bluuebunny/crossref_metadata_2025 huggingface dataset:
A participação militar das mulheres em Portugal: a postura e a reação dos partidos políticos com representação parlamentar (1990-2020)
Authors: Nunes Andreia , Madeira Bruno
Published: June 2024

Esta pesquisa centra-se no estudo da integração das mulheres nas Forças Armadas Portuguesas (1990-2020). Abordamos a situação militar da mulher nas Forças Armadas dos países da OTAN e, de entre os vários países-membros, analisamos o processo de incorporação feminina nos Estados Unidos da América, em Espanha, em Israel e em Portugal. Examinamos os debates parlamentares sobre a participação militar feminina, em Portugal, em momentos de alteração legislativa (1990, 2010 e 2020). O estudo destes discursos revelou que a incorporação das cidadãs nas Forças Armadas Portuguesas esteve longe de ser uma preocupação para os partidos e para os deputados, uma vez que não se apresentou como um tópico relevante na discussão política.
From the École polytechnique to the École de la régulation
Authors: Tadjeddine Yamina
Published: June 2024

This article traces the intellectual career of Michel Aglietta, an economist attached to the École de la regulation (Regulation school), from his youth to the publication of his book Régulation et Crise du capitalisme (1976). It is one of a series of recent studies on the structuring of economic thought, and macro-economic theory in particular, at the turn of the 1970s. The theoretical perspective of the article combines the history of economic thought and the sociology of science to place Aglietta’s career in a dual dynamic: the course of a lifetime–education, places of work, scientific collaborations–and the economic, social and political contexts he has traversed. The study of published articles is supplemented by recourse to archives and interviews with Aglietta and those who worked with him. The structure of the article follows the three institutions that Aglietta frequented and that shaped him as a student at the École Polytechnique (1959–1965), a senior civil servant at the Institut national de la statistique et des études économiques (INSEE) (1965–1970) and a doctoral student at the Sorbonne under the supervision of Raymond Barre (1970–1974). The presentation of Aglietta’s life and career between 1959 and 1976 helps to explain his contribution to the advent of Regulation theory, and also to understand his stance as an expert economist in the service of public policy.
The institutionalisation of the social and solidarity economy in France as a meso-space
Authors: Celle Sylvain
Published: June 2024

Nowadays, the social and solidarity economy (SSE) is seen as a relatively specific economic system within contemporary economies. Despite a relative lack of interest in the SSE, certain “institutional” economists—in particular regulationists–have underlined its specificity within an array of various institutional arrangements in capitalist economies. More specifically, regulationist studies view the SSE, or some of its components at least (e.g., cooperatives, mutual insurance, etc.) as relatively autonomous meso-economic spaces within capitalist regimes. From this perspective, this article aims to shed light on how the SSE has become, over time, a relatively unified and autonomous meso-economic space around three main periods, corresponding to three historical compromises of the SSE as a meso-space with regard to its constituent elements (entities, legal rules, ideologies, etc.) and its integration into the evolution of French capitalist regimes. The first (liberal) compromise (1790–1880) was characterised by the emergence of the original, fragmented SSE entities, in a regime dominated by economic liberalism. The second (republican) compromise (1880–1970) saw the institutionalisation and division of large SSE “families” (e.g., cooperatives, mutual insurances, associations) under the guidance of the social state. The third (neoliberal) compromise (since 1970) reflects the recent unification and institutionalisation of the SSE as a meso-economic space, but whose unity and autonomy in the face of contemporary capitalist pressures remain fragile.
The financialization of healthcare
Authors: Martins Norberto Montani , Ocké-Reis Carlos
Published: June 2024

In contemporary capitalism, finance has extended its reach to encompass a growing array of economic sectors traditionally associated with public provisioning or social policy, with healthcare emerging as a prominent domain where fictitious capital has flourished. Financialization exerts a direct influence on the delivery of public health services while also reshaping the behavior and operations of private healthcare providers and health insurance firms. This paper aims to characterize the process of financialization of healthcare in Brazil by analyzing the behavior of firms in the private health insurance market from 2007 to 2019. These firms provide healthcare coverage alongside the functioning of the Unified Health System (SUS), constituting an avenue for the accumulation of capital. The paper analyzes how the strategies for managing assets, liabilities, and the equity of leader firms operating in the market of private healthcare plans firms, as expressed by the movements recorded in their balance sheets, inform us on their process of financialization. A set of financialization indexes is developed, addressing: (i) asset financialization; (ii) liability financialization; and (iii) the maximization of shareholder value. Economic-financial data and financial statements made available by the Brazilian Regulatory Agency for Private Health Insurance (ANS) are used to build such indexes. The results show a greater engagement of leader firms in the allocation of their resources in financial assets, but the weight of financial gains in total profits is small. Regarding indebtedness, results do not show an increase in leverage and financial burden, and does not confirm the hypothesis of increased susceptibility to creditor influence. Finally, changes in the equity structure and initial public offerings suggest a greater alignment of management practices with the standards of corporate governance established in capital markets. We conclude that those firms are increasingly serving as platforms for the financial accumulation of other economic agents and set a research agenda on this topic.
Nona Nenovska, Gouvernance des biens communs et spécificités du rapport social à la nature en Bulgarie : le cas de l’aire marine protégée de Kaliakra
Authors: Nenovska Nona
Published: June 2024

