bluuebunny/crossref_metadata_2025 huggingface dataset:
Navigating the Storm; Effective Crisis Communication Strategies
Authors: Mwandembo Faraja
Published: April 2024

This article explores the critical role of effective crisis communication in navigating organizational challenges. It highlights the importance of proactive planning, transparency, and empathy in mitigating the negative impact of crises and preserving stakeholder trust. The introduction emphasizes the growing interconnectedness of the world and the frequency of crises faced by organizations. These crises can significantly impact reputation, operations, and even survival. The article defines crisis communication as a public relations strategy aimed at protecting an organization during a public challenge to its reputation. Following this, the piece delves into the importance of effective crisis communication. Research indicates that poorly managed communication can escalate crises into public relations disasters. The Tylenol poisoning incident of 1982 serves as a prime example, where Johnson & Johnson's swift and transparent response helped restore public trust. Effective crisis communication strategies contribute to preserving reputation, maintaining trust, ensuring legal compliance, protecting stakeholder interests, and facilitating organizational learning and improvement. The article then outlines essential steps for navigating a crisis through communication. It emphasizes the importance of proactive planning, including identifying potential crises, establishing communication protocols, and outlining response strategies. Transparency is a crucial element, as withholding information can erode trust and fuel speculation. Additionally, empathy and acknowledging the concerns of those affected by the crisis are vital for fostering understanding and support. Furthermore, the article details the creation of a crisis communication plan. This plan should establish clear objectives and key messages, assemble a dedicated crisis communication team with diverse expertise, and allocate sufficient resources for effective communication. Moving on, the article explores specific techniques for effective crisis communication. Open and transparent communication forms the cornerstone, even amid uncertainties. It highlights the need to balance transparency with responsible communication, acknowledging limitations when necessary. Regular and consistent communication updates are crucial for building trust. Timely and accurate information dissemination is equally important. Delays can create a space for misinformation to flourish. Establishing clear communication protocols beforehand ensures a swift and coordinated response when a crisis strikes. Utilizing a multi-channel approach, encompassing press briefings, social media engagement, and website announcements, empowers organizations to effectively communicate with all stakeholders. Finally, the article emphasizes tailoring messages to different stakeholders. Employees, customers, and investors will each have distinct information needs and preferred communication styles. Addressing these variations ensures effective crisis response and fosters understanding during turbulent times.
Voice to Text Conversion using Deep Learning
Authors: Azhagusundaram R. , Naveen Ravipati , Ganesh Ravipati Ganesh , Sivani Rambha , Kumari Jha Pragya
Published: April 2024

Speech recognition is one of the quick developing engineering innovation. It has numerous applications in different areas, and offers numerous potential benefits. Numerous individuals might not communicate due to the dialect obstruction. Our objective is to diminish this boundary with our program planned and created to get to the framework in particular cases, giving crucial help in empowering individuals to share data by working the framework utilizing voice input May. This venture takes that calculate under consideration and endeavors to guarantee that our program recognizes discourse and changes over the input sound to content; This empowers the client to perform record operations such as spare, open, or select out of voice-only input. We plan a framework that recognizes human voices and sound clips and interprets between English and English. The yield is in content arrange and we offer choices to change over the sound from one dialect to another. Following, we trust to include a work that gives word reference implications for English words. Neural machine interpretation is the essential strategy utilized to perform machine interpretation within the industry. This work on discourse acknowledgment starts with an presentation to the innovation and its applications in different areas. Portion of the report is based on computer program enhancements in speech recognition.
El ‘noirfronterizo’: violencia, migración, intertextualidad y paranoia enLas tierras arrasadasde Emiliano Monge
Authors: ALONSO MARÍA ALONSO , SELLÉS CARMEN LUNA
Published: April 2024

Las tierras arrasadas(2015), novela del mexicano Emiliano Monge, es unaroad novelque lleva al público lector a la frontera entre México y Guatemala para explorar el lado más oscuro del ser humano. Se trata de un texto con ciertas características propias delnoiry que se instalan de forma heterodoxa en el texto como estrategia narrativa, forzando una reinterpretación del género negro. Sugerimos el término ‘noirfronterizo’ para definir esta obra donde la intertextualidad, a través de continuas referencias a laDivina comedia(c. 1308–1321) de Dante, y lo testimonial, a través de entrevistas reales con migrantes recogidas de fuentes como Amnistía Internacional, juegan un papel fundamental para construir una trama trepidante que en ningún momento baja de nivel. Elnoirfronterizo deLas tierras arrasadasilustra las violencias visibles e invisibles, así como la ficción paranoica de un texto que sirve para recordar al público lector que la realidad es más dura, si cabe, que la ficción.
Absolute Calibration. IV. Use of G-type Stars as Primary Calibrators
Authors: Rieke G. H. , Schlawin Everett , Proffitt Charles R. , Willmer Christopher
Published: April 2024

We demonstrate an approach to determine spectral energy distribution (SED) templates that are accurate to the 1% level from the visible through the infrared for nearby (unextincted) solar-type stars. Our approach is based only on measurements of T
eff, log(g), and M/H and the use of standard theoretical SED models. The success of this approach confirms that the existing absolute calibration is likely to be accurate to this level throughout this spectral range. We then demonstrate how to measure and correct for extinction, allowing extension of this calibration approach to faint levels (and more distant stars). We provide template SEDs in digital form for 11 G-dwarf stellar calibrators.
Velocity Dispersion of the Open Cluster NGC 2571 by Radial Velocities and Proper Motions
Authors: Kulesh Maxim V. , Samirkhanova Aleksandra E. , Carraro Giovanni , Sales-Silva Joao V. , Capuzzo Dolcetta Roberto , Seleznev Anton F.
Published: April 2024

