bluuebunny/crossref_metadata_2025 huggingface dataset:
Créer, même en soins palliatifs l’expression au travers de la peinture, un art accessible à tous
Authors: Carpinelli Isabella , Carpinelli Isabella
Published: December 2024

Créer, même en soins palliatifs : l’expression au travers de la peinture, un art accessible à tous – La peinture apporte une multitude d’avantages essentiels aux enfants et à leurs familles confrontées à des conditions médicales graves et incurables. Elle propose à ceux–ci un moyen créatif de partager leurs émotions comme la tristesse, colère ou peurs, mais offre également une échappatoire pour réduire stress et anxiété, elle améliore leur estime de soi, la communication, ou encore crée des souvenirs significatifs et des moments de partage. Avec mon chariot d’arts créatifs mobile contenant le matériel nécessaire, je me déplace dans les chambres des patients. Chaque atelier est adapté en fonction de l’âge, le rythme, les besoins physiques, émotionnels et spirituels de l’enfant. Les activités varient autour d’une multitude de techniques de peinture, de collage, de dessin ; crayons, feutres, pinceaux, rouleaux, doigts, éponges… J’y ajoute aussi un fond musical sélectionné par le patient. Cet instant partagé, offre un moment de répit. L’enfant voit ses capacités et son talent artistique s’améliorer, renforçant ainsi sa confiance en lui ce qui favorise la communication. Ses peintures prennent parfois de l’importance auprès des familles, souvent après le décès de l’enfant, ses créations artistiques peuvent être des souvenirs émotionnels importants. La création artistique, permet aux patients mais aussi parfois aux accompagnants et à la fratrie, de pouvoir s’échapper temporairement des souffrances et des préoccu– pations qui les affligent. Elle offre une gamme de bienfaits, allant de l’expression émotionnelle non verbale, à un sentiment de fierté et d’accomplissement. Ce moment privilégié, est une voix sans parole, une voie d’évasion et de réconfort.
Économie circulaire et émergence de nouveaux modèles d’affaires
Authors: Ntsondé Joël
Published: December 2024

La transition vers l’économie circulaire rencontre de nombreux obstacles d’ordre technologique, économique, réglementaire, culturel et organisationnel, comme le souligne la littérature. Après un état des lieux de ces obstacles, cet article présente les contributions des auteurs au cahier thématique, en mettant en lumière dans quelle mesure les modèles d’affaires circulaires constituent une voie potentielle pour instaurer une circularité forte et ouvrent de nouvelles perspectives théoriques.
Limites et frontières de la responsabilité de l’entreprise : l’exemple du projet Pepenadores au Mexique
Authors: Renouard Cécile , Ezvan Cécile , L’Huillier Hélène
Published: December 2024

À partir d’une revue de la littérature sur la responsabilité politique des entreprises dans les économies émergentes et de la notion de frontières – au double sens d’un plancher social et d’un plafond environnemental, cet article analyse les enjeux et les tensions liés à la mise en œuvre de cette responsabilité en s’appuyant sur le terrain empirique d’un projet du fonds Danone Ecosystem auprès de chiffonniers ( pepenadores ) au Mexique. L'article analyse les conditions de mise en œuvre d’une responsabilité politique de l’entreprise qui favorise la justice entre les êtres humains et le respect des frontières planétaires. Ces résultats ont à la fois une portée conceptuelle - étayage composante de la responsabilité politique du projet Danone au Mexique – et managériale – mise en évidence des marges de manœuvres et des tensions auxquelles sont confrontées les parties prenantes responsables des projets ayant une contribution sociétale.
Pratiques RSE, orientation entrepreneuriale et performance financière : le cas des entreprises tunisiennes
Authors: Garrouch Hela , Ben Abdallah Mohamed Anis , Ayed Tahar-Lazhar , Mejri Tarek
Published: December 2024

Dans le but de renforcer leur position concurrentielle, les entreprises cherchent à mettre en œuvre diverses stratégies dont l’orientation entrepreneuriale (OE) et la responsabilité sociale qui gagnent en popularité. À travers une étude quantitative réalisée auprès de 144 entreprises tunisiennes, nous examinons le rôle médiateur de la Responsabilité Sociale de l’Entreprise (RSE) dans la relation entre l’OE et la Performance Financière (PF). Les données recueillies ont été analysées à l'aide de la technique des équations structurelles de moindres carrés partiels (SEM-PLS). Les résultats rapportent que l’OE a un effet positif et significatif sur la PF. En revanche la RSE ne joue pas de rôle médiateur dans cette relation. D’où l’importance de ce travail pour attirer l’attention des managers tunisiens afin d’énoncer une vision stratégique ‘‘responsable’’ et de reconnaître le rôle des actifs intangibles pour une meilleure performance durable. La théorie socio-économique et le management associé pourraient offrir une réponse pertinente en intégrant une approche macroéconomique de la RSE avec une approche opérationnelle grâce à des outils développés conjointement par des praticiens et des chercheurs.
Politique étrangère : du grand dessein au désenchantement
Authors: Vircoulon Thierry
Published: December 2024

