bluuebunny/crossref_metadata_2025 huggingface dataset:
La fin de vie à domicile à La Réunion : rester chez soi à tout prix ?
Authors: Lépori Mélanie , Pennec Sophie
Published: September 2024

Mourir à domicile à La Réunion est une pratique courante, inscrite dans la conception traditionnelle de la mort comme étape du cycle de vie, surtout pour les personnes âgées. Considéré comme plus à même de maintenir les repères et habitudes, le domicile permettrait d’ancrer la fin de vie dans une vision de la mort « ordinaire », étape finale de la vie. Cet article s’intéresse aux différentes facettes du maintien à domicile en fin de vie. À partir d’une enquête qualitative auprès de proches ayant accompagné une personne en fin de vie et de professionnels et bénévoles investis dans l’accompagnement de la fin de vie à domicile, nous montrons que la fin de vie à domicile à La Réunion s’inscrit dans des logiques « classiques » : valorisation d’une mort entourée dans un environnement familier et familial en continuité de la vie antérieure sans pour autant que le domicile ne protège des aménagements du logement, de l’arrivée d’aidants professionnels et de bouleversements dans les rythmes des personnes accompagnées et surtout de ceux de leurs proches.
Bien-vieillir : réflexions autour d’un dispositif de prévention adaptable
Authors: Picault Anne-Laure , Beauchamps Camille , Blanc Emma , Lopes Johanna , Bailly Nathalie , Pothier Kristell
Published: September 2024

La prévention est un enjeu déterminant des politiques publiques actuelles. Le dispositif sanitaire et social français, fondé sur une prise en charge réparatrice des risques sociaux, semble comporter certaines limites à la promotion des politiques publiques préventives. Les actions de promotion du « bien-vieillir » ciblent majoritairement les personnes âgées. Cependant, ces actions manquent de cohérence au vu de la littérature scientifique existante mais également au regard du décalage entre ce qui est proposé et les attentes des bénéficiaires eux-mêmes. Cet article dresse les déterminants de la prévention au « bien-vieillir » et propose une réflexion psycho-sociale ainsi que des recommandations pour les interventions futures. Les interventions associant un partenariat, une co-construction, une communication engageante et une approche centrée sur les besoins des individus seraient les plus efficaces ; notamment, parce qu’elles incluent les aspects motivationnels des individus, la participation de bénévoles, des professionnels en santé et des acteurs locaux. Parallèlement, un objectif global serait de déstigmatiser les pratiques ne relevant pas du « bien-vieillir » afin de promouvoir une approche plus compréhensive des pratiques individuelles.
Yves Bonnefoy, une répétition créatrice
Authors: Née Patrick
Published: September 2024

La répétition n’a pas très bonne presse, c’est elle qui toujours risque de bloquer la dynamique psychique dans une inexorable compulsion . Pourtant, il y a bien une ouverture possible grâce au transfert dans le cadre de la cure. Et n’est-ce pas également le mode de fonctionnement de l’écriture poétique ? C’est ce que l’article se propose de montrer, sur l’exemple de la répétition créatrice mise en jeu dans un « récit en rêve » d’Yves Bonnefoy, à partir des divers états manuscrits de son texte.
Les revenants
Authors: Dessons Marie
Published: September 2024

Souvent associée à l’échec de la remémoration, la répétition peut confronter, dans la cure avec l’enfant, à l’actualisation projective et la reproduction en actes d’éléments plus clivés que refoulés. Ce qui fait retour en séance, parfois de manière hallucinatoire, appelle un travail de figuration et de représentation, comme en témoigne l’évocation de la cure d’un jeune garçon autour des fantômes. Transformer la répétition agie, en empêchant la revenance fantomatique sans fin, a permis la remise en mouvement d’une vie fantasmatique animée par le vif de l’infantile.
Bis repetita
Authors: Neau Françoise
Published: September 2024

Le ressassement, comme une caricature de la répétition, fait partie de l’ordinaire du psychanalyste et des patients, parfois jusqu’à la lassitude pour les deux protagonistes. Pourtant, de la résistance par un dire ressassé à ses destins dans le transfert, l’article évoque à propos de deux cures des dynamiques bien différentes du ressassement, en s’appuyant aussi sur ses formes et ses fonctions chez certains écrivains.
Droits sociaux déniés : le triste retour au bled des Marocains retraités
Authors: Smolski Brun Anouk
Published: September 2024

Ils sont repartis au Maroc après des années de pénible labeur en tant que saisonniers agricoles en France. Selon la convention bilatérale de Sécurité sociale, ils devraient, à ce titre, bénéficier des droits sociaux pour lesquels ils ont cotisé. En pratique, tout semble concourir à les en priver. Ce déni massif des droits sociaux suscite la colère et l’indignation parmi les fonctionnaires marocains et la société civile, tandis qu’en France, les autorités jouent la carte de l’indifférence.
La santé sacrifiée des chauffeurs Uber
Authors: Bernard Sophie
Published: September 2024

Ils ont vu, dans leur reconversion en chauffeurs Uber, une opportunité d’ascension sociale, une façon d’échapper à la ségrégation professionnelle qui les relègue dans des secteurs d’activité précaires et pénibles. Mais les méthodes de travail instituées par cette plateforme ont rapidement douché leurs espoirs : diminution de la rémunération, intensification des rythmes de travail, usure physique accélérée. Pris au piège de ce « capitalisme de plateforme », ils s’épuisent tandis qu’Uber sait pouvoir compter sur une armée de réserve, parmi les populations racisées.
« Le patron savait… »
Authors: Chappart Pascaline , Samba  , Isidro Lola
Published: September 2024