We use a kernel density estimator method to evaluate the stellar velocity dispersion in the open cluster NGC 2571. We derive the 3D velocity dispersion using both proper motions as extracted from Gaia Data Release 3 and single-epoch radial velocities as obtained with the instrument FLAMES at ESO's Very Large Telescope. The mean-square velocity along the line of sight is found to be larger than the one in the tangential direction by a factor of 6–8. We argue that the most likely explanation for such an occurrence is the presence of a significant quantity of unresolved binary and multiple stars in the radial velocity sample. Special attention should be paid to single-line spectroscopic binaries (SB1) since in this case we observe the spectral lines of the primary component only, and therefore the derived radial velocity is not the velocity of the binary system center of mass. To investigate this scenario, we performed numerical experiments varying the fractional abundance of SB1 in the observed sample. These experiments show that the increase of the mean-square radial velocity depends on the fractional abundance of SB1 to a power in the range [0.39, 0.45]. We used the 3D velocity dispersion obtained by the dispersions in the tangential directions and the assumption that the radial velocity dispersion is the same as a tangential one to estimate the virial cluster mass and the cluster mass, taking into account the gravitational field of the Galaxy and the nonstationarity of the cluster. These estimates are 650 ± 30 M
⊙ and 310 ± 80 M
⊙, respectively, in substantial agreement with the photometric cluster mass.
Data-driven Discovery of Diffuse Interstellar Bands with APOGEE Spectra
Authors: McKinnon Kevin A. , Ness Melissa K. , Rockosi Constance M. , Guhathakurta Puragra
Published: April 2024

Data-driven models of stellar spectra are useful tools to study nonstellar information, such as the diffuse interstellar bands (DIBs) caused by intervening interstellar material. Using ∼55,000 spectra of ∼17,000 red clump stars from the APOGEE DR16 data set, we create second-order polynomial models of the continuum-normalized flux as a function of stellar parameters (T
eff,

log
g

, [Fe/H], [α/Fe], and age). The model and data show good agreement within uncertainties across the APOGEE wavelength range, although many regions reveal residuals that are not in the stellar rest-frame. We show that many of these residual features—having average extrema at the level of ∼3% in stellar flux on average—can be attributed to incompletely removed spectral lines from the Earth’s atmosphere and DIBs from the interstellar medium (ISM). After removing most of the remaining contamination from Earth’s sky, we identify 84 absorption features not seen in unreddened sightlights that have <50% probability of being noise artifacts—with 25 of these features having <5% probability of being noise artifacts—including all 10 previously known DIBs in the APOGEE wavelength range. Because many of these features occur in the wavelength windows that APOGEE uses to measure chemical abundances, note that characterization and removal of this nonstellar contamination establish an important step in reaching the precision required for chemical tagging experiments. Proper characterization of these features will benefit Galactic ISM science and the currently ongoing Milky Way Mapper program of Sloan Digital Sky Survey V, which relies on the APOGEE spectrograph.
A Geometric Neutron Star Model of Repeating and Nonrepeating Fast Radio Bursts
Authors: Liu Ze-Nan , Xia Zhao-Yang , Zhong Shu-Qing , Wang Fa-Yin , Dai Zi-Gao
Published: April 2024

Fast radio bursts (FRBs) are millisecond-duration extragalactic radio transients. They fall into the categories of repeaters and apparent nonrepeaters. However, such a classification causes a lack of motivation to investigate the physical picture. Here, we propose a unified geometric model to distinguish between repeaters and apparent nonrepeaters, in which the quasi-tangential (QT) propagation effect within the magnetosphere of a neutron star is considered. In this model, apparent nonrepeaters arise from sources whose emitting region has a smaller impact angle with respect to the magnetic axis, while repeaters come from sources whose emitting region has a larger impact angle. The observational discriminant polarization properties between repeaters and apparent nonrepeaters are an important clue for verifying this unified geometric model since the polarization is sensitive to the QT propagation effect. Moreover, our model effectively explains all of the other discriminant properties, including bandwidth, duration, peak luminosity, energy, brightness temperature, time–frequency downward drifting, and repetition rate, providing compelling evidence for the magnetospheric origin of FRBs.
Compton Scattering of Electrons in the Intergalactic Medium
Authors: Yang Yuanyuan , Long Heyang , Hirata Christopher M.
Published: April 2024

This paper investigates the distribution and implications of cosmic-ray electrons within the intergalactic medium (IGM). Utilizing a synthesis model of the extragalactic background, we evolve the spectrum of Compton-included cosmic rays. The energy density distribution of cosmic-ray electrons peaks at redshift z ≈ 2, and peaks in the ∼MeV range. The fractional contribution of cosmic-ray pressure to the general IGM pressure progressively increases toward lower redshift. At mean density, the ratio of cosmic-ray electron to thermal pressure in the IGM

