bluuebunny/crossref_metadata_2025 huggingface dataset:
Impacts d’une production de biocarburant dans une économie pétro-dépendante et reconversion agricole
Authors: Mathouraparsad Sébastien , Decaluwé Bernard
Published: May 2022

Dans cet article, nous utilisons un modèle d’équilibre général calculable microsimulé pour examiner les effets sur les émissions de gaz à effet de serre, la croissance et la pauvreté monétaire d’une production de biocarburant à base de canne-à-sucre en Guadeloupe. Cette biomasse est produite par des agriculteurs qui se confrontent à des « usiniers » dans un jeu coopératif pour négocier le prix de la canne. Les résultats montrent qu’un développement de biocarburant permettrait de réduire les émissions de gaz à effets de serre, de réduire la dépendance à l’énergie fossile et de diversifier les débouchés agricoles pour les planteurs de canne. Toutefois, les effets sur la pauvreté monétaire dans cette économie dépendante au fioul seraient négatifs.
Racisme : entre exclusion sociale et peur identitaire
Authors: Seekings Jeremy , Jamart Véronique
Published: May 2022

Depuis la fin de l’apartheid, l’Afrique du Sud reste « racialisée » d’un point de vue culturel et social, et inégale en termes de revenus et d’opportunités. L’intégration demeure faible, notamment dans les champs de l’éducation et de l’emploi, malgré l’amélioration des rapports entre groupes raciaux. L’inégalité économique semble désormais moins le résultat de pratiques discriminatoires que de distances de classe.
On the asymptotic stability of a Bresse system with two fractional damping terms: Theoretical and numerical analysis
Authors: Bentrcia Toufik , Mennouni Abdelaziz
Published: May 2022

The aim of this work is to investigate the asymptotic stability of a viscoelastic Bresse system in one dimensional bounded domain. In this context, we introduce two internal damping terms expressed using the generalized Caputo fractional derivative. By adopting a diffusive representation, we show the well-posedness of the proposed system and we prove some decay results. In order to validate the theoretical findings, we implement a finite difference method and we conduct intensive numerical simulations. Moreover, we provide some insights on the convergence of the elaborated numerical scheme.
Random attractors of supercritical wave equations driven by infinite-dimensional additive noise on $ \mathbb{R}^n $
Authors: Chen Jianing , Wang Bixiang
Published: May 2022

In this paper, we prove the existence and uniqueness of tempered pullback random attractors of the supercritical stochastic wave equations driven by an infinite-dimensional additive white noise on \begin{document}$ \mathbb{R}^n $\end{document} with \begin{document}$ n\le 6 $\end{document}. We first construct a tempered pullback random absorbing set in the natural energy space, and then establish the pullback asymptotic compactness of the solution operator by applying the idea of uniform tail-ends estimates as well as the uniform Strichartz estimates of solutions to circumvent the lack of compactness of Sobolev embeddings on unbounded domains.
Energy development: A global perspective and advances in Ghana
Authors: Arthur Emmanuel
Published: May 2022

Climate change, population increase, and urbanisation present severe threats to energy security throughout the world. As a result, governments all over the world have made significant investments in diversifying and developing local energy systems, notably in the renewable energy sector. In this light, this review was conducted to analyse the production trends of fossil energy, renewable energy and nuclear energy, as well as the impact of renewable energy production on fossil energy production, between 2000 and 2021. Using correlation and regression analysis, the relationship between these energy sources and the impact of renewable energy on fossil energy production were studied and then measured against similar studies in the literature. The findings showed an increasing trend in fossil energy and renewable energy production and a slightly decreasing trend in nuclear energy production from 2000 to 2021. In addition, there was a significant impact of renewable energy production on fossil energy production in the last two decades. In Ghana, it was found that the addition of solar energy generation to the national grid significantly influenced thermal energy generation. On the whole, renewable energy production has significantly increased over the last decades, and it has the potential to reduce the dependence on fossil energy if effectively developed and managed.

Therefore, future energy development should focus on more research and development in the area of smart and efficient renewable energy technologies.
An enhanced VIKOR method for multi-criteria group decision-making with complex Fermatean fuzzy sets
Authors: Akram Muhammad , Muhiuddin G. , Santos-García Gustavo
Published: May 2022

This paper aims to propose a new decision-making approach retaining the fascinating traits of the conventional VIKOR method in the context of the enrich multidimensional complex Fermatean fuzzy $ N $-soft set. The VIKOR technique is contemplated as the most reliable decision-making approach among others which employs a strategy to identify the compromise solution with advantageous distance from the positive ideal solution possesses maximum majority utility and minimum individual regret. At the same time, the paramount characteristic of the complex Fermatean fuzzy $ N $-soft set considers the proclivity to capture two-dimensional uncertain and imprecise information along with the multi-valued parameters. This article expands the literature to handle the multi-attribute group decision-making strategy by introducing a technique, namely, the complex Fermatean fuzzy $ N $-soft VIKOR method that amalgamates the unconventional traits of complex Fermatean fuzzy $ N $-soft with the capability of the VIKOR method. The proposed technique permits the assignment of the $ N $-soft grades to the decision-makers, alternatives, and attributes based on their performances. Firstly, we unify these individual opinions of all decision-makers about the alternatives by employing the complex Fermatean fuzzy $ N $-soft weighted average operator. After that, all entities of the aggregated decision matrix are converted into crisp data by utilizing the score function. Furthermore, we calculate the ranking measures of the group utility and the individual regret by assigning the weight of strategy belongs to the interval $ [0, 1]. $ To find the compromise solution, we arrange the ranking measures in ascending order, and the alternative that possesses the conditions of compromise solution is selected. We demonstrate the presented multi-attribute group decision-making technique by selecting the best location for a nuclear power plant. We conduct the comparative analysis of the presented technique with Fermatean fuzzy TOPSIS to endorse the veracity and accuracy of our method. Finally, we explain the merits and limitations of our strategy and give some concluding remarks.
Mathematical modelling of bio-inspired frog leap optimization algorithm for transmission expansion planning
Authors: Shandilya Smita , Izonin Ivan , Shandilya Shishir Kumar , Singh Krishna Kant
Published: May 2022

