (CRNs)) is to optimize radio spectrum usage. CRNs have two types of users: Primary users (PUs) and secondary users (SUs). PUs are licensed users who can utilize the available spectrum at any instance of their licensed time. SUs are unlicensed users who can utilize the spectrum only when PUs are not utilizing the allocated spectrum band. This chapter reviews various artificial intelligence (AI) techniques in cognitive radio applications to enhance CRN cognition capability. AI enables systems to solve problems by emulating human behaviours (e.g., reasoning, and learning), and these behaviours are studied in applications related to the tasks of cognitive radio
Dynamic Spectrum Allocation in Cognitive Radio Networks
Authors: Daoudi Lhoussaine , Baslam Mohamed , Safi Said
Published: August 2024

In cognitive radio networks, secondary users face spectrum scarcity. Cognitive radio offers a solution by enabling sharing of frequency bands to maximize spectrum utilization. This chapter explores spectrum allocation behavior, where secondary users allocate underutilized spectrum to maximize profit. Prior research suggests cooperative spectrum sharing benefits users, but real networks see selfish behavior to mitigate risks. The authors propose a dynamic duopoly game for competitive spectrum allocation. Secondary users employ bounded rationality to adapt strategies, aiming for Nash Equilibrium. One user considers competitors' past allocations to estimate future ones. The authors establish the existence and uniqueness of Nash Equilibrium, ensuring fairness. Local stability analysis of fixed points is conducted. Numerical simulations, including bifurcation diagrams, show that users integrating historical data and bounded rationality are more likely to reach Nash Equilibrium and maintain system stability.
Investigation and Prediction of Itemsets Frequency Using Machine Learning Techniques
Authors: Banu M. Sameera , S. R. Samyuktha , Duraikannu Gajalakshmi , Paramarthalingam Arjun
Published: August 2024

Frequency of Itemsets plays a crucial role in analytics of retail industry, which delves into latent patterns in customer purchasing behavior. This paper presents an Apriori algorithm to extract associations among products in a given dataset, shedding light on frequently co-occurring items. By discerning these relationships, the business gains profound insights into customer preferences and tendencies, aiming not only to understand current purchasing behavior but also to identify potential cross-selling opportunities. As businesses rely on transactional data for insights, analysis reliability hinges on data quality. This study explores missing values, outliers, and data inconsistency, impacting market basket analysis accuracy. Leveraging the Apriori algorithm facilitates the revelation of robust product associations, enabling strategic optimization and heightened customer satisfaction. The gleaned insights inform targeted marketing, product placements, and inventory management, catalyzing more effective business optimization in the retail sector.
Online Fraud Detection Using Machine Learning Algorithms and Quantum Annealing Solvers
Authors: Akshaya B. , Das Bakshi Agnimita , A. Annie Micheal
Published: August 2024

Machine learning applications are widely used in identifying fraudulent transactions. Still, the majority of the applications detect fraudulent activities only after their occurrence, rather than in real-time or near real- time. The significant rarity of fraudulent transactions compared to normal ones creates a highly imbalanced data, posing substantial challenges for effective fraud detection. Addressing this issue extends beyond traditional machine learning approaches and requires alternative strategies. This chapter discusses the importance of fraud detection methods and compares k-nearest neighbor (KNN), random forest approach, artificial neural network (ANN) and support vector machine (SVM) enhanced with quantum annealing solvers that are used to detect fraud in online banking transactions. This study focuses on choosing the optimal approach for various types of datasets, while considering the three key factors such as accuracy, speed, and cost.
QoS-Aware Smart Resource Allocation for Green Cognitive Radio Networks
Authors: Ahmed Arifa , Mishra Deepak , Prasad Ganesh , Baishnab Krishna Lal
Published: August 2024

