bluuebunny/crossref_metadata_2025 huggingface dataset:
Bioethics in the education of the future healthcare professionals
Authors: Kirkov Vidin , Vodenicharova Alexandrina , Markova Krasimira , Borisova Lyudmila , Popova Kristina
Published: May 2024

Background: Ensuring and maintaining the quality of higher medical education is of strategic importance to society, bearing in mind that is producing competent medical personnel who will conduct health care activities with a view any decision in medical practice to be based both on evidences and values. Bioethics case studies are intended to be a useful training tool to help medical students in their future daily practice as doctors and contribute to improving doctor-patient relationships and team work.

Methods: A questionnaire survey was distributed among the medical students of Medical University – Sofia, included 640 students in 4, 5 and 6 years of their study. It analyses the necessity of learning the Universal Declaration on Bioethics and Human Rights, approved on the 19th of October 2005 by the UNESCO General Assembly.

Results: About ½ of the participants in the empirical study, to varying degrees, were not familiar with the bioethical principles of UNESCO Universal Declaration on Bioethics and Human Rights. A large proportion of respondents gave affirmative responses about the importance of ethical knowledge in their future medical practice. According to the respondents, training in Bioethics and Human Rights will increase their ethical competence as medical professionals.

Conclusions: The results of the empirical study give us grounds to make recommendations to the responsible institutions to update and reorganize the undergraduate internship of medical students by including the discipline of Medical Ethics and the Universal Declaration on Bioethics and Human Rights.
L’écrit professionnel : un exercice périlleux pour les psychologues
Authors: Cohen Patrick
Published: May 2024

Dans une société où l’utilisation et la place de l’écrit évoluent considérablement depuis quelques années, l’écrit professionnel, pour le psychologue, reste néanmoins un outil incontournable dont il faut connaître les enjeux et les limites pour ne pas faillir aux règles déontologiques de notre profession, notamment en matière de confidentialité. Patrick Cohen, ancien président de la Cncdp, revient sur les points qui en font un exercice périlleux et propose quelques préconisations concrètes.
Analyse d’un mouvement anti-barrage en Chine : conflits, controverses et réseau d’actants
Authors: Arantes Virginie
Published: May 2024

L’objectif principal de cet article est de démontrer que la sociologie de l’acteur-réseau est une grille d’analyse adaptée à la lecture des mouvements sociaux environnementaux en Chine. Ce travail s’appuie sur l’exemple du mouvement contre le barrage de la « Gorge du Saut du Tigre » qui a réussi à faire pression sur le gouvernement provincial du Yunnan pour en annuler la construction. Nous suivrons les acteurs dans leurs développements, leurs stratégies et leurs motivations afin d’explorer la création et l’expansion de leur processus d’innovation. La sociologie de l’acteur-réseau est utilisée comme stratégie de recherche pour comprendre comment un activiste en particulier, dans un contexte autoritaire, initie un mouvement environnemental pour faire interdire la construction du barrage. Cette étude a révélé la capacité de cet activiste à identifier les acteurs concernés et à les enrôler dans son mouvement anti-barrage en développant un réseau d’intérêts communs. Ce cas d’étude confirme la capacité actuelle, en Chine, de l’activisme environnemental dans l’autonomisation sociale au niveau local.
Chine-Costa Rica: la projection des normes chinoises en Amérique centrale
Authors: Wintgens Sophie
Published: May 2024

La République populaire de Chine (Chine) est aujourd’hui devenue un partenaire commercial incontournable, un important pourvoyeur d’investissements directs étrangers et un grand fournisseur de prêts financiers pour un nombre croissant de pays d’Amérique du Sud. Cette tendance s’observe également de plus en plus en Amérique centrale. L’accroissement de ses échanges économiques et commerciaux avec le Costa Rica, premier pays centraméricain à avoir établi des relations diplomatiques et signé un accord de libre-échange avec Pékin, va de pair avec la projection des normes économiques et politiques dont sa politique commerciale internationale est porteuse. Cet article analyse les enjeux stratégiques de la présence chinoise au Costa Rica afin d’évaluer la portée de l’influence du projet économico-politique de la Chine en Amérique centrale.
Le scrutin communal du 14 octobre 2018 à Bruxelles : une élection détonante
Authors: Delwit Pascal , Van Haute Émilie
Published: May 2024

C’est peu de dire que les élections communales du 14 octobre 2018 dans les dix-neuf communes de la Région de Bruxelles-capitale ont frappé les imaginations par l’ampleur des mouvements électoraux et politiques observés. Cette contribution propose d’en faire le relevé et l’analyse à l’aune des dynamiques politiques et électorales des partis engagés dans la confrontation.
La-N-VA et les élections d’octobre 2018 : des aspirations contrariées
Authors: Delwit Pascal
Published: May 2024

Le 14 octobre 2018, la Nieuw-Vlaamse Alliantie (N-VA) ambitionnait de s’affirmer comme le nouveau parti populaire de Flandre aux élections communales et d’affirmer son statut de parti dominant au scrutin provincial. A l’examen des résultats électoraux et politiques des deux élections, il apparaît que la N-VA a échoué à atteindre ses deux buts. Au contraire, elle a encouru une défaite électorale et a assisté à un certain retour en grâce du Vlaams Belang, le parti flamand d’extrême droite. Son recul électoral est généralisé mais est plus marqué dans ses zones d’implantation moyenne. Ce faisant, le parti affiche un caractère – encore – plus anversois et se donne à voir comme un parti mineur ou de format intermédiaire en Flandre occidentale, dans le Limbourg et, dans une moindre mesure, en Flandre orientale.
Mettre en scène le conflit à la télévision en période électorale. Deux émissions de la RTBF et RTL-TVI sur le grill
Authors: Grignard Guillaume
Published: May 2024