P

CRe

/

P

th

is 0.3% at z = 2, rising to 1.0% at z = 1, and 1.8% at z = 0.1 (considering only the cosmic rays produced locally by Compton scattering). We compute the linear Landau damping rate of plasma oscillations in the IGM caused by the ∼MeV cosmic-ray electrons, and find it to be of order ∼10−6 s−1 for wavenumbers 1.2 ≲ ck/ω
p ≲ 5 at z = 2 and mean density (where ω
p is the plasma frequency). This strongly affects the fate of TeV e
+
e
− pair beams produced by blazars, which are potentially unstable to oblique instabilities involving plasma oscillations with wavenumber

ck

/

ω

p

≈
sec
θ

(θ being the angle between the beam and wavevector). Linear Landau damping is at least thousands of times faster than either pair beam instability growth or collisional effects; it thus turns off the pair beam instability except for modes with very small θ (ck/ω
p → 1, where linear Landau damping is kinematically suppressed). This leaves open the question of whether the pair beam instability is turned off entirely, or can still proceed via the small-θ modes.
Observability of Substructures in the Planet-forming Disk in the (Sub)centimeter Wavelength with SKA and ngVLA
Authors: Wu 吴 Yinhao 寅昊 , Liu 刘 Shang-Fei 尚飞 , Jiang 蒋 Haochang 昊昌 , Nayakshin Sergei
Published: April 2024

Current imaging observations of protoplanetary disks using the Atacama Large Millimeter/submillimeter Array (ALMA) primarily focus on the submillimeter wavelength, leaving a gap in effective observational approaches for centimeter-sized dust, which is crucial to the issue of planet formation. The forthcoming Square Kilometre Array (SKA) and ngVLA may rectify this deficiency. In this paper, we employ multifluid hydrodynamic numerical simulations and radiative transfer calculations to investigate the potential of SKA1-Mid, ngVLA, and SKA2 for imaging protoplanetary disks at subcentimeter/centimeter wavelengths. We create mock images with ALMA/SKA/ngVLA at multiwavelengths based on the hydrodynamical simulation output and test different sensitivity and spatial resolutions. We discover that both SKA and ngVLA will serve as excellent supplements to the existing observational range of ALMA, and their high resolution enables them to image substructures in the disk’s inner region (∼5 au from the stellar). Our results indicate that SKA and ngVLA can be utilized for more extended monitoring programs in the centimeter wave band. While in the subcentimeter range, ngVLA possesses the capability to produce high-fidelity images within shorter observation times (∼1 hr on source time) than previous research, holding potential for future survey observations. We also discuss for the first time the potential of SKA2 for observing protoplanetary disks at a 0.7 cm wavelength.
An Exactly Energy-conserving Electromagnetic Particle-in-cell Method in Curvilinear Coordinates
Authors: Croonen J. , Pezzini L. , Bacchini F. , Lapenta G.
Published: April 2024

In this paper, we introduce and discuss an exactly energy-conserving particle-in-cell method for arbitrary curvilinear coordinates. The flexibility provided by curvilinear coordinates enables the study of plasmas in complex-shaped domains by aligning the grid to the given geometry or by focusing grid resolution on regions of interest without overresolving the surrounding, potentially uninteresting domain. We have achieved this through the introduction of the metric tensor, the Jacobian matrix, and contravariant operators combined with an energy-conserving fully implicit solver. We demonstrate the method’s capabilities using a Python implementation to study several one- and two-dimensional test cases: the electrostatic two-stream instability, the electromagnetic Weibel instability, and the geomagnetic environment modeling reconnection challenge. The test results confirm the capability of our new method to reproduce theoretical expectations (e.g., instability growth rates) and the corresponding results obtained with a Cartesian uniform grid when using curvilinear grids. Simultaneously, we show that the method conserves energy to machine precision in all cases.
Les éternelles questions existentielles
Authors: Citot Vincent
Published: April 2024

La philosophie, dans toutes ses dimensions et spécialités, est une activité qui s’exerce en contexte (historique, culturel et sociopolitique) en même temps qu’elle ambitionne de s’élever à l’universel et au transculturel. Mais le poids du contexte n’affecte pas identiquement tous les champs de la discipline. Dans le domaine cognitif, il est écrasant ; dans le domaine axiologique, il est modéré ; dans le domaine pratique, il est léger. Les questionnements existentiels, qui relèvent de la philosophie pratique, sont particulièrement peu contextualisés. Ils sont presque invariables, parce que l’existence humaine est, au fond, assez semblable à elle-même par-delà la diversité des existants. L’universalisme existentiel est d’un autre ordre que l’universalisme théorique.
Réflexions autour de Merleau-Ponty et de l’écriture dans la recherche en philosophie
Authors: Jesuha Thomas
Published: April 2024

Dans cet article, il s’agit d’interroger les conditions d’écriture de la philosophie universitaire à partir de certains traits repérables dans ses productions textuelles. Sans chercher à essentialiser une réalité qui est par définition plurielle et traversée d’une variété de styles, nous pensons cependant qu’on peut repérer, dans la littérature de recherche en philosophie, une tendance des textes à chercher à démontrer leur légitimité à partir de leur forme même d’écriture. C’est à partir de la phénoménologie de Maurice Merleau-Ponty que nous voulons mettre en lumière ces traits formels, car le plaidoyer du philosophe français en faveur de l’expressivité dans les différentes formes de rapport au monde permet de contraster avec les normes techniques et intentionnelles qui poussent les textes de recherche à affirmer avant tout leur conformité à des standards.
Transgressions
Authors: Fréjaville Annette
Published: April 2024

La fonction paternelle, fonction symbolique, fait tiers entre la mère et son enfant. Elle est contrainte à l’éducation et à la civilisation. Elle procède du père œdipien qui est lui-même reviviscence du Père des origines. Les enfants ont à composer avec les injonctions et interdictions transmises par cette fonction paternelle, qui se réfère au couple idéal du moi/surmoi, des parents mais aussi de la société d’appartenance. Les transgressions des enfants sont souvent des interrogations quant à la cohérence des exigences rencontrées, quant à la constitution de la fonction paternelle.
Transgressions
Authors: Dechaud-Ferbus Monique
Published: April 2024