Cognitive radio (CR) technology has gained attention in wireless communications for its ability to enhance spectrum utilization efficiency through the implementation of dynamic spectrum access. This technology enables secondary users (SUs), or unlicensed users, to access the radio spectrum of primary users (PUs) in a limited manner that doesn't interfere with the PUs. The implementation of spectrum handoff can enhance SU's throughput performance however it may cause high energy consumption. This, in turn, can reduce device lifetime and affect system performance, particularly for battery-operated CR devices. This chapter focuses on optimizing the available resources in the green CR system to maximize energy efficiency (EE) and throughput performance while maintaining system reliability. It also explores using energy beamforming techniques to enhance the throughput performance of multi-antenna CR systems. Furthermore, this chapter addresses the challenges associated with SU's spectrum sensing by introducing a new transmission protocol designed for smart sensing implementation.
Revolutionizing Waste Management Through the Integration of IoT and Deep Learning Technology
Authors: Sathana V. , Daniel Sherwin Prince , Srikanth C. B. , Senthilvel K. , Santhoshraj D.
Published: August 2024

The constantly growing volume of waste produced daily by people and businesses has made the management of waste in urban contexts a challenging issue. These days, it's common practice to combine deep learning and the internet of things model with efficient waste management tactics to offer flexible real-time data monitoring and categorization solutions. The proposed methodology involved IoT-enabled garbage management which is used to detect the level of thrash and to gather images of the garbage objects from the onboard camera. In this model, the bounding-box regressor and the object classifier are removed. Instead, the garbage detection and segregation process uses the backbone model architecture of TensorFlow on ResNet. It is trained to detect and recognize different types of waste items in images. The trained deep learning model is integrated into the trash bin to categorize waste products into relevant groups (such as biodegradable and non-biodegradable). The method outperforms other existing methods in terms of garbage segmentation and categorization.
A Novel Sequential Three-Way Decision With Rough Fuzzy Sets Based on Optimal Granularity Selection
Authors: Yang Jie , Li Shuai
Published: August 2024

By introducing the cost measure and three-way decisions theory into the multi-granulation spaces, the uncertain knowledge is approximately described, and the selection method of cost-sensitive optimal knowledge space is proposed. To choose the optimal cost knowledge space to describe a fuzzy concept, a sequential three-way decisions model with rough fuzzy sets (S3WDRFS) is established. It is found that decision cost in multi-granulation knowledge spaces will monotonically decrease with finer knowledge spaces. A selection method of cost-sensitive optimal knowledge space for approximating a fuzzy concept is achieved.
Laboratory Abnormal Behavior Detection Based on Multimodal Information Fusion
Authors: Zhang Dawei
Published: August 2024

The traditional laboratory anomaly detection methods mainly focus on the hidden dangers caused by chemical leaks and other items, ignoring the impact of abnormal behaviors such as incorrect operations and improper behavior on safety in the laboratory. This paper proposes a laboratory abnormal behavior detection method based on multimodal information fusion. The method generates a dense optical flow field of RGB image sequences based on optical flow theory and global smoothing constraints, and mines motion mode information. Meanwhile, the contour modal information of behavior is captured through convolution and adjacency matrix operations. Using decision level and proximity functions to integrate student behavior motion mode information and contour mode information, and using the maximum value as the behavior detection result. The experimental results show that the method can effectively detect abnormal behavior in the laboratory environment, with small detection errors and a specificity close to 1.00, effectively ensuring the safety of the laboratory environment.
Sinus venosus atrial septal defect device closure
Authors: Reddy G. B Chandra Shekara , Srinivas Arun , Chawath Siddarth Kumar , Prasad H. P Guru
Published: August 2024

With technical advancements, transcatheter closure of sinus venosus atrial septal defect (SVASD) proves safe and effective, even in developing countries. A 38-year-old male with recurrent palpitations underwent transesophageal echocardiography and cardiac computerized tomography, confirming a 14 mm SVASD with left-to-right shunt. Under GA and mechanical ventilation, we deployed a 19–25 mm ZYPHER-covered peripheral stent using 22 mm × 60 mm Z-Med II Balloon guidance. An angiogram confirmed adequate defect coverage. Postprocedure, occasional ventricular premature contractions and intermittent atrioventricular block were noted on 72-h Holter. Follow-up showed symptom resolution, with transthoracic echocardiography confirming stent placement and no residual shunt, endorsing device closure as a viable alternative to surgery.
Unveiling acute myocardial infarction in young adults of rural India: Exploring demographic, clinical, and angiographic profiles
Authors: Bhattacharjee Manna , Nagarwal Amitesh , Prakash Sai Durga , Gaurab Vishal , Yadav Bijay Prakash , Charan Sheshkaran Singh , Wakade Vishvajit Magan , Mishra Sundeep
Published: August 2024

Introduction:

Cardiovascular disease, particularly myocardial infarction (MI), remains a leading cause of mortality globally and in India. The prevalence of coronary artery disease (CAD) among young adults in India presents unique challenges, marked by earlier onset and distinct risk factor profiles. However, comprehensive data on young MI patients in rural areas are scarce, necessitating an investigation into their demographics, clinical characteristics, and outcomes.