Samba, un jeune malien accidenté du travail, démonte tous les mécanismes qui ont préparé le drame : la condition de sans-papiers qui l’expose à la domination et à la dépendance, le comportement – associant racisme, paternalisme et exploitation – que le patron s’autorise à l’égard de son ouvrier, l’esquive par l’employeur de ses responsabilités après l’accident, qui dépouille la victime de ses droits sociaux comme de son projet de vie, les difficultés à obtenir reconnaissance, et l’impossible réparation. Ce récit témoigne d’un impératif besoin de justice.
La politique industrielle verte de l’Union européenne et l’indépendance énergétique
Authors: Viñuales Jorge E.
Published: September 2024

Jusqu’à peu considérés comme inconciliables, les objectifs d’accès à l’énergie, de sécurité énergétique et de décarbonisation sont en passe de s’aligner, notamment en raison de la lutte contre le changement climatique et de la situation géopolitique mondiale. Cet alignement permet à l’Union européenne d’approfondir et accélérer sa politique industrielle verte, pour ainsi prendre la voie de l’indépendance énergétique.
La souveraineté numérique européenne, vers une troisième voie ?
Authors: Türk Pauline
Published: September 2024

La notion de souveraineté numérique déborde la perspective juridique classique, attachée au pouvoir des États et au cadre national. Elle reçoit d’autres acceptions, économique, technique ou fonctionnelle, et peut se concevoir plus utilement à l’échelle de l’Europe. La souveraineté numérique européenne renvoie à la capacité des États membres de l’Union à s’autodéterminer dans l’espace numérique, face aux puissances – américaines et chinoises notamment – qui s’y déploient. Reconquérir son autonomie et sortir de la dépendance technologique implique de renforcer la capacité de l’Union à peser sur l’élaboration des normes applicables, à protéger ses ressortissants de menaces protéiformes, et à développer son poids industriel et ses capacités d’innovation.
Europe souveraine. Entre provocation juridique et refondation politique
Authors: Bourlanges Jean-Louis
Published: September 2024

L’appel à une Europe souveraine est juridiquement paradoxal car dans l’Union seuls les États membres sont souverains. Son véritable sens est plus politique que juridique : celui d’un appel à une Europe indépendante. Celle-ci passe par une mutation en profondeur du projet européen, le Vieux Continent devant désormais s’assumer comme une communauté géopolitique particulière et non comme l’ébauche d’une république universelle. Il lui faut donc à la fois définir cette identité et accepter les disciplines de la confrontation.
Quand les localités créent des centres de santé. Ajustements locaux d’une politique étatique de répartition médicale
Authors: Joubert Lucas
Published: September 2024

À l’heure où les inégalités sociales et territoriales de santé sont reconnues comme un problème majeur de santé publique, des formes d’action et de solidarités par le bas viennent ajuster des politiques publiques centralisées et orientées vers la médecine libérale. Ces « localités », collectivités territoriales et associations, participent à l’attractivité de la médecine sur le territoire en créant des centres de santé, structures salariales sans profit pratiquant le tiers payant. Le développement de cette offre de soins médicaux contribue à recomposer la structure du système de santé : au niveau politique, le local rééquilibrant le national, et au niveau professionnel, le recours au salariat se substituant à l’exercice libéral. Il s’inscrit dans un processus d’hybridation des réponses à un problème public : du libéral et du salariat, du central et du local, du public et du privé, associatif ou non, du professionnel de santé et du profane, ainsi que du politique et de l’administré.
Les usages de l’informatique en maisons de santé pluriprofessionnelles : de la bureaucratisation contrainte à l’appropriation professionnelle
Authors: Plegat Manon
Published: September 2024

Cet article étudie la collaboration en santé à partir des usages de l’informatique des soignants. En prolongeant les travaux sur l’analyse du pilotage par les indicateurs en contexte hospitalier, il se concentre sur le cas des maisons de santé pluriprofessionnelles (MSP), des structures regroupant des praticiens libéraux issus de métiers différents qui sont amenés à se coordonner entre eux et avec les autorités de tutelle afin d’améliorer l’offre de soins. Les observations et les entretiens semi-directifs réalisés mettent en évidence la coexistence de deux tendances ambivalentes dans les représentations et les pratiques que les utilisateurs associent à leur système d’information partagé (SIP). Bien que les pouvoirs publics aient imposé l’utilisation de SIP aux équipes de soins primaires afin de soutenir conjointement la production de données médicales (dédiées au suivi des patients) et gestionnaires (dédiées à l’évaluation de l’activité des soignants), les praticiens distinguent et hiérarchisent ces deux usages de l’informatique. L’injonction au suivi informatisé des soins est perçue tantôt comme une tentative de contrôle externe, tantôt comme une opportunité permettant aux soignants de valoriser leur travail. Ces deux réceptions contraires d’une même politique affectent l’organisation du travail coordonné et les usages de l’informatique privilégiés par les équipes.
La transition climatique dans le secteur bancaire : une approche par les matrices de matérialité
Authors: Paulet Elisabeth , Relano Francesc
Published: September 2024