Cette thèse étudie la gouvernance locale de l’Aire marine protégée de Kaliakra, sur la côte bulgare de la mer Noire. Cette recherche se concentre principalement sur les arrangements institutionnels formels/informels repérés dans cette zone. Bien que les institutions formelles soient importantes pour fixer les règles de la gouvernance des ressources naturelles, cette étude constate que les institutions informelles, spécifiques au contexte historique et culturel du pays, tendent à façonner les résultats et les objectifs de cette gouvernance et reflètent les caractéristiques socio-économiques du macrocontexte dans lequel elle s’inscrit.
Julien Pharo, Démocratie d’entreprise et fiscalité. Enjeux théoriques et pratiques de la mise en place d’une fiscalité incitative procédurale
Authors: Pharo Julien
Published: June 2024

Cette thèse, qui se situe avant tout dans le champ de la théorie économique, se propose d’envisager, dans une optique pragmatiste et institutionnaliste, la possibilité que la fiscalité incitative à l’égard des entreprises se fixe comme objectif de démocratiser leur organisation. Elle a ainsi pour objet de fonder une conception de la fiscalité incitative procédurale (FIP), afin d’une part de sortir du particularisme des dispositifs fiscaux actuels et, d’autre part, de contribuer, de manière complémentaire à d’autres outils de régulation, à démocratiser l’entreprise. La FIP repose donc sur le projet de transformer la structure organisationnelle de l’entreprise dans un sens éthico-politique en y favorisant le déploiement de la raison pratique, par opposition à la FII (fiscalité incitative instrumentale) qui ne vise que les résultats des comportements, et notamment les prix de marché, avec pour effet indirect de renforcer la prédominance de la rationalité instrumentale au sein de l’entreprise. Cette thèse nous a permis non seulement de réexaminer la possibilité d’une action publique pour démocratiser l’entreprise, mais aussi de questionner le sens de l’incitation fiscale du point de vue des pouvoirs publics. Dans l’optique de différencier fiscalement les entreprises et de conditionner sur cette base les aides publiques, elle nous a amené à formuler des critères multidimensionnels pour évaluer les entreprises en fonction de leur engagement (ou non) dans des processus de démocratisation de leur organisation.
ENSEMBLE MODEL WITH IMPROVED U-NET-BASED SEGMENTATION FOR LEUKEMIA DETECTION
Authors: Hasan Mehadi , Vijay M. , Sharanyaa S. , Tejaswi Vinnakota Sai Durga
Published: June 2024

An essential component of the immune system that aids in the fight against pathogens is white blood cells. One of the most prevalent blood diseases, leukemia can be fatal if not properly diagnosed. Diagnosing this disease at an early stage may reduce the severity of the disease. This research intends to propose an ensemble model with improved U-net for leukemia detection (EMIULD) with the following four phases: preprocessing, segmentation, feature extraction and detection. The preprocessing step involves preprocessing the blood smear image, which includes filtering and scaling the image. The segmentation phase is applied to the preprocessed image, and U-Net-based segmentation is used to segment the image. As a result, features for the segmented images are extracted, including better Local Gabor XOR Pattern (LGXP), area, and grid-based form features. The extracted features are fed into the suggested ensemble model, which consists of Deep Convolutional Neural Network (DCNN), Support Vector Machine (SVM) and Random Forest (RF) classifiers, with the purpose of detecting leukemia. Finally, the proposed Bidirectional Long Short-Term Memory (Bi-LSTM) network to predict whether the given blood smear image is leukemia or not. The suggested model attained the best outcome when evaluated over the extant approaches.
A ROBUST ENSEMBLE SEGMENTATION APPROACH AND OPPOSITION-BASED RAIN OPTIMIZATION ALGORITHM FOR ENHANCING ACUTE LYMPHOBLASTIC LEUKEMIA (ALL) DETECTION
Authors: Abirami M. , George G. Victo Sudha , Sam Dahlia
Published: June 2024

Generally, leukemia is one of the blood cancers that can lead to death. A huge amount of immature WBCs in the bone marrow affect the healthy cells and this has become the leading cause of leukemia disease. Moreover, “Acute Lymphoblastic Leukemia (ALL)” is a type of blood cancer that is generally categorized with a huge amount of immature lymphocytes that are given as blast cells. But, the analysis of this model is dependent, boring as well as time-consuming based on the skills of hematologists. So, there is a requirement for the most desirable techniques to tackle these restrictions. Additionally, the accurate and automated diagnosis of ALL is a crucial task. In this case, an automated detection model of ALL using ensemble segmentation and a heuristic-assisted layer-improved hybrid deep learning approach is implemented. In the initial stage, the raw images are collected from benchmark datasets. Further, the image pre-processing is undergone by contrast enhancement and filtering process. After pre-processing, the image segmentation is carried out by ensemble segmentation, which is acquired by the region growing, K-medoids, and Fuzzy C-Means (FCM). From the segmented images, based on the mutual information, the pixel is selected optimally, in which the optimal pixel is identified by Opposition-based Rain Optimization Algorithm (OROA). Subsequently, the optimal pixels are fed as input to the Layer Improved Hybrid DenseNet and ResNet (LIH-DRNet) model that is constructed with DenseNet and ResNet, where some hyperparameters are tuned optimally by the improved ROA. At last, the performance is evaluated with diverse performance metrics. Thus, the findings reveal that the developed hybrid deep learning method achieves a higher detection rate to ensure the effectiveness of the model.
Impact of Palladium Decoration on the Performance of Co-SmFeO3 Based Gas Sensor
Authors: Mankar Rajendra Babanrao , Kapse Vivek Dalpatrao
Published: June 2024