Materials and Methods:

This institution-based, cross-sectional study was conducted at the Department of Cardiology, NIMS Super Specialty Hospital, Jaipur, focused on individuals under 45 years old admitted with MI. Data encompassing demographic, clinical, echocardiographic, and angiographic profiles were collected and analyzed. The study spanned from December 2022 to December 2023.

Results:

Among 45 young MI patients studied, males constituted a substantial majority (86.67%). Lower socioeconomic status (SES) was prevalent (71.11%), and risk factors such as smoking (51.11%) and hypertension (35.56%) were notable. Troponin-T/CPK MB levels were significantly elevated in 57.78% of cases, indicating myocardial damage. Angiographic assessments revealed predominance in left anterior descending (LAD) artery abnormalities (55.56%) and a significant proportion underwent primary percutaneous transluminal coronary angioplasty (PTCA) (46.67%).

Conclusion:

The study highlights the concerning prevalence of MI among young adults in rural areas of India, with a predominance of males and a high prevalence of traditional risk factors such as smoking and hypertension, as well as the notable influence of low SES (P = 0.0046). Contrary to previous studies that linked higher SES and sedentary lifestyles to an increased risk of CAD, this study underscores the significant burden of CAD among young individuals from lower socioeconomic groups. The elevated levels of troponin-T and CPK-MB, along with the predominance of LAD artery abnormalities, emphasize the severity and distinct coronary involvement patterns in this demographic. These findings highlight the urgent need for targeted preventive strategies and improved access to health-care services for young adults in lower socioeconomic groups in rural areas.
Aberrant right subclavian artery – A roadblock for radial interventionalists
Authors: Sahu Ankit Kumar , Goel Pravin K.
Published: August 2024

Extreme difficulty was faced while negotiating diagnostic catheter in a septuagenarian hypertensive male undergoing transradial coronary angiography due to the long tortuous course of the aortic arch. Biplane imaging helped in unearthing an aberrant right subclavian artery originating anomalously from the descending thoracic aorta.
Evaluation of the Prevalence and Pattern of Dyslipidemia in Newly Detected Type 2 Diabetes Mellitus Patients and Nondiabetic Controls
Authors: Shekhawat Vikram Singh , Behera Vineet , Nayak Akshay Kumar , Kamal Kiran Deep , Ramamoorthy Ananthakrishnan , Kumar Ritu Ranjan , Roy Sudeep Kumar
Published: August 2024

Introduction:

Dyslipidemia comprises disorders of lipoprotein metabolism, which is usually characterized by increased plasma levels of total cholesterol (TC), triglycerides (TG), low-density lipoproteins (LDL), or reduced plasma level of high-density lipoprotein (HDL). Dyslipidemia is commonly found in Type 2 Diabetes Mellitus (T2DM) patients causing an increased risk of atherosclerosis and cardiovascular disease. Many studies done previously show variable prevalence of dyslipidemia (68 to 85 %) in known diagnosed patients of T2DM (with unknown history of onset), however, only limited studies have been done for finding prevalence of dyslipidemia in newly detected T2DM patients.

Aim:

This study is a cross-sectional observational study done in a tertiary care hospital in Mumbai (India), aiming to study prevalence and pattern in newly detected T2DM patients. The secondary objective is to compare the prevalence and pattern of dyslipidemia in newly detected T2DM patients with non-diabetic controls.

Material and Method:

For this, 100 newly detected T2DM patients were chosen along with 100 cases of age & gender-matched non-diabetic controls. Their clinical profile and lipid profile of both groups were observed and compared.

Result:

Results showed higher prevalence of dyslipidemia in newly detected T2DM patients (64%) which was significantly more than the control group (32%). Moreover, the pattern of dyslipidemia showed greater mean levels of TC, TG, and LDL and low mean levels of HDL in T2DM patients compared to the control group.