Bio-inspired computing has progressed so far to deal with real-time multi-objective optimization problems. The Transmission expansion planning of the modern electricity grid requires finding the best and optimal routes for electricity transmission from the generation point to the endpoint while satisfying all the power and load constraints. Further, the transmission expansion cost allocation becomes a critical and pragmatic issue in the deregulated electricity industry. The prime objective is to minimize the total investment and expansion costs while considering N-1 contingency. The most optimal transmission expansion planning problem's solution is calculated using the objective function and the constraints. This optimal solution provides the total number and best locations for the candidates. The presented paper details the mathematical modeling of the shuffled frog leap algorithm with various modifications applied to the method to refine the results and finally proposes an enhanced novel approach to solve the transmission expansion planning problem. The proposed algorithm produces the expansion plans based on target-based evolution. The presented algorithm is rigorously tested on the standard Garver dataset and IEEE 24 bus system. The empirical results of the proposed algorithm led to better expansion plans while effectively considering typical electrical constraints along with modern and realistic constraints.
Shilling attack detection for collaborative recommender systems: a gradient boosting method
Authors: Shao Chen , Sun Yue zhong yi
Published: May 2022

Organized malicious shilling attackers influence the output of the collaborative filtering recommendation systems by inserting fake users into the rating matrix within the database. The existence of shilling attack poses a serious risk to the stability of the system. To counter this specific security threat, many attack detection methods are proposed. Some of the past methods suffer from two disadvantages, the first being that they only analyze the rating matrix from a single perspective of user rating values and ignore other perspectives. Another is that some methods only use a single classifier to handle the classification of malicious attackers. Considering the above disadvantages, this paper proposes a gradient boosting method (named XGB-SAD) to achieve attack detection by combining double-view and gradient boosting. We first analyze the rating matrix with a double-view of time and item, which in turn defines the TPUS collection. Then our method uses eXtreme Gradient Boosting to perform heuristic iterative optimization of the model's objective function and uses the idea of ensemble learning to integrate multiple sets of base classifiers into strong classifier. The integrated strong classifiers are used to complete the detection of malicious attackers. Finally, we perform several experiments and the results demonstrate that XGB-SAD outperforms the comparison methods in terms of small-scale attack detection and overall detection, which proves the performance of our method.
Deep Learning Approach to Nailfold Capillaroscopy Based Diabetes Mellitus Detection
Authors: K V Suma , Selvi Sethu , Nanda Pranav , Shetty Manisha , M Vikas , Awasthi Kushagra
Published: May 2022

Diabetes mellitus is a commonly occurring chronic metabolic disorder which has affected almost 400 million people around the world. It can lead to vascular structure alterations and various renal, cardiovascular, and neurologicalcomplications claiming several lives. Since diabetes mellitus results is vascular structure changes, NailfoldCapillaroscopy(NFC) based approach can be employed for the detection of diabetes. NFC is an inexpensive, non-invasive method which involves acquisition of images of capillaries in the nail bed region using a USB digital microscope. Qualitative parameters of the capillaries such as tortuosity, hemorrhages, angiogenesis, elongated capillariesand quantitative parameters like length, width and mean capillary density are considered for diabetes detection. About 600 capillary images of healthy and diabetic subjects were collected and further data augmentation was performed to increase this to 1018 images dataset. This paper focuses on using NFC to obtain capillary images and employdeep learning-based object detection algorithm to localize these capillary loops on the nailbed and differentiate them into five classes namely, normal, wide, elongated, tortuosity and hemorrhages. This classification is of prominent significance to medical practitioners as this helps in gauging the severity and progressionof the disorder.
Efficiency of Mobile Application of Thai Criteria Based Dispatch: A Randomized Controlled Crossover Trial
Authors: Jengsuebsant Nantanan , Wittayachamnankul Borwon , Tianwibool Parinya , Tangsuwanaruk Theerapon , Wongtanasarasin Wachira , Sutham Krongkarn
Published: May 2022