Dans le cadre des élections générales du 26 mai 2019 en Belgique, les médias francophones ont créé plusieurs nouvelles émissions qui mettaient en scène les relations entre le citoyen et le monde politique. Nous nous sommes intéressés à deux émissions : « Les 109 » sur la RTBF et « Un politique à la maison » sur RTL-TVI. Nous observons des différences entre les deux médias. Alors que sur la RTBF, l’émission a exacerbé des interactions conflictuelles entre le public et les invités politiques, l’émission sur RTL-TVI a au contraire proposé un format visant à aseptiser cette relation, à réconcilier le citoyen avec la politique dans un contexte de forte défiance de l’un envers l’autre. L’analyse d’émissions originales et spécifiques au contexte préélectoral permet d’explorer d’une autre manière cette relation entre représentants et représentés.
“This is the final fall”. An electoral history of European Social Democracy (1870-2019)
Authors: Delwit Pascal
Published: May 2024

Malgré un nombre appréciable de contributions consacrées à la social-démocratie européenne, il subsiste certains angles morts dans l’analyse de cette famille politique. Un conflit d’interprétation sur l’état actuel de la social-démocratie européenne se donne par ailleurs à voir. Pour certains, la résilience du socialisme européen est réelle. Pour d’autres, son déclin est patent et, dans la logique de l’empan de vie isolé par Pedersen, sa fin est annoncée. L’objectif de ce papier est d’arbitrer ce différend sur le destin de la social-démocratie européenne et de comprendre sa dynamique électorale sur 150 ans. À partir d’une analyse de 692 élections intervenues dans 32 États européens entre 1870 et 2019, quatre grandes étapes de l’histoire électorale de la social-démocratie sont mises en évidence : a) une lente émergence à la fin du XIX e siècle et un premier envol au début du vingtième, b) l’installation dans le paysage politique européen au sortir de la première guerre et un pic électoral qui est quasiment atteint dès les années 1930 dans les pays démocratiquement consolidés, c) une stabilisation de cette performance sur un demi-siècle et d) un tassement entamé dans les années 1980 qui mène à un déclin très prononcé dans les années 2010. Le chute de la famille socialiste européenne entre 2010 et 2019 est détonante. L’histoire électorale de la social-démocratie européenne est mise en perspective de celle de l’ensemble de la gauche socio-économique, ce qui permet d’observer non seulement la chute marquante dans la période contemporaine mais aussi la perte d’influence de la social-démocratie au sein du spectre de gauche.
Avoir peur
Authors: Isnard-Davezac Nathalène
Published: May 2024

Entre l’intemporalité de la peur comme « expérience impressionnante pour le psychisme », son actualisation sur la scène de la réalité extérieure, la façon dont elle est retravaillée par le culturel et traitée par le collectif, la question se partage. C’est ce qui aura été l’objet de ce travail.
Avoir peur
Authors: Alfandary Isabelle
Published: May 2024

Malgré le souci freudien de clairement distinguer la peur de l’angoisse, ces deux affects semblent inextricablement liés dans son œuvre. Il apparaît que pour Freud l’angoisse est originaire – qu’il s’agisse de l’angoisse de la naissance ou de l’angoisse de castration. Une des manifestations cliniques qui retiennent son attention est les phobies infantiles d’animaux. Les cas du petit Hans ou le petit Arpad mettent Freud sur la piste de l’analogie entre phylogénétique et ontogénétique, développement du petit homme et évolution de l’humanité. Pourtant, contre toute attente, la peur et l’angoisse sont passées sous silence dans l’anthropologie freudienne des origines, alors même qu’elles apparaissent comme l’un des ressorts, si ce n’est le mobile, du mythe du meurtre du père de la horde.
Avoir peur
Authors: Chiantaretto Jean-François
Published: May 2024

La période Covid fait obligation aux analystes de repenser le malaise dans la culture, non pas en le psychopathologisant, mais en reprenant encore et toujours la question des fondements métapsychologiques de leur pratique. Le fil suivi ici est celui de « l’effroi infans », au cœur de la dépendance vitale caractérisant l’état sans-aide originel. Cela amènera à réinterroger l’approche freudienne du Nebenmensch , esquisse restée sans suite métapsychologique chez Freud.
Méthodologie des ateliers thérapeutiques auprès des patients atteints de la maladie d'Alzheimer et maladies apparentées
Authors: Sillou Jean-Marie
Published: May 2024

Le recours à la médiation animale, comme prise en soins, dans les établissements médico-sociaux et hospitaliers est de plus en plus fréquent. Parmi les nombreuses approches non-médicamenteuses, la thérapie assistée par le chien semble être un facteur important de bien-être psychologique dans le soin des troubles du comportement des personnes âgées atteintes par la maladie d’Alzheimer ou de démences apparentées.
La place des consommateurs dans les dynamiques territoriales de connaissance
Authors: Dewals Jean-François , Le Floc Pascal , Daurès Fabienne , Lucas Sterenn
Published: May 2024