The enhanced ammonia gas sensing properties of palladium decorated Co-SFO are demonstrated here. Pristine SmFeO3 thick films fabricated by screen printing technique were surface modified with Co by dipping method (dipping time 3 min) and identified as Co-SFO thick films. They showed maximum sensitivity to 50 ppm ammonia at 200 °C. In order to further increase its sensitivity, Co-SFO thick film was dipped into Palladium nitrate solution for 1 min, 2 min and 3 min. Surface morphology of as-prepared thick films was studied by FE-SEM. Formation of PdO phase and its uniform distribution over Co-SFO surface was confirmed from EDAX spectra. Gas sensing results revel that the sensitivity of Pd decorated Co-SFO thick films towards 50 ppm ammonia was increased. Moreover, decrease in operating temperature was also observed. Pd decorated Co-SFO thick film with dipping time 3 min has maximum sensitivity at lower operating temperature. The improved sensitivity at low temperature was attributed to the sensitization of palladium which was discussed in details. Keywords: Co-SFO, Chemical sensitization, Noble metal, Gas Response, Reducing gas.
Effect of Sulfonating Agent on Esterification Reaction Using Aerogel Carbon Based Support Material
Authors: Laksono Sudibyo Enggar , Suryandari Ade Sonya , Widiyastuti Widiyastuti , Nurtono Tantular , Setyawan Heru
Published: June 2024

The effect of sulfonic agents on the performance of solid acid catalysts in esterification reactions of long-chain fatty acids has been studied. Herein, sulfonated activated carbon with sulfanilic acid (SAC-SA) and sulfuric acid (SAC-SO4) as a sulfonic agent were prepared and used for esterification reaction to convert long-chain fatty acids into methyl esters within 5 h at 65°C. The obtained SAC-SA has a higher surface area than SAC-SO4 of 1301.981 and 1182.096 m2/g, respectively. When SAC-SO4 and SAC-SA catalysts were applied to the esterification reaction, the FAME product conversion results were 74.47 and 46.98 %, respectively. The physical property of SAC-SO4 has more macropores size distribution than mesopores size based on the BJH method. Large pore size on the catalyst will support the diffusion of large organic molecules to improve catalytic ability. The pore size determines the performance of solid acid catalysts, especially in long-chain fatty acid reactants for biodiesel production.
Cancer Cell Small Molecule Secretome Induces the Immune Checkpoint NKG2A and Dysfunction of Human CD8+ T Cells
Authors: Rodriguez-Garcia Gabriel J , Graves Diana K , Mirza Muhammad B , Idrees Kamran , Kim Young J , Korrer Michael J , Rathmell Jeffrey C
Published: June 2024

PD-1 blockade has been approved for head and neck squamous cell carcinoma (HNSCC) patients. However, many HNSCC patients do not respond to this treatment, and other tumor microenvironmental factors may promote resistance to PD-1 blockade. We previously identified increased expression of the inhibitory receptor NKG2A on CD8+ T cells in HNSCC tumors compared with T cells in matching PBMC samples. Mechanisms that promote NKG2A expression and the role of NKG2A on human T cells in the tumor microenvironment, however, are uncertain. In this study, we show that tumor-conditioned media (TCM) of HNSCC cancer cell lines or ascites fluid from colorectal carcinoma patients is sufficient to induce the expression of NKG2A and other inhibitory receptors on activated CD8+ T cells isolated from PBMCs of healthy donors. Boiling or small molecular mass cutoff filtering did not eliminate the effect of TCM, suggesting that a small molecule promotes NKG2A. T cell activation in TCM decreased the basal and maximal mitochondrial respiration to metabolically restrain CD8+ T cells. Functionally, T cell activation in TCM reduced CD8+ T cell cytotoxicity as shown by lower production of cytokines, granzyme B, and perforin. Furthermore, TCM prevented CD8+ T cells from killing cancer cells in response to an anti-CD19/anti-CD3 bispecific T cell engager. Thus, a small secreted molecule from HNSCC cells can induce NKG2A expression and promote T cell dysfunction. Our findings may lead to targets for novel cancer therapies or biomarkers for NKG2A blockade response and provide a model to study T cell dysfunction and impaired metabolism.
Camera traps equipped with macro lenses as a tool for monitoring arboreal small mammals: a case study in an agroecosystem (NE Italy)
Authors: Nardotto Alessandro , Bertolin Cristian
Published: June 2024