The main purpose of the emergency medical system is a timely and appropriate response that significantly impacts health outcomes. In Thailand, due to lack of staff, emergency medical personnel at the dispatch center have to multitask to interview and dispatch the EMS responses. According to these problems the novel triage mobile application “Triagist” was developed based on Criteria Based Dispatch (CBD) to optimize prehospital care.  This study is a pilot study aiming to test the app by evaluating the reliability and rapidity of code dispatching using “Triagist” compared with the usual method; ITEMS, Criteria Based Dispatch Handbook, or emergency medical personnel’ experiences only.A randomized-controlled crossover (AB/BA) design was conducted which compared mobile application “Triagist” and conventional methods. Eighteen experienced emergency medical personnel each were randomly assigned to AB or BA arm.  The primary outcome measure was the accuracy and rapidity of code dispatching to 6 simulated scenarios among experienced emergency medical personnel. Using triage mobile application by experienced emergency medical personnel had gained a chance of correct dispatch 1.5 times, which was significantly more accurate than the conventional method (95%CI 1.03-2.28) and also significantly more rapid dispatch than the conventional method (82 vs 95 sec., p = 0.03)
Cuisiner les kīrai (légumes feuilles) et soigner les corps
Authors: Guétat-Bernard Hélène , Sebastia Brigitte
Published: May 2022

Les kīrai, légumes feuilles, sauvages ou cultivés, sont consommés dans la ville de Pondichéry (Inde du Sud) par toutes les catégories de sa population. Oubliés des politiques publiques, ils contribuent à assurer l’apport en fibres, en micronutriments et en vitamines qui sont largement déficients dans ce pays aux fortes inégalités nutritionnelles. Appréhendés dans une analogie plantes-corps/être-environnement, ils sont aujourd’hui redécouverts par les classes moyennes sensibilisées aux questions nutritionnelles et environnementales. Ce sont les marqueurs de savoirs relatifs à la santé et au bien-être de la famille, transmis spécifiquement entre femmes, dans l'espace domestique de la cuisine. Penser l’alimentation comme une préoccupation collective 'invite à prendre en considération ces savoirs et à inscrire les cuisinières dans leur capacité à résister aux politiques de marchandisation de l'alimentation. Espace central de la reproduction des inégalités de genre, la cuisine est également le site où l’agentivité des cuisinières s’exprime en politisant, à partir de la sphère privée, les délibérations sur le régime alimentaire souhaité collectivement.
Latin America in the Chef’s Table
Authors: Santos Ana Rosa D. , Mansey Carina J.
Published: May 2022

Food media, such as Netflix’s Chef’s Table, presents both an empirical and a normative-aspirational dimension, communicating specific instructions and projecting powerful images of what constitutes a good meal and a culinary authority. This investigation examines the five episodes in the series that portrayed Latin American chefs. The selected episodes present and reproduce the inequalities and gendered distinctions in Latin American professional kitchens. Gender and centre-periphery inequities emerge as intertwined issues, feeding colonialist perspectives and the discourse that a woman's place is in the domestic realm, while men are presented as dreamers, avant-garde, innovators in the fine dining scene.  However, the series also promotes environmental sustainability and brings attention to local ingredients and culinary techniques.
Seeing (Speaking) Through Her Eyes (Brain)
Authors: Fallon Courtney D.
Published: May 2022

This case study examines the experience of Louisa, a new employee at a conflict resolution consulting firm, as she navigates her ADHD and the workplace. She faces ableist biases in the organizational culture at her job that cause her to question her own abilities. Louisa's Journey follows Louisa's interactions with her team as she struggles with her skills as a professional in her field and as a neurodivergent person who needs accommodations to function and prosper in her daily life. Louisa soon finds that the nuances of disclosure and workplace inclusivity are incredibly challenging for her, especially as someone with an invisible disability. She struggles to balance her ambitions in the company, her needs as a neurodivergent person, and the complexities of her identity. This case study challenges readers to consider how organizational culture can contribute to ableism, especially toward neurodivergent people and others with invisible disabilities.
Avoiding “Beige Cubicle Hell”
Authors: Pink Kari J. , Godager Emily A.
Published: May 2022

Every job has tradeoffs. When choosing an occupation, individuals are faced with choices about pleasure, freedom, security, and financial gain. This case study invites readers to consider how workers manage emotions and work-life spillover by contrasting the experiences of white-collar workers with an example of nontraditional workers—adventure workers, or individuals who have short-term adventurous jobs or perform seasonal work to support an adventurous lifestyle. An understudied group in organizational communication scholarship, nontraditional workers do not fit into the white-collar, ideal worker identities commonly represented in organizational communication research. To examine this understudied group along with a range of different work-related emotions, Amy's story and work-life experiences as a seasonal adventure worker are contrasted with the experiences of her brother and his friend who are employed in what she views as “beige cubicle hell.” These characters grapple with what makes work emotionally fulfilling and the tradeoffs they face in balancing security with freedom.
Convergence and Divergence at Work
Authors: Park Seulgi , Gettings Patricia
Published: May 2022

Communication at work often occurs among people from different power, culture, or language groups. Communicating with a difficult co-worker can become a major source of job dissatisfaction. This chapter introduces communication accommodation theory and the exit, voice, loyalty, and neglect model as theoretical lenses for exploring the case of a recent immigrant healthcare worker experiencing job dissatisfaction because of unsatisfying interactions with a co-worker. This chapter then applies these theoretical frameworks to discuss how tensions between co-workers can arise in communicative forms such as convergence, divergence, and overaccommodation and how an employee responds to a deteriorating work condition stemming from difficult interpersonal communication.
“You're Very Smart for a Black Woman”
Authors: Gilchrist-Petty Eletra
Published: May 2022

