bluuebunny/crossref_metadata_2025 huggingface dataset:
Entre gestion des risques et opportunités stratégiques : l’originalité de l’expérience israélienne dans le cyberespace
Authors: Scialom Ilan
Published: July 2024

Cet article présente la posture nationale israélienne dans le cyberespace et son évolution dans un environnement cyber en dynamique constante. Tout en mettant en œuvre une gestion robuste des risques cyber, l’État hébreu a contribué à l’émergence d’un important écosystème qui alimente une diplomatie du cyber dont les objectifs sont pluriels. Cet article s’intéresse finalement aux différents défis rencontrés par Israël pour maintenir sa maîtrise du cyberespace et accroître son influence aux niveaux régional et mondial.
Donors talk: The signaling and imprinting effects of giving to social enterprises
Authors: D’Espallier Bert , Hudon Marek , Khavul Susanna , Szafarz Ariane
Published: July 2024

Comment les donateurs doivent-ils financer les organisations de microfinance afin de maximiser leur impact social ? Doivent-ils concentrer leurs contributions sur quelques bénéficiaires ou plutôt les répartir entre de nombreuses organisations ? Nous abordons cette question délicate en estimant séparément les effets sur les performances sociales du don en tant qu’acte d’une part, et du montant donné de l’autre. L’analyse s’applique à des organisations de microfinance du monde entier. Prenant appui sur la théorie du signal, nous formulons l’hypothèse que le don en tant qu’acte a plus d’impact que le montant donné. En outre, nous établissons l’existence d’un effet d’empreinte ( imprinting effect ) selon lequel les performances sociales persistent même lorsque les dons se tarissent. En d’autres termes, le niveau accru des performances sociales observées au cours des périodes subventionnées se maintient lors des périodes ultérieures non subventionnées. Il s’ensuit que des contributions diversifiées et réparties entre de nombreuses organisations peuvent amener le donateur à atteindre un impact social global supérieur à celui résultant de contributions concentrées sur un petit nombre d’organisations bénéficiaires.
Trois scénarios de fin à la guerre en Ukraine
Authors: Drevet Jean-François
Published: July 2024

Au moment où paraît ce numéro de la revue Futuribles , cela fait deux ans et quatre mois que la Russie a lancé son offensive contre l’Ukraine, et il faut bien avouer que l’heure n’est pas à l’optimisme quant à l’issue de ce conflit. Alors qu’au printemps 2022, la résistance de Kiev face aux troupes russes avait amené à parier sur une guerre plus longue qui finirait par desservir les projets de Moscou, ce printemps 2024 confirme que la guerre dure, qu’elle s’enlise, et montre des forces ukrainiennes exsangues face à des troupes russes en apparence plus solides. Les atermoiements des États-Unis et de l’Union européenne qui ont retardé l’envoi de soutien matériel ont sans doute leur part de responsabilité ; mais même si l’armée ukrainienne parvient à se relancer, on a peine à croire à l’avènement d’un scénario rose, d’autant que la situation tend à échauffer les esprits dans d’autres pays d’Europe de l’Est et du Caucase. Dans cette chronique, Jean-François Drevet examine trois scénarios contrastés portant sur la façon dont pourrait se terminer la guerre en Ukraine, et les incidences qui en découleraient pour l’Union européenne et la sécurité du continent : un retrait russe (quasi utopique), la stabilisation du front (de manière temporaire — ou pas) ou la défaite de l’Ukraine (à quel prix ?). Comme il l’indique en conclusion, il est fort peu probable que le projet européen sorte grandi de l’issue du conflit. Faute d’avoir pris la mesure des enjeux sécuritaires à ses frontières et d’avoir su forger une politique de défense commune à la hauteur, l’Union devra en tirer des conclusions — un quitte ou double ? S.D.
Les Assemblées du personnel et des travailleurs de 1949 à nos jours. Trois configurations du corporatisme chinois
Authors: Andreas Joel , Li Yao , Li Peiyao , Goudarzi Tiam
Published: July 2024

Toutes les grandes entreprises chinoises sont tenues de convoquer des organes de représentation connus sous l’appellation d’« assemblée du personnel et des travailleurs » (APT). À travers l’étude de cas d’une grande usine de fabrication de verre appartenant à l’État, cet article examine l’évolution du système des APT de 1949 à nos jours. Au cours des dernières années, ce système s’est massivement développé, se traduisant par la mise en œuvre d’APT, au moins en principe, dans plus de 5 millions d’organisations employant quelque 250 millions de travailleurs. Pour évaluer les performances réelles du système quant à la capacité des travailleurs à influencer la gouvernance des entreprises, par le passé ou encore de nos jours, et dans la mesure où le système a toujours fonctionné sous la tutelle de l’État, nous utilisons le concept de corporatisme d’État emprunté à Philippe Schmitter. Nous soutenons que, depuis 1949, la Chine a connu trois configurations du corporatisme d’État. Dans la première, le nouveau régime a brièvement mis en place des institutions tripartites composées de représentants de l’État, du travail et du capital, avant de mobiliser les travailleurs pour qu’ils participent à l’expropriation du capital. La configuration suivante, de la fin des années 1950 au début des années 1990, a incarné une relation directe entre l’État et les travailleurs. La configuration la plus récente, fondée à nouveau sur une structure tripartite, a vu la transformation des usines en entreprises en quête de profits. Selon nous, dans les deux premières, l’État a intégré les travailleurs, de manière solide mais limitée, dans la gouvernance des usines. La configuration actuelle, au contraire, les marginalise.
Big Data et Open Data : Socles indispensables pour les entreprises
Authors: Monino Jean-Louis
Published: July 2024