Despite their increasing use, camera traps as a monitoring tool for arboreal small mammals leave room for further improvements to increase their effectiveness. In the summer of 2023, we conducted a small mammal survey in a wooded area of a lowland agroecosystem in the Veneto region, using standard camera traps equipped with macro lenses for close-up shooting. This camera trap technique made it possible to contact three species of small mammals in the tree-shrub layer: Eurasian red squirrel Sciurus vulgaris, wood mouse Apodemus sylvaticus, and black rat Rattus rattus. The use of macro lenses combined with the standard camera trapping technique made it possible to obtain better quality images and more information even on smaller species compared to more traditional camera traps.
Considerations for delayed-onset spinal arachnoid web after intracranial subarachnoid hemorrhage
Authors: Wong Georgia , Pivazyan Gnel , Breton Jeffrey M. , Dowlati Ehsan , Felbaum Daniel R.
Published: June 2024

Spinal arachnoid web (AW) is a rare condition causing spinal cord-related issues. Its cause is often idiopathic but can be linked to past trauma or spine surgery. We describe two cases of AWs that developed after subarachnoid hemorrhage (SAH). Case #1 is a 71-year-old male with nonaneurysmal SAH who developed myelopathy 1 year later. Magnetic resonance imaging revealed upper thoracic cord edema and an AW. Case #2 is a 57-year-old female who underwent coiling of a ruptured basilar artery aneurysm and ventriculoperitoneal shunting for hydrocephalus. Twenty months later, she developed mid-thoracic AW requiring surgical resection. Both patients showed symptom improvement postresection avoiding further reoperation. History of SAH is emerging as a risk factor for AW development, emphasizing the importance of monitoring delayed-onset myelopathy and back pain in recent SAH patients.
To Compare the Effects of 0.2% Ropivacaine Continuous Infusion versus Programmed Intermittent Bolus on Postoperative Analgesia with Adductor Canal Block, in Patients Undergoing Unilateral Knee Arthroplasty: A Randomized Controlled Trial
Authors: Thomas Anu Krupa , Medidi Anand Babu , Karuppusami Reka , Thomas Anju Sarah , Pillai Rahul , Salins Serina Ruth , Adhikary Sanjib Das
Published: June 2024

Background:

Multimodal regimens are the mainstay of postoperative analgesia. Analgesic effectiveness of programmed intermittent bolus (PIB) versus continuous infusion (CI) in ultrasound-guided adductor canal block (ACB) for unilateral knee arthroplasty, were compared.

Materials and Methods:

Following Ethical and Clinical Trials Registry approval, eligible patients were administered pericapsular infiltration, intraoperatively and ACB with catheter, postoperatively. As per randomization, the PIB group received 10 ml 0.2% ropivacaine every 3 hourly while the CI group received 6mL/h. In addition, both groups received patient controlled boluses of 5mL with lockout interval of 30 minutes. The numerical rating score (NRS) score, plasma concentration of ropivacaine, use of rescue analgesics, quadricep strength by Straight Leg Rising Test (SLRT), Medical Research Council (MRC) scale for motor power, were monitored at 0, 1, 4, 24, 48 h, and Likert Scale for patient satisfaction, was measured at 72 h. To be clinically meaningful, sample size calculation, was according to a difference in NRS, for a power of 0.80, and σ‐standard deviation of two points, thus requiring at least 17 patients in each group.

Results:

In PIB group, patients experienced better analgesia in the first 24 h (rest - 95% CI - 0.089–0.669, P = 0.010 and movement - 95% CI - 0.82–0.884, P = 0.018) and motor power, in the first (P = 0.051) and 4th h (P = 0.034), after recovery, along with improved patient satisfaction (P = 0.001). Ropivacaine plasma concentration, at regular intervals, was independent of the pain scores with rest and movement. Rescue analgesia was inconclusive in both groups.

Conclusion:

The PIB option provided better analgesia in the postoperative period.
Management of Type A Aortic Dissection in the Emergency Department: A Comprehensive Case Report
Authors: Aalhamad Aya Hasan , Hazra Darpanarayan , Ellouze Nejah F.
Published: June 2024

This case report elucidates the presentation and management of a 54-year-old man with type A aortic dissection (TAAD) in the emergency department. The patient, a known diabetic with uncontrolled hypertension and a history of heavy smoking, presented with severe central chest pain radiating to the back, accompanied by diaphoresis. Clinical evaluation revealed tachycardia and normotension. An immediate computed tomography angiogram confirmed the diagnosis of TAAD. The patient received timely medical intervention with intravenous beta-blockers and was prepared for a surgical consultation. This report underscores the critical importance of rapid diagnosis, effective blood pressure control, and multidisciplinary collaboration in the management of TAAD in the emergency setting, emphasizing contemporary evidence-based practices. While the article omits details on operative procedures, it notes that the patient was discharged in stable condition postsurgery, and at the 3-month follow-up, he is progressing well.
Linear and Annular Lupus Panniculitis of the Scalp with Annular Lupus Panniculitis of the Face in a Child
Authors: Baskaran Narayanan , Bharti Prashant , Arava Sudheer , Khandpur Sujay
Published: June 2024