This case study explores an instance of microaggressive communication occurring at an organizational professional meeting. The case examines how “You're very smart for a Black woman” functions as a microinsult. Though intended as a compliment, this chapter illustrates the negative impact of this racially biased and stereotypical communicative act. This case study adds further credence to the everyday slights and indignities experienced by Black women academics, who represent an understudied population within organizational communication.
It's Just a Part of Life
Authors: Buzzanell Patrice M. , D'Enbeau Suzy
Published: May 2022

“It's Just a Part of Life” focuses on career and personal challenges as two couples (Maria and Brad; Sara and Alejandro) deal with anticipated and unexpected disruptions in their lives. These couples experience events and opportunities including returns-to-work after laborforce gaps, job changes, geographical relocations, infertility, unplanned business trips and workloads, and sleep deprivation during early child rearing years. As they devise strategies for managing these stressful situations both individually and collectively, they adapt to and transform their new normals by enacting communication resilience processes. Throughout the case, there are episodes in which they, and the children (Eden and Lucy), perform the five processes: crafting normalcy; using, maintaining, and creating new networks; backgrounding negative feelings while foregrounding productive action; utilizing alternative logics; and anchoring identities. They enact resilience for themselves and others, for the present and the future, and by reflecting upon their pasts.
Neuroleptic-induced tardive dystonia in young patients suffering from psychosis
Authors: Angane Amey Yeshwant , Anvekar Aditya R. , Keshari Prerna K. , Unnithan Vishnu B.
Published: May 2022

Tardive dystonia is one of the extrapyramidal syndromes that start after long-term use of dopamine receptor antagonists. Tardive dystonia is underdiagnosed and often misdiagnosed; some of the treatment possibilities are hardly known among psychiatrists and are notorious for being resistant to treatment. Here, we present a set of two cases who had come with neuroleptic-induced tardive dystonia, initially given oral tetrabenazine and injectable botulinum toxin, but they did not respond. They got better after treatment with the combination of oral baclofen and electroconvulsive therapy (ECT). ECT is thought to prevent the super sensitization of postsynaptic dopamine receptors that contribute to the development of tardive states. Baclofen is a presynaptic gamma-aminobutyric acid receptor agonist primarily used to treat spasticity. Both may have acted synergistically to treat the dystonia. Tardive dystonia needs to be ruled out in patients with a history of long-term antipsychotic medication use. Consultant liaison with psychiatrists will be of paramount importance in the timely management of these cases. The combination of ECT and baclofen may be an effective choice for patients of schizophrenia with tardive dystonia developed in the course of neuroleptic treatment. However, further controlled studies are needed to develop and refine the guidelines for managing it.
Lower serum ferritin levels and higher inattentiveness in attention deficit hyperactivity disorder in a case–control study
Authors: Anand Bhogaraju , Sireesha Chemarthi Venkata
Published: May 2022

Introduction:

Attention deficit hyperactivity disorder (ADHD) has hyperactivity, impulsivity, and inattentiveness. Brain iron stores influence dopamine synthesis and behavior. Serum ferritin is a marker for iron stores. Few studies are there on serum ferritin levels in ADHD, and the results showed either way as low or equal to controls. Contradictory results were observed in two published Indian studies, hence the need for the study.

Aims and Objectives:

The objectives of this study were to compare serum ferritin and hematological indexes between children with ADHD and normal controls and also to compare ADHD subscales in two of ADHD groups divided on a cutoff serum value of below 15 ng/ml (World Health Organization criteria).

Materials and Methods:

Children with ADHD without comorbidities were compared with controls at a child and adolescent psychiatry unit, Hyderabad, India, after ethics committee approval. The assessments included Conners' Parent Rating Scale (CPRS)-Revised (S), serum ferritin, and hematological indexes.

Results:

Two-three children with ADHD and 38 normal children as controls participated. The mean (standard deviation [SD]) of serum ferritin levels in the ADHD group 28.26 (16.46) and controls 23.06 (18.88) was not statistically significant. Significantly higher mean values (14.60) on cognitive/inattention subscale was noticed In below (15 ng/ml) serum ferritin level group compared to the mean (11.50) in above (15 ng/ml) serum ferritin group. Negative nonsignificant correlation (r = −0.366) between cognitive-inattention subscale of ADHD and serum ferritin levels was noticed.

Conclusions:

Iron-deficiency state showed higher inattentiveness on CPRS subscale than noniron-deficiency state. There is a weak negative correlation between serum ferritin and inattentiveness.
Outcome of idiopathic pulmonary fibrosis with pregnancy
Authors: Esmaeel Hend M. , Ali Rasha A. , Mahmoud Hamza A. , Gadallah Doaa
Published: May 2022

Background

Idiopathic pulmonary fibrosis (IPF) is a chronic pulmonary disease with an unknown etiology. It is uncommon in women of childbearing age. Limited data are available regarding the outcome of IPF with pregnancy.

Objectives

To evaluate both maternal and neonatal outcomes among pregnant women with IPF in comparison with pregnant asthmatic patients. Analysis of potential factors associated with unfavorable outcomes was done.