«  Big Data  » et «  Open Data  » constituent des gisements d’informations encore sous-exploités. La question associée à cet article considère quels éléments peuvent éclairer une meilleure intégration de leur potentiel. Par un travail d’analyses conceptuelles, seront montrées leurs aptitudes à transformer « business », gouvernement et société. Le Big Data donne le pouvoir d’analyser et changer le monde. L’ Open Data assure que ce pouvoir soit partagé et favorise des démarches d’innovation ouverte, suivant, d’une part des organisations détenant des données exploitables, d’autre part des entreprises créatives, dont startups et PME, fournisseuses de technologies innovantes, cela aboutissant à faire émerger des solutions radicalement nouvelles. Avec l’évolution de la démarche d’analyse, des modèles économiques basés sur les stratégies de monétisation sont donc à construire. En devenant le socle actif de nouveaux produits et services, le Big Data Analytics appelle une révision profonde des modèles économiques, désormais nécessairement orientés données.
Agilité des organisations paysannes africaines : leçons apprises de la Covid-19
Authors: Avalla Rubain Hodehoué , Agossou Patrice Aimé , Hounkou Emmanuel
Published: July 2024

La pandémie sanitaire de Covid-19 qu’a connu la planète Terre n’a épargné aucun secteur d’activité. Les organisations paysannes ont été lourdement bouleversées par cette pandémie avec les marchés et les frontières fermés, les champs et les récoltes abandonnés faute de main-d’œuvre. L’objectif de cet article est d’analyser l’agilité des organisations paysannes africaines face à cette pandémie sanitaire de Covid-19. La méthodologie mobilise une enquête qualitative de terrain et trois études de cas à travers trois organisations paysannes du Bénin, du Burkina Faso et de la Côte d’Ivoire. Les résultats montrent que la pandémie sanitaire a permis aux organisations paysannes l’enracinement des réseaux sociaux, la création de nouveaux circuits de distribution. L’agilité des organisations paysannes s’explique par le niveau de motivation des membres, le leadership des dirigeants et le degré élevé de relation entre les membres.
Reconnaissance professionnelle des seniors en situation de vulnérabilité : Vers une transformation de l’expérience des accompagnants
Authors: Baujard Corinne
Published: July 2024

Cet article interroge la reconnaissance professionnelle des seniors en situation de vulnérabilité sur le vécu des accompagnants dans une entreprise européenne de logistique. Nous étudions l’expérience dans la manière dont les accompagnants se construisent eux-mêmes afin de comprendre les transactions sociales qui favorisent l’action des seniors. Comment la posture professionnelle de reconnaissance favorise-t-elle l’engagement des seniors au travail ? Une étude exploratoire conduite en 2022 auprès des accompagnants, complétée par une observation sur site réalisée à l’automne 2023 permet de relever l’existence d’une certaine distance subjective dans la considération d’autrui. Dans bien des situations, les seniors parviennent à un sens pour eux-mêmes qui engage le vivre ensemble dans l’activité du travail réalisée.
Affirmationes incompactae . La double opération dans le langage de la figure de l’incompact dans le Commentaire de l’Exode de Maître Eckhart
Authors: Casteigt Julie
Published: July 2024

Cet essai prend en vue le paradoxe que soulève l’exégèse eckhartienne du verset Ex.  15, 3, dans le commentaire du livre de l’ Exode , à propos de l’objection formulée par la thèse dionysienne, dans la Hiérarchie céleste , chapitre 2, § 3, selon laquelle toute affirmation au sujet de Dieu est incompacte, tandis que Maître Eckhart soutient qu’elle est propre. Maître Eckhart limite la portée de l’objection dionysienne au mode de signifier selon l’inhérence et renverse l’incompacité des affirmations au sujet de Dieu en compacité, dès lors que ces dernières sont prises selon le mode de signifier selon l’identité essentielle.
Impact of supervise neural network on a stochastic epidemic model with Levy noise
Authors: Ikram Rukhsar , Khan Amir , Raezah Aeshah A.
Published: July 2024

This paper primarily focused on analyzing a stochastic $ \mathcal{SVIR} $ epidemic model that incorporates Levy noises. The population may be divided into four distinct compartments: vulnerable class ($ \mathcal{S} $), vaccinated individuals ($ \mathcal{V} $), infected individuals ($ \mathcal{I} $), and recovered individuals ($ \mathcal{R} $). To achieve this, we chose existing and unique techniques as the most feasible solution. In the nexus, the stochastic model was theoretically analyzed using a suitable Lyapunov function. This analysis broadly covered the existence and uniqueness of the non-negative solution, as well as the dynamic properties related to both the disease-free equilibrium and the endemic equilibrium. In order to eradicate diseases, a stochastic threshold value denoted as "$\textbf{R}_0$" was used to determine if they may be eradicated. If $ \textbf{R}_0 < 1, $ it means that the illnesses have the potential to become extinct. Moreover, we provided numerical performance results of the proposed model using the artificial neural networks technique combined with the Bayesian regularization method. We firmly believe that this study will establish a solid theoretical foundation for comprehending the spread of an epidemic, the implementation of effective control strategies, and addressing real-world issues across various academic disciplines.
“Entre Deux Transatlantiques”: American Religion and the French Family at the Comédie-Française (1890)
Authors: Broderick LeeAnn , Charles Carter , Cropper Corry
Published: July 2024

