bluuebunny/crossref_metadata_2025 huggingface dataset:
Un envol révolutionnaire
Authors: Moralès Étienne
Published: September 2024

Les trafics aéropostaux cubains se développent de façon spectaculaire après la Seconde Guerre mondiale. Cet article vise à éclairer les transformations de la poste aérienne cubaine après la révolution qui met au pouvoir Fidel Castro en 1959. Grâce à des sources variées, issues de fonds diplomatiques et d’articles de presse, il étudie les modalités de la quarantaine postale imposée à Cuba dès le début des années 1960 et les stratégies de contournement mises en place jusque dans les années 1970 par les différents acteurs concernés pour faire passer le courrier et les colis entre Cuba et le reste du monde.
Révolutionnaires contre la révolution : les informateurs du Service de contrôle et d’assistance des indigènes en France durant l’entre-deux-guerres
Authors: Bollenot Vincent
Published: September 2024

Cet article propose une approche comparée de deux indicateurs indigènes du Service de contrôle et d’assistance des indigènes du ministère des Colonies (CAI) durant l’entre-deux-guerres. Ces deux hommes ont un profil différent. Le premier, Đặng Đình Thọ ou l’agent Thomas, est d’extraction populaire indochinoise et caractéristique du prolétariat colonial mobile, ouvrier du secteur de la navigation. Communiste, il est formé à Moscou avant d’être retourné par le service de renseignement. Le second, Thomas Ramananjato, vient de la bourgeoisie malgache et a servi sous les drapeaux français lors du premier conflit mondial. Patriote, il se met au service du CAI sous le pseudonyme d’agent Joe. Il devient l’un des cadres du mouvement anti-impérialiste hexagonal. L’article cherche à comprendre les dispositions favorables à la collaboration des indicateurs au service du ministère des Colonies.
L’association entre entrepreneuriat social et projet sociopolitique : une réflexion critique sur les apports de la Loi ESS 2014
Authors: Gardin Laurent , Gianfaldoni Patrick , Hiez David
Published: September 2024

Suivant une approche pluridisciplinaire, cet article analyse l’attention que la Loi ESS 2014 a porté à l’entrepreneuriat social associatif et à la contribution sociopolitique dont les associations sont potentiellement le creuset. A contrario du droit européen, la Loi 2014 ne reconnait pas la catégorie économique d’entreprise sociale tout en envisageant les propriétés entrepreneuriales de l’Association. Quant à la dimension sociopolitique de l’Association, la loi fait abstraction du principe de réciprocité, l’expression juridique des espaces publics de proximité et des processus de co-construction des politiques publiques manquant de consistance.
Le Commerce Équitable dans la Loi ESS 2014 : une révolution silencieuse aux impacts profonds
Authors: Maisonhaute Julie , Stoll Julie
Published: September 2024

La (re)définition légale du commerce équitable via l’article 94 de la Loi Hamon a entraîné des répercussions majeures sur le développement du secteur depuis 2014. En particulier elle a permis le développement d’un commerce équitable « Made in France » structuré : une expérience unique en Europe. Cet article analyse l’articulation du commerce équitable avec l’économie sociale et solidaire et montre comment la mise en œuvre de ses principes constituent des leviers d’accélération de la transition (agro)écologique. Il dresse un bilan à dix ans des évolutions qui en ont découlé avant de dégager quelques leçons et perspectives pour l’avenir.
Les références à l’œuvre de Jean Dubergé dans la doctrine fiscale contemporaine
Authors: Bin Fabrice
Published: September 2024

The studies of Jean Dubergé have made it possible to correct the image of taxpayers. They have thus been the subject of curiosity and interest among several authors specialists of tax law who have relayed them. However, those Law Professors are happy few. Above all, the limits of multidisciplinarity did not make possible a continuation of his works among lawyers specialized in taxation.
La politique fiscale de l’Italie fasciste
Authors: Schmitt Sylvie
Published: September 2024

Jean Dubergé published his doctoral dissertation in law, La politique fiscale de l’Italie fasciste, in 1938. He discribes there the reformed Italian fiscal system by the fascist in a more centralizing and a more moralizing sense.
Relation de confiance et incivisme fiscal
Authors: Luppi Philippe
Published: September 2024

La montée en puissance de l’incivisme fiscal porte atteinte à la construction d’une relation de confiance durable entre l’administration fiscale et les contribuables. Mais cette relation de confiance peut être valorisée par la recherche d’un « nouveau » civisme fiscal.
La Constitution financière du Nigeria : originalités et similitudes avec celles des États francophones d’Afrique de l’Ouest
Authors: Toni Errol
Published: September 2024

The examination of the constitutional framework of public finance in Nigeria, in the light of that existing in the French-speaking states of the same geographical area, reveals the existence of a common legal and financial patrimony. It is characterized, among other things, by similar principles and distribution of budgetary power. However, there are some interesting specificities in Nigeria. They can be inspiring elements for the French-speaking states of the space studied. This is the case, for example, with the regulation of the financial benefits of elected officials and the external control mechanism put in place.
La réforme et la suppression de la Taxe Professionnelle : un signal fort
Authors: Thiria Philippe
Published: September 2024