L’article propose une lecture du concept de dynamique territoriale de connaissance en intégrant les consommateurs au triptyque industrie-recherche-administration. Les modèles récents associant consommateurs et producteurs s’inscrivent dans l’économie de la connaissance et des innovations. La problématique repose sur un double questionnement : l’industrie des produits de la mer (PDM) répond-t-elle aux caractéristiques des économies fondées sur la connaissance ? Cette connaissance est-elle partagée avec les consommateurs ? Si les innovations de rupture sont rares, les améliorations incrémentales sont fréquentes dans cette industrie. Les résultats d’une enquête nationale sur les consommateurs séparés en fonction de leur département de résidence, littoral et non littoral, appuient l’hypothèse d’une influence de la proximité géographique dans la connaissance des produits de la mer. La discussion retient deux sujets, celui de l’impact environnemental des méthodes de pêche et la réglementation commerciale. Si les ménages littoraux détiennent une meilleure connaissance sur ces deux sujets, la controverse existe.
Le genre de l’hystérie
Authors: Legrand Julia
Published: May 2024

La critique de l’hystérie est ancienne ; la catégorie plus récente de troubles histrioniques, censée l’avoir remplacée, a aussi fait l’objet de nombreuses critiques de la part des militantes féministes, ainsi que par des chercheurs et chercheuses en sciences sociales et en études de genre. Cet article a comme ambition de poursuivre et de compléter ces travaux de deux manières : en interrogeant la perdurance de la catégorie d’hystérie « en pratique », en regard des recherches sur les classifications ; et en éclairant ce diagnostic à l’aune d’objets très concrets et jusqu’alors peu étudiés : les traitements médicamenteux. L’objectif de cet article est alors de comprendre pourquoi, alors que les psychiatres ont enlevé la catégorie d’hystérie des nosographies officielles en raison de son caractère genré, ce diagnostic demeure utilisé en pratique. Plus largement, cet article interroge les raisons pour lesquelles certaines catégories anciennes, qui sont censées avoir disparu, sont encore d’usage. Enfin, il explore comment se maintient l’autorité psychiatrique sans science stabilisée.
Les dispositions de classe au travail
Authors: Imbert Arthur
Published: May 2024

Cet article explore l’agencement des socialisations plurielles au travail de deux groupes de travailleuses de l’école maternelle – les enseignantes et les ATSEM (agentes territoriales spécialisées des écoles maternelles) – en étudiant deux modalités de leur activité : le travail pédagogique et le travail disciplinaire. Dans le premier cas, chaque groupe est porteur d’un modèle pédagogique ancré dans leur socialisation de classe basé sur une opposition entre l’abstrait et la finalité, entre le visible et l’invisible. Les pratiques disciplinaires sont quant à elles homogènes, tant dans les discours que dans les actes. Ce résultat vient discuter la littérature qui mettait en avant les oppositions entre « styles » ou « modèles » éducatifs des classes populaires et classes moyennes à fort capital culturel et pointe la malléabilité des dispositions.
Inspiring and Nurturing Human-Centered Leaders: The Vital Role of Mentorship
Authors: Campis Susan , Leclerc Lucy , Kennedy Kay
Published: May 2024

Because health care is a relational profession, logic suggests the structures, processes, and outcomes of nursing leadership and mentoring should be strongly grounded in relational concepts. Human-Centered Leadership in Healthcare™ provides an evidence-based, contemporary structure to carry out the vital process of mentoring for future leaders to deliver on patient and team member outcomes.

[
J Contin Educ Nurs
. 2024;55(6):276–278.]
The Mediating Role of Alexithymic Traits in the Relationship Between Social Appearance Anxiety and Life Satisfaction in Adolescents
Authors: Doğan Tuğçenur , Keskinkiliç Ayşegül
Published: May 2024

This cross-sectional study sought to examine the mediating role of alexithymic traits in the relationship between social appearance anxiety and life satisfaction in adolescents. The study sample included 295 adolescents 12 to 14 years of age. The data were collected using a Personal Information Form developed by the researchers, the Social Appearance Anxiety Scale (SAAS), Multidimensional Students' Life Satisfaction Scale (MSLSS), and Alexithymia Questionnaire for Children (AQC). The results revealed there is a significant negative relationship between life satisfaction and social appearance anxiety in adolescents, and there is a significant negative relationship between alexithymia and social appearance anxiety in adolescents. There is a significant positive relationship between life satisfaction and alexithymia in adolescents (
P
< 0.05). There is no mediating role of alexithymic traits in the relationship between social appearance anxiety and life satisfaction in adolescents.

[
Psychiatr Ann.
2024;54(5):e155–e161.]
Social Capital as a Framework to Address Organizational Climate Change Policy
Authors: Becker Julie , McDermott-Levy Ruth , Moore Caroline , Mitsdarffer Mary Louise
Published: May 2024

Purpose:

To examine state Area Agencies on Aging (AAAs) in Pennsylvania for services they provide to older adults regarding extreme events and how readiness can be captured through social networks and policies at the local, state, and federal levels.

Method:

Using an online survey, 79% of AAA directors answered questions describing perceptions and actions related to social capital and its influence on policy.

Results:

AAAs acknowledged weather/temperature changes impact the need to prepare for common scenarios of extreme weather, temperature, and flooding. AAAs reported major social connections with county government and one state agency, with limited connections with federal agencies.