Au début du xxi e siècle, le président Thabo Mbeki a formulé un grand dessein pour la diplomatie sud-africaine : être le leader de l’Afrique et jouer un rôle moteur sur la scène internationale au sein des pays émergents. Énoncées alors que l’aura de l’Afrique du Sud était à son zénith, ses priorités se sont progressivement heurtées au mur des réalités tant nationales qu’internationales. Le grand dessein s’est effacé laissant place à une diplomatie économique plus modeste, une réévaluation des ambitions en Afrique et un basculement, non assumé mais réel, dans le camp anti-occidental.
Frequency-hopping scheduling algorithm for energy-efficient IoT, long-range, wide-area networks
Authors: Mhatre Jui , Lee Ahyoung , Aygun Ramazan
Published: December 2024

A long-range, wide-area network is a cost-effective, energy-efficient technology for wide-area sensor networks. But the massive Internet of Things (IoT) brings challenges such as increased traffic and energy consumption. Thus, there is a pressing need to design a scheduling strategy to improve network energy efficiency without compensating for its reliability. We have proposed a deep deterministic policy gradient-based scheduling algorithm with a frequency-hopping spread spectrum that avoids repeated collisions and retransmissions. Frequency-hopping divides frequency channels into subchannels, allowing multiple devices to operate simultaneously. This makes it a favorable scheduling strategy for dense networks, as it reduces collisions and energy consumption. Scheduling in a long-range, wide-area network involves selecting transmission parameters for each device, which can be cumbersome. We used the deep deterministic policy gradient algorithm to optimize schedule generation for high-density networks, enhancing energy efficiency. In this paper, we compared the performance of the frequency-hopping spread spectrum with other heuristic and machine learning-based algorithms using the LoRaSim simulator. We observed a 42% increase in the packet delivery ratio and a 17% improvement in energy efficiency with our solution, along with detailed results on the transmission time and collision reduction.
On generalized biderivations of Banach algebras
Authors: Arslan Berna
Published: December 2024

The aim of this paper is to introduce the concept of generalized biderivations of unital Banach algebras and prove some results concerning generalized biamenability of unital Banach algebras. Let $ A $ and $ B $ be unital Banach algebras, and let $ X $ be a unital $ A $-$ B $-module. Let $ T = Tri(A, X, B) $ be the corresponding triangular Banach algebra. We also study the generalized biamenability of triangular Banach algebras and show that if $ X = \{0\} $ and $ T $ is generalized biamenable, then $ A $ and $ B $ are both generalized biamenable.
Global well-posedness for the 2D MHD equations with only vertical velocity damping term
Authors: Long Huan , Ye Suhui
Published: December 2024

This paper concerns two-dimensional (2D) incompressible magnetohydrodynamic (MHD) equations without magnetic diffusion with only vertical velocity damping term in the periodic domain. We prove the stability and decay rate for smooth solutions on perturbations near a background magnetic field of the system under the assumptions that the initial magnetic field satisfies the Diophantine condition.
Numerical method for solving the subdiffusion differential equation with nonlocal boundary conditions
Authors: Sultanov Murat A. , Misilov Vladimir E. , Sadybekov Makhmud A.
Published: December 2024

This work was devoted to the construction of a numerical algorithm for solving the initial boundary value problem for the subdiffusion equation with nonlocal boundary conditions. For the case of not strongly regular boundary conditions, the well-known methods cannot be used. We applied an algorithm that consists of reducing the nonlocal problem to a sequential solution of two subproblems with local boundary conditions. The solution to the original problem was summed up from the solutions of the subproblems. To solve the subproblems, we constructed implicit difference schemes on the basis of the L1 formula for approximating the Caputo fractional derivative and central difference for approximating the space derivatives. Stability and convergence of the schemes were established. The Thomas algorithm was used to solve systems of linear algebraic equations. Numerical experiments were conducted to study the constructed algorithm. In terms of accuracy and stability, the algorithm performs well. The results of experiments confirmed that the convergence order of the method coincides with the theoretical one, $ O(\tau^{2-\alpha}+h^2) $.
L’idée d’écologie de l’esprit
Authors: Barthélémy Jean-Hugues
Published: December 2024

Après une première partie consacrée aux péripéties de l’écriture de l’œuvre de Bernard Stiegler, nous disons en quoi les différentes priorités successivement adoptées par lui selon les trois périodes de son œuvre conduisent assez rapidement cette dernière à proposer à l’économie politique, mais aussi à l’écologie politique, ce que l’on pourrait nommer une écologie de l’esprit en tant que problématique plus fondamentale parce que pharmacologique – la pharmacologie stieglerienne étant centralement pharmacologie de l’esprit en temps de « bêtise systémique ». Dans les dernières années de sa vie et de sa pensée, cette écologie pharmacologique et fondamentale de l’esprit s’adressait d’autant plus à l’écologie politique qu’elle prenait la forme d’un nouveau projet : celui de la « néguanthropologi » pour le « Néguanthropocène ».
La philosophie atranscendantale de Bernard Stiegler
Authors: Crevoisier Michaël
Published: December 2024