Le recours au corps, notamment au toucher, dans la PPC, a pu apparaître transgressif et a souvent éveillé la suspicion concernant la séduction, l’érotisation et la suggestion ; il se révèle cependant nécessaire pour revenir aux fondements de l’appareil psychique. L’élaboration du contre-transfert de l’analyste permet à ce dernier d’en éviter les écueils. Au stade du passage par l’acte qu’est le toucher prégénital, les manifestations du vécu échotactile redynamisent le fonctionnement psychique pour aboutir au double interdit du toucher œdipien.
Coercition et détention dans le cadre de l’addiction aux substances psychoactives : A propos de 2 cas observés au Centre Spécialisé de Détention et de Réinsertion des Femmes (CSDRF) « Bollée) de Bamako (Mali)
Authors: Traoré Kadiatou , Traoré Joseph , Coulibaly Souleymane dit Papa , Mounkoro Pakuy Pierre , Tembely Mody Baba , Maiga Aboubacar H. , Dara Aperou Eloi , Koné Mahamadou , Kodjougou Diabaté Mahamadou , Kamaté Zoua , Kamissoko Talibé , Diarra Zoumana , Togola Hawa , Ag Ismael Alkassane , Diop Maïmouna , Mouhoumed Hassan , Togora Arouna , Coulibaly Souleymane , Coulibaly Bakoroba , Koumaré Baba
Published: April 2024

La lutte contre les addictions est une impasse au Mali, on constate que des placements sont faits dans des structures de détention à but répressif ou d’arrêt de consommation des substances sans tenir compte des conséquences que cela pourrait engendrer. Nous rapportons deux situations cliniques de conduites addictives ayant conduit à la détention comme moyen de dissuasion et de traitement. Il s’agissait des observations cliniques de deux jeunes filles XX âgée de 25 ans et de ZZ âgée de 16 ans détenues au centre spécialisé de détention et de réinsertion des femmes (Bollée) pour consommations de substances psychoactives, difficultés socioprofessionnelles et overdose pour XX, difficultés scolaire et relationnelle avec fugue pour ZZ. L’examen psychiatrique a trouvé chez elles des troubles de l’usage de substances psychoactives. La détention loin d’être une solution ne peut qu’être nocive pour la prise en charge efficace d’une addiction.
Facteurs socio-familiaux liés à l’abus de consommation de cannabis vus au service de psychiatrie de Morafeno Antsiranana
Authors: Barihely Bienvenido , Tonina Roxane , Ravonirina Eric Alson , Zanadaory  , Andriamiakatsoa Raobelle Evah Norotiana , Raharivelo Adeline
Published: April 2024

Introduction : Le cannabis est la substance illicite la plus consommée dans le monde, et intéresse la population jeune. L’objectif de cette étude était de décrire les facteurs socio-familiaux liés à l’abus de consommation de cannabis. Méthodologie : Il s’agit d’une étude rétrospective, descriptive et monocentrique des patients consommateurs de cannabis admis au service de psychiatrie de Morafeno Antsiranana, sur une période de 3 ans. Résultats : Parmi les 551 patients hospitalisés, et 88 ont été sélectionnés. L’âge moyen a été 24,43 ans, majoritairement de genre masculin (96,6 %) dont 93,2 % ont fumé en groupe, 80, 7 % ont été célibataire et 63,6 % ont été vécu dans d’une famille monoparentale. L’influence de groupe (62,5 %) a dominé le motif de consommation. Conclusion : Cette substance intéresse un certain nombre d’individus. La connaissance des facteurs liés à cette consommation pourrait contribuer à freiner sa progression.
Les « quartiers » français
Authors: de Santos Barbosa Joaquín
Published: April 2024

Les quartiers français sont l’objet de fantasmes dans l’imaginaire collectif. Leur problématisation en tant que territoires exclus nécessitant une action de la part de l’État ne va toutefois pas de soi, elle est l’objet d’une dynamique qui a évolué et a été contestée. Nous verrons également comment ce processus a pu influencer l’action publique belge envers ses propres quartiers.
Adapter l’intervention sociale à l’exclusion rurale
Authors: Maisin Charlotte
Published: April 2024

Comment le travail social s’organise-t-il au sein des territoires wallons ruraux ? Comment envisager et organiser la couverture de quartiers situés hors des villes et des agglomérations, peu desservis en transports en commun ? Comment y détecte-t-on les situations de fragilité, de désaffiliation, de stigmatisation ? Cet article propose un récit des savoirs professionnels, donnant à voir les difficultés et les leviers de dispositifs de terrain dans l’accompagnement de la parentalité et des familles précarisées et marginalisées vivant au sein des territoires isolés de Wallonie.
Christian Baudelot. Un sociologue collectif
Authors: Serre Delphine
Published: April 2024

Christian Baudelot est l’auteur d’ouvrages majeurs sur l’école, co-écrits avec Roger Establet ( L’école capitaliste en France, Le niveau monte , Allez les filles ! ) et de nombreux autres explorant l’ampleur des inégalités dans des domaines divers (salaires, suicides, lecture des jeunes, travail, greffe avec donneur vivant, etc.). Né en 1938, il découvre la sociologie dans le contexte intellectuel des années 1960 et se familiarise avec l’enquête statistique dont il restera un fervent adepte et pédagogue toute sa carrière. Dans son parcours, il revient sur sa formation, sa carrière, sa pratique collective de la sociologie et sur les expériences conjugales et pédagogiques qui l’ont conduit à s’intéresser aux inégalités entre femmes et hommes et plus seulement aux inégalités de classe.
Sous le vernis des ongles et des capots : les risques du métier
Authors: Rollin Zoé
Published: April 2024