Conclusion:

Multiple opportunities exist for AAAs to consider climate change in expansion efforts, specifically regarding health care. Geriatric nurses can play a key role in expansion, advocacy, and policy development for AAAs that serve older adults in the context of climate change. [
Journal of Gerontological Nursing, 50
(6), 11–15.]
Development of a preliminary extraction protocol for phenol compounds during table grape grafting formation
Authors: Gamba Giovanni , Donno Dario , Razafindrakoto Zoarilala Rinah , Sabbatini Paolo , Beccaro Gabriele Loris
Published: May 2024

The development of rootstocks that are less sensitive to abiotic and biotic stresses can help mitigate the negative effects of climate change on crop productivity, soil health, and water use. Though, the phenomenon of graft incompatibility is a significant limitation to the spread of new rootstock genotypes. Numerous studies have focused on this issue, highlighting the role of certain phenolic molecules as predictive markers of incompatibility. Given the lack of specific research on table grape, , this study proposes a protocol for the extraction of polyphenols from its woody tissues, which is a fundamental prerequisite for further analysis on secondary metabolites involved in graft incompatibility. The proposed eco-friendly method coupled a traditional maceration using solvent with a green technique utilizing an ultrasound-assisted extractor. The following parameters were compared: (1) sample weight (0.1 g, 0.5 g, and 1 g), (2) time of ultrasound-assisted extraction (10 min, 20 min, and 30 min), and (3) solvent volume for maceration (10 mL, 15 mL, and 20 mL). Four phenol classes were considered based on previous works on Vitis spp.: cinnamic acids, flavonols, benzoic acids, and catechins. The characterization of polyphenolic biomarkers was carried out via HPLC. 1 g of plant material, 30 minutes of sonification, and 20 mL of organic solvent was the combination of factors that resulted in the most efficient fingerprint, both quantitatively (267.68 ± 3.91 mg/100 g fresh weight [FW]) and qualitatively, with the four classes analyzed significantly represented. This is the first work to come up with an extraction protocol for phenol compounds in table grape woody tissue based on both ecological and routine techniques.
Droits humains ou « privilèges de criminels » ? Les malheurs de la démocratisation brésilienne
Authors: Caldeira Teresa Pires do Rio
Published: May 2024

À partir des années 1980, la majorité de la population de São Paulo s’est mise à interpréter la défense des droits humains pour les prisonniers de droit commun, comme la défense de « privilèges de criminels ». Cet article propose une analyse de ce qui a donné lieu à cet amalgame pervers. J’examine pour cela les arguments et les actions des défenseurs des droits humains pour les prisonniers de droit commun, ainsi que de leurs opposants. J’aborde également les notions de droits qui existent dans la société brésilienne. Je compare en outre les perceptions des droits sociaux et des droits individuels en montrant que, si les premiers sont largement légitimés, les seconds – qui incluent les droits humains – sont assimilés à des privilèges. Enfin, je mets également en lumière la façon dont, à São Paulo, la criminalité, les criminels et les droits humains qui leur sont associés, offrent un espace privilégié pour articuler des discours et des pratiques de résistance au changement social, de discrimination sociale, de soutien au recours à la force et d’accentuation de la privatisation.
Various Upcycling and Recycling Methods
Authors: Kaur Param jeet , Singh Jaswant , Rani Jyoti
Published: May 2024

The chapter underscores the crucial role of recycling and upcycling in contributing to several SDGs, including SDG 12 (Responsible Consumption and Production) and SDG 13 (Climate Action). These practices support a closed-loop model, embodying the ethos of “for all forever” within a world grappling with finite resources. By reusing materials and garments, the fashion industry actively engages in waste reduction, mitigates environmental impact on landfills, and conserves resources such as water and virgin fibres, contributing to SDG 15 (Life on Land) and SDG 14 (Life Below Water). In response to sustainability requirements across economic, environmental, and social dimensions, the industry is transitioning from staple fibres to continuous filaments, creating opportunities for innovation in recycling technologies. This shift not only promises economic stimulation and job creation but also aligns with SDG 8 (decent work and economic growth) and SDG 9 (industry, innovation, and infrastructure).
Revolutionizing Agricultural Waste Management With Nanotechnology for a Sustainable Future
Authors: Madhavan Asha Anish , Nallathambi Godwin Joseph , Paul Ankita Maria
Published: May 2024

Agricultural operations, essential for human survival, annually produce between 10 to 14 billion tons of waste, endangering environmental stability. This waste encompasses remnants from crops, agro-industrial activities, livestock, and aquaculture. Common disposal methods like incineration and landfills pose health and environmental risks. Effective waste management is imperative for sustainable agriculture, transforming waste into valuable resources like compost, biogas, and biochar. Nanotechnology contributes to waste management by creating nanostructured materials from agricultural waste and generating bioactive compounds for diverse applications. Nano-bioremediation enhances soil vitality and eliminates pollutants, while nano-biosensors enable precise waste monitoring. Smart delivery systems for agrochemicals reduce environmental impact, and nano-enabled plant disease management enhances crop health. Green nanomaterial synthesis from agricultural biomass promotes resource efficiency. These advancements in nanotechnology are fostering sustainable agricultural waste management practices, reducing the environmental footprint of agriculture, and promoting a circular economy.
Distributed and Fair Beacon Power and Beaconing Rate Adaptation Based on Game Theoretic Approach for Connected Vehicles
Authors: Ouaskou Mohamed , Garmani Hamid , Baslam Mohamed
Published: May 2024

In vehicular ad hoc networks, vehicles regularly transmit information through beacons to raise awareness among nearby vehicles about their presence. However, as the number of beacons increases, the wireless channel becomes congested, resulting in packet collisions and the loss of numerous beacons. This paper addresses the challenge of optimizing joint beaconing power and rate in VANETs. A joint utility-based beacon power and rate game is formulated, treated both as a non-cooperative and a cooperative game. To compute the desired equilibrium, three distributed and iterative algorithms (Best Response Algorithm, Cooperative Bargaining Algorithm) are introduced. These algorithms simultaneously update the optimal values of beaconing power and rate for each vehicle in each step. Extensive simulations showcase the convergence of the proposed algorithm to equilibrium and offer insights into how variations in game parameters may affect the game's outcome. The results demonstrate that the Cooperative Bargaining Algorithm is the most efficient in converging to equilibrium.
Improvement of a Machine Learning Model Using a Sentiment Analysis Algorithm to Detect Fake News
Authors: Atchariyachanvanich Kanokwan , Saengkhunthod Chotipong , Kerdnoonwong Parischaya , Chanlekha Hutchatai , Cooharojananone Nagul
Published: May 2024