Mormonism, seen in 1865 by French critic Hippolyte Taine as an American religious and social experiment conducted “for our benefit,” appears frequently in French thinking in the second half of the nineteenth century. Whether Taine intended it or not in his use of the word “benefit,” this American religion was mobilized in French conversations about pressing sociopolitical issues such as gender identity, marriage, and the social norms surrounding those issues. Relying on a cultural studies approach, we illustrate in this article how French literary critic and playwright Philippe Gille uses Mormonism in Camille, a play in which he explores issues of gender in the context of the état civil during the Third Republic. First performed at the French national theater (Comédie-Française) in 1890, Gille’s play stages the transatlantic encounter of Franco-American cultures and values as a way to displace questions about the capacity of the French state to regulate marriage and family relationships.
Sylvia Plath’s Poetry in Multiple Versions: A Case Study of UK School Anthologies
Authors: Blake Julie
Published: July 2024

The history of poetry anthologies created for use in compulsory nation-state education is largely untold. As material objects, school anthologies tend to be regarded as low status and ephemeral. Yet these objects have a lasting impact, as they facilitate encounters that are formative in shaping public understanding of poetry. This paper illustrates how two poems that are commonly featured in school poetry anthologies, Sylvia Plath’s “You’re” and “Morning Song,” encode a historical rationale for their material form in their bibliographic practices. It shows how “You’re” and “Morning Song” became “enregistered” (Agha 190) as acceptable tokens for the discussion of motherhood and domestic relationships by school-based adolescent readers with different social valuings of poetry and different levels of literacy. The case study of these two poems illuminates how poems in their multiple versions become established within a long-lasting and pervasive pedagogical canon of poetry. As such, the multiple pedagogical versions of poems have a value in constructing a complete story of the everyday “afterlife” of a poet’s work.
Public crowdsourcing and co-production processes: A case study on European innovation contests
Authors: Liotard Isabelle , Revest Valérie
Published: July 2024

While many studies in economics and management have examined the phenomenon of crowdsourcing in the private sector, research on public crowdsourcing is limited. This article aims to fill this gap by exploring how public actors mobilize crowdsourcing to create innovation policies. Our work is part of a wider effort to renew innovation policies, embedded in the Transformative Innovation Policy approach, of which co-production between different stakeholders is a key component. In line with this view, we draw on a specific tool: public innovation contests. Through the study of twenty-two contests launched by the European Commission between 2015 and 2020, and on the basis of interviews conducted with contest managers, we characterize the type of public crowdsourcing mobilized. The findings show that European innovation contests are based on a combination of competitive and collaborative crowdsourcing and that each type of crowdsourcing involves a specific audience. While we observe a form of co-production with stakeholders, this remains limited to the design and evaluation stages of the contests. The renewal of innovation policies through the mobilization of new tools such as contests and crowdsourcing highlights the importance of digital tools for public actors wanting to involve stakeholders in the design and implementation of future innovations.JEL classification: O33, O35, L38.
The dialectic between knowledge, knowing, and concept in the theory of objectification
Authors: Radford Luis
Published: July 2024

The theory of objectification (TO) is a theory of learning that seeks to foster conceptually rich, and critical, inclusive, and democratic pedagogical practices. The conception of these practices is based on a new understanding of learning as a cultural-historical process. In turn, the theoretical formulation of learning is anchored in a conception of knowledge that departs from the accounts of rationalists and (new and old) empiricists. The purpose of this article is to offer an overview of knowledge and learning as conceived in the TO. This overview is, of necessity, philosophical, as it addresses a problem that has often been overlooked in educational research: the ontological problem of the nature of knowledge – such as mathematical and scientific knowledge. The philosophical overview presented here is based on a specific philosophy that inspires the theory of objectification: dialectical materialism. Drawing on this philosophy, I theorize learning as a social, embodied, affective, semiotic, and material process where individuals encounter knowledge. In this encounter knowledge manifests itself in sensible practical and material activity through what it is called here knowing and concept. As argued in this article, knowledge, knowing, and concept are three modes of existence of a same entity that is invoked in the movement of learning.
When the sea does have character: post-Brexit maritime cooperation as place-consciousness
Authors: Nicolini Matteo
Published: July 2024

The essay applies the practices of spatial production to maritime cooperation taking place across (and around) the Channel. Although its geographical features make its crossing particularly difficult, this stormy stretch of water has been a place of connection, co-operation, and separation between the UK and the Continent. This makes maritime cooperation around the Channel and its coastal areas an intriguing field of research in the aftermath of Brexit. Evidently, the Channel’s collective place-consciousness will depart from that previously produced under EU maritime cooperation schemes. A renewed collective place-consciousness for the Channel is therefore needed.
Bubbles, currents and splashes: metaphors to make sense of innovation and learning practices in the public sector
Authors: Brandalise Isabella , Werneck Caio
Published: July 2024

This paper explores how metaphors can help create and reflect on project-based training initiatives in the public sector. We build on the experience of a capacity-building program for public servants led by the Brazilian National School of Public Administration (Enap) in 2020. We used the metaphor of a project as a collective diving both to design the methodology of the program, and also to analyse its effects after the end of the projects. Through conversations with project facilitators and participants, we expanded the initial metaphor, to explore how diving connects to breathing, a necessary condition for experimentation and learning. Additionally, we found that the project conditions were like bubbles and currents, creating a reference for understanding the relationship with the environment in which teams are embedded. Finally, we looked at the variable yet often overlooked outcomes that can be understood as splashes, a key metaphorical concept for discussing programs that aim to simultaneously foster public innovation and collective learning. In this paper, we present an example of metaphors acting as boundary objects, adding granularity and nuance to the inquiry into public innovation initiatives, and identifying their possible implications in relation to institutional logics and complex structures.
Futures Leads the Spot but Why not so When Market in Shocks? A Time-Varying Price Discovery of Indian Precious Metals
Authors: Saini Chanchal , Sharma Ishwar
Published: July 2024