À partir d’une enquête ethnographique menée en centres de formation des apprentis, cet article entend interroger le rapport à la formation, au travail, et aux expositions professionnelles tel qu’il est appréhendé par des apprenti·es en filière Beauté (esthétique et coiffure) et maintenance Automobile (mécanique et carrosserie). Le rapport à la pénibilité, traversé par des processus genrés, se construit lentement, au fil d’une socialisation tout à la fois familiale, scolaire et professionnelle. Cet article vise à étayer la synergie construite progressivement qui aboutit à une normalisation de la pénibilité, couplée à une invisibilisation persistante du risque chimique en apprentissage.
Models of Power System Elements in Phase Coordinates for the Study of Non-Symmetrical Steady-State and Transition Modes
Authors: Ibrahimov Famil
Published: April 2024

One of the main issues is the construction of mathematical models of its elements and three-phase replacement schemes to study the non-symmetric steady-state and transition modes of modern energy systems in phase coordinates. Therefore, in the work under review, the replacement scheme and mathematical models of the main elements for the calculation of the non-symmetric steady-state and transition processes of the energy system are given.
Pecto-intercostal Fascial Plane Block: A Novel Technique for Analgesia in Patients with Sternal Dehiscence
Authors: Joshi Pooja , Borde Deepak , Apsingekar Pramod , Pande Swati , Tandale Mangesh , Deodhar Anand , Jangle Sachin
Published: April 2024

Sternal wound complications following sternotomy need a multidisciplinary approach in high-risk postoperative cardiac surgical patients. Poorly controlled pain during surgical management of such wounds increases cardiovascular stress and respiratory complications. Multimodal analgesia including intravenous opioids, non-opioid analgesics, and regional anesthesia techniques, like central neuraxial blocks and fascial plane blocks, have been described. Pecto-intercostal fascial plane block (PIFB), a novel technique, has been effectively used in patients undergoing cardiac surgery. Under ultrasound (US) guidance PIFB is performed with the aim of depositing local anesthetic between two superficial muscles, namely the pectoralis major muscle and the external intercostal muscle. The authors report a series of five cases where US-guided bilateral PIFB was used in patients undergoing sternal wound debridement. Patients had excellent analgesia intraoperatively as well as postoperatively for 24 hours with minimal requirement of supplemental analgesia. None of the patients experienced complications due to PIFB administration. The authors concluded that bilateral PIFB can be effectively used as an adjunct to multimodal analgesia with general anesthesia and as a sole anesthesia technique in selected cases of sternal wound debridement.
3D Virtual Bronchoscopy as an Aid to Airway Management in a Patient with Anterior Mediastinal Mass
Authors: Arora Divya , Tewari Prabhat , Shamshery Chetna , Chandra Bipin , Gupta Archna , Pal Lily
Published: April 2024

Mediastinal masses pose one of the great challenges for any anesthesiologist during airway maintenance, underlining the need to devise a well-formulated plan to avoid perioperative complications. As a general rule, such patients are managed with spontaneous ventilation without the use of muscle relaxants and awake intubation. We report a case of a 66-year-old male with severe dyspnea, having a very large invasive anterior mediastinal mass, causing left lung collapse for urgent debulking surgery. The tracheobronchial compromise was ruled out using three-dimensional reconstruction on computed tomography imaging (virtual bronchoscopy) and that helped in using general anesthesia with muscle relaxation for subsequent endotracheal intubation and surgery.
Late Migration of Fully Deployed Left Main Coronary Stent into Aortic Root: A Late Complication and Its Surgical Management
Authors: Ahmad Tanveer , Alafifi Azza Abdelalem , Aldossari Mubarak , Tasca Giordano , Aljerayed Nasser
Published: April 2024

Migration and embolization of a deployed stent is a rare complication of percutaneous coronary interventions (PCI) and can result in serious and potentially life-threatening complications. There are many reports of intracoronary stent entrapment, stripping, and dislodgement during PCI, however, only a few reports about migration. We report a rare case of migration of the left main coronary stent into the aortic root, which happened 5 months after the procedure and was treated by its partial removal through aortotomy along with surgical revascularization. The patient was discharged 5 days later, after an uneventful hospital stay.
A Novel Case of SCN1A Mutation Presenting as Hyperkinetic Movement Disorder
Authors: Mohinish S. , Cornelius Leema P. , Elango Neeraj , Livingston Jered K.
Published: April 2024

SCN1A mutation is most often associated with Dravet syndrome, which is characterized by severe encephalopathy. One of the other presentations of SCN1A mutation is developmental and epileptic encephalopathy-6B (DEE6B). It is a severe neurodevelopmental disorder characterized by early-infantile seizure onset, profoundly impaired intellectual development, and a hyperkinetic movement disorder. Here we report a rare case of novel SCN1A mutation presenting as hyperkinetic movement disorder in the form of multifocal dystonia and parakinesia in a 12-year-old boy, which aggravated with the use of sodium channel blockers.
Machine learning approach to assess the association between anthropometric, metabolic, and nutritional status and semen parameters
Authors: Bachelot Guillaume , Lamaziere Antonin , Czernichow Sebastien , Faure Celine , Racine Chrystelle , Levy Rachel , Dupont Charlotte ,   Nutrition and Fertility (ALIFERT) Group
Published: April 2024