Patients and methods

This prospective case–control study recruited 20 pregnant women with IPF and 43 asthmatic pregnant controls. Demographics and disease-related parameters were recorded. Functional and radiological evaluations were performed. Watchful peripartum follow-up and precise management in a multidisciplinary team were done. Maternal and neonatal outcomes were evaluated with an analysis of prognostic factors for unfavorable outcomes.

Results

The mean age (SD) of study patients was 31.2 (6.4) years. Seven (35%) cases showed moderate functional impairment, and nine (45%) cases showed severe impairment. All cases required oxygen therapy by the third trimester. Five (25%) cases required ICU admission during the peripartum period. A total of 15 (75%) cases needed domiciliary oxygen upon discharge from the hospital (unfavorable maternal outcome) with no maternal mortality recorded. Overall, 11 (55%) cases were associated with neonatal complications (unfavorable neonatal outcome). The degree of functional impairment showed a significant association with neonatal outcome (P=0.02). Both maternal and neonatal outcomes were significantly better in the control group than in cases (P<0.001).

Conclusion

Pregnancy course in patients with IPF can be associated with adverse effects on maternal and neonatal outcomes and disease progression. However, collaborative management can minimize maternal mortality.
Severity scoring systems and different biochemical markers as predictors of mortality in the respiratory ICU
Authors: El-Kholy Maha M. , Sadek Samiaa H. , El-Morshedy Reham M. , Ali Alaa S.
Published: May 2022

Background

Predicting mortality and outcome of critically ill patients is an interesting point for research, so different acuity scores, such as Acute Physiology and Chronic Health Evaluation II, Simplified Acute Physiology Score II (SAPS II), Mortality Probability Model II (MPM II), and Sequential Organ Failure Assessment (SOFA), and biochemical markers are under investigation for its assessment.

Aim

The aim of this study were to compare between different ICU scores, for predicting mortality and to assess validity of some biochemical markers such as C-reactive protein (CRP), neutrophil–lymphocytic ratio (NLR), platelet to lymphocyte ratio, red cell distribution width, and mean platelet volume in the assessment of ICU outcome.

Patients and methods

This prospective cross-sectional study included 104 patients. The patients were subdivided into survivor and nonsurvivor groups. Acute Physiology and Chronic Health Evaluation II and SAPS II scores of the patients were recorded on the first day of admission to respiratory ICU, while SOFA and MPM II scores were recorded on the first and third (SOFA72, MPM72) days of ICU admission, where both groups were compared in terms of different ICU acuity scores as well as some biochemical markers. Sensitivity and specificity of each parameter for predicting mortality were calculated.

Results

The nonsurvivor group included 41 (39.4%) patients. All model scores as well as CRP and NLR were significantly higher in the nonsurvivor group; SOFA72 score had the highest sensitivity of 94.8% with an area under the roc curve (AUR) of 0.94 while the MPM72 score had the highest specificity of 91% with an AUR of 0.81 with a cutoff value of 5 and16, respectively.

Conclusion

While SOFA72 score has the highest sensitivity, MPM72 score has the highest specificity for predicting ICU mortality. NLR and CRP values are independent prognostic factor for hospital mortality in critically ill patient.
Malignant solitary fibrous tumors
Authors: Nidhal Belloumi , Imen Bachouche , Mouna Mlika , Mehdi Abdennadher , Abdallah Fatma Chermiti Ben , Sarra Zairi , Hazem Zribi , Faouzi Mezni , Adel Marghli , Soraya Fenniche
Published: May 2022

Introduction

Thoracic solitary fibrous tumors (SFTs) are usually pleural-based lesions and diagnosed incidentally. The authors, hereby, report two cases of symptomatic SFT of the pleura with locally aggressive potential.

Case 1

A 63-year-old male patient presented with chief complaints of dyspnea at rest and thoracic pain. Computed tomography scan revealed a mass of the right visceral pleura with multiloculated pleural effusion. Microscopic examination with immunostaining of the resected mass confirmed the diagnosis of malignant SFT. Local recurrence occurred after 5 months.

Case 2

A 32-year-old patient had a massive tumor of the left hemithorax, invading the descending aorta and thoracic vertebrae, causing a shifting of the heart and mediastinum. A needle transcutaneous biopsy confirmed the diagnosis of SFT. Considering the respiratory failure, surgical treatment was preceded by a general preparation. The patient died few days before the operation owing to respiratory distress.

Conclusion

This paper sustains the heterogeneity of these tumors. SFT of the pleura could have malignant potential at first presentation or in a young patient.
Predictors of reintubation in respiratory intensive care unit patients
Authors: El-Shenawy Olfat , Metwally Mohamed , Abdelaleem Nermeen , Ali Mahmoud
Published: May 2022

Background

Weaning and extubation follow each other in clinical practice, and are two isolated processes that pose distinct problems. Extubation failure is the need for reinstitution of ventilatory support within 24 to 72 hours of planned removal of endotracheal tube. Nearly 20% of patients require reintubation. Reintubation is more serious and may be associated with more adverse effect than the initial intubation procedure. Patients needing reintubation had significantly increase the duration of mechanical ventilation as well as ICU, hospital stay and mortality.

Objective of the study

To predict risk factors of reintubation in respiratory patients.