Linear and annular lupus panniculitis of the scalp is a rare form of lupus panniculitis recently reported in literature. It presents as linear or annular or arciform areas of nonscarring alopecia of the scalp with minimal surface changes. We report a 4-year-old Indian female child with arciform erythematous plaque over the forehead extending on the scalp with nonscarring alopecia with annular erythematous plaque over the cheek. Histology showed lobular lymphocytic panniculitis with abundant mucin deposition. Antinuclear antibody and systemic screen for lupus were negative. After treatment with oral corticosteroids, complete remission was achieved with good regrowth of scalp hair with no relapse during the follow-up period of 6 months. This is the youngest reported case of linear and annular lupus panniculitis of the scalp.
The relationship between emotional intelligence and academic performance among medical students in Mysuru
Authors: Bilimale Anil S. , Hegde Saurish , Pragadesh R. , Rakesh M. , Anil Deepak , Gopi Arun
Published: June 2024

Introduction:

In medical education, it was known that only abstract intelligence was enough for patient treatment, but frequent failures and inabilities to handle social issues by students have led researchers to come out to explore other aspects of intelligence.

Materials and Methods:

It is a cross-sectional study for 3 months. The sample size was 110, and the data were collected using a Schutte self-assessment questionnaire from medical students in a medical college. The data were analyzed using mean, Pearson’s correlation, Student’s t-test, and ANOVA test using SPSS version 22.

Results:

The mean emotional intelligence (EI) of the participants was 121.11 ± 12.778. Most of the participants belonged to the age group of 19–23 years. Most belonged to the nuclear family (80%) and most fathers were professionals (81.8%). Sixty-five percentage of the students scored between 65% and 75% in their examinations. There was a negative correlation between EI and academic scores. High EI can mean that they can handle crises and emotional turmoil well but may not necessarily mean that it would translate to a good academic performance according to the current assessment techniques in medical universities.

Conclusion:

A negative correlation between EI and academic performance can be implied that either academic performance is independent of EI or the current education system is considering the cognitive domain in academic performance assessment which is not influenced by EI.

The following core competencies are addressed in this article: Practice-based learning and improvement, Professionalism.
How to Peer Review for Scientific Journals?
Authors: Wyawahare Mukta
Published: June 2024

Peer review is the evaluation of scientific, academic, or professional work by experts in the field. This process starts when the editor of a peer-reviewed journal sends an article or a manuscript to two or more reviewers for review. They convey their suggestions to the editor. If the reviews are positive, the editor requests the authors to revise and resubmit the manuscript. The corresponding author provides a point-wise explanation of the various queries raised by the reviewers and resubmits the paper. The editor may send the paper for re-review, following which the editor makes the final decision. If accepted, the author is informed, and the paper is published. The peer review process has many variations such as blinded review (single or double blind), open review, and collaborative review. Each variant has its pros and cons. Peer review, when done before publication in a journal, has the advantage of producing papers that have undergone thorough scrutiny of their research question, methodology, and outcomes. Although this process may take more time compared to other methods, it has stood the test of time as a key quality control mechanism in scientific publishing. The reviewer should be unbiased and professional in his/her conduct and provide constructive feedback to improve the research paper. Several journals provide a checklist for peer reviewers, which facilitates a detailed review. Peer reviewing is a skill that improves the quality of publication at the level of an individual manuscript and benefits the scientific community at large.
Antimicrobial resistance: A looming threat to public health and global well-being
Authors: Deori Chinmoyee , Sonowal Tonushyam , Das Monalisha
Published: June 2024

Antimicrobial resistance (AMR) is a global issue that transcends borders and affects countries at all income levels. Various contributing factors include limited access to clean water, sanitation, and hygiene for both humans and animals; inadequate infection and disease prevention and control in households, health-care facilities, and farms; restricted access to high-quality and affordable vaccines, diagnostics, and medications; insufficient awareness and knowledge; and a lack of enforcement of relevant legislation. People in low-resource settings and vulnerable populations are disproportionately affected by both the causes and consequences of AMR. The identification and subsequent incorporation of antimicrobial agents into clinical medicine marked a significant milestone in 20th-century medical achievements, fundamentally transforming the management of bacterial diseases. Nevertheless, the gradual rise of antibiotic-resistant bacterial populations, stemming from the inappropriate usage, misapplication, and unconditional abuse of antibiotics, has evolved into a substantial global public health challenge. Today, different mechanisms of bacterial resistance have been reported in almost all the present antibiotics on the market. The international community has been striving to address and recognize AMR as a global alarming situation, as considered by the World Health Organization as well as the Centers for Disease Control and Prevention. The unrestrained utilization of antibiotics at public and commercial levels has invigorated the evolution of multi-drug resistant microbiota across the globe, leading to an elevated mortality rate due to microbial infections. This review paper explored the inception and resistance genes, provides a comprehensive overview of global antimicrobial resistance, analyzes factors promoting its dissemination, discusses control strategies, examines control challenges, and underscores the ramifications of an inability to effectively contain antimicrobial resistance in bacteria, effectively.
Age, gender, and regional variations in stroke epidemiology in India: A systematic review and meta-analysis
Authors: Joseph Jaison , Varkey Biji P. , Varghese Abin , Mathews Elezebeth , Dhandapani Manju , Sharma Suresh K. , Shah Saleena , Narasimha Venkata Lakshmi , Renjith Vishnu , Dhandapani Sivashanmugam , Manjula G. B.
Published: June 2024

Introduction:

There is a wide variation in stroke epidemiology in India due to the differences in culture and the variability in the distribution of risk factors across the states. The present meta-analysis provides a pooled estimate of age, gender, and region-based stroke epidemiology in India based on epidemiological transition level (ETL) groups described in the Global Burden of Disease (GBD) Study (2016).