L’évolution de la Taxe Professionnelle de sa création en 1975 à sa suppression en 2010 fait apparaître clairement l’érosion de l’autonomie fiscale des collectivités territoriales par l’amenuisement progressif des bases sur lesquelles s’appliquaient les taux qu’elles avaient le pouvoir de voter. Les critiques qu’elle a soulevées montrent également la difficulté de concevoir un impôt local sur les entreprises qui soit économiquement acceptable.
Le Québec et le contrôle parlementaire de la gestion administrative et financière de l’État
Authors: Renauld Guillaume
Published: September 2024

Le système de gouvernement responsable dont a hérité le Québec au XIX e siècle confie à l’Assemblée nationale une place centrale dans le contrôle de la gestion administrative et financière de l’État. Face une administration gouvernementale qui se complexifie inévitablement, une nouvelle forme de reddition de comptes est apparue au début des années 2000, par l’implantation d’un régime d’imputabilité des sous-ministres et des dirigeants d’organisme public. Une commission parlementaire est désormais chargée exclusivement d’entendre ces individus sur la gestion administrative de leur organisation, cet exercice constituant une pratique parlementaire unique au Canada. Ce régime d’imputabilité, qui complète le contrôle financier traditionnel de l’action étatique par le Parlement, donne aujourd’hui davantage de poids au pouvoir de contrôle et de surveillance de l’Assemblée nationale et s’arrime harmonieusement avec le principe de gouvernement responsable.
$ L^1 $ local stability to a nonlinear shallow water wave model
Authors: Meng Jun , Lai Shaoyong
Published: September 2024

A nonlinear shallow water wave equation containing the famous Degasperis$ - $Procesi and Fornberg$ - $Whitham models is investigated. The novel derivation is that we establish the $ L^2 $ bounds of solutions from the equation if its initial value belongs to space $ L^2(\mathbb{R}) $. The $ L^{\infty} $ bound of the solution is derived. The techniques of doubling the space variable are employed to set up the $ L^1 $ local stability of short time solutions.
Online Portfolio Based on Trend Trading Strategy Considering Investor Sentiment Using Text Analysis
Authors: Zeng Zhiming , Xu Weijun , Zhong Yannan
Published: September 2024

Intelligent online portfolios have become an important research topic in the field of quantitative finance. This paper proposes an online portfolio based on trend trading strategy using fuzzy logic technology analysis method and considering investor sentiment. Firstly, the paper uses SVM classification algorithm to analyze stock comment text data in online forums and constructs investor sentiment indicators. Secondly, the paper transforms the heuristic algorithm of technical trading into corresponding fuzzy IF-THEN rules and combines them into a fuzzy investment decision system. Thirdly, the paper constructs a new online portfolio based on trend trading strategy. Finally, the paper uses the text data of investor reviews and stock trading data on the internet for empirical analysis to illustrate the effectiveness of the online portfolio strategy constructed. The results indicate that online portfolios constructed based on trend trading strategies can achieve higher performance than benchmark strategies while considering transaction costs.
‘Christian inspiration seeks in the boldest and most modern achievements and technologies the dimension of service'
Authors: Poletti Ugo
Published: September 2024

Not available.
For the world to breathe new values
Authors: Bausola Adriano
Published: September 2024

Not available.
The psychiatrist and his patient
Authors: Mazza Salvatore , Azzoni Antonella
Published: September 2024

Among the medical sciences that, all of them, require particular commitment and dedication from those who practise them, psychiatry can undoubtedly be considered the science that, more than any other, burdens the bearer of it with human and social responsibility.
Reproductive technologies: the position of the Anglican Church
Authors: Di Pietro Maria Luisa
Published: September 2024

Not available.
Thomistic actus essendi and spirituality of the soul.
Authors: Pangallo Mario
Published: September 2024

The purpose of this contribution is to rethink the problem of the ‘infusio animae rationalis’ within Thomist thought, based on the same metaphysical principles that Aquinas used to define the ontological structure of the human soul.
An evaluation of support to the second victims in Tshwane District Health Services, South Africa
Authors: Nzaumvila Doudou K. , Bongongo Tombo , Govender Indiran , Okeke Sunday O.
Published: September 2024

Background: Initiatives to reduce patient safety incidents (PSI) and support healthcare professionals who may experience psychological trauma as a result are becoming increasingly common. However, little is known about the quality of the support provided by Tshwane District Health Services. Therefore, it is necessary to assess their assistance for the second victims in order to evaluate their effectiveness.Methods: A cross-sectional study was conducted, and 319 healthcare professionals from six primary health care institutions were invited to participate in the study. The sociodemographic information, work experience, emotional support, familiarity with the concept of the ‘second victim’ and involvement with PSIs were collected.Results: The mean age was 39.8 years, ranging from 22 years to 66 years. The majority of participants were females (n = 249; 78.1%), nurses (n = 153; 49.2%), and those with 5–9 years of experience (n = 82; 25.8%). Most participants (n = 168; 52.7%) were aware of the possibilities of emotional support, while less than half (n = 142; 44.5%) were familiar with the term ‘second victim’. The cumulative incidence of adverse events in the institutions was 19.4%, and the majority of second victims (n = 39; 62.9%) emotionally felt the need to speak with someone about it, preferably outside of the workplace. Less than 5% of individuals received support that was initiated by existing structures at their workplace.Conclusion: Frameworks exist to assist second victims, although they are only known to some healthcare professionals. However, their current use in Tshwane health facilities is ineffective. After experiencing PSIs, second victims often rely on psychological assistance outside of the workplace.Contribution: Authorities need to determine the causes behind some healthcare professionals’ lack of awareness regarding the support framework for second victims, as well as their growing tendency to rely on psychologists outside of the workplace, and corrective measures should be implemented.
Lithium-induced cognitive dysfunction assessed over 1-year hospitalisation: A case report
Authors: Murase Yuji , Kato Masaki , Kinoshita Toshihiko , Takekita Yoshiteru
Published: September 2024