Patients and methods

The present study was a prospective observational study. It involved 100 mechanically ventilated patients who were admitted to RICU with different respiratory diseases. All patients met the criteria for readiness to wean: 50 patients need to be reintubated (group 1), and the other 50 patients were successfully extubated without needing for reintubation within 48–72 hours of extubation process (group 2). Different clinical, laboratory analysis, hemodynamic and respiratory variables, ventilator parameter and SAPS II score were collected in both groups.

Results

The mean age of reintubated patients was (66.06±10.3 years) and most of them were males (58%). We found that heamoglobin level (11.4±1.93) and Albumin level (2.47±0.61 g/dl) were significantly lower in reintubated group. Also, PH (7.11±0.032) and PaO2 (38.3±4.85 mmHg) at time of first intubation were significantly lower in reintubated cases. Half (50%) of reintubated cases expressed difficult weaning. On the other hand, 64% in non reintubated patients expressed simple weaning. Age (≥64 years old), PH (≤7.13), PaO2 (≤45) at first intubation, SAPS II Score, hemoglobin level (≤10.1), albumin level (≤3.1) were independent predictors of reintubation in respiratory ICU patients.

Conclusion

Age, arterial PH, PaO2 at first intubation, SAPS II Score, hemoglobin, albumin, higher length of ICU stay and hospital stay were an independent predictors of reintubation in respiratory ICU patients.
Self-Assessment Quiz
Authors: Moleyar Vishnu Sharma
Published: May 2022

Intra thoracic tumors can lead to a variety of para-neoplastic manifestations which is often overlooked. Awareness about the para-neoplastic manifestations and the possible intra thoracic causes for the same will lead to early diagnosis and appropriate management. In this self assessment quiz we have discussed regarding the para-neoplastic manifestations in Carcinoid tumor.
Unexplained Fever, Weight Loss, and Worsened Dyspnea with Pulmonary Hypertension as the Presenting Symptoms of Mixed Connective Tissue Disease with Interstitial Lung Disease
Authors: Patil Shital , Gondhali Gajanan , Narwade Ganesh
Published: May 2022

Pulmonary manifestations of mixed connective tissue disease (MCTD) include as bronchiolitis, bronchiectasis, and interstitial lung disease with or without pulmonary hypertension. Tuberculosis (TB) is the most common diagnosis in India in the presence of constitutional symptoms such as cough, fever, and weight loss with lung parenchymal abnormality, irrespective of microscopic or nucleic acid amplification test abnormalities due to high tuberculosis prevalent tropical setting. In this case report, a 35 year old female presented with constitutional symptoms and lung parenchymal nodules, interstitial involvement with lung fibrosis and pulmonary hypertension. Mediastinal window documented necrotic mediastinal lymph nodes, without negative mycobacterial microscopic (smear examination) or genome documentation (Gene Xpert MTB/RIF). She had received empirical anti tuberculosis treatment for three months without clinical or radiological response, resulted in progression of disease with clinical and radiological worsening and referred to our unit for further workup. Bronchoscopy guided evaluation for tropical screen including bacterial, fungal and tuberculosis with malignancy was inconclusive. Vasculitis and CTD workup documented antinuclear antibody (ANA) test strongly positive with very highly raised titres, with positive antigen as U1 small nuclear ribonucleoprotein particle, SSA/RO, single strand DNA, and Scl 70. Treatment initiated with systemic steroids, tadalafil, mycophenolate and diuretics, and satisfactory clinical response documented as near complete resolution of pulmonary parenchymal abnormalities in 24 weeks and pulmonary hypertension in 12 weeks. Pulmonary manifestations of MCTD are common, underestimated in the presence of constitutional symptoms, and early pickup of entity in course of illness will have good outcome with excellent prognosis.
Hair loss in women
Authors: Dias Maria F.R.G. , Rezende Hudson D. , Trüeb Ralph M.
Published: May 2022

Alopecia in women is capable of causing anxiety and depression. Hair loss is more common in women than is men due to variation in hormone levels seen during menarche, puberty, pregnancy, menopause and use of contraception drugs. This article approaches the clinical features, trichoscopy, treatment option and differential diagnosis of the most common causes of hair loss in women: telogen effluvium, female pattern hair loss, frontal fibrosing alopecia, fibrosing alopecia in a pattern distribution and central centrifugal cicatricial alopecia.
Vitamin-D receptor expression in cutaneous warts
Authors: Tawfik Noha Z. , Abdel Rahman Asmaa A. , Mansour Sahar F. , Gomaa Amal H.A.
Published: May 2022

Background

Warts are common viral skin infections with a high prevalence rate in both children and adults. Vitamin-D receptors (VDR) are expressed abundantly in the skin and affect cell differentiation, proliferation, and apoptosis. Vitamin D is believed to regulate epidermal cell proliferation and formation of antimicrobial peptides. There is escalating evidence showing that vitamin D3 has a significant role in the immune-system regulation through VDR.

Objective

To study the expression of VDR in cutaneous warts.

Patients and methods

This cross section study included 30 patients of viral warts. Shaved biopsies were taken from the wart lesions and the perilesional skin. Immunohistochemical stain was done for demonstration of VDR expression using a scoring system, depending on the percentage of stained cells and the intensity of staining.