Many lifestyle factors, such as nutritional imbalance leading to obesity, metabolic disorders, and nutritional deficiency, have been identified as potential risk factors for male infertility. The aim of this study was to evaluate the relationship between semen parameters and anthropometric, metabolic and nutritional parameters. Relationship was first assessed individually, then after the application of a previously constructed and validated machine learning score that allows their combination. Anthropometric, metabolic, antioxidant, micronutrient, and sperm parameters from 75 men suffering from idiopathic infertility from four infertility centers in France (Jean-Verdier ART Center Hospital, Bondy; North Hospital ART Center, Saint-Étienne; Navarre Polyclinic ART Center, Pau; and Cochin Hospital ART Center, Paris) between September 2009 and December 2013 were collected. After assessing standard correlation analysis, a previously built machine learning model, providing a score ranging from 0 (the poorest) to 1 (the most favorable), was calculated for each man in the study cohort. This machine learning model, which separates infertile/fertile men with unexplained infertility on the basis of their bioclinical signature, provides a more holistic evaluation of the influence of the considered markers (anthropometric, metabolic, and oxidative status). We observed a significant correlation of some anthropometric, metabolic, and nutritional disorders with some sperm characteristics. Moreover, an unfavorable machine learning score was associated with a high level of sperm DNA fragmentation. Favorable anthropometric, metabolic, and oxidative patterns, which may reflect an appropriate lifestyle, appear to positively impact overall health, in particular reproductive function. This study, consistent with previous publications, suggests that beyond semen quality parameters, in an essential assessment of male fertility, other key factors should be taken into account. In this regard, the application of emerging artificial intelligence techniques may provide a unique opportunity to integrate all these parameters and deliver personalized care.
Fibromuscular Dysplasia Implicated in Spontaneous Coronary Artery Dissection (SCAD): A Case Report of Chest Pain in Young Women
Authors: Al-Mahrizi Balqees , Al Kindi Fahad , Al Kindi Faiza , Al Hajri Ruqyia , Al Ismaili Abdullah , Al Kindi Ahmed
Published: April 2024

Spontaneous coronary artery dissection (SCAD) is a well‐recognized cause of acute coronary syndrome (ACS) which can lead to myocardial infarction and sudden death. Unlike typical atherosclerosis, SCAD operates through distinct pathophysiology, affecting both individuals with and without conventional cardiovascular risk factors. We present a case of a young female presented with retrosternal chest pain radiating to the left arm, mimicking ACS symptoms with mildly elevated troponin levels, and slightly reduced left ventricular ejection fraction (45%). Subsequent evaluation using coronary angiography unveiled a Type 2A SCAD. A comprehensive computed tomography angiography (CTA) of her entire body revealed findings suggestive of fibromuscular dysplasia (FMD) affecting multiple arteries in different sites. Our case entailed the successful management of a young female patient with SCAD stemming from FMD.
Positive Predictive Value of Computerized Tomography Coronary Angiography versus Computerized Tomography Fractional Flow Reserve in a Real-world Population
Authors: Sinclair Hannah , Yongli Reuben Loi , Farag Mohamed , Alkhalil Mohammad , Beattie Anna , Egred Mohaned
Published: April 2024

Background:

Computed Tomography coronary angiography and fractional flow reserve (CTCA and CT-FFR) are noninvasive diagnostic tools for the detection of flow-limiting coronary artery stenoses. Although their negative predictive values are well established, there is a concern that the high sensitivity of these tests may lead to overestimation of coronary artery disease (CAD) and unnecessary invasive coronary angiography (ICA). We compared the positive predictive value (PPV) of CT-FFR with computerized tomography coronary angiography (CTCA) against the gold standard of ICA in different real-world patient groups.

Methods:

A retrospective analysis of 477 patients referred for CTCA or CT-FFR for investigation of possible coronary ischemia. Patients were excluded if the image quality was poor or inconclusive. Patient-based PPV was calculated to detect or rule out significant CAD, defined as more than 70% stenosis on ICA. A sub-analysis of PPV by indication for the scan was also performed. Patients who underwent invasive nonhyperemic pressure wire measurements had their instant wave-free ratio or resting full-cycle ratio compared with their CT-FFR values.

Results:

In a patient-based analysis, the overall PPV was 59.3% for CTCA and 76.2% for CT-FFR. This increased to 81.0% and 86.7%, respectively, for patients with stable angina symptoms. In patients with atypical angina symptoms, CT-FFR considerably outperformed CTCA with a PPV of 61.3% vs. 37.5%. There was not a linear relationship between invasive pressure wire measurement and CT-FFR value (r = 0.23, P = 0.265).

Conclusion:

The PPV of CTCA and CT-FFR is lower in the real world than in previously published trials, partly due to the heterogeneity of indication for the scan. However, in patients with typical angina symptoms, both are reliable diagnostic tools to determine the presence of clinically significant coronary stenoses. CT-FFR significantly outperforms CTCA in patients with more atypical symptoms and the targeted use of CT-FFR in this group may help to avoid unnecessary invasive procedures.
Emergence characteristics comparing endotracheal tube to reinforced laryngeal mask airway during endoscopic sinus surgery – A randomised controlled study
Authors: Raokadam Vasanth , Thiruvenkatarajan Venkatesan , Bouras George S. , Zhang Alex , Psaltis Alkis
Published: April 2024

Background and Aims:

During endoscopic sinus surgery, anaesthetic conditions significantly impact the intraoperative surgical field and bleeding during emergence. While the endotracheal tube (ETT) has been traditionally used in sinus surgery, a reinforced laryngeal mask airway (RLMA) that produces less upper airway stimulation may result in smoother emergence.