These days, the problem of fake news has grown to be a major social and personal concern. With the amount of information generated through social media, it is very crucial to be able to detect and properly take care of that fake information. Previous studies proposed a machine learning model to detect fake news in online Thai health and medical articles. Still, the problem of detecting fake news with similar content but different objectives exists, and the accuracy of the model needs improvement. Therefore, this study aims to solve these problems by adding 33 new features, including textual features, sentiment-based features, and lexicon features, i.e., herbs, fruits, and vegetables, to identify the objective of an article. We trained and tested the model's prediction accuracy on a new dataset containing 582 reliable and 435 unreliable (fake news) articles from eight Thai websites. Our improved classification model using XGBoost with Lasso, the best feature selection method, achieved an accuracy of 97.76% without over-fitting, reflecting a 7.16% improvement over our earlier model.
Evaluating prognostic indicators for in-hospital mortality in Fournier's gangrene: a 7-year study in a tertiary hospital
Authors: Wirjopranoto Soetojo , Affandi Mohammad Reza , Ashari Faisal Yusuf , Azmi Yufi Aulia , Soetanto Kevin Muliawan
Published: May 2024

Background: Fournier's Gangrene Scoring Index (FGSI), Simplified FGSI (SFGSI), Uludag FGSI (UFGSI), Laboratory Risk Indicator for Necrotizing (LRINEC), Neutrophil-Lymphocyte ratio (NLR), and Platelet-lymphocyte ratio (PLR) have been devised to assess the risk of mortality in Fournier's Gangrene (FG) patients. However, the effectiveness of these indicators in predicting mortality at the time of admission remains uncertain. The aim of this study is to assess the prognostic efficacy of FG’s various indicators on in-hospital mortality.
Methods: This study analyzed 123 patients from Dr. Soetomo General Hospital’s emergency department in Indonesia from 2014 to 2020. Data included demographics, wound cultures, and parameters like FGSI, UFGSI, SFGSI, NLR, PLR, and LRINEC. In-hospital mortality status was also recorded. The data was subjected to comparative, sensitivity, specificity and regression analyses.
Results: In our study of 123 patients, the median age was 52, with a mortality rate of 17.9%. The majority of patients were male (91.1%) and the most common location was scrotal (54.5%). Non-survivors had a shorter median stay (6.5 days) compared to survivors (14 days). Diabetes was the most prevalent comorbidity (61.8%). The highest sensitivity and specificity were found in FGSI and UFGSI indicators. Multivariate logistic regression identified LoS and FGSI as independent predictors of mortality.
Conclusions: FGSI and UFGSI, upon admission, demonstrated the highest sensitivity and specificity, with hospital stay duration and FGSI as key mortality determinants.
Assessing muscle architecture with ultrasound: implications for spasticity
Authors: Boissonnault Ève , Hyon April , Munin Michael C. , Filippetti Mirko , Picelli Alessandro , Haldane Chloe , Reebye Rajiv
Published: May 2024

Botulinum Neurotoxin Type A (BoNT-A) injections using Ultrasound (US) guidance have led to research evaluating changes in muscle architecture. Controversy remains as to what constitutes increased Echo-Intensity (EI) in spastic muscles and whether this may affect outcomes. We aim to provide a narrative review of US muscle architecture changes following Central Nervous System (CNS) lesions and explore their relationship to spasticity. Medline, CINAHL, and Embase databases were searched with keywords: ultrasonography, hypertonia, spasticity, fibrosis, and Heckmatt. Three physicians reviewed the results of the search to select relevant papers. Reviews identified in the search were used as a resource to identify additional studies. A total of 68 papers were included. Four themes were identified, including histopathological changes in spastic muscle, effects of BoNT-A on the muscle structure, available US modalities to assess the muscle, and utility of US assessment in clinical spasticity. Histopathological studies revealed atrophic and fibro-fatty changes after CNS lesions. Several papers described BoNT-A injections contributing to those modifications. These changes translated to increased EI. The exact significance of increased muscle EI remains unclear. The Modified Heckmatt Scale (MHS) is a validated tool for grading muscle EI in spasticity. The use of the US may be an important tool to assess muscle architecture changes in spasticity and improve spasticity management. Treatment algorithms may be developed based on the degree of EI. Further research is needed to determine the incidence and impact of these EI changes in spastic muscles.
Wellness in South Africa
Authors: Jobson Roy
Published: May 2024

Wellness is a term increasingly being used in South Africa society. However it's use is inconsistent and confusing. Even certain medical aids are using the term to promote their particular products ans increase their membership claiming to be offering their clients something 'special' and 'different'. Many complementary and alternative medicine practitioners have also jumped onto the Wellness bandwagon. 'Stress management' features prominently. Some biokineticits and exercise physiologists use Wellness to describe their particular approaches.
Familial hypercholostrolaemia: A South African perspective
Authors: Crowther N.J. , Paiker J.E.
Published: May 2024

No abstract available.
Quality use of medicines: The teenager with moderate acne
Authors: Gray Andy , Harries Kate
Published: May 2024