The study empirically measures the average and time-varying contribution of the spot and futures market to the price discovery of benchmark Indian precious metals from June 2005 to March 2023. The two most popular precious metals in India, i.e., Gold and Silver, were selected for the study. The average contribution is measured through VECM (Vector Error Correction Model) and CFW (common factor weights). Additionally, for getting time-varying contribution, VECM is reformulated into state space form and Kalman filter and smoothening are applied for computing time-varying CFW. Findings reveal that price discovery depicts time-varying behaviour during the study period. While most of the time, futures lead the spot, in case of any shocking news, the spot market dominates the futures as noise trading happens in the futures market for both precious metals, i.e., Gold and Silver. Furthermore, futures market volume, volatility, and COVID-19 negatively affect the price discovery in both precious metals.
Acute kidney injury in critically ill obstetric patients: Incidence and role of neutrophil gelatinase-associated lipocalcin – A prospective observational cohort study
Authors: Pipil Kartik , Tyagi Asha , Tyagi Surbhi , Nigam Chanchal , Das Shukla
Published: July 2024

Background and Aims:

Data focussing on acute kidney injury (AKI) in obstetric patients admitted to the intensive care unit (ICU) are scarce and even more so regarding the role of neutrophil gelatinase-associated lipocalcin (NGAL) in detecting AKI or predicting outcomes in these patients. Hence, we aim to evaluate the incidence of AKI in obstetric ICU patients and validate the role of urinary and serum NGAL in predicting the onset of AKI and mortality.

Methods:

This prospective observational cohort included 45 obstetric patients admitted in ICU, excluding those with prior renal dysfunction. Serum creatinine and urine output were monitored for the occurrence of AKI during the ICU stay. The outcome of the patient (survival or death) in the ICU and hospital was recorded, and serum and urinary NGAL were determined at the time of ICU admission.

Results:

AKI occurred in 32 [71.1%; 95% confidence interval (CI): 55.4%, 86.8%] patients during their ICU stay. Serum NGAL showed an area under receiver operating characteristic curve (AUROCC) of 0.630 (95% CI: 0.417, 0.842) (P = 0.231) for AKI and 0.486 (95% CI: 0.295, 0.676) (P = 0.883) for ICU mortality. Urinary NGAL showed AUROC = 0.472 (95% CI: 0.285, 0.660) (P = 0.772) to predict AKI and 0.430 (95% CI: 0.268, 0.652) (P = 0.684) for ICU mortality.

Conclusions:

AKI is common amongst critically ill obstetric ICU patients. However, serum and urinary NGAL cannot be advocated to discriminate between patients with or without AKI or between survivors and non-survivors in critically ill obstetric patients.
Potential role of mitochondrial uncoupling protein 2 as a biomarker in patients with sepsis and septic shock: A prospective observational study
Authors: Sachidananda Roopa , Bhat Vikram Kemmannu , Kurjogi Mahantesh , Vanti Gulam Nabi L. , Kayara Madhura
Published: July 2024

Background and Aims:

Early diagnosis of sepsis is crucial. The primary objective of this study was to explore the role of uncoupling protein 2 (UCP2) in diagnosing sepsis and septic shock.

Methods:

This prospective observational study was conducted over 19 months. All adult patients aged more than 18 years with a diagnosis of sepsis or septic shock based on quick sequential organ failure assessment (qSOFA) score were enroled. Blood was drawn for procalcitonin (PCT) and UCP2 on days 0, 3, 7 and 28. Blood samples from 50 healthy volunteers were used as controls. An electrochemiluminescence test was done for PCT. A quantitative enzyme-linked immune sorbent assay was used for UCP2. The Chi-square test was used for qualitative variables and the independent t-test for quantitative variables. The receiver operator characteristic curve was used to evaluate the diagnostic efficacy of UCP2.

Results:

A total of 128 subjects were included in the study. Out of these, 78 patients (qSOFA score ≥2) were subcategorised into the infection group, sepsis or septic shock group based on the PCT levels. The UCP2 levels in the infection, sepsis or septic shock group were significantly higher than in the control group (P > 0.001). The UCP2 levels correlated with PCT on admission, day 3 and day 7.

Conclusion:

The UCP2 levels were significantly higher in sepsis and septic shock groups compared to controls and hence could be a potential diagnostic biomarker of sepsis.
Costoclavicular versus lateral sagittal infraclavicular brachial plexus block for postoperative analgesia in patients undergoing upper limb orthopaedic surgery: A randomised controlled trial
Authors: Mondal Soumyajit , Sinha Chandni , Kumari Poonam , Kumar Abhyuday , Kumar Ajeet , Agarwal Prabhat
Published: July 2024

Background and Aims:

Perineural catheters inserted through the costoclavicular (CC) technique of infraclavicular brachial plexus are helpful for postoperative analgesia. This trial compared postoperative local anaesthetic (LA) consumption in an ultrasound (US)-guided perineural catheter inserted by the CC technique with the conventional lateral sagittal (LS) technique.