Introduction: Lithium-induced neurotoxicity is almost always reversible but can cause irreversible neurological sequelae, namely the syndrome of irreversible lithium-effectuated neurotoxicity (SILENT). As there is no definitive treatment for SILENT, caution is required when administering lithium. Reports on the effect of lithium-effectuated neurotoxicity on cognitive function are limited. We report a case in which high cognitive function was lost after lithium overdose and hardly recovered, as evaluated using multiple neuropsychological tests during a 1-year hospitalisation period.Patient presentation: A 52-year-old man on lithium medication with bipolar disorder was admitted to the intensive care unit because of lithium overdose. The patient achieved lucid consciousness after continuous haemodiafiltration. However, he could not move his body as desired or produce appropriate verbal expressions; thus, he was moved to our psychiatric ward, where his treatment continued.Management and outcome: After several months, the patient was diagnosed with SILENT owing to persistent motor and cognitive dysfunctions. Multiple neuropsychological tests were performed, and cognitive function was evaluated. The Neurobehavioural Cognitive Status Examination showed a worsening trend, and the full intelligence quotient of the Wechsler Adult Intelligence Scale-Third Edition was in the mild intellectual disability range.Conclusion: This is a clear case of cognitive dysfunction due to SILENT and is difficult to treat. Thus, it is crucial to prevent the onset of SILENT.Contribution: This report is valuable because it is one of the few to track changes in cognitive function over time in a patient with SILENT using objective measures over 1 year of hospitalisation.
A Gamut of Astounding Diagnosis as Paraganglioma of Urinary Bladder: A Retrospective Study from North India
Authors: Walvir Nazia Manzoor , Aiman Aiffa , Abeer Inara , Lone Mohammad Iqbal , Maqsood Shadab
Published: September 2024

Background and Aim:

Urinary bladder paraganglioma (UBPGL) is a rare neuroendocrine neoplasm, accounting for <0.05% of all bladder tumors and 0.7% of all paragangliomas. This study aimed to describe the histopathology of UBPGL, emphasizing the histologic attributes that may help pathologists recognize this rare bladder tumor and aid in differentiation from urothelial malignancies and other tumors that may resemble paragangliomas.

Materials and Methods:

This retrospective observational study was conducted in the pathology department of a tertiary care hospital in North India for 4 years between 2019 and 2022. The study included all cases diagnosed with UBPGL on histopathology and confirmed on immunohistochemistry.

Results:

Nine study cases were included in this study with a median age of 56 years. Most cases had a history of palpitations, hematuria, and hypertension. Tissue specimens for all the cases were obtained after transurethral resection of bladder tumors. Histologically, the zellballen pattern was present in seven (78.8%), and a diffuse growth pattern was present in two (22.2%) cases. Delicate fibrovascular stroma was pronounced in eight (88.9%) cases. Immunohistochemically, all nine tumors were positive for chromogranin A and eight were positive for synaptophysin. Muscularis propria invasion was seen in seven (78.8%) cases, a focal sheet-like pattern in one (11.1%), a ribbon-like growth pattern in one (11.1%), focal necrosis in three (33.3%), and associated significant cautery artifacts in four cases (44.5%).

Conclusions:

UBPGL is often misdiagnosed as urothelial cancer because of its frequent muscle invasion and similar morphology. Distinguishing paraganglioma from urothelial cancer is vital because of the difference in prognosis and surgical management. A conclusive diagnosis can be made with thorough histologic examination and immunohistochemical analysis.
Asiaticoside ameliorates type 2 diabetes mellitus in rats by modulating carbohydrate metabolism and regulating insulin signaling
Authors: Prathap B. , Satyanarayanan V. , Duraipandian K. , Subashree P.
Published: September 2024

Objective:

To evaluate the effect of asiaticoside on streptozotocin (STZ) and nicotinamide (NAD)-induced carbohydrate metabolism abnormalities and deregulated insulin signaling pathways in rats.

Methods:

Asiaticoside (50 and 100 mg/kg body weight) was administered to STZ-NAD-induced diabetic rats for 45 days, and its effects on hyperglycaemic, carbohydrate metabolic, and insulin signaling pathway markers were examined.

Results:

Asiaticoside increased insulin production, lowered blood glucose levels, and enhanced glycolysis by improving hexokinase activity and suppressing glucose-6-phosphatase and fructose-1,6-bisphosphatase activities. Abnormalities in glycogen metabolism were mitigated by increasing glycogen synthase activity and gluconeogenesis was decreased by decreasing glycogen phosphorylase activity. Furthermore, asiaticoside upregulated the mRNA expressions of IRS-1, IRS-2, and GLUT4 in STZ-NAD-induced diabetic rats and restored the beta cell morphology to normal.