La présente étude explore la transition climatique dans le secteur bancaire par le biais d’un nouvel outil de communication externe mis à disposition des entreprises : la matrice de matérialité. Son principal intérêt est qu’elle incorpore explicitement le rôle des parties prenantes dans le positionnement stratégique de l’entreprise. L’étude se déroule donc en deux temps. On analyse d’abord la logique du discours stratégique fait par des banques tel qu’il transparaît dans les matrices, notamment en relation aux enjeux climatiques. Nous prospectons ensuite l’articulation entre l’image stratégique transmise par lesdites matrices d’une part, et la réalité pratique des affaires, notamment en ce qui concerne le financement fait par les banques de l’industrie fossile, de l’autre.
Envisioning the Future
Authors: Sharma Gaurav
Published: September 2024

Massive multiple-input multiple-output (MIMO) is a dominant technology that, combined with advanced techniques and architectures, is set to play an integral role in the next-generation wireless systems. This cutting-edge technology has proved its adaptability and scalability in 5G networks by producing significant results. Recent years have seen a remarkable succession of evolutionary breakthroughs leading to revolutionary trends projected to transform future 6G wireless systems drastically. Terahertz (THz) communication, artificial intelligence (AI), cell-free structures, intelligent omni-surfaces/intelligent reflecting surfaces (IOS/IRS), and other technologies will further improve the performance capabilities of large MIMO. Furthermore, the range of diversified applications based on massive MIMO's foundation include vehicle communications, wireless localization and sensing, inter-planetary communications remote sensing, etc., and these are continuously expanding.
Artificial Intelligence in Communications
Authors: S. C. Vetrivel , Sabareeshwari V. , K. C. Sowmiya
Published: September 2024

As technological advancements continue to reshape the landscape of electronic communications, artificial intelligence (AI) emerges as a pivotal force driving unprecedented transformations. This chapter explores the multifaceted integration of AI in electronic communications, focusing on its impact on connectivity, interaction, and the overall user experience. The application of AI in electronic communications spans various domains, ranging from telecommunications and messaging platforms to email systems and social media. AI-driven algorithms enhance network efficiency, optimize data transmission, and contribute to the seamless functioning of communication infrastructures. Machine learning models are employed to predict network congestion, dynamically allocate resources, and ensure the uninterrupted flow of data, leading to improved reliability and reduced latency. In the realm of user interaction, AI plays a crucial role in enhancing personalization and customization.
Revolutionizing Healthcare
Authors: Rajamani Santhosh Kumar , Iyer Radha Srinivasan
Published: September 2024

The healthcare industry is undergoing a significant transformation driven by advancements in artificial intelligence (AI), particularly in the field of computer vision. Computer vision AI has emerged as a powerful tool with diverse applications across healthcare, offering improved diagnostic accuracy, enhanced patient care, and efficient clinical workflows. This chapter explores the significant impact and potential of computer vision AI in revolutionizing healthcare practices. From image-based diagnosis and surgical assistance to automated health monitoring and personalized medicine, computer vision algorithms are reshaping the healthcare landscape. By providing valuable insights from medical images, supporting clinical decision-making, and enabling early detection of diseases, computer vision AI is improving patient outcomes and transforming the way healthcare services are delivered. This chapter delves into the current state, challenges, and future prospects of computer vision AI in healthcare, highlighting its pivotal role in driving innovation and improving healthcare quality.
Design and Optimization of a CMOS-Based Li-Ion Battery Charger With LDO Regulator
Authors: Mamouni Hajjar , Ouremchi Mounir , El Khadiri Karim , Jamil Mohammed Ouazzani , Qjidaa Hassan
Published: September 2024

In this chapter, the authors introduce a novel lithium-ion battery charger based on an LDO regulator that controls three charging methods: trickle current, constant current, and constant voltage. The proposed charger exhibits haute precision, haute efficiency, as well as a small area, which all contribute to extending the lifetime of the battery. Simulation results demonstrate that the proposed charger can deliver a trickle current equal 280 mA, a maximum load current equal 1.37 A, as well as a maximum load voltage equal 4.2 V when supplied with 4.8 to 5 V. The simulations also show that the proposed charger achieves high efficiency of 92% with an area of only 0.35 mm 2, using 180 nm TSMC CMOS technology.
A Voltage-Mode PID-Controlled DC-DC Buck Converter Design for Automotive Applications
Authors: Boutaghlaline Anas , El Khadiri Karim , Jamil Mohammed Ouazzani , Qjidaa Hassan , Chenouni Driss , Tahiri Ahmed
Published: September 2024

The chapter introduces the design and simulation of a PID-controlled DC-DC buck converter for regulating DC voltage from 12 V to 5 V for automotive applications using LTspice software. The simulation results show that the proposed converter with an op-amp-based PID controller can regulate the output voltage, even under load current variations. The converter operates at a switching frequency of 550 kHz, delivering a regulated output voltage of 5 V for load currents ranging from 1 A to 5 A, with a maximum output voltage ripple of 49.47 mV. The proposed buck converter settles to its regulated value within 3.32 ms with a peak efficiency of 86.18% at a load current of 1 A. The experimental results show that the proposed design responded quickly to changes in the load current, settling to its regulated value with an undershoot voltage of 168.97 mV and an overshoot voltage of 176.51 mV and a recovery time of 157.49 us and 278.69 us respectively.
Design of a Very Low Power Temperature Sensor in 65 nm CMOS Technology
Authors: Ouremchi Mounir , El Khadiri Karim , Qjidaa Hassan , Ouazzani Mohammed Jamil
Published: September 2024

This chapter presents an energy-efficient temperature sensor for temperature monitoring. A thermal sensor is presented that used transistor MOSFET biased in subthreshold to generate a proportional to absolute temperature source that can operate at low supply voltage of 1 V. The proposed temperature sensor is featured with low power consumption, high performance and sensitivity with inaccuracy as low as possible. The proposed sensor is designed and simulated in cadence analog design environment in TSMC 65nm CMOS technology.
Low Back Pain or Injury Before Collegiate Athletics, a Potential Risk Factor for Noncontact Athletic Injuries
Authors: Harris-Hayes Marcie , Solomon Steven , Lin Sylvia , Prather Heidi , Hunt Devyani , Agarwal Mansi , Bloom Nancy J. , Mills Lauren , Clohisy John C.
Published: September 2024

Context

Surrounding the predictive value of clinical measurements and assessments for future athletic injury, most researchers have not differentiated between contact and noncontact injuries.