Conclusion:

These findings show that there is an increased risk of Dyslipidemia in new onset T2DM patients.
Prognostic Significance of Caudal-type Homeobox Gene 2 and Sex-determining Region Y-Box 2 Immunohistochemistry Markers in Gastric Cancer – A Clinicopathological Study
Authors: Mishra Aabhas , Singh K. J. , Gahlot G. P. S. , Pal Seerat
Published: August 2024

Background:

Gastric cancer is one of the most commonly diagnosed cancers and the third leading cause of cancer-related deaths in the world as it has a poor prognosis due to its delayed presentation. Adenocarcinoma (intestinal or diffuse type) is the most common type histologically, and tumor, node, and metastasis staging is essential for prognosis and treatment planning. Gastric cancer patients may have different clinical presentation even within the same cancer stage group, hence it is important to evaluate additional markers in such patients which can help in prognosticating them to aid in effective management of such patients. This study evaluates two new immunohistochemistry (IHC) markers and their clinical correlation which will help in prognosticating gastric cancer patients.

Materials and Methods:

Biopsy tissues from 30 patients between April 2016 and April 2019, who underwent upper gastrointestinal endoscopy in a tertiary care center of Armed Forces and were found to have gastric cancer, were studied. Caudal-type homeobox gene 2 (CDX2) and sex-determining region Y-box 2 (SOX2) immunoreactivity was correlated with histomorphology, clinical presentation, and staging of tumor.

Results:

CDX2 positivity (P = 0.002) as well as SOX2 negativity (P = 0.058) was associated with an advanced stage of disease in our study. CDX2+/SOX2− profile was also noted to be statistically correlating (P = 0.014) with poor prognosis in gastric cancer.

Conclusion:

Loss of SOX2 together with positive CDX2 expression had a good correlation with advanced disease and poor outcome. Further studies should be undertaken for targeted therapy for these IHC markers.
Strengthening Patient Care through Training Students in Mindfulness as a Part of the Medical Curriculum
Authors: Shrivastava Saurabh RamBihariLal , Bobhate Prateek Sudhakar , Badge Ankit , Tiwade Yugeshwari
Published: August 2024

Mindfulness clinical practice refers to the deliberate efforts to stay in the present moment while dealing with patients and not being judgmental. There is an immense need for health-care professionals to deliver an objective and compassionate response to their patients by demonstrating their genuine presence, better understanding, and empathy. Mindfulness practice by health-care professionals is linked with professional development and multiple benefits in patient care, and it is quite essential that medical students are trained in the same during their undergraduate period. This will essentially require systematic planning and collaboration between teachers, as exposure of mindfulness across the curriculum will play a defining role in facilitating the comprehensive development of medical students. In conclusion, acknowledging the multiple benefits of mindfulness to health-care professionals and improvement in the quality of patient care services, it is the need of the hour that every medical college or health-care establishment should take active interventions to plan and implement the same within their settings.
Management of Early Childhood Caries under General Anesthesia at a Tertiary Care Service Hospital: A Retrospective Study
Authors: Sharma Anoop , Jain Aditi , Chengappa M. M. Dempsy , Meshtha Nikhil Kumar , Goje H. K.
Published: August 2024

Introduction:

Early childhood caries (ECC) affects almost 50% of preschool children and may lead to chronic pain, halitosis, fever, trismus, poor growth and development, and repeated airway and gastrointestinal infections. Managing this is challenging in the face of anxiety, developmental delay, and other comorbidities in children. This necessitates their management under general anesthesia (GA).

Methodology:

We carried out a retrospective descriptive study to analyze the characteristics of pediatric patients who underwent oral rehabilitation under GA at a tertiary care service hospital.

Results:

The data of 20 children inflicted with ECC who underwent full-mouth rehabilitation under GA were analyzed. The majority were boys and the mean age was 69.5 months. Five of these children had comorbidities. The most common indication for GA was the uncooperation of the child. Inhalational induction was carried out for most of them, and postoperatively, two children had emergence delirium and one child had nausea and vomiting.