En quoi la prise en considération du caractère constitutif de la technique implique-t-elle de penser nouvellement la question transcendantale ? L’œuvre de Bernard Stiegler commence par cette question en tâchant d’élaborer les outils permettant une analyse des conditions techniques a priori de la noèse. À partir de La technique et le temps nous interrogeons la raison pour laquelle Stiegler tient à hériter de cette question et nous montrons comment il la transforme. L’enjeu principal de cette transformation réside d’une part dans une nouvelle articulation du fait et du droit selon une logique de l’après-coup, et d’autre part dans une conception hétéronome de la raison impliquant de penser à nouveaux frais la croyance en sa nécessité.
Henri Bergson ou l’universel devenir dans La Pensée et le Mouvant
Authors: Abahani Loubna
Published: December 2024

Le présent article met le focus sur le dernier ouvrage d’Henri Bergson La Pensée et le Mouvant qui fut la consécration de sa théorie de l’universel devenir. Convaincu plus que jamais, Bergson fait du changement la substance même de la réalité, cependant qu’il voit dans l’immobilité un leurre forgé par l’intelligence. Pour percevoir le changement en nous et autour de nous, Bergson nous appelle à fournir l’effort de détourner notre attention du côté utilitaire et pratique de la vie, d’abroger nos habitudes perceptives, philosophiques et langagières qui poudrent d’oubli la durée. Il lève cet oubli en se servant, en guise de méthode philosophique, de l’intuition qui consiste à convertir l’attention « vers ce qui, pratiquement, ne sert à rien ». De son avis, seule l’intuition est à même de nous ouvrir une percée dans les choses mêmes, c’est-à-dire les saisir sub specie durationis, et de venir à bout des pseudo-problèmes métaphysiques. Penser intuitivement la durée ou l’être mouvant n’exige pas de sortir du temps, de faire un saut dans le monde des Idées éternelles et immuables. Il s’agit d’un acte immanent qui prend place dans la vie et en cette durée même.
Les limites de l’organologie générale pour une pensée de la technique
Authors: Lamy-Rested Élise
Published: December 2024

L’organologie générale de Stiegler peut-elle nous aider à sortir de notre époque anthropocène et à penser notre époque électromagnétique ? Après une lecture synthétique de La technique et le temps qui montre en quel sens la « mémoire épiphylogénétique » en termes anthropologiques ou la « mémoire tertiaire » en termes phénoménologiques constituent le cœur de la philosophie des techniques de Stiegler, je tente de poser les limites d’une telle conception pour penser, aujourd’hui, les enjeux qui sont les nôtres : l’anthropocène et le développement des technologies numériques. La cosmologie de Whitehead qui, pourtant, est antérieure à nos préoccupations anthropocéniques et qui ne se focalise pas sur les techniques apparaît finalement plus féconde et précieuse pour nous projeter dans l’avenir.
Désynchronisation des consciences et travail zombie
Authors: Cassou-Noguès Pierre
Published: December 2024

Le but de cet article est de confronter à Internet les analyses que Stiegler consacre à la télévision. La première partie reprend le thème de la synchronisation des consciences pour montrer qu’Internet réalise une désynchnronisation tout en engendrant les mêmes effets d’uniformisation, et en augmentant même la production « de temps de cerveau disponible ». Cette expression de P. Le Lay, dont Stiegler montre l’importance, fait l’objet d’une deuxième partie qui vise à montrer comment cette marchandise qu’est le temps de cerveau disponible est produite dans un travail spécifique du téléspectateur ou de l’internaute. La troisième partie discute de la spécificité de ce travail zombie dans le contexte de l’automatisation de la société telle que la décrit Stiegler.
La techno-esthétique et la question du glitch
Authors: Fitzpatrick Noel
Published: December 2024

Cet article propose de revisiter la question de la techno-esthétique telle qu’elle est posée par Gilbert Simondon puis d’étendre le concept de techno-esthétique en passant par des travaux de Bernard Stiegler, et notamment par rapport à la manière dont celui-ci aborde la relation entre esthétique et technologie dans le contexte du Néguanthropocène. Un exemple contemporain de l’émergence de nouvelles formes d’expérience techno-esthétique est présenté, cette expérience se faisant grâce à l’utilisation de formes spécifiques d’algorithmes issus des mondes du streaming en ligne. Il s’agit du glitch qui est utilisé comme moyen de surmonter une brèche dans l’expérience spatio-temporelle et qui illustre l’impact des technologies computationnelles contemporaines sur l’expérience esthétique.
The Role of Social Media Marketing for the Hospitality Business
Authors: Hussain Zahid , Safeer Asif Ali , Ahmed Muhammed Junaid
Published: December 2024

Understanding the social media landscape is essential for crafting effective marketing strategies. This chapter analyses major social media platforms—Facebook, Instagram, Twitter, LinkedIn, and emerging networks like TikTok and Threads. Each platform's unique features and user demographics are examined to illustrate how hospitality businesses can tailor their content and engagement approaches to maximize impact. For instance, Facebook's broad reach and advertising tools support community building and event promotion, while Instagram's visual emphasis allows for showcasing the aesthetic appeal of hospitality offerings. Twitter's real-time updates facilitate customer interaction and feedback management, and LinkedIn serves as a platform for professional networking and B2B opportunities.
Innovative Solutions for Employee Well-Being in the Digital Hospitality Era
Authors: Talukder Mohammad Badruddoza , Kumar Sanjeev , Das Tonny Oyshi
Published: December 2024