Objectives

We assessed the association between clinical measures and questionnaire data collected before sport participation and the incidence of noncontact lower extremity (LE) injuries among Division III collegiate athletes.

Design

Prospective cohort study.

Setting

University setting, National Collegiate Athletic Association Division III.

Patients or Other Participants

Here, 488 Division III freshmen athletes were recruited to participate in the study during their preseason physical examinations.

Main Outcome Measure(s)

Prospective incidence of noncontact LE injury. Athletes completed questionnaires to collect demographics and musculoskeletal pain history. Clinical tests, performed by trained examiners, included hip provocative tests, visual appraisal of a single-leg squat to identify dynamic knee valgus, and hip range of motion. Injury surveillance for each athlete’s collegiate career was performed. The athletic training department documented each athlete-reported new onset injury and documented the injury location, type, and outcome (days lost, surgery performed). Univariable generalized estimating equation models were used to analyze the relationship between each clinical measure and the first occurrence of noncontact LE injury. An exchangeable correlation structure was used to account for repeated measurements within athletes (right and left limbs).

Results

Of the 488 athletes, 369 athletes (75%) were included in the final analysis. Sixty-nine noncontact LE injuries were reported. Responding yes to, “Have you ever had pain or an injury to your low back?” was associated with an increased risk of noncontact LE, odds ratio = 1.59 (95% confidence interval = 1.03, 2.45; P = .04). No other clinical measures were associated with an increased injury risk.

Conclusions

A history of prior low back pain or injury was associated with an increased risk of sustaining a noncontact LE injury while participating in National Collegiate Athletic Association Division III athletics.
Can Peripheral Gentral Venous Lines be inserted safely and successf ully where X-ray facilities are no available?
Authors: Boon J.M. , Kirby R.E.
Published: September 2024

Background: Primary care settings often lack facilities for radiological evaluation of the position of supra-and infra-clavicularly inserted central Yenous catheters' lf peripherally inserted central venous lines could reliably be successfully inserted this would make the need for immediate confirmatory radiological studies less crucial. Previous studies with peripherally inserted catheters reported a low success rate.This study was performed to determine whether the placement of a more flexible peripherally inserted catheter, the Arrow PICC (Arrow PS-O165 l), would result in an improved and acceptable success rate.Method: Twenty-three patients in the casualty unit of the Mamelodi Hospital during 1997 and 1998, who required a central venous line and had this inserted via the peripheral venous route were evaluated after insertion of the catheter. The best basilic or median cubital vein in the cubital fossa was used for insertion following a standardized method.A number of l4 catheters were inserted in the right arm and 9 were inserted in the left arm. The position of the placement was assessed by an AP supine chest X-ray.Results: Successful placement was achieved in 9l% of insertions (21 of 23 catheters). In both of the unsuccessful placements the catheter tip was located in the ipsilateral internal jugular vein. (One on the left and one on the right') No clinically significant complications resulted from these procedures.Conclusions: This study showed that central venous catheterisation with soft catheters (ArrowPlCC- Arrow PS-O1651), via visible palpable peripheral veins in the cubital fossa is easy to perform and is a safe procedure with a high success rate for correct catheter placement. This route warrants serious consideration when central venous catheterisation is desirable, especially in settings where X-ray facilities are not available to exclude complications or confirm placement.
Wonca 5th World Conference on Rural Health, Melbourne
Authors: De Vries Elma , Reid Steve , Ross Andrew , Cameron David
Published: September 2024

No abstract available.
The Patient's Perception of the role of Prayer in the Family Practice Consultation
Authors: Liddle A.S.
Published: September 2024

This study aims for a deeper understanding of patients' views on prayer in the family practice consultation. Family practice patients have diverse religious beliefs and practices. Relating religion to medicine is, on the one hand, considered an unusual occurrence, and a sensitive almost taboo subject. On the other hand, religion is considered to form an integral part of medicine, not only by divine authority but by virtue of factual knowledge and reason. Reticence, to research prayer, based on the potential of divine punitive reaction is rejected since it confuses the spiritual action of prayer with its consequences. Lay press articles, books written by doctors and medical publications have brought these issues under the spotlight. A review of the literature (PRE- 1995), reveals two studies, which assessed patients' expectation of prayer and discussion of religion.
Die toksikologiese telefoniese konsultasies gerig aan die Departement Farmakologie van die Universiteit van die Vrystaat gedurende 1998
Authors: Engelbrecht C.J. , Folmer J. , Steyn W.C. , Joubert G. , Fourie N.
Published: September 2024