Acne is an oft-encountered presentation in family practice, and while sometimes downplayed as essentially a 'cosmetic' and self-limiting problem, it is nonetheless associated with a definite risk of scarring, both physically and emotionally. This paper uses the P-drug approach, as outlined in the WHO Guide to Good Prescribing, to describe a rational approach to the problem of choosing drug therapy for acne, particular in the teenager presenting with moderate acne.
Asthma in young children
Authors: Green Robin J.
Published: May 2024

No abstract available.
Quality use of medicines: The vomitting child
Authors: Gray Andy , Mathibe Lehloboholo
Published: May 2024

No abstract available.
Quality use of medicines: The postmenopausal woman with osteoporosis
Authors: Gray Andy , Botha Julia , Hoffman Deon
Published: May 2024

Guidelines for the management of any condition suffer the ravages of time and can be challenged even by the publication of a single study. This may well apply to any guidelines that include hormone replacement therapy (HRT), such as the Osteoporosis Clinical Guideline published in 2000 by the South African Medical Association. Nothing that 'reliable comparative data on the various drugs registered for the treatment of osteoporosis are not available', the Osteoporosis Working Group attempted to guide clinicians' drug choices.
Supplements (Part 1): Vitamins
Authors: Jobson Roy
Published: May 2024

No abstract available.
Repeatability of retinal nerve fiber layer and ganglion cell complex measurements with spectral-domain optical coherence tomography in normal and glaucomatous eyes
Authors: Abd Elfatah Hatem F. , Ziko Othman A. , Elghropy Osama M. , Ashour Doaa M.
Published: May 2024

Purpose

The current study was set out to investigate the repeatability of retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) measurements in normal and glaucomatous patients using spectral-domain optical coherence tomography (OCT).

Patients and methods

This prospective cross-sectional study included 30 healthy and 30 glaucomatous eyes. Three OCT scans with the Nidek RS-3000 advance were performed three times for each scan protocol: optic disk map, optic disk circle, and macular map to determine the RNFL, cup-to-disk ratio, and GCC. Repeatability was assessed by calculating the intraclass correlation coefficient (ICC) and within-subject coefficient of variation.

Results

The ICC values for RNFL thickness measurements taken from the optic disk map were 0.44–0.86 in normal eyes and 0.33–0.93 in glaucomatous eyes, whereas those obtained from the optic disk circle were 0.76–0.96 and 0.92–0.99 in normal and glaucomatous eyes, respectively. The ICC values for the vertical and horizontal cup-to-disk ratio were 0.81 and 0.86 in normal eyes and 0.83 and 0.90 in glaucomatous eyes, respectively. The ICC values for the upper and lower hemifields were 0.79 and 0.83 in normal eyes and 0.84 and 0.96 in glaucomatous eyes, respectively.

Conclusion

RNFL thickness measurements obtained using Nidek RS-3000 advance spectral-domain-OCT demonstrated variable repeatability in healthy and glaucomatous eyes. Measurements obtained from the optic disk circle scan showed better repeatability than those obtained from the disk map. The GCC measurements exhibited good repeatability.
Distinct patterns of occurrence, common associations, and survival of patients with second primary maligancies
Authors: Vadgaonkar Rohit Avinash , Nayak Sonali Susmita , Doni Subhashreddy , Digumarti Leela , Mullapally Sujith Kumar , Digumarti Raghunadharao
Published: May 2024

Background:

Multiple primary malignancy (MPM) is defined as occurrence of two or more synchronous or metachronous primary malignancies. With the rise in cancer burden and meticulous screening of index primary malignancy (IPM) during treatment, increased incidence of second primary malignancy (SPM) is expected. This study was undertaken with an attempt to analyze the incidence, commonest associations, management strategies, and clinical outcomes of MPM.

Materials and Methods:

This is an observational retrospective study carried out in a single institute with patients registered between 1st January 2015 and 31st August 2019. The International Association of Cancer Registries and International Agency for Research on Cancer (IACR/IARC) definition was used for identification of IPM and SPM. Synchronous SPM was defined as malignancy occurring within 6 months from the diagnosis of IPM.

Results:

Out of 16,461 registered patients during the study interval, 44 (0.26%) cases were found to have MPM. A total of 31 (70.5%) cases were women and 13 (29.5%) cases were men. Median age at presentation of IPM was 48 years and of SPM was 56 years, with median duration between two primaries being 38 months. Seven patients (15.9%) had synchronous malignancies. Gynecological tumors were the most common site of IPM presentation (n = 14, 31.8%) followed by breast (n = 09, 20.5%) and head and neck tumors (n = 07, 15.9%), respectively. The most common SPM was gynecological tumors (n = 12, 27.3%) followed by gastrointestinal malignancies (n = 10, 23.3%). Curative treatment was offered to 88% of patients with IPM and 70% patients with SPM. At a median follow-up of 365 days, 21 (47.72%) patients were disease free, six (13.6%) died of disease and nine (20.5%) were lost to follow-up.

Conclusion:

The study emphasizes the importance of detecting SPM as a result of improved diagnostic and screening procedures. Clinicians should be aware of it and offer multidisciplinary management.
Programmed cell death ligand – 1 expression in triple negative breast carcinoma and its prognostic significance in Indian population
Authors: Gajaria Pooja K. , Gupta Manjudevi R. , Patil Asawari , Desai Sangeeta B. , Shet Tanuja M.
Published: May 2024

Background:

The programmed cell death protein – 1 (PD-1) – programmed cell death ligand – 1 (PD-L1) axis is emerging as a promising target for immunotherapy in triple-negative breast cancers (TNBC).