The well-being of employees has emerged as an essential factor in making them more productive and less likely to find better opportunities as the hospitality industry is highly competitive. This chapter examines how technology can enhance employees' wellness through wellness applications, emotion detection systems using artificial intelligence technologies, and telehealth frameworks. Wearable technology and real-time data analytics create ways for employers to collect essential health data, assess stress levels at the workplace, and develop individual health interventions. On-demand care and remote consulting provide convenient healthcare for a company's workforce, which ensures a happier and more productive workforce. That is why utilizing effective tech-enabled wellness programs in the hospitality industry helps decrease the number of sick days, increase staff content, and promote the whole organization's high productivity. This chapter focuses on emerging trends to provide a strategic reference for the hospitality industry and its wellness promotion based on digital technology.
Innovative Tech Strategies for Employee Wellness in Hospitality
Authors: Talukder Mohammad Badruddoza , Swarna Dil Afrin , Kabir Firoj
Published: December 2024

Modern technological solutions profoundly change employees' welfare and organizational outcomes in the hospitality sector. Some essentials are wearable health kits and stress relievers such as intelligent health monitoring apparel, VR & AR training kits, relaxation kits, and health and wellness apps that include mental health promoters and individualized health fitness managers. The artificial intelligence-based chatbot and the prediction algorithm deliver mental health support and prompt burnout identification. Telehealth provides a means for obtaining medical consultations and virtual counselling, while gamification increases engagement and team cooperation through wellness competitions. Teleworking possibilities and new kinds of flexible time arrangements enhance the quality of work life. Spreading implementation initiatives and adapting strategies evaluations are cornerstones of implementation. Hospitality organizations contribute to supporting the methods, indicating the possibility of improving a healthier, more productive workforce in the hospitality industry.
Institutional Complexities in Organisations: A Theoretical Integration of Multiple Logics and the Locus of Paradoxical Tension
Authors: Damayanthi Sujeewa , Gooneratne Tharusha
Published: December 2024

Organisations encounter a multiplicity of influences developing complexities that stem from competing or contradicting logics of the institutional field. When such influences enter organisations and interface with organisational actors’ sense-making, they create paradoxical tensions with implications for decision-making. This paper theorises how in the organisational field, multiple logics develop complexities and get intertwined with organisational actors’ sense-making, resulting in paradoxical tensions. It presents propositions leaning on a theoretical framework that integrates multiple logics and the locus of paradoxical tension. We propose that in an unstructured institutional field, organisational actors face increased tension, leading to a decision-making situation of either ‘acquire and adjust’ or ‘reject and maintain existing practices’. The selection of ‘acquire and adjust’ then results in a choice between ‘acquire’ (conformity) and ‘partial conformity or non-conformity’ to the prevailing logics in the field. Our integrative framework provides insights to future researchers for making sense of messy organisational realities amid broader influences.
Comparison between paracervical block and intrauterine lidocaine for pain management in surgical termination of first-trimester miscarriage: a randomized clinical trial
Authors: Effat Doaa M. , Elkafrawy Mona A. , Shaban Amira A.E.
Published: December 2024

Background and aim

Pain relief is a fundamental issue for women requiring gynecological procedures, including first-trimester evacuation.

This study aimed to evaluate and compare the efficacy of paracervical block versus intrauterine lidocaine instillation versus combined paracervical block and intrauterine lidocaine anesthesia as pain-relief methods during surgical termination of first-trimester miscarriage on perceived pain, satisfaction, side effects, and safety.

Patients and methods

One hundred fifty pregnant women suffering from first-trimester miscarriage and requiring pregnancy termination were randomly assigned into three equal groups. Group I (n=50), receiving paracervical block (10 ml of 2% of lidocaine 100 mg). Group II (n=50), received (10 ml of 2% lidocaine intrauterine). Group III received both of paracervical block and intrauterine lidocaine. Assessment of pain was measured for participants by numeric rating scale three times, intraoperative, immediately, after, and 30 min postoperative.

Results

There was a significant decrease of pain-perception level in women of group III compared with group I and group II. There was an insignificant difference in the frequency of adverse effects of drug like nausea, vomiting, drowsiness, and dizziness among the study groups. In terms of pain-relief satisfaction, there was adequate satisfaction in group III compared with other groups.

Conclusion

Injection of 2% lidocaine intrauterine in combination with standard paracervical block significantly provides adequate intraoperative and postoperative pain relief and satisfaction more than paracervical block or intrauterine lidocaine alone in the first-trimester surgical miscarriage. Also, this method is safe and effective.
Management of forearm ganglion: a comparative study from a medical college hospital
Authors: Hassan Yaqoob , Rather Ajaz A. , Ahmad Irshad , Wani Ishfaq A.
Published: December 2024

Background

Ganglionic cysts are smooth, fluctuant benign tumors of forearm commonly encountered in our day-to-day outdoor practice. The study aims to compare the efficacy, safety, and recurrence rates of triamcinolone, mixture of triamcinolone and hyaluronidase, and surgical excision in our tertiary care hospital.