Methods:

Eighty American Society of Anesthesiologists (ASA) I/II patients scheduled for upper limb orthopaedic surgery were randomly assigned to receive a perineural catheter by either the CC technique (Group CC) or LS technique (Group LS). Postoperatively, all patients received patient-controlled regional analgesia (PCRA): bolus-only regime with 0.125% bupivacaine 6 ml and a lock-out interval of 20 minutes. The primary outcome was the 24 h LA consumption. The secondary outcomes were time of activation of PCRA, pain scores, patient satisfaction scores, and block-related complications. Categorical variables are presented as frequency, while continuous variables are expressed as mean [standard deviation (SD)] or median [interquartile range (IQR)]. An independent t-test or Mann–Whitney U-test was used to compare these continuous variables. A P value less than 0.05 was considered to be statistically significant.

Results:

Patients in Group CC required less LA 24 h postoperatively (P < 0.001) and more time to activate PCRA (P = 0.003). The mean 24 h LA requirement was 83.35 (SD: 31.92) in Group CC as compared to 121.40 (SD: 48.51) ml in Group LS. They also reported better satisfaction scores (P = 0.001). Pain scores were comparable at all time points. Postoperatively, one patient in Group CC complained of paraesthesia, which subsided on removal of the catheter.

Conclusion:

Patients receiving post-operative analgesia by the CC catheter require lesser 24 h LA and report better satisfaction than those receiving analgesia through the LS technique.
Diagnostic Yield of Colonoscopy in Patients Presenting with Lower Gastrointestinal Bleeding at a Tertiary Care Center
Authors: Essa Suhair Aboud , Mudhir Hiba Dhari , Rustum Farah Lateef
Published: July 2024

Background and Aims:

Lower gastrointestinal bleeding (LGIB) poses a significant challenge in clinical practice due to its diverse etiologies and potential for serious morbidity and mortality. Colonoscopy is the preferred, valuable diagnostic tool for identifying the underlying cause of LGIB. This study aimed to evaluate colonoscopic findings in patients presenting with LGIB at a tertiary care hospital in Baghdad.

Subjects and Methods:

This retrospective descriptive study reviewed records of patients, who underwent colonoscopy for LGIB, at the Gastroenterology and Hepatology Teaching Hospital in Baghdad Governorate between January 1 and July 31, 2023. The analysis included age, sex, and endoscopic findings.

Results:

A total of 228 patients were included, with 124 (54.4%) males and 104 (45.6%) females. The mean age was 39.23 ± 20.57 years. A colonoscopy revealed a diagnostic yield of 68.0%. LGIB was more prevalent among individuals aged 40 years and younger (53.5%). The most common colonoscopic finding was hemorrhoids (20.2%), followed by polyps (13.1%), colitis (9.2%), ulcerative colitis (8.3%), and colorectal cancer (7.9%).

Conclusion:

This study underscores the importance of colonoscopy in evaluating LGIB. Larger, multicenter studies are recommended to validate these findings and guide clinical practice in LGIB management.
Prevalence and Factors Associated with Sarcopenia among a Sample Aged 60 Years and Older in Iraq
Authors: Al-Taghlubee Israa M. , Al-Saffar Atheer J
Published: July 2024

Background:

Aging is an unavoidable process characterized by a progressive decline in body organs and skeletal muscle. Sarcopenia is defined as low muscle mass and function; it is diagnosed according to the working group of sarcopenia definition; also, it can predict the adverse disability outcome and subsequent functional deterioration.

Objectives:

This study aims to estimating the prevalence of sarcopenia in old Iraqi adults and determines some sociodemographic factors that may be related.

Methods:

A descriptive cross-sectional study was conducted on 500 elderly aged ≥60 years in a community-dwelling and senior citizen center in Baghdad. The data were obtained from a questionnaire (sociodemographic and behavioral data) in addition to anthropometry measurements. The cut-off point score was derived from the European Working Group on Sarcopenia in Older People 2.

Results:

Sarcopenia was present in 15%, 21.5% in males and 8.2% in females. It was positively associated with aging, significantly associated with males, marital state, retirement, nonsmoker, alcoholic, fall history, normal body mass index, and elderly. While it was negatively related to educational level and physical activity.

Conclusions:

Sarcopenia prevalence was presented with a considerable prevalence among old adults, as well as had a great association with all behavioral and lifestyle variants studied.
Caseous Calcification of the Mitral Annulus Associated with Severe Mitral Regurgitation: A Multimodality Diagnostic Approach
Authors: Cozac Dan Alexandru , Lassandro Eleonora , Motta Raffaella , Pergola Valeria
Published: July 2024

Caseous calcification of the mitral annulus (CCMA) is a rare variant of mitral annular calcification, and a multimodality approach is advised to ensure an accurate diagnosis. We report a case of a patient with CCMA, associated with severe mitral regurgitation. An 82-year-old woman was admitted due to worsening heart failure. Transthoracic echocardiography revealed a fixed, hyperechogenic mass, accompanied by restriction of the posterior mitral leaflet, and subsequent severe mitral regurgitation. Transesophageal echocardiography demonstrated a restricted motion of the posterior mitral leaflet, because of a large, echogenic mass (15 mm × 11 mm), attached to the mitral annulus, vacuolated with a central echolucent aspect, lacking acoustic shadowing. Contrast-enhanced cardiac computed tomography identified a distinct oval mass (18 mm × 11 mm × 19 mm) presenting a central hypodense content and peripheral calcification, strongly suggestive of CCMA. Considering the patient’s profile, surgical valvular replacement was considered unsuitable. Therefore, a transcatheter edge-to-edge repair was performed, resulting in mild residual regurgitation.
A Case Report of Aortic Intramural Hematoma: From Diagnosis to Endovascular Treatment Guided by Transesophageal Echocardiography
Authors: Benedetti Giovanni , Trimarchi Giancarlo , Palmieri Cataldo , Paradossi Umberto , Berti Sergio , Rizza Antonio
Published: July 2024