Aims:

We analyzed the expression of PD-L1 in TNBC cases, with special emphasis on lymphocyte-predominant tumors along with correlation of the same with clinicopathological features and outcome.

Settings and Design:

Tissue microarrays (TMA) were prepared from resection specimens of TNBC cases diagnosed from 2004 to 2008.

Subjects and Methods:

Immunohistochemical staining was performed on the TMA using the ventana PD-L1 antibody (Clone SP 263).

Statistical Analysis:

Chi-square test was used for correlation of PD-L1 positivity in tumor and immune cells with clinicopathological features. Univariate and multivariate survival analyses were carried out using the Kaplan Meir and Cox Regression methods, respectively.

Results:

Overall, PD-L1 staining was seen in 35.9% (66 out of 184) tumors. PD-L1 positivity of tumor cells was seen in 14.7% (27 out of 184 cases), whereas stromal immune cell expression was observed in 21.2% (39 out of 184) cases. Lymphocyte-predominant tumors showed statistically significant expression of PD-L1 in both tumor (P < 0.0001) and immune cells (P 0.036). On univariate analysis, PD-L1 in immune cells was associated with good overall survival (P 0.05) as well as disease-free survival (P 0.013). On multivariate analysis, the same was associated with a significantly decreased risk for recurrence (P 0.018).

Conclusion:

PD-L1 expression in stromal immune cells proved to be a significant prognostic factor for TNBC. This data can serve as a baseline to plan clinical trials with anti-PD-L1 drugs for TNBC in the Indian setting.
Expression of TLE1, INI1, β-catenin, Claudin1, CK7, CK19, SS18 and calponin in synovial sarcoma
Authors: Madakshira Manoj Gopal , Radotra Bishan Dass , Kaman Lileswar , Saikia Uma Nahar
Published: May 2024

Background and Objectives:

Synovial sarcomas (SS) are enigmatic soft tissue tumors, which are yet to have a defined cell of origin. SS have a variety of differential diagnosis depending upon the age of the patient and the site of presentation. This makes diagnosis cumbersome unless the specific fusion SS18:SSX is identified by reverse transcription-polymerase chain reaction (RT-PCR) or fluorescence in situ hybridization (FISH). Immunohistochemistry is a useful tool in resource-poor settings in helping to narrow the differentials and help diagnose this tumor. This study set about assessing possible candidate immunohistochemical markers in their utility to recognize SS.

Methods:

Forty cases of SS, proven by FISH were included. A tissue microarray (TMA) was constructed, and immunohistochemistry was done using antibodies – TLE1 (OTI1F5), β-catenin (14), INI1 (MRQ-27), CK7 (OV-TL), CK19 (polyclonal), SS18 (polyclonal), calponin (CALP), and claudin1 (Polyclonal). The expression was analyzed to arrive at sensitivity and specificity.

Results:

TLE1 had a sensitivity of 92.5% and a specificity of 100%; β-Catenin had a sensitivity of 17.5% and specificity of 100%; Calponin had a sensitivity of 97.5% and a specificity of 81.25%; SS18 had a sensitivity of 95% and specificity of 100%; INI1 had a sensitivity of 95% and specificity of 100%; CK7 had a sensitivity of 90% and specificity of 87.5%; CK19 had a sensitivity of 90% and a specificity of 59.38%; and Claudin had a sensitivity of 85% and a specificity of 78.12%.

Interpretation and Conclusions:

The study showed both TLE1 and SS18 are robust diagnostic markers of synovial sarcoma with a sensitivity of 92% and 95%, respectively. INI1 can be used to discriminate SS from nonepithelioid and nonrhabdoid differentials. Calponin expression is helpful to differentiate poorly differentiated SS from its mimics. CK7 is a better marker than CK19 and can be used as a replacement for EMA in the initial screening panel. The use of claudin1 was restricted to delineating the epithelial component. β-Catenin had poor sensitivity, restricting its utility in SS.
The role of R21 expression in differential diagnosis of melanocytic lesions
Authors: Turcan Didem , Paşaoğlu Özgül , Arik Deniz
Published: May 2024

Background:

Cyclic adenosine monophosphate (cAMP) is an intracellular signal transmitter involved in the regulation of melanocyte growth, proliferation, and melanogenesis. R21 is a monoclonal antibody against the soluble adenylyl cyclase (sAC) protein. Various nuclear and cytoplasmic R21 expression patterns in melanocytic lesions have been previously reported. Pan-nuclear staining was defined as specific for melanoma and was found supportive in the assessment of surgical margins.

Aims:

The aim of this study is to evaluate the different expression patterns of R21 immunostain and investigate its effectiveness in the differential diagnosis of cutaneous malignant and benign melanocytic lesions.

Settings and Design:

Fifty invasive cutaneous melanoma and 50 benign melanocytic proliferation were included in the study.

Materials and Methods:

Paraffin blocks that best reflected tumor morphology were studied via immunohistochemical staining for R21. For all patterns, the cases showing staining in 25% or more tumor cells were considered as positive.

Statistical Analysis used:

Yates’ Chi-square, Pearson Chi-square exact test, Spearman correlation were used.