Conclusions:

Asiaticoside has the potential to ameliorate type 2 diabetes by improving glycolysis, gluconeogenesis, and insulin signaling pathways.
Symptomatic bradycardia in tuberculosis-related giant bullae (vanishing lung syndrome): A case report
Authors: Laysandro Reynard , Meha Jessie Julian Mila , Mulia Resley Ongga , Mikha  , Yusfiatuzzahra Nazamta
Published: September 2024

Rationale:

Vanishing lung syndrome is rare and can be associated with a history of smoking and marijuana use. The occurrence of giant bullae can also be linked to infections, particularly tuberculosis in tropical countries.

Patient concerns:

A 26-year-old male complained of weakness, severe vomiting, and reduced breathlessness when lying on the left side. He had a history of pulmonary tuberculosis two years ago.

Diagnosis:

Symptomatic bradycardia in tuberculosis-related giant bullae.

Interventions:

The patient was recommended to undergo an elective bullectomy, but he decided not to proceed with the procedure. Atropine sulfate was administered to alleviate symptoms of bradycardia, while a standardized anti-tuberculosis regimen were started for the next six months.

Outcomes:

Following 7 days of intensive care treatment involving antituberculosis medications and atropine sulfate, the patient achieved hemodynamic stability, opting against bullectomy despite residual symptoms of dyspnea. Subsequent six months of antituberculosis therapy notably alleviated symptoms without requiring bullectomy.

Lessons:

Increasing intrathoracic pressure can also be caused mechanically by giant bullae. Cardiac symptoms in vanishing lung syndrome are reversible and can be alleviated once the underlying cause is addressed. In this case, symptomatic bradycardia was reduced only with tuberculosis treatment without bullectomy intervention.
Epidemiological observations of invasive group B Streptococcus infections in six major hospitals in Peninsular Malaysia
Authors: Muthanna AbdulRahman , Desa Mohd Nasir Mohd , Rahman Nurul Asyikin Abdul , Dzaraly Nurul Diana , Baharin Nurul Hana Zainal , Aziz Nur Afiza , Shan Chua Hui , Ismail Zalina , Nor Lailatul Akmar Mat , Ali Marlindawati Mohd , Ahmad Nur Hanani , Azmai Mohammad Noor Amal , Amin-Nordin Syafinaz
Published: September 2024

Objective:

To address the lack of research on invasive group B Streptococcus (GBS) infections in Malaysia and Southeast Asia through a comprehensive analysis of GBS isolates obtained from hospitals.

Methods:

Medical records from patients with GBS infection isolated from the sterile site, such as blood and cerebrospinal fluid from 14 July 2019 to 15 December 2020, were reviewed from six major hospitals in Peninsular Malaysia. Inclusion criteria were invasive GBS, sterile sites and non-repeated GBS isolated from the same patients in the same admission. Viable isolates were re-identified for GBS and serotyped.

Results:

A total of 118 patients were eligible, with a majority of non-pregnant adults (76.3%). Over half of the patients (62.7%) had underlying medical conditions, with diabetes as the most common disease, followed by respiratory disease, renal disease, cardiovascular disease and skin and soft tissue disease. The most common manifestations were sepsis, followed by soft tissue abscess, diabetic foot ulcer, wet gangrene and cellulitis. The overall mortality was 7.6%. The most common serotype was serotype V.

Conclusions:

Invasive GBS infection among non-pregnant adults showed a rising trend, particularly among diabetic individuals. The study underscores the importance of reducing risk factors and highlights the necessity of developing GBS vaccination as a preventive strategy for both infants and adults.
To Assess the Impact of the Quality and Level of Family Support to Pregnant Women on Maternal and Fetal Outcomes
Authors: Mane Ujwala R. , Salunkhe Jyoti A. , Kakade Satish V.
Published: September 2024

Background:

Throughout pregnancy, women need support from the family to gain better maternal and fetal outcomes. Emotional distress in women during pregnancy is known to increase the risk of adverse outcomes in women and newborns. Increasing family support can improve birth outcomes and maternal wellbeing and can reduce complications in mother and increased neonatal birth weight.

Aim and Objective:

This study aims to evaluate the influence of the level and quality of family support during pregnancy on maternal and fetal outcomes and to identify any association between sociodemographic variables and the impact of the level and quality of family support during the third trimester.

Materials and Methods:

This study used a quantitative approach combined with a survey research design. Data were collected from four primary health centers (Rethare, Vadgaon, Kale, and Supane) at Karad, Maharashtra, India. A consecutive sampling technique was used to select the 344 subjects from the Rethare, Vadgaon, Kale, and Supane areas of Karad Taluka. Data were collected before the completion of the first trimester, then during the second trimester, and post-delivery. Upon evaluation, the tool was validated by experts representing the fields of community health nursing, mental health nursing, obstetric gynecology, and pediatric care. A pilot study was conducted on 30 samples. The data collected were analyzed by using descriptive and inferential statistics.

Result:

Findings regarding level of family support show that 133 women (38.7%) received good total support, 164 (47.7%) received moderate support, and 47 (13.7%) received poor family support during the third trimester. Results regarding maternal outcomes show that there was a significant association found between type of delivery and family support received after delivery with maternal outcomes and total support during the third trimester (P < 0.05). It means that physical, emotional, and psychosocial support (total support) received by women would prevent complications during delivery, i.e., prevent Cesarean sections, results in the mother giving normal birth to baby. Hence, the mother needs total support during the third trimester.