Aortic intramural hematoma (IMH) accounts for approximately 10%–25% of acute aortic syndromes (AAS), and multi-slice computed tomography and magnetic resonance imaging are the leading techniques for diagnosis and classification. In this context, endovascular strategies provide a valid alternative to traditional open surgery and transesophageal echocardiography (TEE) could play a role in therapeutic decision-making and in endovascular repair procedure guidance. A 57-year-old female patient with IMH extending from the left subclavian artery to the upper tract of the abdominal aorta, underwent endovascular aortic repair using an unibody single-branched stent grafting in the aortic arch and descending aorta with a side branch inserted in the left common carotid artery. To restore proper flow in the left axillary artery, a carotid-subclavian bypass graft was performed. The procedure was guided by angiography and TEE. Intraoperative TEE revealed aortic IMH with a significant fluid component in the middle tunic of the aorta with a wall thickness of over 13 mm. TEE was useful in monitoring of all steps of the procedure, showing the presence of the guidewires into the true lumen, the advancement of the prosthesis, and the phases of release and anchoring. This case highlights the importance of using multimodality imaging techniques to evaluate AAS and demonstrates the growing potential of TEE in guiding endovascular repairs.
Hot Air Balloon in the Left Atria
Authors: Carvalho Pedro Rocha , Carvalho Catarina Ribeiro , Fontes José Paulo , Moreira José Ilídio
Published: July 2024

A 54-year-old patient with a medical history of hypertension, dyslipidemia, and diabetes underwent mitral valve replacement surgery with a biologic valve. During a chest computed tomography scan for breast neoplasia staging, a reduced luminal filling in the left atrium (3.6 cm) was unexpectedly found, prompting further cardiac evaluation. The patient was referred to the emergency department experiencing shortness of breath and fatigue, which improved after furosemide administration, and remaining stable throughout hospitalization. A transesophageal echocardiogram was performed the following day and revealed a biologic mitral valve prosthesis slightly displaced toward the left ventricle with an average transprosthetic gradient of 7 mmHg. Notably, a sizable intermediate echogenic mass measuring 3.0 cm × 3.5 cm was detected and attached to the prosthesis ring in a lateral and posterior position, within the left atrium. A mild degree of periprosthetic regurgitation was also noted. Given the substantial suspicion that the observed mass was a thrombus, the patient was commenced on anticoagulation therapy while awaiting cardiac magnetic resonance imaging for better characterization of the mass. Over 4 weeks, the thrombus notably decreased in size, disappearing entirely by the 6th week. This case highlights the significance of employing multiple imaging techniques in managing cardiac masses. The incidental discovery of the mass, its characterization, and subsequent management through anticoagulation, followed by confirmation and monitoring through echocardiogram, underscore the importance of a multimodal approach in diagnosing and treating such conditions.
Predischarge Peak Atrial Longitudinal Strain and Plasma N-terminal Pro-hormone Brain Natriuretic Peptide as a Predictor of Short-term Rehospitalization and Cardiovascular Mortality in Patients with Acute Heart Failure
Authors: Kaler I. Gusti Bagus Putu Suwarjana , Wibhuti Ida Bagus Rangga , Wiryawan I. Nyoman , Lestari A. A. Wiradewi
Published: July 2024

Context:

The postacute heart failure (AHF) rehospitalization rate is attributed to persistent hemodynamic congestion despite clinical improvement. Peak atrial longitudinal strain (PALS), utilizing speckle tracking echocardiography technology, shows potential in post-AHF prognosis. Meanwhile, N-terminal pro-hormone brain natriuretic peptide (NT-proBNP) remains a known biomarker of intracardiac congestion.

Aims:

This study aimed to determine the relationship between predischarge PALS and NT-proBNP as predictors of major adverse cardiac event (MACE) in patients after AHF hospitalization.

Settings and Design:

This study is a prospective cohort study, conducted in Prof. Dr. I G.N.G Ngoerah Hospital, Bali, Indonesia.

Subjects and Methods:

The study included hospitalized AHF patients, collecting demographic data, comorbidities, therapies, and echocardiographic measures before discharge. Predischarge PALS and NT-proBNP were taken within 24 h before discharge. The main outcome was MACE, defined as rehospitalization and cardiovascular mortality within 90 days.

Statistical Analysis Used:

Comparative statistical analyses was done using independent t-test for continuous variables (Mann–Whitney U test for variables with abnormal distribution) and Chi-squared tests. Receiver operating characteristic (ROC) used in determining optimal threshold values of predischarge PALS and NT-proBNP as a predictor of MACE. Kaplan–Meier curves were employed to gauge event-free survival differences between these cohorts. Then, independent Cox regression was used to identify the predictors of MACE.

Results:

The study enrolled 67 patients with varying ejection fraction (EF) (16 – heart failure with preserved ejection fraction, 10 – heart failure with mildly reduced ejection fraction, and 41 – heart failure with reduced ejection fraction; mean age: 56.88 ± 14.57 years). Over the 90-day follow-up, 21 patients (31.3%) encountered MACE. Both PALS (area under the curve [AUC] 0.816) and NT-proBNP (AUC 0.856) before discharge served as predictors of MACE. There was no significant AUC difference between ROC curves (area difference: 0.039, P = 0.553). The regression model highlighted that PALS and NT-proBNP level before discharge acted as independent predictors of MACE, irrespective of EF, average E/e’, or estimated predischarge pulmonary capillary wedge pressure.