Methods:

We searched in PubMed and Google Scholar, and relevant studies published till February 2022 were included. Observational studies conducted in the Indian setting were included and global or Indian studies that exclusively estimated the prevalence, incidence, or mortality data among patients with stroke were excluded. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used for the risk-of-bias assessment and publication bias was evaluated by funnel plots and Egger’s test. The R software was used to perform this meta-analysis; I2 statistics were calculated to measure heterogeneity among studies.

Results:

We included 58 studies in the systematic review, and after quality assessment, 47 studies were finally included for meta-analysis. The sample sizes of the included studies ranged from 40 to 4989 and the mean age of the participants ranged from 31.7 (Standard Deviation, SD-7.4) to 70.5 (SD-10.7). The burden of stroke was estimated based on the ETL groups described in the GBD Study 2016. We found a male preponderance (64.5%; 95% confidence interval [CI]: 62.5%-68.3%) in the gender distribution of strokes and 75.2% (95% CI: 68.7%-81.7%) of the stroke occurred above the age of 50 years. Ischemic stroke is the predominant subtype of stroke in India, with a higher proportion in the middle ETL region (74.0%; 95% CI: 65.1%-81.3%) as compared to those with low ETL (67.2%; 95% CI: 49.9%-80.8%) and high ETL regions (67.5%; 95% CI: 57.0%-76.4%).

Conclusion:

There was a significant heterogeneity among the included studies. Majority of strokes occurred in the age group of more than 50 years with a male preponderance. Ischemic stroke was the most common type of stroke with its proportion varying from 67% to 74% depending on ETL.

PROSPERO Registration: CRD42022316774.
Clinical utility of dermatoscopy in identifying cutaneous myiasis complicating pemphigus vulgaris lesions
Authors: Qureshi Mohammed Asif , Yadav Rabindra Kumar , Agrawal Sonu Kumari
Published: June 2024

A teenage girl with pemphigus vulgaris (PV) and abetalipoproteinemia experienced an acute PV flare and wound myiasis on her right thigh. Dermatoscopy aided in larval identification as Phormia regina. Treatment included dexamethasone, oral prednisolone, turpentine oil flushes, and larval removal. At the 4-week follow-up, disease activity was controlled, and Magnetic Resonance Imaging (MRI) showed no larvae. This rare case highlighted the co-occurrence of wound myiasis and PV, likely due to poor living conditions. Dermatoscopy was crucial for larval identification, and turpentine oil flushes facilitated larval removal. Ethanol, chloroform spray, and ivermectin are also effective myiasis treatments.
Effective Management of Severe Burn Injury Complicated by Acute Kidney Injury in a Patient with Preexisting Chronic Kidney Disease
Authors: Abhyankar Suhas Vidyadhar , Chaudhari Chandan , Patil Vedanti Rajesh , Bahadur M. M. , Vartak Arvind M.
Published: June 2024

Acute kidney injury (AKI) is a common and severe complication in severe burns. Preexisting chronic kidney disease (CKD) can make the management more challenging. We present the management strategy adopted in such a case, highlighting the adaptations in fluid resuscitation, dialysis, and septicemia prevention. The case involved the 2nd and 3rd degree burns covering 53% body surface, in a patient with preexisting CKD and hypertension. Despite initial fluid resuscitation, the patient developed AKI. Sustained low-efficiency dialysis (SLED) was started, along with nutritional support using buttermilk diet. Aggressive antibiotic prophylaxis was initiated based on wound swabs culture and sensitivity. Wound debridement was deferred and daily dressing with silver nitrate gel and moisture-retaining film was used. Debridement and grafting were performed on postburn days 43 and 65. The patient was discharged after 80 days, with healed wounds. Our approach included meticulous fluid and nutrition supplementation coupled with SLED and appropriate wound management coupled with aggressive antimicrobial prophylaxis to prevent septicemia.
Transfusion Practices in Severely Injured Patients at a Level 1 Trauma Center
Authors: Krishna Aparna , Subramanian Arulselvi , Chaurasia Rahul , Sinha Tej Prakash , Pandey Shivam , Malhotra Rajesh
Published: June 2024

Introduction:

Acute trauma resuscitation is challenging and disorganized in low- and middle-income countries as there is lack of evidence-based transfusion practices with respect to ratio, volume, trigger, cutoff points for various triggers. This study aims to study the patterns of blood use in various mechanisms of injury, by interfacility transfer status and define triggers for transfusion of various blood components. Prospective observational study, emergency department of level 1 trauma center (August 2017–August 2018).