Methods:

A randomised controlled trial of 72 patients undergoing elective sinus surgery was conducted, with the allocation of airway technique to either ETT with a throat pack or RLMA. The primary outcome measure was emergence time, measured by time to opening eyes on commands at the cessation of anaesthesia, and the secondary outcomes were time to removal of airway device, remifentanil use, procedure times, mean arterial pressure (MAP) and the RLMA grade of blood contamination. The continuous variables were analysed using Student’s t-tests and discrete variables, count tables were analysed using Fisher’s exact tests.

Results:

There was no significant difference in the emergence time between the ETT and RLMA groups (P = 0.83). Remifentanil use was significantly higher in the ETT group than in the RLMA group (P = 0.022). The ETT group showed a significantly increased total anaesthetic time (P = 0.01). MAP was not significant during preinduction, maintenance or post-RMLA removal. The highest grade of contamination was grade 2 in RLMA. RLMA had lower rates of postoperative adverse events.

Conclusions:

RLMA comparable to ETT in terms of emergence time. The RMLA group had lower remifentanil use, anaesthesia duration and fewer postoperative adverse events such as cough and throat pain.
A Clinical, Dermoscopic, and Histopathological Study of Follicular Psoriasis
Authors: Saep Maqbool , Shenoy Manjunath Mala , Rao Anuradha C. K. , Pinto Malcolm , Hegde Spandana Prakash , Iqbal Amina Asfiya M.
Published: April 2024

Introduction:

Follicular psoriasis is one of the underdiagnosed clinical types of psoriasis. Literature is grossly limited to anecdotal case reports and series. Clinical and investigational aspects are not studied in depth.

Materials and Methods:

A study was conducted to determine the frequency of follicular psoriasis, which includes cases with an exclusive or substantial number of follicular lesions. We analyzed the clinical, dermoscopic, and histopathological features of follicular psoriasis in a descriptive study.

Results:

A total of 117 patients with psoriasis were screened. An exclusive or substantial number of follicular lesions were found in 22 patients. Four patients had exclusively follicular lesions and others were psoriasis vulgaris with follicular psoriasis. Dermoscopy revealed perifollicular scaling and white homogeneous area with normal terminal hair in all cases. Vascular features were visible in 14 cases and all had dotted vessels, with four having additional globules. Twenty patients revealed one or more features suggestive of follicular psoriasis on histopathology.

Conclusion:

Follicular lesions can appear exclusively or can coexist with plaque type of lesions in psoriasis. They may indicate early psoriasis lesions. Dermoscopy is a useful and rapid tool to confirm the diagnosis of follicular psoriasis. Histopathology, though confirmatory, demands an astute interpretational skill. Diagnosis of follicular psoriasis can have therapeutic implications.
Treatment Response to Diphenylcyclopropenone in Patients with Alopecia Totalis/Universalis
Authors: Varghese Smitha Ancy , Nair Sandhya S. , George Anuja Elizabeth , Yadev Induprabha
Published: April 2024

Introduction:

Alopecia totalis (AT) and Alopecia universalis (AU) are forms of Alopecia areata (AA) which represent the strongest predictor of poor prognosis since spontaneous regrowth is <10%. Topical immunotherapy agent, diphenylcyclopropenone (DPCP) has shown clinical efficacy with limited side effects in severe forms of AA. However, its specific role in AT/AU characterized by complete hair loss over the scalp can help highlight the efficacy of the drug with fewer confounders.

Methodology:

Data were collected from 18 patients diagnosed with AT/AU and treated with topical immunotherapy with DPCP as per protocol by Happle et al. Baseline Severity of Alopecia Tool (SALT) score and subclass was recorded. In the case of AU, baseline body hair loss score was also recorded. Patients were reassessed after 6 months of treatment in terms of change in SALT score and hair regrowth was assessed using the Global Assessment Score. The side effects during treatment were also assessed and recorded.

Results:

Eighteen patients of whom eleven (61.1%) were diagnosed as AU and seven (38.9%) as AT were treated. The mean age was 21.6, with a male: female ratio of 3:2. The comorbidities noted were atopy in six (33.3%), atopy and hypothyroidism in one (5.5%), Down’s syndrome in two (11.1%), and hypothyroidism alone in one (5.5%) patient. The mean duration of disease at the time of presentation was 3 years and all patients had remained refractory to various other modalities of treatment. All patients had a baseline SALT score of 100 corresponding to S5. After 6 months of treatment, 27.7% of patients did not show any response (SALT score S5), 16.6% had a score of S4, 11.1% had a score of S3, 11.1% had a score of S2, 22.2% had a score of S1, and 11.1% had a score of S0. On assessing improvement in body hair loss score, 36.3% of patients showed no improvement, 36.3% showed partial improvement, and 27.2% of patients showed complete body hair regrowth. About 55.5% of patients developed notable side effects that included severe local reactions, cervical lymphadenopathy, acne and pigmentation at the site of application as well as untreated sites.