Conclusions:

Predischarge PALS is comparable to NT-proBNP levels as independent predictors of short-term MACE after AHF hospitalization.
Actinium-225 in Targeted Alpha Therapy
Authors: Rahman A. K. M. Rezaur , Babu Mahathe Hasan , Ovi Mustofa Khalid , Zilani Md. Mahiuddin , Eithu Israt Sultana , Chakraborty Amit
Published: July 2024

The utilization of actinium-225 (225Ac) radionuclides in targeted alpha therapy for cancer was initially outlined in 1993. Over the past two decades, substantial research has been conducted, encompassing the establishment of 225Ac production methods, various preclinical investigations, and several clinical studies. Currently, there is a growing number of compounds labeled with 225Ac that are being developed and tested in clinical trials. In response to the increasing demand for this nuclide, production facilities are either being built or have already been established. This article offers a concise summary of the present state of clinical advancements in compounds labeled with 225Ac. It outlines various processes involved in the production and purification of 225Ac to cater to the growing demand for this radionuclide. The article examines the merits and drawbacks of different procedures, delves into preclinical trials, and discusses ongoing clinical trials.
Wean early leave early: Apt strategy for weaning from non-invasive ventilation
Authors: Thampan Sebin J. , Prasath Arun , Moses Jackin , Kisku King H. , Sagar Pinkutty , Ravichandran Kandasamy
Published: July 2024

Background:

Weaning protocols from Non-invasive ventilation (NIV) are scant. We set out to study a protocol that was different from the British Thoracic Society protocol and lay down a weaning protocol from NIV in patients with Acute acidotic hypercapnic respiratory failure (AAHRF).

Materials and Methods:

Patients admitted with AAHRF and treated with NIV (baseline pH<7.35, PaCO2 >45 mmHg, and not requiring intubation) at a tertiary care teaching hospital, after taking into consideration the inclusion and the exclusion criteria were randomised in to one of the two group of weaning form NIV and serial ABGs were monitored.

Results:

The primary outcome of the study shows that there was no significant differences in the success rates of weaning from NIV in both the arms. The secondary outcome shows a few factors such as age, gender, SAPS2 score having an effect on the determination of weaning failure.

Conclusion:

Our study showed that both weaning by duration reduction and pressure reduction had equal success rates but a point on noting the SAPS II score on admission and the age of a particular patient will help decide on weaning initiation.

CTRI/2019/12/022560 [Registered on: 30/12/2019].
The severity of non-smoking chronic obstructive pulmonary disease is correlated with biomass fuel exposure and COPD assessment test score
Authors: Pandey Anuj Kumar , Verma Ajay Kumar , Singh Arpita , Kant Surya , Chaudhary Shyam Chand , Bajpai Jyoti , Dixit Rakesh Kumar
Published: July 2024

Background and Objective:

Tobacco smoking is an established risk factor for chronic obstructive pulmonary disease (COPD). Current evidence suggests that non-tobacco-related risk factors vary geographically and are less understood than smoking. This study aims to compare the risk factors, symptoms, and clinical features of smoking (S-COPD) and non-smoking (NS-COPD) in a COPD population.

Materials and Methods:

In this retrospective cross-sectional study, 489 COPD patients were screened. Data on socio-demographics, smoking and medical history, other risk factors, symptoms, and clinical characteristics including COPD Assessment Test (CAT) score, and Modified Medical Research Council (mMRC) Dyspnea Scale were examined.

Results:

Of the total selected 416 COPD patients, 35.34% were NS-COPD while 64.66% were S-COPD. S-COPD was predominant in males, whereas NS-COPD was predominant in females (P < 0.0001). In NS-COPD, biomass fuel exposure was a major risk factor (P < 0.0001), and 61% of subjects had a biomass fuel exposure index of >60. In bivariate and multivariate analyses, no risk factors were correlated with forced expiratory volume in 1 second (FEV1)% predicted, while among clinical features, duration of illness (P = 0.001) was correlated with lower values of FEV1 in the multivariate table of S-COPD. In the multivariate analysis, biomass fuel exposure (P = 0.039) and CAT score (P < 0.0001) were correlated with FEV1(%) in NS-COPD.

Conclusion:

Biomass fuel exposure is a substantial risk factor for NS-COPD and was correlated with FEV1(%) predicted. In addition, the CAT score correlated with disease severity in patients with NS-COPD. The development of COPD in non-smokers is being recognized as a separate phenotype and it should be managed according to risk factors.
Evaluation of alpha-defensins as a marker of severity in chronic obstructive pulmonary disease
Authors: Kumar Kritika , Kaur Komaldeep , Jaswal Shivani , Aggarwal Deepak , Saini Varinder
Published: July 2024

Background:

Defensins are key effector molecules of innate immunity that can contribute towards the diagnosis and monitoring of chronic obstructive pulmonary disease (COPD). The present study was conducted to investigate the role of alpha-defensins in patients with COPD by quantifying serum and sputum samples.

Methods:

A total of 180 patients were enrolled and divided into four groups, and sputum and serum values of alpha-defensins were assessed. The sensitivity, specificity, and accuracy of sputum alpha-defensin as a diagnostic biomarker were evaluated to assess its utility in diagnosing COPD.

Results:

The mean value of sputum alpha-defensins was found to be statistically significant amongst the four groups (P < 0.001). The highest levels were found in subjects with AECOPD (385.76 ± 116.62 ng/mL). Sputum alpha-defensins were found to be negatively correlated with FEV 1 values (rho = −0.31, P < 0.001).