Conclusion:

We share our experiences toward standardization of safe anesthesia practices.
Drug Errors in Obstetric Anesthesia: A Narrative Review
Authors: Pruthi Gegal , Dey Ankita , Tamilchelvan Hemanthkumar , Kapoor Sameer , Jain Kajal , Kasodekar Shilpa V. , Grewal Anju
Published: August 2024

The subspecialty of obstetric anaesthesiology is different from other subspecialties in anaesthesiology in that, at any point of time, two lives are at stake, making drug errors particularly critical. This narrative review explores the incidence, contributing factors, and preventive strategies for medication errors in Obstetric Anaesthesia. Key contributors of medication errors include distractions, fatigue, look-alike/sound-alike drugs, lack of standardized protocols, poor communication strategies, inadequate training and education. Effective strategies for reducing errors include double-check procedures, bar-coded medication administration systems, implementing “Tall Man lettering for look-alike/sound-alike drugs, structured communication tools, continuous education and training. The review also introduces the mnemonic "SAFE-LABEL CHECK" to encapsulate best practices for minimizing drug errors. Future directions suggest integrating advanced technologies and fostering a multidisciplinary approach to enhance patient safety in obstetric anaesthesia.
Posterior Reversible Encephalopathy Syndrome After Inadvertent Dural Puncture Vs Bupivacaine-Induced Adverse Drug Reaction: A Case Report
Authors: Merchant Kiran , Ali Muhammad A. , Salim Bushra
Published: August 2024

A case involving a 29-year-old female patient with a known case of hypothyroidism at 38 weeks gestation. She developed a fronto-occipital, postural type of headache. This ensued on the second postoperative day after undergoing an unintended dural puncture with the introducer needle during spinal anesthesia for an elective cesarean section. It was initially treated as a post-dural puncture headache until she developed generalized tonic–clonic seizures the next day. Magnetic resonance imaging (MRI) of the brain exhibited features of posterior reversible encephalopathy syndrome (PRES). With anticonvulsants and antibiotics, the neurological symptoms subsided, and the patient was discharged home symptom-free. We call attention to the importance of suspecting PRES in obstetric cases with an inadvertent dural puncture in a normotensive patient. Neuroimaging plays a crucial role in making a diagnosis of headaches, especially during the peripartum period. Lastly, keeping in view, the potential medicolegal implications in such cases, further research seems vital, especially in the Asian population.
Knowledge, perception, and risk scoring of diabetes among rural nondiabetics in southern coastal Karnataka, India
Authors: Dsouza Agnes Moira Preethi , Bhat Sowmya , Kodyalamoole Nishanth Krishna , Suresh Sucharitha
Published: August 2024

Background:

Diabetes is one of the top 10 contributors to death globally. It is affecting more and more younger populations due to lifestyle changes in India. Tools like the Indian Diabetic Risk Score (IDRS) help in screening high-risk individuals for diabetes. Early diagnosis and prompt treatment help in avoiding complications and disabilities due to diabetes. Hence, this study was conducted to calculate the risk of diabetes using IDRS and to determine the knowledge and risk perception of diabetes among the nondiabetics residing in the rural field practice area of a medical college.

Methodology:

A descriptive cross-sectional study was conducted in the rural field practice area of a medical college. A total of 885 people participated in our study. All nondiabetics above 18 years of age were involved. The data were collected using a questionnaire and the IDRS questionnaire was used to determine the risk of diabetes. Data were analyzed using IBM SPSS 20th version.

Results:

Majority of the participants were between the age of 18 and 50 years. About 65.8% of the study population had medium risk according to IDRS. There was a significant relationship between gender, body mass index, and IDRS. A majority had good knowledge about diabetes. Only 31.5% knew that diabetes can cause complications in other organs of the body.

Conclusion:

Compared to prior research on rural Indians, this study’s population knew more about diabetes. To encourage people to adhere to their medication and treatment, further health education sessions should concentrate on minimizing the risk factors and complications of diabetes.
Nursing care for respiratory failure in a patient with pulmonary edema and acidosis metabolic
Authors: Stefani Stefani , Emaliyawati Etika
Published: August 2024