Results

The expression of VDR was markedly increased in wart lesions with a statistically significant difference between wart lesions and perilesional skin. There was no relation between the VDR expression in warts or perilesional area with different variables such as sex, age, number, size, site of warts or disease duration.

Conclusion

The high expression of VDR in cutaneous warts may be related to the epidermal hyperplasia in wart lesions that support the effectiveness of usage of intralesional vitamin-D injection in the treatment of warts. Further large scale studies may be needed to confirm the present results.
Can skin affection be a clue to COVID-19? results from a dermatology outpatient clinic in Egypt
Authors: Mostafa Pakinam I.N. , Alieldin Lobna G. , El-Kalioby Mona
Published: May 2022

Background

Coronavirus disease 2019 (COVID-19)-infected individuals can be asymptomatic or have mild symptoms. Cutaneous affection with COVID-19 is a unique presentation.

Objective

To describe the clinical presentations of skin affection in COVID-19-confirmed patients attending a dermatology outpatient clinic.

Patients and methods

A retrospective analysis was performed on the medical records of a single dermatology outpatient clinic described cutaneous presentations associated with COVID-19 infection in patients attending in the period from October 2020 to December 2020.

Results

A total of 44 COVID-19-positive patients presented with skin affection. The most common presentation was urticaria (24, 54.5%), followed by herpes simplex (seven, 15.9%), herpes zoster (four, 9.1%), papulosquamous (three, 6.9%), papulovesicular (two, 4.6%), acral lesions (two, 4.6%), leukocytoclastic vasculitis (one, 2.3%), and Kawasaki-like disease (one, 2.3%). Nine (20.5%) patients had asymptomatic COVID-19 infection, 24 (54.5%) patients had mild COVID-19, nine (20.5%) patients had moderate COVID-19, and two (4.5%) patients had severe COVID-19. Among patients with COVID-19 symptoms (35, 79.5%), seven (20%) patients presented with the cutaneous presentation before the onset of COVID-19 symptoms, whereas in the rest of the patients, cutaneous affection was simultaneous with COVID-19 symptoms (28, 80%).

Conclusion

Cutaneous affection can be the striking presentation for COVID-19 requiring dermatological consultation. Awareness and early recognition of skin affection associated with COVID-19 are required. Dermatologists should follow all of the precautions and use adequate personal protective equipment during their outpatient practices. Skin presentations, notably urticaria, can precede the systemic and respiratory symptoms of COVID-19. Severe mucocutaneous herpes simplex can occur with COVID-19 and require prompt medical treatment.
Can invasive diagnostic methods be reduced by magnetic resonance imaging in the diagnosis of diaphragmatic injuries in left thoracoabdominal penetrating injuries?
Authors: Alizade Elchin , İlhan Mehmet , Durak Görkem , Kaan Gok Ali Fuat , Ertekin Cemalettin
Published: May 2022

Aim:

In this study, we aimed to investigate the effect of magnetic resonance imaging (MRI) in detecting diaphragmatic injury by comparing preoperative computed tomography (CT) and MRI imaging results with diagnostic laparoscopy/thoracoscopy results in patients with left thoracoabdominal penetrating injury. We investigated whether MRI reduces the rate of unnecessary surgery by examining its sensitivity and specificity.

Materials and Methods:

Patients with left thoracoabdominal penetrating injuries who applied to the Emergency Surgery Unit of Istanbul University Istanbul Faculty of Medicine between November 2017 and December 2020 were evaluated. Patients who underwent emergency surgery, who could not undergo MRI or CT for any reason or who could not be operated on were excluded from the study. Preoperative MRI and CT images of patients who underwent diagnostic laparoscopy/thoracoscopy due to left thoracoabdominal injury in our clinic were evaluated retrospectively by a radiologist who did not know the surgical results. MRI results of the cases were compared with surgical findings and CT images.

Results:

A total of 43 (41 males, mean age: 31, range: 15–57) patients were included in the study. The most common physical examination finding was lateral injury. The diaphragmatic injury was detected in 13 (30%) cases during surgical interventions. Laparoscopic repair was performed in 11 (84%) cases and thoracoscopic repair was performed in 2 (15%) cases with diaphragmatic injuries. MRI images of 14 (32%) cases were found to be compatible with diaphragmatic injury, in 1 of them no injury was observed during surgical intervention. According to these data, the sensitivity of MRI was calculated as 100%, specificity 94%, positive predictive value 86%, and negative predictive value 100%. The mean hospital stay was 6 days (1–30) in all cases.

Conclusion:

In our study, MRI was found to have high specificity and sensitivity in detecting diaphragmatic injuries. The number of negative laparoscopy/thoracoscopy can be reduced by performing surgical intervention only in cases with positive or suspected diaphragmatic injury on MRI. Results should be supported by conducting new studies with larger case series with normal MRI findings and long follow-ups.
Community-Based Cross-Sectional Study of the Relationship between Sars-Cov-2 Antibody Titres and Clinico-Epidemiological Profile of Population above 6 Years of Age in the Pimpri Chinchwad, Pune, Maharashtra
Authors: Pandve Harshal T. , Bawa Mukesh S. , Desale Atul V. , Gaikwad Shruti R. , Patil Tushar , Dadewar Abhaychnadra A.
Published: May 2022

Context:

COVID-19 response needs to be enlightened with representative data regarding the humoral response to the virus, and its relationship with the clinico-epidemiological profile of the general population.