Conclusion:

Total family support is needed by pregnant women during the third trimester to achieve maternal and fetal outcomes.
Outcome after Arthroscopic Meniscal Repair
Authors: Ashish Shukla , Ravindra Chauhan , Aditya Dwivedi , Ashish Pande
Published: September 2024

Objective:

The objective of this study was to evaluate the functional outcomes of all-inside meniscal repair using the Fast-Fix suturebased fixation device and its correlation with postoperative MRI findings in serving military personnel with symptomatic torn menisci.

Materials and Methods:

Thirty patients under 40 years of age with symptomatic meniscal tears were included in the study. Clinical evaluation, arthroscopic assessment, and meniscal repair using the Fast-Fix system were performed. Patients were followed up clinically and with postoperative MRI at one year. Functional outcomes were evaluated using the International Knee Documentation Committee (IKDC) form.

Results:

At one year postoperative follow-up, 10% of patients had excellent results, 66.6% had good results, 13.4% had fair results, and 10% had poor results according to the IKDC evaluation. MRI evaluation showed overall satisfactory results in 86.7% of patients. The Fast-Fix system demonstrated a success rate of 90% in this short-term follow-up study, with minimal complications.

Conclusion:

Arthroscopic all-inside meniscal repair using the Fast-Fix system showed promising clinical outcomes in serving military personnel with symptomatic torn menisci. The success rate was comparable to traditional suture techniques. Postoperative MRI provided valuable information for evaluating the physiological state of the repaired meniscus. Long-term followup studies are necessary to assess the structural and functional integrity of the repaired menisci over time.
Antimicrobial efficacy of clindamycin, linezolid, and calcium hydroxide as root canal medicaments on tubular infection against Enterococcus faecalis biofilm: An in vitro study
Authors: Bharathi Manisha Rani , Tilakchand Mahima , Horatti Priya , Chaliha Rideep
Published: September 2024

Aim:

The aim of the study was to evaluate and compare the antimicrobial efficacy of linezolid, clindamycin, and calcium hydroxide (Ca(OH)2) as an intracanal medicament on Enterococcus faecalis biofilm.

Methods:

Fifty-six root blocks obtained from extracted single-rooted human teeth were decoronated, and the apical part of the root was removed to obtain a 6 mm cylinder of radicular dentin. The specimens were standardized for diameter, infected with microorganisms, and randomly divided into four groups. linezolid, clindamycin, Ca(OH)2, and methylcellulose (control) were placed in the root canal for 7 days. Dentin shavings were collected from 200 to 400 µm depth, and bacterial load was assessed by counting colony-forming units. Scores were statistically analyzed using the Kruskal–Wallis ANOVA and the Mann–Whitney test.

Results:

Linezolid and clindamycin had better antibacterial effects than control at both 200 µm and 400 µm depth after 7 days.

Conclusion:

Linezolid and clindamycin outperformed Ca(OH)2 in reducing bacteria and were equally efficient against E. faecalis but showed no significant differences in antimicrobial efficacy.
Phytochemical profiling of three Egyptian Phoenix dactylifera L. cultivars’ leaves with comparative positive impacts in controlling the streptozotocin diabetic rats
Authors: El Sawi Salma , El-Feky Amal M. , Elbatanony Marwa M. , El-khonezy Mohamed I. , Aly Hanan F.
Published: September 2024

Background

Date palm, Phoenix dactylifera L., is a tropical plant of the Arecaceae family. No sufficient studies have been directed to evaluate leaves’ phytochemistry and bioactivity.

Objective

The major aim of this study is to assess the phytochemical configuration and antidiabetic effect of palm leaf extracts cultivars.

Materials and methods

It included total phenolic and flavonoid contents determination, ultra-performance liquid chromatography coupled with mass analysis, and isolation of the main compounds while, the biological investigation targeted in vitro bioactivities and detailed in vivo antidiabetic activity. Animals were inducted with streptozotocin dose (40 mg/kg b.wt) and treated with different extracts dose (200 mg/kg b.wt).

Results and conclusion

Phenolic and flavonoid contents in three cultivars of Egyptian date palm leaves, Samani, Hayani, and Zaghloul were 545.652, 90.609, and 2231.304 mg GAE/g for phenolics, and 535.63, 118.00, and 2185.00 mg CE/g for flavonoids, respectively. Additionally, UPLC-QTOF-MS/MS elicited the recognition of 28, 27, and 40 phytoconstituents in three extracts, respectively. However, Zaghloul extract exhibited higher in vitro antioxidant activity compared with vitamin C. In vivo treatment with the extracts in contrast to glibenclamide as a standard drug for 4 weeks caused a significant glucose level decrease by 64.81, 65.61, 69.61, and 66.87%, respectively. The tested extracts showed significant in-vitro and in-vivo anti-diabetic activity and ameliorated the other accompanying diabetes parameters e.g. liver and kidney. Histopathological investigation showed that treatment with Zaghloul leaf extract has better results than reference drug and nearly similar effects for other leaf extracts.
Breast Osteosarcoma with Chondroid Differentiation and Lung Metastasis
Authors: Samaila Modupeola O. , Ofunne Chioma N. , Kwapmi Nicholas , Dahir Huraira , Essien Otoobong , Chigozie Chikezie
Published: September 2024