Impaired performance of the respiratory muscle pump or lung dysfunction can lead to a severe condition of respiratory failure. Therefore, mechanical ventilation is used to sustain the life of individuals with this syndrome. Furthermore, this condition is harmful to the body and can cause complications. This study aimed to describe nursing care provided to patients with respiratory failure. The design was a case study with narrative analysis. The data were collected in October 2022 at a Government Teaching Hospital in Bandung. The nursing assessment shows that the patient (Mr. S) was unconscious and unresponsive to pain stimuli under sedation. The patient was in moderate acute respiratory distress syndrome, receiving mechanical ventilation with synchronized intermitten mandatory ventilation pressure control and pressure support (SIMV PCPS) mode, and was breathing spontaneously. Furthermore, there were rhonchi breath sounds, temporary gurgling sounds, pitting edema in the upper and lower extremities, and anuria. Impaired spontaneous breathing is the key nursing concern for this patient, along with poor airway clearance as well as fluid and electrolyte imbalance. In conclusion, ventilation is the primary management of the patient with respiratory failure. This intervention should be given appropriately to reduce the disease’s symptoms and the risk of complications. Therefore, maintaining a low tidal volume, prone position, continuous respiratory assessment, minimizing sedation, suctioning, and chest physiotherapy are essential to achieve a good outcome.
Psycho-ophthalmology: A detailed review
Authors: Vasanthakumar Anugraha , Sathyanath Shashwath , Kakunje Anil , Nishad P. M. A.
Published: August 2024

In many areas of diagnosis and treatment, psychiatry and ophthalmology overlap significantly. A patient who has had a great deal of psychological stress may exhibit vision loss. The results of neuro-ophthalmological testing might influence the psychiatric diagnosis and course of therapy. There is a wide range of psychiatric signs and symptoms noted in various ophthalmological disorders which an ophthalmologist witnesses every day. As a result, there is a great deal of overlap between the two disciplines methods to treatment. It goes without saying that the connection between psychiatry and ophthalmology has not gotten the attention it merits.
Inflammatory cytokines, oxidative stress, and tau protein impairment in cognitive functioning in patients with diabetes mellitus
Authors: Kour Harpreet , Mishra Sanjay , Hattiholi Aishwarya
Published: August 2024

Diabetes mellitus (DM) is a common endocrine disorder. It has an impact on various organs and systems in the body. Both hypo- and hyper-glycemia can lead to cognitive impairment through several metabolic pathways. Previously, the battery of studies has reported the decline in cognitive functions through preclinical studies using in vivo and in vitro methods as well as clinical studies in elderly populations. Previous reports of the clinical studies had limited to one domain of cognitive function, the elderly population, and inflammatory cytokines/chemokines and tau protein levels. The present review article attempts to find the various mechanisms and their inter correlation leading to cognitive impairment among patients with DM.
Hypoglycemia in hospitalized patients: A sleeping monster
Authors: Kuragayala Swarna Deepak , Nayak Sumita , Khatib Khalid
Published: August 2024

Objective:

This study describes the incidence and clinical profile of hypoglycemia (including mild, moderate, severe, and recurrent) and its correlation with the time of the day, duration of diabetes mellitus (DM), administration of insulin/oral hypoglycemic agents (OHAs) and diagnosis at admission in hospitalized adult patients.

Materials and Methods:

This retrospective, observational study analyzed the data of hospitalized patients with episode(s) of hypoglycemia. For each patient, clinical profiles such as age, gender, antidiabetic therapy, timing of hypoglycemic event, duration of diabetes, working diagnosis, place of hypoglycemia, dietary changes, and mode of corrective action were studied.

Results:

Of 100 patients with a mean ± standard deviation age of 62.72 ± 3.54 years, hypoglycemia was the most common among those aged 61–90 years. There were 134 hypoglycemic events and mild hypoglycemia was the most common (72.39% vs. moderate 21.64% and severe 5.97%). There were 59 (44%) events of recurrent hypoglycemia. Hypoglycemic events were maximum during 4:00 am–7:59 am (34%). Longer duration of DM (>15 years, 42%) and insulin therapy were the high-risk factors. There was a statistically significant association between hypoglycemia and duration of diabetes (P < 0.0133), insulin therapy (P < 0.0001), OHA (P < 0.0192), and a combination of insulin and OHA (P < 0.0059) within 24 h before the event but not with the incidence and dietary changes.