Aims:

To estimate the titres of IgG antibodies against SARS-CoV-2 and study the factors associated with the same among the general population of the Pimpri Chinchwad Municipal Corporation area.

Settings and Design:

Population-based cross-sectional study was carried out among the general population aged 6 years and above in the Pimpri Chinchwad Municipal Corporation area.

Methods and Material:

A total of 10,082 individuals from 106 wards of the PCMC area were studied between June 16, 2021 and June 26, 2021. The survey form questionnaire included sociodemographic details, COVID-19 exposure history, symptoms, tests, and vaccination status. About 3 to 5 ml blood samples were collected from each subject. Testing of samples was done using ABBOTT CMIA, SARS-CoV-2 quant assay—sensitivity 92.7% and specificity 99.9%.

Statistical Analysis Used:

Frequency analysis was done for sociodemographic variables, and antibody titres. An appropriate test of association was applied to the association between antibody titres and the sociodemographic and clinical profile of participants.

Results:

Antibody titres were significantly higher in males, aged 45 years and above, participants of upper socioeconomic class, participants residing in elite areas, subjects with a history of COVID-like symptoms in the past, and those who were vaccinated.

Conclusions:

Anti-SARS-CoV-2 IgG antibodies titres were found to be significantly associated with age, sex, socioeconomic status, area of residence, vaccination status, and history of COVID symptoms.
Hermetic Cereal Storage in the Bronze Age
Authors: Dietrich Laura , Dietrich Oliver , Meister Julia
Published: May 2022

The present paper explores the possibility to better understand the function of pits through phytolith and starch analysis. A case study from the Late Bronze Age/Early Iron Age settlement phase of Rotbav in southeastern Transylvania is discussed in detail. It appears that a large storage vessel originally sealed with a bowl was kept in a pit filled with chaff or straw to preserve its contents.
Some Balaton-Lasinja Graves from Veszprém-Jutasi Út and an Outline Chronology for the Earlier Copper Age in Western Hungary
Authors: Regenye Judit , Oross Krisztián , Bánffy Eszter , Dunbar Elaine , Friedrich Ronny , Bayliss Alex , Beavan Nancy , Gaydarska Bisserka , Whittle Alasdair
Published: May 2022

A handful of new radiocarbon dates from three Balaton-Lasinja culture graves at the site of Veszprém-Jutasi út in western Hungary form the starting point for formal models for late Lengyel and post-Lengyel chronology in that region. The graves date to the later fifth millennium cal BC. They provide the opportunity to put the earlier Copper Age Balaton-Lasinja culture of Transdanubia into its regional and wider context, and to highlight both gradually improving understanding of its character and remaining problems of chronology and classification. The Balaton-Lasinja culture was part of a whole series of regional shifts in settlement and society connected to the end of the Neolithic and the demise of major settlement aggregations which had dominated lifestyles in previous centuries. This study indicates how much further detailed research continues to be needed to get fully to grips with this set of important changes, which run on into the Copper Age. Contrasts are drawn between western and eastern Hungary, and the uncertainties surrounding the chronology of the fourth millennium cal BC, including for the Furchenstich pottery style, are emphasised.
Constraints to Women’s Empowerment in Agriculture in Rural Farming Areas in Oyo State, Nigeria
Authors: Ayodeji Abiola Oyeboade , Rauf Ayodeji J. , Joshua Yila , Fapojuwo Oluwakemi Enitan , Alabi Stephen O.
Published: May 2022

This study examined the major barriers to women empowerment in agriculture in rural farming areas in Oyo State, Nigeria. A multi-stage sampling procedure was used to select 100 women farmers and primary data was collected with the aid of a semi-structured questionnaire. Descriptive statistics was used to analyse the data and the findings are presented in table and chart. The study revealed that the inability to access formal credit (x̅= 4.61), heavy domestic workload ( x̅= 4.36 ), and poor pricing of produce (x̅= 3.89 ) are major barriers to women empowerment in agriculture in the study area. Therefore, providing access to formal credit facilities, provision of labour-saving technologies, and regulation of agricultural produce prices will enable women’s empowerment in agriculture.
COVID-19 Pandemic: Implication on the Nigeria Agriculture and the Role of Extension
Authors: Undiandeye U.C. , Ayi N.A.
Published: May 2022

The paper focused on a review of COVID-19 pandemic, its implication on the Nigeria agriculture and the role of extension. The purpose was to review the impact of the pandemic on the Nigeria agriculture and narrate the implication for agricultural extension service. Being a review, data was drawn from verified websites, research papers, journals, statistical bulletins and other online materials. The review uncovered a subtle but undeniable negative impact on all the value chain of the Nigeria agriculture. Also, with enough evidence, there is likelihood of possible food catastrophe if concerted action is not taken to save the sector. One of the most important factors that may avert this negative impact is agricultural extension service. But in this time of global lockdown, travel ban and social distancing, the way out becomes technology. Thus, from the review, it was concluded that government and institutions at all levels should intentionally deploy technology tools to aid effective agricultural extension service transmission to farmers.