Patients and methods

This prospective comparative study was carried out in the SKIMS Medical College and Hospital over a period of 3 years. A total of 96 participants between January 2018 and January 2021 with forearm ganglion were included and treated in three groups: group A included patients who had aspiration and injection of triamcinolone; group B patients had aspiration and injection of a mixture of triamcinolone and hyaluronidase; and group C patients underwent excision under local anesthesia. The data was collected and analyzed.

Results

Among 96 patients who met the inclusion criteria, the mean age was 35.74 years, with a male:female ratio of 0.63. Swelling was the most common clinical presentation recorded in 100% patients. Swelling with symptoms like pain, paresthesia, etc., was present in 59.38%, dissatisfaction with cosmetic appearance in 55.21%, and 36.46% patients had apprehension of a sinister lesion (malignant tumor). Of the patients, 47.92% had aspiration and injection of triamcinolone (group A); 43.75% patients had aspiration and injection of a mixture of triamcinolone and hyaluronidase (group B); and 8.33% patients underwent surgical excision (group C). In group A, 15.22% patients had recurrence, while only 2.38% patients developed recurrence in group B. We observed a 100% success rate after surgical excision. There was significantly positive relation between group A and group B treatment protocols and recurrence rates (P≤0.05). None of our patients developed any major post-procedural complications.

Conclusion

Aspiration and intra-cystic instillation of a mixture of triamcinolone and hyaluronidase is a simple, effective, safe treatment of ganglion with low recurrence rates as compared with triamcinolone alone. Surgical excision after failed primary treatment with aspiration and injection showed excellent results.
Knowledge, attitude and practices regarding standard precautions among registered nurses in medical and surgical wards: A cross-sectional study
Authors: Chauhan Soni , Srivastava Saumya Prakash , Tiwari Surya Kant , Singh Shraddha , Patel Swati Singh , Yadav Lavkush
Published: December 2024

Background:

Hospital-acquired infections (HAIs) are a significant global challenge, particularly in low-income countries. Nurses play a crucial role in preventing and controlling HAIs by adhering to standard precautions. However, challenges persist in ensuring consistent implementation among health care workers.

Aim:

To assess the knowledge, attitudes, and practices (KAP) related to standard precautions among registered nurses posted in medical and surgical wards and to identify related factors.

Materials and Methods:

A descriptive cross-sectional study was conducted among 70 registered nurses at a district-level hospital in Northern India using a purposive sampling technique. Data were collected using a self-structured KAP questionnaire on standard precautions. Two-step cluster analysis was employed to categorise the study samples. Differences between the KAP groups were assessed using statistical tests. Multiple linear regression analysis was performed to identify factors influencing the KAP groups.

Results:

Most nurses (54.3%) belonged to the Poor KAP group, while the remaining 45.7% belonged to the Good KAP group. A significant variation in the KAP clusters was observed according to marital status (P<0.05). A weak negative correlation was found between the knowledge and attitude scores in both KAP groups (P<0.05). Multiple linear regression analysis indicated that nurses’ KAP was significantly influenced by their attitude and practice scores.

Conclusions:

Most nurses exhibited poor knowledge, attitudes, and practices towards standard precautions. Attitude and practices had a significant negative influence on nurses’ KAP, highlighting the need for targeted interventions to improve adherence to standard precautions and mitigate the risk of HAIs.
Microdontia of Bilateral Permanent Maxillary Second Molars: A Rare Case Report
Authors: Ravi Jyoti , Yadav Lalita
Published: December 2024

During routine dental examinations, abnormalities of the oral and dental tissue are frequently found, and the prevalence of these anomalies varies across various populations. In cases of microdontia, teeth commonly affected are maxillary lateral incisors, third molars, and supernumerary teeth, respectively. This publication aims to provide the details and facts of a highly uncommon case of microdontia of bilateral permanent maxillary second molars. It is uncommon for many dental abnormalities to develop simultaneously in a nonsyndromic patient.
Favorable cochlear implant performance in an adult patient with prior neonatal hyperbilirubinemia
Authors: Aldinger Jeffrey P. , Hwang Yunjoo A. , Volsky Peter G.
Published: December 2024

Adults with hearing loss (HL) from neonatal hyperbilirubinemia may have abnormal peripheral and central auditory dysfunction. Herein, we describe initial observations following cochlear implantation with hearing preservation in a young adult with HL attributed to neonatal hyperbilirubinemia. At presentation, the patient had absent otoacoustic emissions, absent brainstem auditory evoked responses, and poor scores on AzBio comprehension testing. The patient underwent successful bilateral sequential cochlear implantation with hearing preservation and both subjective and objective improvements. We hope these observations assist in the presurgical counseling of patients with HL of similar etiology.
Activity differences in the brain of people with persistent developmental stuttering using functional magnetic resonance imaging during resting state position and active state position
Authors: Alqhazo Mazin , Blomgren Michael , Baroudi Ahmad , Alkhamaiseh Zaidan , Al-Hiari Asem
Published: December 2024

Background:

Examining behavior, structure, and function of the brain of people with persistent developmental stuttering is necessary to unravel the suspected underlying neuronal mechanisms of stuttering.