Background: Epidemiologic surveys of poisonings as well as inquiries regarding poisonings are necessary to obtain information for the combating as well successful medical management of poisonings.Methods: All telephonic consultations regarding poisonings from I January 1998 to 31 December 1998 of two of the four consultants of the toxicology centre of the Department of Pharmacology at the University of the Free State were studied retrospectively. Information was noted on a coding form from the consultation forms of the consultants.Results: 994 consultations were included in the study. Most consultations were on Mondays (20.7%), after hours (68.6%) and by general practitioner: (33.7y;) and registrars (32.1%). Of the inquiries 58.4% was with regard to intentional intake. Medications were responsible for 55.7% of inquiries, followed by household products (27.6%) and agricultural products (10.4%). Paracetamol (10.9%) was the most common medication, followed by benzodiasepine (9.97.) and organophosphate (8.7%). Central nervous system medications were involve d in 23.3% of the inquiries, and pain medication in 15.9%.Conclusion: Undergraduate and postgraduate training of doctors should place sufficient emphasis on the most common types of poisonings and medication over-dosages.
Quality use of medicines: The febrile child
Authors: Gray Andy
Published: September 2024

No abstract available.
HIV/AIDS - let us stop the madness!
Authors: De Villiers Pierre J.T.
Published: September 2024

No abstract available.
Dispensing drugs in general practice - when is it ethically justifiable?
Authors: Ogunbanjo Gboyegu A. , Knapp van Bogaert Donna
Published: September 2024

No abstract available.
Teledermatology in a Rural Family Practice
Authors: O'Mahony D. , Banach L. , Mahapa D.H. , Lancaster E.W. , Van der Linde G.D. , Williams B.H. , Herring R.F. , Asvadi S.A.
Published: September 2024

Background: Telemedicine can provide specialist services at a distance to rural areas where access to such services is limited, especially in developing countries. The objectives of this study are to describe and evaluate a teledermatology service in a rural family practice.Methods: Internet-based store-and-forward technology was used. Patients were selected who needed a specialist dermatologist's opinion for diagnosis and management. Pictures of skin conditions were taken with a digital camera and forwarded, together with clinical data, via electronic mail (e-mail) to specialist dermatologists at either of three distant academic centres. Digital pictures of skin biopsies were also forwarded from the regional pathology laboratory. Results were received via e-mail.Results: Over a twenty-one month period, fifty-two patients had teledermatology consultations. Picture quality was adequate for evaluation in all cases. The family practitioner's provisional diagnosis, compared to the teledermatologists, was correct in 28 (57%) of 49 cases where a definite diagnosis was made. Six patients needed referral to a dermatology clinic. The most common diagnoses (number) were rinea (8), acquired immune-deficiency syndrome associated papulopruritic eruption (3), photosensitive dermatitis (3) scleroderma or morphea (3), pryriasis rosea (2), psoriasis (2) and systemic lupus erythematosis (2).Conclusion: Most patients with dermatology problems in rural family practice can be managed by means of store-and-forward teledermatology.
Making sense of statistics for the family practitioner: Obtaining the 'sample'
Authors: Ogunbanjo G.A.
Published: September 2024

No abstract available.
Managing HIV and AIDS: From Betty's Bay to Barcelona
Authors: Editor SAFPJ
Published: September 2024

No abstract available.
Conflict in the labour ward
Authors: Cameron D.
Published: September 2024

No abstract available.
Chronic obstructive airway diseases: ls the EDL sufficient? A study done at the Heidedal CHC in Bloemfontein.
Authors: Dippenaar H. , Joubert G.
Published: September 2024

Background: With the implementation of the Standard Treatment Guidelines (STG's) and Essential Drug List (EDL) in 1996 some of the traditional medication for the treatment of asthma and chronic obstructive pulmonary disease (COPD) were removed from the medication list, e.g. slow release oral theophylline. The objective of this study was to establish whether we were able to treat patients with chronic obstructive airway disease (which includes asthma and chronic obstructed pulmonary disease) effectively with the guidelines and medication on the Standard Treatment Guidelines and Essential Drug List for Primary Health Care (STGI and EDL), 1996.Method: In this follow-up study all patients with chronic obstructive airway diseases (COAD) at Heidedal Community Health Center (CHC) over a 3-month period were evaluated and a lung function test was done on them. Their old medication was stopped and the treatment guidelines of the STG's and EDL were followed.A repeat lung function test was done on all patients after three months on the new treatment. Four indicators were used namely: FVC, FEV I , FEFmax and FEF25-75.Results: Fifty patients were included in the study. Improvement in all four lung functions were noted after the new guidelines were implemented.Conclusions: The implementation of the EDL guidelines for asthma and COPD controlled the diseases, the guidelines were easy to use and are comparable to the latest international standards. Standard guidelines also create better patient compliance and give confidence to health workers. The revised STGI and EDL for Primary Health Care (1998) are comparable with the guidelines used in this study.
Medical Implant Heavy Metal Contents and Effect on Patients
Authors: Latka Kajetan , Kolodziej Waldemar , Domisiewicz Kacper , Lasowy Piotr , Latka Dariusz
Published: September 2024