Conclusion:

The AT/AU subtypes of AA, was amenable to treatment with contact immunotherapeutic agent DPCP with a >75% hair regrowth in 33.3% of patients. The castling phenomenon was seen in 63.6% of AU patients. The adverse effects noted were not severe enough to deter treatment.
Effectiveness of Ayurvedic medicines in iron deficiency anemia: A review
Authors: Agarwal Bhawana , Singh Naimish R , Varsakiya Jitendrakumar N
Published: April 2024

Anemia is a major global public health issue that mostly affects young children, menstruating adolescent girls and women, and pregnant and postpartum women. The most typical kind of anemia worldwide is iron deficiency anemia (IDA). According to a World Health Organization report, IDA accounts for half of all cases of anemia. The emphasis is moving toward investigating alternative therapy modalities as a result of an expanding amount of data on the adverse effects and long-term implications of conventional treatments for IDA. Ayurveda offers several formulations for the management of IDA. This study will provide the strength of evidance based Ayurveda herble remedies to manage the IDA by the review of published clinical trials which has been competed. Data searches were conducted using databases, including Medline, Cochrane Database, Embase, AYUSH research portal, and many others. All randomized controlled trials involving individuals with IDA using Ayurveda formulations (alone or in combination) with an exposure period of ≥4 weeks were included. The primary outcome assessed was hemoglobin levels. Ten clinical studies were selected, evaluating various Ayurvedic formulations including Aamalki Rasayan, Dhatri Avleha, Dhatri Lauha, Opuntia elatior juice, Trikatrayadi Lauha suspension, Dhatryarishta, Trikatrayadi Lauha, Kasisa Bhasma, Punarnava Mandura, and Pandughni Vati, all of which were found effective in treating IDA. No untoward effects were observed. Most of the Ayurvedic formulations showed statistically significant improvements in subjective and hematological parameters. From this review, it can be concluded that the results of clinical studies conducted on IDA demonstrate the definite role of Ayurveda medication in managing the condition.
Efficacy of Ayurveda medicine in renal calculi (Ashmari) with hydronephrosis: a case study
Authors: Gill Dimpal , Yadav Minu , Choudhary Amit , Sharma Rituraj , Mishra Pramod Kumar , Sharma Indumati
Published: April 2024

Introduction:

Renal stone (Mutrashmari) is one of the most common diseases of Mutravaha Srotas (urinary system). It occurs when the formation of crystals, such as calcium, oxalate, uric acid, etc., takes place due to improper functioning of the filtration in the kidney.

Case Study:

The present study deals with a 20-year-old female patient having complaints of burning micturition, acute left flank pain in the abdomen and back which was radiating from the loin to the groin region, nausea, vomiting, dysuria. She was already diagnosed with renal calculi and was taking allopathic medications since for the last 1 month. Later she encountered the same problem and consulted an Ayurvedic physician. Ayurveda management primarily focuses on Samprapti Vighattana (breaking down the pathogenesis).

Diagnosis:

It was done on the basis of symptoms and USG reports.

Intervention:

By considering the Nidana, Dosha, and Dushya, a judicial combination of Ayurveda drugs-Gokshuradi Guggulu, Varunadi Kwatha, Tab. Cystone, Syp Neeri and Pasanbhedadi Churna were advised to take orally in morning and evening with lukewarm water.

Outcomes:

At the time of consultation her USG finding showed 8 mm calculus with nephrosis. After taking the prescribed formulation for 2 months, her USG report came to normal.

Conclusion:

The prescribed Ayurvedic herbal medicines are seen to be effective in managing the day-to-day life of an Ashmari patient.
Ayurveda intervention in Riehl’s melanosis- A case report
Authors: Raut Disha Anil , Patil Divya Deepak
Published: April 2024

Riehl’s melanosis (RM) is frequently identified as a kind of facial melanosis known as pigmented contact dermatitis (PCD). It results from cosmetic fragrances and their other products. The pigmentation on the forehead, temporal, and zygomatic areas of the face ranges from dark brown to grayish-brown. Satisfactory treatments are presently lacking leading to the psychological suffering of the patient. This study aims to find a promising solution for the RM WSR Dushi Visha. In the present case study, a 45-year-old female patient suffered from RM with blackish discoloration over the periorbital region, cheeks, and in the middle of the eyebrows with severe itching and dryness for the past 22 days. The patient was managed effectively with classical Ayurveda medications. In Ayurveda, this condition can be correlated with the symptoms of Mukhalepajanya Dushi Visha (artificial poison in the form of facial cosmetics), characterized by Mukhashyavata (blackish discoloration of the face), Kotha (round patches and rashes on the skin), intense Rukshata (dryness), and Kandu (itching sensation) followed by Daha (burning sensation). The principle of treatment is Raktamokshana (bloodletting) and drugs having Kushthaghna (antidermatosis), Kandughna (antipruritic), Raktashodhaka (blood purifier), Twak Prasadana (skin quality enhancer), and Varnyakara (promotes complexion) properties. The outcome of the assessment was based on the changes in the symptoms after 15 days of treatment. Recurrence of itching and burning was not observed during the follow-up period. The case sheds on the excellent management of RM by Ayurveda modalities.
Malnutrition and Refeeding Syndrome: Report of Three Patients on Jejunostomy Feeding Following Corrosive Oesophageal Injury
Authors: Jose Toney , John Jose
Published: April 2024

Patients with alternative enteral access for corrosive oesophageal stricture are a particularly sensitive group of patients requiring dedicated nutritional care. The COVID-19 pandemic and the resulting lockdown, restrictions, financial constraints and delayed surgeries have resulted in nutritional deprivation. Many of these patients present late to healthcare institutions with severe malnutrition. Refeeding should be done carefully in them to prevent refeeding syndrome. Here, we describe the clinical course of three patients who were on jejunostomy feeds for corrosive injury of the oesophagus, developed feeding tube-related complications and presented with severe malnutrition during the COVID-19 pandemic.