Aims and Objectives:

The purpose of the present study is to investigate whether brain activation is related to the moment of stuttering can be identified using fMRI.

Materials and Methods:

This study is a case-control study, where seven adult males with persistent developmental stuttering (age range 18-28 years; M= 20.7; SD= 3.4) and seven normally fluent adults (age matched) were engaged.

Results:

Results indicated that adult people who stutter showed bilateral cortical activity in speech-related brain regions (middle temporal gyrus, inferior frontal gyrus, and superior temporal gyrus) during resting state posture. During the active state position, a bilateral cortical activity appeared in speech-related brain regions of precentral gyrus, inferior frontal gyrus and middle frontal gyrus.

Conclusion:

The findings of the current study propose that improvement in the coordination and connectivity between auditory and motor regions may enhance the fluency of speech.
A study on knowledge, attitude, and practice regarding biomedical waste management among health-care providers at a tertiary care hospital, Kolkata
Authors: Alagesan Inba Raja , De Rajesh , Basu Mita , Mitra Sayeli , Sardar Jadab Chandra
Published: December 2024

Introduction:

Proper biomedical waste (BMW) disposal and its management are essential among health-care workers as it causes serious health and environmental hazards. Objectives of the study were to assess the knowledge, attitude, and practice regarding BMW management among health-care providers and to determine the factors associated with, at a tertiary care hospital in Kolkata, India.

Material and Methods:

A study was done among 256 health-care providers at a tertiary care hospital who were actively involved in handling BMWs. A pretested, self-administered questionnaire on knowledge, attitude, and practice regarding BMW management was used. Structured, nonparticipant observation was carried out using the Kayakalp assessment tool in the 20 BMW handling checkpoints. Statistical analysis was done using the SPSS version 20.0 (SPSS Inc., Chicago, Illinois, USA).

Results:

Among 256 health-care workers, 44.9% had adequate knowledge regarding BMW management and the doctors had a higher median score. 37.5% had positive attitudes and the laboratory technologists had higher median scores. 45.3% had satisfactory practice regarding BMW management and both the doctors and nurses had higher median scores. The housekeeping staff had the poorest knowledge, attitude, and practice of BMW management.

Conclusion:

Regular certified training among health-care staff and intense quality assessment by the waste management committee can improve BMW management overall.
Perceptions of postgraduate medical students and guides about dissertation: A qualitative study
Authors: Domple Vijay Kishanrao , Kasdekar Pankaj Motilal , Soyam Gajanan Charandas , Joge Umesh S. , Khakse Gautam Marotrao , Solanke Rahulkumar Anil
Published: December 2024

Introduction:

Health research during medical training is essential to encourage critical thinking and reasoning abilities and a positive attitude among postgraduate (PG) students toward scientific research throughout their medical careers. However, all may not be inclined toward research. Therefore, the present study was formulated to understand the perceptions of PG medical students and guides about dissertations.

Material and Methods:

The current qualitative study was conducted at a tertiary care center in Central India between December 2022 and January 2023. A total of 12 participants (9 PG students and 3 PG guides) were selected by the purposive sampling method. The Institutional Ethics Committee approved the study. For the in-depth interview with audio recording, the interview guide was used. The data were coded, and thematic analysis was done using the Microsoft Word and Excel.

Results:

All participants reported that PG dissertations should be an essential element in the PG curriculum, except two who raised the issue of compulsion. While participants mentioned the positive perspectives about the dissertations, like the development of research skills and expertise, they also pointed out negative perspectives, like single-topic exploration only and minimal connection to clinical practice. Many students were confused, stressed, and disoriented at the beginning of the dissertation. No separate time, patient workload, language barrier, and a lack of academic writing skills and resources were the challenges experienced. The role of a PG guide is indispensable in the process of the dissertation. They felt that the final submission of the dissertation should be at the end of the 2nd year.

Conclusion:

Many participants believed that the dissertation should be an essential component of the PG curriculum. The role of the PG guide is indispensable in the dissertation process. The final submission of the dissertation should be at the end of the 2nd year.
Psychotropic Drugs in Dermatology Part 1: Anti-depressants and Mood Stabilisers
Authors: Kenkare Varsha L. , Madke Bhushan , Choudhary Ankita , Bose Shiti
Published: December 2024