Advanced metal implants are used in modern medical practice and significantly improve clinical prognosis and quality of life; however, the potential health risks caused by the release of heavy metal ions make further research in this area relevant. The aim of this study is to analyze current scientific sources on the impact of heavy metals released from metal biomedical implants on patients’ health, focusing on the clinical manifestations of these complications, the structure and characteristics of different metal implants, and the possibilities of modifying them. The following scientific methods were used in the study: analysis and synthesis, the method of analogy, induction, abstraction, and the bibliographic method. The study revealed significant health risks of heavy metal ions, such as allergic reactions, toxic complications, carcinogenesis, and systemic effects, including neurological and cardiovascular problems. Innovative modification methods, including surface treatments, nanotechnology, and the development of bio-soluble materials, showed potential to reduce these risks. However, the long-term effects of these modifications remain poorly understood and require further investigation. Heavy metal ions from biomedical implants pose significant health risks. Effective management and reduction of these risks require continuous monitoring, development of new materials, and advanced modification techniques. Further research is essential to understand the long-term effects of metal implants and to develop strategies to ensure patient safety and improve implant efficacy.
Mocetinostat as a Novel Selective Histone Deacetylase Inhibitor in the Promotion of Apoptosis in glioblastoma Cell Line C6 and T98G
Authors: Khathayer Firas , Mikael Mohammad Hussein
Published: September 2024

Background:

Histone deacetylase (HDAC) enzymes play a crucial role in regulating gene expression and epigenetic alterations in cancer cells. Mocetinostat (MGCD0103) is a novel, isotype-selective HDAC inhibitor that targets Class I (HDAC1, 2, 3, and 8) and Class IV (HDAC11) enzymes. It has been approved for the use in phase II trials for Hodgkin’s lymphoma.

Methods:

In this study, the glioblastoma cell (GBM) lines T98G and C6 were treated with different concentrations of MGCD0103 (0.0, 0.5, 1.0, 1.5, 2.0, and 2.5 μM). Western blot analysis was used to evaluate protein expression and flow cytometry was employed to assess apoptosis.

Results:

The results demonstrated that MGCD0103 exerts multiple anti-cancer activities in GBMs. MGCD0103 modulated key signaling pathways, including inhibition of the Phosphatidylinositol 3- kinase (PI3K)/protein kinase B mechanism pathway and suppression of HDAC1 enzyme activity. High doses of MGCD0103 significantly induced apoptosis and suppressed cell proliferation by upregulating the pro-apoptotic protein Bcl-2-associated protein x and downregulating the anti-apoptotic proteins BH3 Interacting Domain Death Agonist and B-cell leukemia/lymphoma 2 protein. In addition, MGCD0103 treatment upregulated the expression of the tumor-suppressor gene and downregulated the E2F1 transcription factor. Furthermore, MGCD0103 facilitated cell differentiation by activating the glial fibrillary acidic protein Glial Fibrillary acidic protein (GFAP) as distinguish marker of astrocytes, and suppressing the undifferentiation markers Inhibitor of Deoxyribonucleic acid binding 2 and N-Myc proto-oncogene protein.

Conclusion:

This research suggests that MGCD0103 is a promising drug for inhibiting the proliferation, invasion, and migration of GBMs. The findings also provide new insights into the ability of MGCD0103 to induce differentiation in GBMs. Overall, these results indicate that MGCD0103 could be a potent therapeutic agent for the target of glioblastoma.
A Study on the Conventional and Molecular Approaches for the Identification of Pseudomonas aeruginosa and Its Antimicrobial Susceptibility Pattern in Diabetic Foot Ulcers
Authors: Nazer Madiha Abdul Majeed Abdul , Kuthalaramalingam Sethumadhavan , Sambandam Ravikumar , Ragunathan Latha , Panneerselvam Bharathi , Ilango Deepika
Published: September 2024

Background:

Diabetes mellitus is a major health concern, and the development of foot ulcers is a serious complication. Pseudomonas aeruginosa is a common causative pathogen in diabetic foot infections, which can lead to delayed wound healing and increased morbidity. This study aims to compare the diagnostic performance of conventional microbiological methods and molecular techniques (polymerase chain reaction [PCR]) for the identification of P. aeruginosa in diabetic foot ulcers and to evaluate its antimicrobial susceptibility pattern.

Methods:

This cross-sectional study was conducted in a tertiary care hospital, involving 134 patients with diabetic foot ulcers. Samples were collected and conventional culture methods were used to identify the pathogens and perform antimicrobial susceptibility testing. In addition, a single-step DNA extraction method (AmpReady) and conventional PCR were utilized for the molecular identification of P. aeruginosa.

Results:

The study found that the PCR technique was more efficient than conventional culture methods in identifying P. aeruginosa, with 44% detection by PCR compared to 14% by conventional culture. According to the antimicrobial susceptibility testing, co-trimoxazole was the most resistant drug against P. aeruginosa, while amikacin was the most sensitive.

Conclusion:

The study highlights the importance of using molecular techniques like PCR for accurate and faster identification of pathogens like P. aeruginosa in diabetic foot ulcers, which is crucial for appropriate antibiotic treatment and management of these infections. The findings contribute to a better understanding of the diagnostic validity and antimicrobial susceptibility patterns of P. aeruginosa in diabetic foot ulcers, which can aid in improving clinical management and outcomes for these patients.
The Complete Chloroplast Genome of Syzygium syzygioides (Myrtaceae: Myrtales) and Phylogenetic Analysis
Authors: Huynh Thu-Thao Thi , Quang Minh Trong , Nguyen Hoang Danh
Published: September 2024

Background:

Syzygium syzygioides (Miq.) Merr. and L. M. Perry is a common medicinal plant species known for its biologically active compounds. However, the chloroplast (cp) genome of S. syzygioides has not been previously reported. This study aimed to determine the complete cp genome sequence of S. syzygioides and investigate its phylogenetic relationships within the Syzygium genus.

Methods:

Leaf samples of S. syzygioides were collected from Vietnam, and the complete cp genome was sequenced and assembled. Phylogenetic analyses were then conducted to examine the evolutionary relationships between S. syzygioides and other Syzygium species.