Primary extra-skeletal osteosarcoma of the breast is uncommon, and less than 200 cases have been documented in literature since the first case reported in 1957. Breast osteosarcoma accounts for less than 1% and less than 5% of breast cancers and all sarcomas, respectively. We report a case of primary breast osteosarcoma with chondroid differentiation in a 45-year-old female with lung metastasis. The diagnosis of primary breast osteosarcoma requires extensive tissue sampling and comprehensive use of epithelial immunohistochemical antibodies to differentiate it from malignant phyllodes and metaplastic carcinoma with heterologous osseous or cartilaginous differentiation. The optimal treatment modality is wide excision with free margins and or mastectomy, even though the prognostic outcome is poor due to local recurrences and hematogenous spread to the lungs, liver, and bone. This report seeks to create heightened awareness among pathologists and clinicians.
Barriers to Mental Health Service Utilization Among Patients Attending Tertiary Health Institution in Sokoto State, Nigeria
Authors: Abubakar Ahmad , Magaji Bello Arkilla , Bakare Abdulfatai Tomori , Yakubu Anas Ibrahim , Umar Mukhtar , Illo Nuratu Muhammad , Yusuf Sajjad Muhammad
Published: September 2024

Background:

Globally, the barriers to accessing mental health services remain a public health challenge. These are more pronounced in low- and middle-income countries, where patients are at greater risk for not getting the required mental health services.

Aim:

To determine the barriers to mental health service utilization in two tertiary health facilities in Sokoto State, Nigeria.

Subjects and Methods:

A cross-sectional study was conducted among 52 psychiatric outpatients and 99 patients’ relatives using the multistage sampling technique. A semistructured interviewer-administered questionnaire was used to obtain the data. The outcome variables are physical, cultural, and financial barriers to mental health service utilization. Data were analyzed using IBM Statistical Package for Social Sciences version 25.0 for Windows, and a test of association between the variables was done using the chi-square test.

Result:

A total of 151 respondents were interviewed, with a mean age and standard deviation of 37.92 ± 12.62 years, while the modal age was 41 years. Overall, 95 (62.9%) of the respondents were male and 107 (70.9%) were married. In total, 120 (39.7%) were literate and 94 (60.3%) were self-employed whose average income was N50,766:67 per month. Ninety-nine (65.6%) of the participants have no community support, 116 (76.8%) have limited access to mental health services, and 122 (80.8%) have financial constraints in procuring drugs. Cultural and financial barriers were the significant barriers to mental health service utilization (χ2= 0.672,P= 0.001).

Conclusion and Recommendation:

There exist significant cultural and financial barriers to utilizing mental health services in Sokoto State, Nigeria. Therefore, we recommend more advocacy, public enlightenment, and increasing family and community support for patients with mental disorders.
Critical Delays in Neurosurgical Referral for Sellar Region Tumors: Unveiling the Consequences of Misdiagnosis and the Path to Timely Intervention
Authors: Ogolo Donald E. , Ndukuba Kelechi O. , Ajare Enyereibe C. , Akin-Dosumu Akin , Nnama Sunday , Ndubuisi Chika A. , Mezue Wilfred C. , Ohaegbulam Samuel C.
Published: September 2024

Background:

Sellar region tumors pose significant diagnostic challenges, with delays in neurosurgical referral, leading to irreversible complications such as visual loss. This study explores the causes and consequences of these delays, emphasizing misdiagnosis and systemic healthcare inefficiencies.

Objective:

To quantify delays in neurosurgical referral for sellar region tumors, identify contributing factors, and assess the impact on patient outcomes.

Subjects and Methods:

A retrospective analysis was conducted on patients referred to a tertiary neurosurgical center over 3 years, focusing on demographics, initial symptoms, time to referral, and outcomes.

Results:

The findings indicate substantial delays, with many patients waiting over a year from symptom onset to neurosurgical consultation. The majority were initially seen by non-neurosurgical specialists and often misdiagnosed with ophthalmologic conditions. Contributing factors included lack of provider awareness, socioeconomic barriers, and limited diagnostic resources. These delays correlated with worse outcomes, notably increased irreversible visual impairment, and advanced tumor stages at intervention.

Conclusions:

This study highlights the critical need for improved healthcare provider training, standardized referral protocols, and greater accessibility to diagnostic services. Addressing these issues is essential in reducing delays and improving outcomes for patients with sellar region tumors. Further research into innovative solutions, such as telemedicine and public health campaigns, is warranted to address the barriers identified in this study.
Phenobarbital as an adjunctive agent for sedation in pediatric intensive care unit patients: A single-center, retrospective study from Colorado
Authors: Welter Kelli Jo , DeVine Mackenzie N. , Gordon Sharon E. , Demasellis Gina
Published: September 2024

Background:

Pediatric patients require pharmacological management of pain and agitation associated with mechanical ventilation. Pain and agitation may be refractory to opioids and alpha-2 agonists, prompting the use of adjunctive analgesics and sedatives with alternative mechanisms. The purpose of this study was to describe the use of phenobarbital as an adjunctive agent for refractory agitation in critically ill, mechanically ventilated pediatric patients.