Methods:

Demographic, injury, clinical, laboratory, transfusion characteristics, and patient outcomes were collected from electronic hospital records and transfusion service records. We used multivariate logistic regression to identify triggers of transfusion of red blood cells, plasma, platelets (PLTs), cryoprecipitate, and mortality predictors.

Results:

Among 986 severely injured patients 80% were males, 92% had blunt injuries and commonest trauma was Head. The median length of intensive care unit stay and hospital stay were more in a referred group. Patients brought to center directly received more massive transfusions (56, 13.05% vs. 48, 8.62%). Railway track injuries received the most total median packed red blood cells (PRBCs) units in both groups. The triggers for various blood product transfusions include: Hematocrit < 32.08 for PRBC, PT >16.9 s for plasma, PLT count <130 lakhs for platelets, MAP <89.7 mmHg and PT >18.2 s for cryoprecipitate.

Conclusion:

Railway track injuries with inferior extremity injuries required maximum transfusion requirements and were a trigger for PRBC, plasma, PLTs, and cryoprecipitate. Smartphone-based apps and transfusion prediction models can be framed based on the triggers and cut points.
National Family Medicine Day
Authors: Kumar Raman
Published: June 2024

ABSTRACT

The Academy of Family Physicians of India (AFPI) is a professional association of physicians promoting the knowledge domain, academic discipline, and medical specialty of family medicine in India. AFPI was founded on 27 September 2010. In 2022, 27 September, the foundation day of AFPI, was for formally launched as the National Family Medicine Day (NFMD). NFMD is a momentous occasion dedicated to recognising and celebrating the vital role of family medicine, the academic discipline of family physicians, within the healthcare delivery system. NFMD is a significant event that underscores the essential role of family physicians in providing accessible, comprehensive, and continuous healthcare. This article is an account of the inaugural and initial years of NFMD and AFPI foundation day celebrations.
What matters in good health status of 1-year-old children? – A cross-sectional study of the perinatal factors
Authors: Shenoy Priyanka S. , Chavan Yuvaraj B.
Published: June 2024

ABSTRACT

Background:

A healthy child can make way for a healthy adult. Some of the factors that can be used to determine the health of a young child are nutritional status of the child, the developmental milestones achieved, and frequency of illness.

Objectives:

The health status of children and associated factors are determined.

Methods:

This is a community-based cross-sectional study with 271 participants. The height and weight of the child were measured; questions were asked regarding developmental milestones achieved and frequent illnesses. An interview schedule was used to enquire about the determinants of health status. Descriptive statistics were done; Chi-square test and regression were used to determine association between the health status of children and determinants.

Results:

A total of 127 (46.86%) were found to have a good health status. Family type (Chi square value 9.568; P value = 0.002), birth spacing (Chi square 20.540; P value < 0.001), term or pre-term birth (Chi square 4.598; P value = 0.032), chronic medical problem in the child (Chi square 11.074; P value = 0.001), and immunization status of the child (Chi square 5.666; P value = 0.017) were found to have significant association with the health status of the child. By logistic regression, pre-term child birth and family type were found to have higher odds.

Conclusion:

For better health of the child, specific focus on birth spacing, term birth of baby, better care of the ill, and complete immunization play vital roles.
Case series of unusual cases of hypothyroidism-induced pericardial effusion
Authors: Sahoo Ratnakar , Sirohi Tanvi , Talapa Ravi , Jamir Imnajungla
Published: June 2024

ABSTRACT

Hypothyroidism is an endocrine disorder with a high worldwide prevalence and diverse clinical presentation and can affect multiple organ systems. It can be asymptomatic and subclinical or overtly symptomatic and can prove to be fatal if left untreated. It is an established cause of pericardial effusion, which can rarely lead to cardiac tamponade and severe haemodynamic instability. Herein, we present a few unusual case reports of patients presenting with hypothyroidism with varied causes who presented with tamponade.
Primary polycythaemia: A neglected risk factor
Authors: Rustogi Nitin , Talapa Ravi , Yadav Jitendra
Published: June 2024

ABSTRACT

In this case series, we report a 32-year-old male patient with myocardial infarction and 45-year-old female with portal vein thrombosis with splenic infarcts, which were the initial manifestations of polycythaemia vera. The awareness of myeloproliferative disorders as a possible underlying disease—especially in young patients presenting with myocardial infarction and portal venous thrombosis—is crucial for clinical management, as a missed diagnosis can worsen the patients’ further prognosis.
An experimental study to assess the effectiveness of video-assisted childbirth education programme on knowledge regarding childbirth among primigravida mothers attending antenatal out patient department of a selected hospital in Bhopal
Authors: Priya KM , Podder Lily , Martis Maxie
Published: June 2024

ABSTRACT

Context:

Childbirth is a normal physiological process in a woman’s life, yet it is a life-changing experience for the primigravida mothers. Boosting confidence regarding pregnancy and childbirth by enhancing knowledge is an important component of care.

Aims:

The aim was to assess the effectiveness of the video-assisted childbirth education programme on the knowledge of the primigravida mothers regarding childbirth.