Conclusion:

Patients above 60 years were the most vulnerable population for hypoglycemia, especially during the early hours of the day. Patients who had diabetes for >15 years, on insulin therapy, and those with pulmonary and renal diseases were the most vulnerable to overall and recurrent hypoglycemic events, respectively.
Respiratory morbidity and short-term outcome in moderate preterm, late preterm, and early-term infants at a tertiary care hospital in Southern India
Authors: Satheesh Anusree , Avabratha K. Shreedhara , Shanbhag Sweta , Prabhu H. Sudhir
Published: August 2024

Introduction:

Moderate and late preterm and early-term infants constitute a significant proportion of hospitalizations in neonatal intensive care units (NICU), yet have been perceived as low-risk groups. Their gestational age-specific data have been poorly studied, including respiratory morbidity and outcome.

Objectives:

The objectives of this study were to determine the respiratory morbidity among moderate and late preterm and early-term infants and to study their short-term outcomes.

Materials and Methods:

A longitudinal descriptive hospital-based study was conducted at a tertiary care hospital in Southern India, from January 2018 to June 2019. Newborns between 32 and <39 completed weeks, after gestational age assessment, were observed until discharge and later followed up to 40 weeks of gestation. The outcome was recorded in terms of respiratory issues, length of hospital stay, and readmissions within a month.

Results:

Two hundred and fifty babies were included in the study. NICU care was required in 78%, 72%, and 9.2% of moderate preterm, late preterm, and early-term infants, respectively. Respiratory distress was noted in 78%, 66%, and 6% of moderate preterm, late preterm, and early-term infants, respectively. The association of respiratory distress with gestational age was highly significant (P < 0.0001). Surfactant requirement was 12%, 6%, and 1.7% among the three groups. The average length of NICU stay was 7.8 days, 6.5 days, and 0.3 days among moderate and late preterms and early-term infants, respectively.

Conclusion:

Moderate and late preterms and early-term infants have significant morbidities. Gestational age has a substantial correlation with respiratory distress and neonatal outcomes. Knowledge about these issues can ensure improved outcome in these infants.
Recombinant tissue plasminogen activator protects neurons after intracerebral hemorrhage through activating the PI3K/AKT/mTOR pathway
Authors: Jing Jie , Chen Shiling , Wu Xuan , Yang Jingfei , Liu Xia , Wang Jiahui , Wang Jingyi , Li Yunjie , Zhang Ping , Tang Zhouping
Published: August 2024

Recombinant tissue plasminogen activator is commonly used for hematoma evacuation in minimally invasive surgery following intracerebral hemorrhage. However, during minimally invasive surgery, recombinant tissue plasminogen activator may come into contact with brain tissue. Therefore, a thorough assessment of its safety is required. In this study, we established a mouse model of intracerebral hemorrhage induced by type VII collagenase. We observed that the administration of recombinant tissue plasminogen activator without hematoma aspiration significantly improved the neurological function of mice with intracerebral hemorrhage, reduced pathological damage, and lowered the levels of apoptosis and autophagy in the tissue surrounding the hematoma. In an in vitro model of intracerebral hemorrhage using primary cortical neurons induced by hemin, the administration of recombinant tissue plasminogen activator suppressed neuronal apoptosis, autophagy, and endoplasmic reticulum stress. Transcriptome sequencing analysis revealed that recombinant tissue plasminogen activator upregulated the phosphoinositide 3-kinase/RAC-alpha serine/threonine-protein kinase/mammalian target of rapamycin pathway in neurons. Moreover, the phosphoinositide 3-kinase inhibitor LY294002 abrogated the neuroprotective effects of recombinant tissue plasminogen activator in inhibiting excessive apoptosis, autophagy, and endoplasmic reticulum stress. Furthermore, to specify the domain of recombinant tissue plasminogen activator responsible for its neuroprotective effects, various inhibitors were used to target distinct domains. It has been revealed that the epidermal growth factor receptor inhibitor AG-1478 reversed the effect of recombinant tissue plasminogen activator on the phosphoinositide 3-kinase/RAC-alpha serine/threonine-protein kinase/mammalian target of rapamycin pathway. These findings suggest that recombinant tissue plasminogen activator exerts a direct neuroprotective effect on neurons following intracerebral hemorrhage, possibly through activation of the phosphoinositide 3-kinase/RAC-alpha serine/threonine-protein kinase/mammalian target of rapamycin pathway.