Results and Conclusions:

Dot-like Golgi staining was characteristic for nevi (12/50) and seen only in one melanoma. Pan-nuclear staining was striking for melanoma (36/50). This pattern was observed in 2 dysplastic and 3 common melanocytic nevi too. None of the Spitz nevi expressed R21 in pan-nuclear pattern. For the diagnosis of melanoma, sensitivity and specificity of the pan-nuclear expression were 72% and 90%, respectively. Positive and negative predictive values were found as 87% and 76%. R21, a second-generation immunohistochemical marker, can be used in the differential diagnosis of benign and malignant melanocytic lesions.
The expression of squalene epoxidase in human gastric cancer and its clinical significance
Authors: Ma Yong-Chao , Jin Shao-Ju , Gu Guo-Jian , Zhao Li-Fang , Xu Song-Tao
Published: May 2024

Context:

Squalene epoxidase (SQLE) is overexpressed in a variety of tumors, which may play an important role in their tumorigenesis, development, and prognosis.

Aims:

The aim of this study is to investigate the expression of SQLE and explore its clinicopathological significance in gastric cancer.

Settings and Design:

The correlation between its positive expression and the pathological characteristics of patients (such as sex, age, tumor size, survival, tumor differentiation, TNM staging, and lymph node metastasis) was analyzed.

Materials and Methods:

Immunohistochemical method was used to detect its expression in 107 cases of gastric carcinoma and 34 cases of tumor-adjacent tissues.

Statistical Analysis Used:

Counting data were analyzed by Chi-square test. Its overall survival was analyzed by Kaplan-Meier method and log-rank test. Its hazard factors were analyzed by Cox multivariate analysis.

Results:

The positive rate of SQLE in gastric cancer is 67.3%, which is higher than that in tumor-adjacent tissues (17.6%), <0.001. Expression of SQLE is closely related to tumor differentiation, TNM staging and lymph node metastasis (P = 0.030, P = 0.009, and P = 0.011, respectively). Furthermore, compared with those low expression of SQLE, the patients of overexpression had worse overall survival by Kaplan–Meier analysis (P = 0.025). Cox multivariate analysis shows that lymph node metastasis, tumor differentiation, SQLE, and TNM staging are independent factors for prognosis of gastric cancer (P = 0.003, 0.020, 0.018, and P = 0.001 respectively).

Conclusions:

SQLE is overexpressed in gastric cancer. It could be used for the diagnosis and prognosis of the gastric cancer patients.
Sudden death due to amyloidosis of intramural coronaries in a patient with amyloidosis of hip joint - An autopsy report with a review of literature
Authors: Lanjewar Dhaneshwar Namdeorao , Vaideeswar Pradeep , Deore Nitin Subhash , Jhala Nirag Chandrakant
Published: May 2024

Amyloidosis is caused by an extracellular accumulation of insoluble fibrillary protein predominantly in the kidneys, spleen, and heart. The deposition of amyloid into the joints, synovia, and osseous tissues (amyloid arthropathy) is an uncommon condition with only a few case reports in the English literature. Similarly, amyloid deposition predominantly limited to the vascular wall is rarely described. In this report, we describe an additional case of amyloidosis of the hip joint along with amyloidosis of intramural coronaries leading to sudden death in a middle-aged male.
Two case reports of mixed epithelial and stromal renal tumor of kidney in children and literature review analysis
Authors: Wei Xia , Wang Yizhen , Fang Yuan , Chen Lian
Published: May 2024

Mixed epithelial and stromal tumor of the kidney (MESTK) occurs almost exclusively in perimenopausal women while rarely in children. Only five pediatric patients have been described previously. Herein, we report a girl and a boy with MESTK, aged 3- and 4-years-old, respectively. The two patients presented with hematuria or an abdominal mass. Histologically, the tumors were both composed of epithelial and stromal elements. Immunohistochemical staining of tumor cells expressed epithelial and mesenchymal component markers. They were diagnosed with MESTK by histology and immunohistochemistry after surgery. The patients were at good condition after surgery. To our knowledge, these are the youngest reported cases of MESTK. And the glandular luminal structure formed by the epithelium was lined with urothelium, which expanded the histological map of MESTK.
Adjunctive role of immunohistochemical expression of Nucleostemin in differentiation of grade II and III diffuse astrocytomas
Authors: Arik Deniz , Özen Alaattin , Özkara Emre , Yılmaz Evrim , Canaz Funda , Yıldırım Güneş D.
Published: May 2024

Aims:

Astrocytomas are common tumors and grade is an important parameter in determining the treatment modalities. Tumor proliferation activity should be determined for the differentiation of grades II and III tumors. In difficult cases, an auxiliary parameter is required. Nucleostemin (NS) is nucleolar Guanosine triphosphate (GTP)-binding protein 3. It has important roles in cell proliferation, cell cycle regulation, self-renewal, and apoptosis. In this study, we investigated whether the level of NS expression is different in grades II and III astrocytomas.

Settings and Design:

Adults diagnosed with grades II and III astrocytomas were included in the study.

Material and Methods:

Paraffin blocks that best reflected tumor morphology were studied via immunohistochemical staining for NS. Only nuclear staining was evaluated; cytoplasmic staining was not considered.

Statistical Analysis Used:

Fisher's exact test, continuity corrections, and Pearson's Chi-square tests were used in the crosstabs. The survival analysis was based on the Kaplan-Meier method.

Results:

Only 20% (6/30) of grade II tumors had high intensity staining, while 54,2% (13/24) of grade III tumors had high staining intensity. NS was significantly more intense in grade III tumors than grade II tumors. In cases with high NS expression, survival was significantly shorter than the cases with low expression.

Conclusion:

NS is significantly higher expressed in grade III tumors than grade II tumors. In difficult cases, it can be used as a useful proliferation marker in the differentiation of grades II and III astrocytomas.