Subjects and Methods:

This was a single-center, retrospective chart review at a pediatric intensive care unit (PICU) at a pediatric academic medical center in America between 2016 and 2021. Children aged 2 months to 18 years old were admitted to the PICU were mechanically ventilated and received phenobarbital for adjunct sedation. Sixty-three patients had phenobarbital dosing data evaluated, and the 38 patients who were not receiving continuous neuromuscular blockade were included in the primary and secondary outcome analysis of time within the goal sedation score. Descriptive statistics was used to assess baseline characteristics and the primary outcome. Wilcoxon signed-rank tests were used to evaluate secondary outcomes.

Results:

Patients spent significantly more time within the goal sedation score range after phenobarbital compared to before phenobarbital. The median number of rescue sedative boluses, morphine equivalents (MEs), and benzodiazepine equivalents (BZDE) significantly decreased 2 days after the first phenobarbital dose compared to the 2 days before the first phenobarbital dose.

Conclusions:

The use of phenobarbital as an adjunct sedative was associated with a statistically significant increase in time spent in the goal sedation score range and decrease in ME, BZDE, and concomitant sedative boluses.
Effectiveness of a structured handover tool (I-PASS + C) in patients transferred out from pediatric intensive care unit to ward: A single-center, prospective observational study from Western India
Authors: Upadhyay Vaibhava , Kumar Amit , Tandon Krutika Rahul , Nimbalkar Somashekhar M. , Kadiyawala Saalim M.
Published: September 2024

Background:

Handover is a process of communication between physicians and, thus, integral to medical practice. Communication failures commonly cause preventable medical errors and adverse events. This study was done to evaluate the effectiveness of a structured handover tool.

Subjects and Methods:

It is a prospective observational study conducted in pediatric intensive care unit (PICU) of tertiary care hospital of Western India. The errors were noticed in the handover process of patients who were transferred from the PICU to the pediatric ward. A modified handover tool I-PASS + C was implemented as an intervention. The outcome was measured in the form of changes in the number of errors postintervention.

Results:

The handovers enrolled in the control group were 46 (28.04%) and 40 (24.39%) in the intervention group. Patient’s age ranged from 3 months to 205 months. “Not mentioning information regarding counseling and parent’s response/behavior” and “no cross check by hearing back from the receiver” were the most commonly noticed errors in 40 (86.9%) and 31 (67.4%) patients, respectively, which reduced significantly in the intervention group. Other commonly noticed errors during the stay in the ward were “got phone call from ward to take further information” in 16 (34.78%) patients, followed by “medical errors reported in ward” in 8 (17.4%) patients, which also reduced significantly in the intervention group.

Conclusions:

A structured handover tool reduces the errors of the handover process as well as adverse events, after transferring the patient from the PICU to the ward.
Severe hypertriglyceridemia in an adolescent female with diabetic ketoacidosis: A case report
Authors: Kulkarni Noopur N. , Sarangi Bhakti U. , Walimbe Ajay A.
Published: September 2024

Severe hypertriglyceridemia (SHT) is a rare metabolic complication of diabetic ketoacidosis (DKA) and may complicate the course by leading to acute pancreatitis. While intravenous insulin typically treats the dyslipidemia in these cases, the role of lipid-lowering agents to prevent adverse outcomes in patients not responding to insulin warrants further investigation. We report the case of an adolescent girl who presented to us with DKA and SHT (8639 mg/dL), requiring intravenous insulin as well as fibrates. She did not develop any complications that could be attributed to diabetic lipemia; investigations revealed no sequelae of hyperlipidemia or evidence of familial dyslipidemia.
Utility of renal replacement therapy in poisoning and drug overdosage
Authors: Bhowmick Rohit , Kandasamy Sasidaran
Published: September 2024

Toxic and prescribed drug ingestions are a significant cause of pediatric morbidity and mortality. Management of the poisoned patient begins with a thorough evaluation, identification of the agent(s) involved, and assessment of severity and symptoms. Therapy consists of the provision of supportive care, prevention of poison absorption, use of antidotes, and, when appropriate, the use of renal replacement therapy (RRT) to enhance the elimination of the poison. Among several elimination techniques, extracorporeal treatment such as RRT can be lifesaving as it rapidly removes the toxin independent of the patient’s indigenous clearance. Hemodialysis remains the most commonly used RRT for toxin removal, and the role of continuous RRT and therapeutic plasma exchange is emerging. To properly utilize the RRT, the clinician should understand the chemical properties of the toxins and the underlying mechanism of clearance by the concerned RRT technique. Although pediatric literature is mainly limited to case reports, timely initiation of RRT helps manage children with poisoning and drug overdose.
Potential prospects of Chinese medicine application in diabetic retinopathy
Authors: Zhou Yi-Mai , Cao Yuan-Hao , Guo Jing , Cen Lu-Sha
Published: September 2024