Results:

The cp genome of S. syzygioides was found to be 158,172 base pairs in length, with a GC content of 37.0%. Phylogenetic reconstruction based on the cp genome data revealed that S. syzygioides is closely related to 10 other Syzygium species, including Syzygium buettnerianum, Syzygium bamagense, Syzygium grande, Syzygium megacarpum, Syzygium glomeratum, Syzygium claviflorum, Syzygium tsoongii, Syzygium fluviatile, Syzygium buxifolium, and Syzygium grijsii.

Conclusions:

This study provides the first report of the complete cp genome sequence of S. syzygioides, a medicinally important plant species in the Myrtaceae family. The phylogenetic analysis using the cp genome data sheds light on the evolutionary relationships within the Syzygium genus, which is the largest genus in the Myrtaceae. The new molecular data generated in this study can be used for the molecular identification and further phylogenetic investigations of Syzygium species, contributing to a better understanding of the diversity and evolutionary history of this economically and ecologically significant plant group.
Molecular Detection of Chlamydia pneumoniae, Haemophilus influenza, and Streptococcus pneumoniae and Expression of miR-146, miR-16, and miR-221 in Patients with Chronic Obstructive Pulmonary Diseases
Authors: Moattar Husseini Neda , Mohamadnia Abdolreza , Hosseini Farzaneh , Bahrami Naghmeh
Published: September 2024

Background:

Chronic obstructive pulmonary disease (COPD) is a debilitating respiratory condition characterized by persistent airflow limitation and chronic inflammation. Microbial infections and dysregulated microribonucleic acid (miRNA) expression have been implicated in COPD pathogenesis. This study aimed to investigate the molecular detection of three respiratory pathogens, Chlamydia pneumoniae, Haemophilus influenzae, and Streptococcus pneumoniae, in the respiratory secretions of COPD patients. In addition, it evaluated the expression levels of miR-146, miR-16, and miR-221 in the peripheral blood of COPD patients.

Methods:

Peripheral blood and respiratory secretions were collected from 40 healthy individuals and 40 COPD patients. The messenger ribonucleic acid expression levels of miR-146, miR-16, and miR-221 were determined using real-time polymerase chain reaction. Statistical analyses, including t-test, binomial test, and Pearson correlation, were performed.

Results:

H. influenzae, S. pneumoniae, and C. pneumoniae were detected in the sputum of 12.5%, 17.5%, and 7.5% of COPD patients, respectively. The expression of miR-146, miR-221, and miR-16 was observed in 65%, 15%, and 85% of COPD patients, respectively, compared to 13%, 80%, and 15% of healthy subjects. While miR-221 was downregulated in COPD patients, miR-16 and miR-146 were upregulated. No significant differences were found in the expression of these miRNAs between infected and noninfected COPD patients.

Conclusion:

The molecular detection of respiratory pathogens and the expression profiles of miR-146, miR-16, and miR-221 in COPD patients may have potential diagnostic value. Further research is needed to elucidate the role of these markers in COPD pathogenesis.
Characterization of QuantiFERON Severe Acute Respiratory Syndrome Coronavirus 2 and Anti-severe Acute Respiratory Syndrome Coronavirus 2 Nucleocapsid and S1 Spike Protein Antibodies in Vaccinated and Unvaccinated Coronavirus Disease 2019 Patients
Authors: Mortaz Esmaeil , Roofchayee Neda Dalil , Jamaati Hamidreza , Tabarsi Payam , Ahmadi Shahrzad , Shahi Heshmat , Varahram Mohammad , Mogadam Kimia Behzad , Sajadi Mohammad M. , Adcock Ian M.
Published: September 2024

Background:

Coronavirus disease 2019 (COVID-19) vaccination has been shown to elicit both humoral (antibody) and cell-mediated (T-cell) immune responses. This study aimed to characterize and compare the QuantiFERON severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and anti-SARS-CoV-2 antibody responses in vaccinated and unvaccinated COVID-19 patients, as well as vaccinated healthy controls (HCs).

Methods:

A total of 96 COVID-19 patients (68 vaccinated with Sinopharm and 15 with AstraZeneca), 13 unvaccinated COVID-19 patients, and 16 vaccinated HCs (8 Sinopharm and 8 AstraZeneca) were included. Serum antibodies against the SARS-CoV-2 spike (S1) protein and nucleocapsid (N) protein were measured by enzyme-linked immunosorbent assay. T-cell responses were evaluated using the QuantiFERON assay against three SARS-CoV-2 viral antigens (Ag1, Ag2, and Ag3).

Results:

There were no significant differences in S1 antibody levels between COVID-19 patients (vaccinated or unvaccinated) and HCs. However, 100% of unvaccinated COVID-19 patients had anti-N antibodies, which was significantly higher than the AstraZeneca-vaccinated group. T-cell responses did not differ significantly between vaccinated and unvaccinated patients or between vaccinated patients and HCs. Vaccination with Sinopharm induced higher levels of total N antibodies and greater interferon-gamma release against the viral antigens compared to the other groups.