Conclusion:

Sputum alpha-defensins can be used as a potential marker for predicting acute exacerbation of COPD. In addition, they could serve as an indicator of disease severity in COPD patients.
Effect of Transcutaneous Electrical Nerve Stimulation of T6 Dermatome on Appetite and Weight Reduction in Obese Individuals: A Pilot Study
Authors: Sahu Pradeep Kumar , Ranjan Piyush , Agrawal Deepak , Singh Garima
Published: July 2024

Background:

Previous work demonstrated the beneficial effect of T6 dermatomal stimulation by the percutaneous method in managing obesity. However, a simple, cost-effective, and feasible intervention stimulating the dermatome can be a potential solution for obesity care.

Objective:

The objective of this study was to find the effect of transcutaneous electrical nerve stimulation (TENS) of T6 dermatome on appetite and weight loss in obese individuals.

Material and Methods:

In this prospective single-arm experimental study, 20 obese patients received TENS treatment of T6 dermatome for 30 min, once a week and for 12 weeks. Outcome measures such as appetite level in the visual analog scale (VAS), weight in kg, and basal metabolic index (BMI) in kg/m2 were assessed at baseline, 12 weeks -post-intervention, and at 8 weeks of follow-up.

Results:

A statistically significant difference in all the variables was found from baseline to 12 weeks of intervention (P < 0.001) and maintained till 8 weeks of follow-up. From pre- to post-treatment, the effect size for appetite reduction was large (>1) while for weight and BMI loss was (0.14, 0.16), respectively small. Additionally, a weak correlation was found between pre- and follow-up appetite and weight loss (r = 0.25, P = 0.294).

Conclusions:

Twelve weeks of TENS treatment of T6 dermatome showed a positive effect in reducing appetite with sustained reduction up to 8 weeks of follow-up even after completion of the intervention. However, in the absence of dietary modification, TENS treatment was associated with low effect sizes weight and BMI loss.
Successful Thrombolysis in Artery of Percheron Infarction: Grabbed an Extremely Rare Opportunity
Authors: Zanzmera Paresh , Jain Kalpesh , Garg Sudhir , Parmar Alpesh
Published: July 2024

Artery of Percheron (AOP) is an uncommon anatomical variation in the posterior circulation neurovasculature. It is a single artery arising from P1 segment of posterior cerebral artery (PCA) which supplies bilateral paramedian thalami and the rostral midbrain and as a result, occlusion of it leads to bilateral thalamic and mesencephalic infarction. Due to very low incidence (ranges from 0.1% to 2% of all ischemic strokes) and varied presentation, the diagnosis of AOP infarction requires strong clinical and radiological suspicion and hence, AOP infarction is often missed and patients are rarely thrombolysed. Here we discuss a patient with acute altered sensorium who recovered completely in short time following treatment with intra-venous thrombolysis for bilateral medial thalamic ischemic stroke due to AOP occlusion.
Design and Development of a Cost-Effective Transnasal Skull Base Bone Wax Applicator: A Technical Note
Authors: Teegala Ramesh
Published: July 2024

Bone wax is an important hemostatic agent used in neurosurgical practice from more than a century. It acts by mechanical tamponade effect to stop the oozing from cancellous bone. Bone wax application over the skull surface over the vertex is easy and can be applied with fingers. In deeper areas, one uses dissector to apply the bone wax; however, it becomes difficult at times to apply in transnasal surgery using the same dissectors. Author designed a cost-effective 20-cm-long different angled bone wax applicator for skull base transnasal surgery. This applicator is cost-effective and not described previously in English literature.
Prevalence and Factor Associated with Anti-N-Methyl-D-Aspartate Receptor Encephalitis Among Patients with Medical Conditions: A Systematic Review and Meta-Analysis
Authors: Lee Kai Wei , Khan Abdul Hanif Khan Yusof , Ching Siew Mooi , Kumar Sathish Jaya , Raj Charlene Lily Vincent Paul , Chia Peck Kee , Basri Hamidon , Sulaiman Wan Aliaa Wan , Mat Liyana Najwa Inche , Veettil Sajesh K , Hoo Fan Kee , Loh Wei Chao
Published: July 2024

Background:

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe autoimmune encephalitis due to immune production of anti-NMDAR antibodies against the NR1 subunit of the NMDA receptor which is present throughout the central nervous system. This condition had been reported to be prevalent in patients with certain medical conditions; however so far, there have been limited systematic reviews and meta-analyses on the prevalence and factors associated.

Objective:

This study was to determine the prevalence and factors associated with anti-NMDAR encephalitis among affected patients.

Material and Methods:

The protocol of this study has been registered (2019: CRD42019142002) with the International Prospective Register of Systematic Reviews (PROSPERO). The primary outcome was the incidence or prevalence of anti-NMDAR encephalitis and secondary outcomes were factors associated with anti-NMDAR encephalitis.

Results:

There were 11 studies and a total of 873 million patients taken from high-risk populations across 11 countries that were included in the primary analysis. The overall pooled prevalence of anti-NMDAR encephalitis among patients with medical conditions was 7.0% (95% CI = 4.4, 9.6). Those with first episode of psychosis or schizophrenia were at a higher risk of developing anti-NMDAR encephalitis with an odds ratio of 5.976 (95% CI = 1.122, 31.825).

Conclusion:

We found that almost one-tenth of patients with medical conditions had anti-NMDAR encephalitis; particularly those with first episode of psychosis or schizophrenia were among the high-risk medical conditions.