Current treatment strategies for diabetic retinopathy (DR), an eye condition that can lead to blindness, have mainly focused on proliferative DR, including vitreous injection, retinal photocoagulation, and vitrectomy. Vitreous injections mainly depend on anti-vascular endothelial growth factor therapy. In this editorial, we comment on the article by Sun et al . We focus specifically on the mechanisms of the protective effect of genipin on the retina. Genipin is a gardenia extract used in traditional Chinese medicine (TCM). In their study, the authors suggest that controlling advanced glycosylation by the intraocular injection of genipin may be a strategy for preventing retinopathy. The innovative use of a Chinese medicine extract injected into the eye to achieve a curative effect has attracted our attention. Although TCM is effective in treating DR, the topical application of DR, especially intraocular injections, is not yet feasible. Herein, we present a brief analysis of effective Chinese medicines for the treatment of DR. The effectiveness of local injections of TCM applied directly into the eyes holds promise as an effective treatment approach for DR.
Immunotherapy in type 1 diabetes: Novel pathway to the future ahead
Authors: Ray Sayantan , Palui Rajan
Published: September 2024

Since the discovery of insulin over 100 years ago, the focus of research in the management of type 1 diabetes (T1D) has centered around glycemic control and management of complications rather than the prevention of autoimmune destruction of pancreatic β cells. Fortunately, in recent years, there has been significant advancement in immune-targeted pharmacotherapy to halt the natural progression of T1D. The immune-targeted intervention aims to alter the underlying pathogenesis of T1D by targeting different aspects of the immune system. The immunotherapy can either antagonize the immune mediators like T cells, B cells or cytokines (antibody-based therapy), or reinduce self-tolerance to pancreatic β cells (antigen-based therapy) or stem-cell treatment. Recently, the US Food and Drug Administration approved the first immunotherapy teplizumab to be used only in stage 2 of T1D. However, the window of opportunity to practically implement this approved molecule in the selected target population is limited. In this Editorial, we briefly discuss the various promising recent developments in the field of immunotherapy research in T1D. However, further studies of these newer therapeutic agents are needed to explore their true potential for prevention or cure of T1D.
Role of cyclic guanosine monophosphate-adenosine monophosphate synthase-stimulator of interferon genes pathway in diabetes and its complications
Authors: Fan Ming-Wei , Tian Jin-Lan , Chen Tan , Zhang Can , Liu Xin-Ru , Zhao Zi-Jian , Zhang Shu-Hui , Chen Yan
Published: September 2024

Diabetes mellitus (DM) is one of the major causes of mortality worldwide, with inflammation being an important factor in its onset and development. This review summarizes the specific mechanisms of the cyclic guanosine monophosphate-adenosine monophosphate synthase (cGAS)-stimulator of interferon genes (STING) pathway in mediating inflammatory responses. Furthermore, it comprehensively presents related research progress and the subsequent involvement of this pathway in the pathogenesis of early-stage DM, diabetic gastroenteropathy, diabetic cardiomyopathy, non-alcoholic fatty liver disease, and other complications. Additionally, the role of cGAS-STING in autonomic dysfunction and intestinal dysregulation, which can lead to digestive complications, has been discussed. Altogether, this study provides a comprehensive analysis of the research advances regarding the cGAS-STING pathway-targeted therapeutic agents and the prospects for their application in the precision treatment of DM.
Delayed treatment of diabetic foot ulcer in patients with type 2 diabetes and its prediction model
Authors: Chen Hui , Xi Ying
Published: September 2024

BACKGROUND

Diabetic foot (DF) is a serious complication of type 2 diabetes. This study aimed to investigate the factors associated with DF occurrence and the role of delayed medical care in a cohort of patients with type 2 diabetes.

AIM

To reveal the impact of delayed medical treatment on the development of DF in patients with type 2 diabetes and to establish a predictive model for DF.

METHODS

In this retrospective cohort study, 292 patients with type 2 diabetes who underwent examination at our hospital from January 2023 to December 2023 were selected and divided into the DF group (n = 82, DF) and nondiabetic foot group (n = 210, NDF). Differential and correlation analyses of demographic indicators, laboratory parameters, and delayed medical treatment were conducted for the two groups. Logistic regression was applied to determine influencing factors. Receiver operating characteristic (ROC) analysis was performed, and indicators with good predictive value were selected to establish a combined predictive model.

RESULTS

The DF group had significantly higher body mass index (BMI) (P < 0.001), disease duration (P = 0.012), plasma glucose levels (P < 0.001), and HbA1c (P < 0.001) than the NDF group. The NDF group had significantly higher Acute Thrombosis and Myocardial Infarction Health Service System (ATMHSS) scores (P < 0.001) and a significantly lower delayed medical treatment rate (72.38% vs 13.41%, P < 0.001). BMI, duration of diabetes, plasma glucose levels, HbA1c, diabetic peripheral neuropathy, and nephropathy were all positively correlated with DF occurrence. ATMHSS scores were negatively correlated with delayed time to seek medical treatment. The logistic regression model revealed that BMI, duration of diabetes, plasma glucose levels, HbA1c, presence of diabetic peripheral neuropathy and nephropathy, ATMHSS scores, and delayed time to seek medical treatment were influencing factors for DF. ROC analysis indicated that plasma glucose levels, HbA1c, and delayed medical treatment had good predictive value with an area under the curve of 0.933 for the combined predictive model.

CONCLUSION

Delayed medical treatment significantly affects the probability of DF occurrence in patients with diabetes. Plasma glucose levels, HbA1c levels, and the combined predictive model of delayed medical treatment demonstrate good predictive value.