Settings and Design:

A quantitative research approach with a quasi-experimental non-equivalent control group design was adopted. Non-probability convenient sampling technique was used to select the 60 primigravida mothers who completed 34 weeks of gestation and are attending the Gynaec Outpatient Department (OPD) of a tertiary care hospital in Bhopal.

Methods and Material:

The self-structured knowledge questionnaire was developed. On the first day of contact with the sample, pretest was taken from both groups. A tailor-made video was administered to the experimental group on the same day. Posttest was taken on the seventh day from both groups.

Statistical Analysis Used:

Repeated measures analysis of variance (ANOVA) used to determine the effectiveness of video-assisted childbirth education programme revealed a significant interaction between the intervention and time, F (1,58) =29.398, P < .001.

Results:

The mean difference in knowledge score over time was greater in the experimental group compared to the control group and the difference was statistically significant.

Conclusions:

The video-assisted childbirth education programme was effective in enhancing the knowledge of primigravida mothers regarding childbirth.
Mental health status among chronic disease patients in Bangladesh during the COVID-19 Pandemic: Findings from a cross-sectional study
Authors: Jahan Yasmin , Khair Zara , Moriyama Michiko , Amin Md Robed , Hawlader Mohammad Delwer Hossain , Ananta Taiyaba Tabassum , Aziz Asma Binte , Sharif Mohiuddin , Hasan Monirul , Chowdhury Md Forhadul Islam , Nizam Nusrat Benta , Islam Syed Mohammad Ariful , Rahman Mohammad Habibur , Sarker Mohammad Habibur Rahman , Rahman Md Moshiur
Published: June 2024

ABSTRACT

Context:

The COVID-19 epidemic has had a substantial influence on the mental health of chronic disease patients. However, there is a scarcity of research on them in Bangladesh.

Aims:

This study aims to explore the prevalence of and identify the risk factors for depression, anxiety, and stress symptoms during the COVID-19 pandemic among people with chronic diseases in Bangladesh.

Materials and Methods:

This cross-sectional study involving face-to-face and telephone interviews was carried out among Bangladeshi people diagnosed with chronic diseases between September and November 2020. The total sample size was 878, and a convenient sampling technique was used. Logistic regression analysis was performed to investigate potential influencing factors for depression, anxiety, and stress.

Results:

The mean age of respondents was 50.10 years. Among them, 35.0%, 36.0%, and 29.0% suffered from depression, anxiety, and stress symptoms, respectively. In multivariable logistic regression, depression had a significant positive association with higher age (≥60 years), lower income, rural residency, and loss of close family members due to COVID-19. Anxiety had a significant positive association with higher age (≥40 years), lower education, lower income, rural residency, and loss of close family members due to COVID-19. Stress had a significant positive association with higher age (≥40 years), no income, rural residency, and loss of close family members due to COVID-19.

Conclusion:

It is urgent to consider the risk of developing mental health distress among chronic disease patients, especially aged people, by health service providers and generate effective programs for emergency situations.
Is the National Medical Commission aligning with discontinuity and transitory in times of uncertainty by making the science and art of family medicine redundant?
Authors: Raina Sunil Kumar
Published: June 2024

ABSTRACT

Policy decisions shape strategies which in turn influence the outcome. The expected outcome of medical education in India is to produce an MBBS graduate of first contact. Are we able to do so or are we failing in that and what are the reasons behind our failure Is it a failure on part of the regulatory body to align with the expected outcome using a continuity of approach or a willingness to accept transitory as the process to achieve the objective?
Prevalence of attention deficit hyperactivity disorder in school-going children in rural Konkan region of Maharashtra
Authors: Gogate Sonali , Kurane Anil , Nanaware Sagar Subhash , Padma Kumari
Published: June 2024

ABSTRACT

Background:

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder of childhood characterised by attention deficit, hyperactivity and impulsiveness. The present study was designed to compute the prevalence of ADHD and assess the association of the predetermined demographic variables and ADHD in school-going children aged 6–12 years in rural areas of Konkan.

Material and Methods:

The present study was a descriptive, cross-sectional study. Using the first edition of Vanderbilt’s scale – D4 (Teacher’s informant) by National Institute for Children’s Health Quality (NICHQ) for identifying symptoms of ADHD in children, a questionnaire was filled out for each child with input from their class teacher. These data were then compiled and analysed.

Results:

Out of the 133 participants in the study aged 6–12 years, the gender distribution was 69 boys and 64 girls. The mean age was 9.2 ± 2.3 years. Of which, one student (0.75%) was found to have a predominantly inattentive subtype of ADHD (ADHD-IA). The prevalence was found to be 1.5% (2/133). In addition, one student (0.75%) was found to have a combined ADHD-IA and hyperactive (ADHD-H/I) subtype of ADHD (ADHD-C). The latter was also positive for the anxiety/depression screening scale administered as part of the same questionnaire. The total symptom score for questions 1–18 was 8.44 ± 7.29.

Conclusion:

One of the most common neurodivergent conditions among school-age children is ADHD. Using an easy-to-use questionnaire, teachers and parents can report those experiencing symptoms of ADHD. Early diagnosis and treatment are recommended to avoid complications and aid in the improvement of quality of life.