Psycho-dermatology is an evolving speciality of psychosomatic medicine where psychological factors play a role in initiating and/or exacerbating the dermatological conditions. Dermatologists should be well versed with the basic pharmacotherapy of psycho-cutaneous disorders and work in close liaison with the psychiatrists when it comes to the holistic management of the same. The review has been divided into two parts, with part 1 consisting of anti-depressants and mood stabilisers and part 2 consisting of anti-psychotics, anxiolytics, and sedative-hypnotic agents used in psycho-dermatology. This comprehensive review focusses on the various psychotropic drugs which are of paramount significance to the dermatologists. The knowledge of these drugs will lead to the pertinent treatment of the psychiatric dermatoses, which has been a less explored territory in the arena of dermatology. Within the realm of psycho-dermatology, a diverse array of anti-depressants is utilised to address psychiatric dermatoses. These include selective serotonin reuptake inhibitors like citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline, alongside selective serotonin norepinephrine reuptake inhibitors such as venlafaxine, desvenlafaxine, and duloxetine. Additionally, norepinephrine dopamine reuptake inhibitors like bupropion; tricyclic antidepressants including doxepin, amitriptyline, imipramine, and clomipramine; and tetracyclic antidepressants like mirtazapine are commonly employed. Supplementary medications like anti-convulsants (e.g., gabapentin and pregabalin) further enrich the therapeutic landscape in psycho-dermatology. The approach to treatment in psycho-dermatology is meticulous, starting with a precise psychiatric diagnosis and followed by tailored drug interventions. Factors such as individual response, side-effect profiles, potential drug interactions, and concurrent medical conditions guide the selection and titration of medications. Typically, treatment initiates at conservative doses, with adjustments made based on patient progress and tolerability. This comprehensive review not only illuminates the psycho-cutaneous indications of these medications including in patients with co-morbidties but also underscores the imperative of vigilant monitoring for adverse effects and its management. This systematic review aimed to evaluate the use of psychotropic medications, including antidepressants and mood stabilizers, in dermatology. A comprehensive search of PubMed Central was conducted for studies published between 1986 and 2023, focusing on meta-analyses, reviews, and systematic reviews. After screening 2287 records, 26 studies met the inclusion criteria. The findings underscore the potential role of psychotropic drugs in managing dermatological conditions, highlighting the need for further research to strengthen the evidence base in psycho-dermatology.
Effects of Ceramic Membrane Composed of Clay and a Mixture of Rice Husks, Sawdust, Coconut Shell Charcoal, and Coffee Grounds on Reducing Total Coliforms in Well Water
Authors: Aditama Wiwit , Zulfikar Zulfikar , Sofia Sofia
Published: December 2024

Aim:

The study was conducted to determine the effects of a ceramic membrane composed of clay and a mixture of rice husks, sawdust, coconut shell charcoal, and coffee grounds on reducing total coliforms in well water.

Methods:

The materials used were clay and a mixture of materials including rice husks, sawdust, coconut shell charcoal, and coffee grounds. These materials were mixed, molded, dried, and burnt. Total coliforms in well water were measured as the observed parameter, and the different material compositions were compared. Coliforms were assessed with the membrane filter method, while data were analyzed with a one-way analysis of variance.

Results:

The results showed that the greatest reduction in total coliforms was found on the ceramic membrane of clay and coffee grounds with a value of 105.8 CFU, while the lowest was observed in a mixture of clay and coconut shell charcoal at 92.8 CFU. The percentage decline rate in total coliforms caused by ceramic membrane with a mixture of land clay and coffee grounds reached 91.3%.

Conclusion:

Although there was no significant difference in the reduction of total coliforms among the various membrane compositions, the combination of clay and coffee grounds caused a reduction reaching >90%.
Outcome of 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy in Progressive Metastatic Neuroendocrine Tumors from a Tertiary Care Center
Authors: Mathew David , Sunny Saumya S. , Benjamin Justin , John Junita R. , Jebasingh Felix K. , Georgy Josh T. , Singh Ashish , Oommen Regi
Published: December 2024

Introduction:

Functioning neuroendocrine tumors (NETs) that do not respond to standard therapies are commonly considered for Peptide Receptor Radionuclide Therapy (PRRT). The benefit of 177Lu-DOTATATE PRRT in patients with progressive metastatic NET was analyzed and survival in multi-organ involvement.

Methods:

Forty-one patients with refractory, progressive, or advanced symptomatic NETs, with or without previous treatment modalities were studied. They were treated with 177Lu-DOTATATE IV infusion 150 mCi per dose up to four cycles. Retrospectively, they were assessed for response to PRRT based on clinical, Imaging-Contrast CT/68Ga-DOTATATE PET-CT, and biochemical markers. After treatment, classification based on disease status, symptomatic improvement, and response to treatment based on Chromogranin A level was done. The organs involved and their respective survival benefits, as estimated by Kaplan Meier, were plotted for 60 months.

Results:

The mean serum Chromogranin A level at baseline was 2841 U/ml (Median = 3150). The main site of primary NET was in the pancreas, and the most common site for metastases was the liver. Following PRRT, all patients, except one, reported an improvement in their baseline complaints. Most (82%) reported no new symptoms, and 50% had a reduction in serum Chromogranin A levels. Follow-up imaging showed regression in one patient, static tumor in 18, and progression in rest. Considering radiological and clinical responses, the overall benefit was noticed in 29 (70%) patients. Despite symptomatic improvement, there was no significant survival benefit for those with pancreatic, liver, or nodal metastasis.