Conclusions:

Vaccination, especially with Sinopharm, induced robust humoral (N antibodies) and cellular (T-cell) immune responses in COVID-19 patients. The findings highlight the importance of vaccination in eliciting a comprehensive immune response against SARS-CoV-2, even in the context of prior infection.
Agreement between Phenotypically Detected Linezolid Resistance and Mutations in rrl and rplC Genes of Mycobacterium tuberculosis Isolates Using Nanopore Sequencing
Authors: Sengupta Senjuti , Jain Parul , Ratnam Rashmi , Pandey Bhoopendra Kumar , Singh Urmila , Kumar Vijay , Paliwal Ashutosh , Jain Amita
Published: September 2024

Background:

Phenotypic drug susceptibility testing (DST) is considered the gold standard for detecting linezolid (LZD) resistance in Mycobacterium tuberculosis (MTB), but it is time-consuming. Nanopore sequencing offers a potentially faster alternative approach. This study evaluated the agreement between phenotypically detected LZD resistance and mutations in the rrl and rplC genes of MTB isolates using nanopore sequencing.

Methods:

Consecutive drug-resistant MTB isolates from pulmonary samples collected in 2021 underwent liquid culture (LC) DST for LZD. All resistant isolates and an equal number of susceptible isolates were subjected to targeted sequencing of the rrl and rplC genes using nanopore technology.

Results:

Sequencing identified a C154R mutation in the rplC gene in only one LZD-resistant isolate. No mutations were detected in the rrl gene. The agreement between sequencing and LC-DST for detecting LZD resistance was poor (Cohen’s kappa: 0.03571, 95% confidence interval [CI]: −0.034–0.105). Additionally, no significant association was found between LZD resistance and clinical or microbiological outcomes at 6-month follow-up.

Conclusion:

This study revealed a considerable discrepancy between phenotypic and genotypic detection of LZD resistance in MTB. Further research is needed to better understand the genetic mechanisms underlying LZD resistance and to develop reliable molecular diagnostics for rapid resistance detection.
Diagnostic Accuracy of FluoroCycler XT MTBDR Assay for Detection of Rifampicin and Isoniazid-resistant Mycobacteria tuberculosis in Clinical Isolates from Kenya
Authors: Mwangi Zakayo Maingi , Ireri Samson , Opwaka Haron , Otieno Leon , Simam Joan , Onyambu Frank Gekara , Mukiri Nellie
Published: September 2024

Background:

Drug-resistant tuberculosis (DR-TB) poses a major global challenge to public health and therapeutics. It is an emerging global concern associated with increased morbidity and mortality mostly seen in the low- and middle-income countries. Molecular techniques are highly sensitive and offer timely and accurate results for TB drug resistance testing, thereby positively influencing patient management plan.

Methods:

The study was carried out at the National Tuberculosis Reference Laboratory (NTRL) in Kenya in the period between January and October 2022. A total of 243 Mycobacterium tuberculosis (M.tb) clinical isolates were included in the study. These isolates comprised of 50 isolates with mutations in rpoB, 51 isolates with katG mutations, 51 isolates with mutations in inhA, and 91 M.tb isolates lacking mutations in these genes based on Genotype MTBDRplus results. DNA from the isolates was extracted using the FluoroLyse extraction kit. Real-time polymerase chain reaction targeting the rpoB, InhA, and katG genes was performed using the FluoroType MTBDR amplification mix. Isolates with discordant results between Genotype MTBDRplus and FluoroCycler® MTBDR assays underwent targeted sequencing for the respective genes, then, sequences were analyzed for mutations using Geneious version 11.0 software.

Results:

The sensitivity of the Fluorocycler XT MTBDR assay for the detection of mutations that confer drug resistance was 86% (95% confidence interval [CI] 73.0–94.0) for rpoB, 96% (95% CI 87–100) for katG and 92% (95% CI 81–98) for inhA. The assay’s specificity was 97% (95% CI 93–99) for rpoB, 98% (95% CI 96–100) for katG, and 97% (95% CI 93–99) for inhA.

Conclusion:

The diagnostic accuracy of FluoroType MTBDR for the detection of mutations conferring resistance to rifampicin and isoniazid was high compared with that of Genotype MTBDRplus and demonstrates its suitability as a replacement assay for Genotype MTBDRplus.
Application of electrospray triple quadrupole mass spectrometry in assessing thalassemia in a population
Authors: Putchen Deepalakshmi D. , Nambiar Athira , Bijur Ashwini , Amirtharaj Nelson , Ramaprasad Sujay
Published: September 2024

Introduction:

Thalassemia is widely prevalent in Asian countries and the Middle East region of the world. While the prevalence of α thal is around 5-20% in the population, the incidence of β thal is around 3-4%. The available data on thalassemia in Indians is based on chromatographic or electrophoretic techniques. The present study demonstrates the utility of mass spectrometry in detecting thalassemia in a small, healthy population from Tiptur, Karnataka.

Materials and Methods:

The study included a population of 315 individuals, spanning both children and adults, with ages ranging from 4 to 76 years. EDTA whole blood was collected after obtaining their written consent. The intensities of various globin chains were measured using a triple quadrupole mass spectrometer. The ratio of the peak areas of globin chains (α/β, δ/β (%)) served as biomarkers to detect thalassemia. Thirty random samples of α thalassemia were analyzed using GapPCR.

Results:

The prevalence of a thal is 21.65% (68/314) based on α/β (< =0.8) and the prevalence of β thal is 3.8% (12/314) based on δ/β (%) (> =11.0). GapPCR detected three heteromutants of α deletion, one mutation in the HBA1 gene, and one a triplication (16.7%, 5/30). One sample was excluded from the analysis due to the presence of a variant.

Conclusion:

The utility of mass spectrometry for screening thalassemia in a population is demonstrated. The higher occurrence of α-thalassemia in the studied population underscores the importance of screening for thalassemia in regions with reportedly high prevalence rates.