Conclusion:

A majority of patients who were treated with PRRT demonstrated clinical, radiological as well as biochemical positive responses warranting an earlier consideration for this well-tolerated treatment modality.
The Impact of Epigenetics on the Pathophysiology of Type 2 Diabetes and Associated Nephropathic Complications
Authors: Mukherjee Amit , Debbarman Tanusree , Banerjee Basu D. , Siddiqi Sheelu S.
Published: December 2024

Type 2 diabetes (T2D) is a long-term metabolic condition that presents considerable health challenges globally. As the disease progresses, the interplay between genetic, environmental, and lifestyle factors becomes increasingly evident, leading to complications. Epigenetics has emerged as a critical area of research, providing insights into how these factors can modify the expression and cellular behavior without altering the underlying DNA sequence. Various epigenetic mechanisms, including DNA methylation, histone modifications, chromatin remodeling, and non-coding RNA regulation, drive cell dysfunction, inflammation, and fibrosis, aggravating diabetes and its complications. Amongst all the complications diabetic kidney disease (DKD) also known as diabetic nephropathy (DN), is a significant microvascular complication often regarded as a silent killer, as early diagnosis remains highly complicated. This review investigates various epigenetic modifications associated with T2D and DKD, employing a database search strategy incorporating the PICO framework method to ensure comprehensive coverage of relevant literature. Advancements in epigenome profiling provide valuable insights into the functional outcomes and chromatin states of cells impacted by T2D. Understanding epigenetics thus emphasizes its crucial role in the development and progression of T2D and transition to DKD, while also highlighting the potential reversibility of epigenetic modifications and potency as a biomarker for predicting DKD. More extensive research is needed to identify specific epigenetic mechanisms involved in DKD to further refine predictive models and therapeutic strategies. This unified exploration of significant epigenetic modifications offers a focused analysis of how these alterations influence the trajectory of disease and presents new avenues for therapeutic intervention.
Surveying the Perceived Impact of Stress on Periodontal Health, Including Patient Experiences with Stress-related Periodontal Issues and Coping Mechanisms
Authors: Mathur Ritu
Published: December 2024

Background::

Stress has been identified as a contributing factor to periodontal disease due to its impact on immune function and behavioral responses. This study aims to explore the perceived influence of stress on periodontal health from the patient’s perspective, focusing on stress-related periodontal issues and coping strategies.

Objectives::

The objectives of this study were to assess patient-reported experiences of stress-related periodontal problems and the coping mechanisms employed to manage these issues.

Materials and Methods::

A cross-sectional survey was conducted with 400 participants recruited from dental clinics and online platforms. The survey included questions about demographics, perceived effects of stress on periodontal health, common stressors, and coping mechanisms. Descriptive statistics, Chi-square tests, and logistic regression analyses were performed to identify significant associations.

Results::

Of the 400 participants, 65% (n = 260) reported experiencing periodontal issues related to stress. The most common symptoms were gum bleeding (40%), gum recession (30%), and tooth mobility (20%). Work-related stress was the most frequently cited source of stress (55%), and physical exercise (45%) was the most commonly reported coping mechanism. However, 35% of participants engaged in unhealthy coping behaviors, such as smoking or poor diet.

Conclusions::

The findings highlight the significant perceived impact of stress on periodontal health, with work and financial stress being major contributors. Although many participants utilized healthy coping mechanisms, a substantial proportion engaged in behaviors that could exacerbate periodontal disease. Dental professionals should consider stress management as part of comprehensive periodontal care.
Acute intraoperative fluid misdirection managed with anterior approach irido-zonulo-hyaloido-vitrectomy
Authors: Dikshit Siddharth , Tuluva Sushma , Senthil Sirisha
Published: December 2024

Purpose:

To evaluate the causes of acute fluid misdirection (AFM) and the role of irido-zonulo-hyaloido-vitrectomy (IZHV) in the management of AFM.

Methods:

Among the 95,712 cataract surgeries performed between April 2017 and August 2022 at a tertiary center, six eyes of six patients developed intraoperative AFM and underwent IZHV through the anterior approach. AFM was diagnosed intraoperatively when there was sudden shallowing of the anterior chamber with markedly elevated intraocular pressures (IOPs) not attributable to external causes or choroidal effusion/hemorrhage. The condition resolved with deepening of AC following IZHV.

Results:

Five eyes had angle closure disease (one of them also had pseudoexfoliation), and one eye had open-angle glaucoma. The mean preop IOP was 25.8 ± 7.3 mmHg, with an IOP range of 18–36. The mean number of preop AGM was 3 ± 1.7. Four eyes developed AFM during combined cataract and trabeculectomy, and two eyes during cataract surgery. Four eyes had aqueous misdirection during or after cortical aspiration, and two eyes after creation of internal trabeculectomy ostium. IZHV was performed for all eyes through an anterior approach using a 23G vitrector, which resulted in instant resolution and deepening of the anterior chamber. The mean follow-up was 8.75 months (1–48 months), the mean postoperative IOP was 16.1 ± 2.6 mmHg, and the mean number of AGM at the last follow-up was 2.8 ± 2.2. The anterior chamber was deep, and IOP was under control in all eyes with four eyes needing AGM. One eye developed postoperative aqueous misdirection due to blockade of the IZHV opening.

Conclusion:

IZHV can be an effective solution for acute intraoperative AFM, which can be performed via an anterior approach by the anterior segment surgeon.