bluuebunny/crossref_metadata_2025_split huggingface dataset:
Baseline Widal Agglutination Titre in Apparently Healthy Nepalese Blood Donors
Authors: Acharya Tankeshwar , Raj Tiwar Bishnu , Mani Pokhrel Bharat 
Published: December 2019

Widal test could be the useful tool for the diagnosis of Typhoid fever, provided the results of Widal test are correctly interpreted. Interpretation of Widal test is based on the baseline titre of healthy population of particular geography. This study was carried out in view to determine Widal baseline titre of healthy blood donors in Nepal from June to December 2009, in Nepal Red Cross Central Blood Transfusion Service and Department of Microbiology of National College. Blood samples were collected from 490 apparently healthy blood donors from 5 different developmental regions. Widal agglutination titre was determined with the use of standard technique as per the manufacture’s instruction. Of the total 490 blood samples, 35.1% (172) samples showed anti O titre ≥ 1:20 against serotype Typhi, similarly 32.9% and 24.1% samples had titre ≥ 1:40 and ≥ 1:80 respectively. About 10.4% population had anti-O titre ≥ 1: 160. Of the total blood samples, 29.4% (143) samples showed anti H titres ≥ 1:20 against serotype Typhi, similarly 26.1% had a titre ≥ 1:40, and 16.3% had a titre ≥ 1:160. Anti-H titres ≥ 1:20 were found in serotype Paratyphi A (6.3%) and Paratyphi B (3.1%). Both ‘O’ and ‘H’ agglutination titre varied according to the geographical location. This study showed high titres >1:160 for serotype Typhi, ‘O’(10%) and ‘H’ (16.3%) of widal agglutinin in apparently healthy individuals. This necessitates larger rise in widal agglutinin titre for a ‘positive’ diagnosis. Widal test had played a major role in the diagnosis of typhoid fever in the past, but its diagnostic significance is less now.
Keyword: Widal test, Enteric fever, Nepal
Attitude on Premarital Sex, Marriage and Family Size among Adolescents in Pokhara Valley
Authors: Raj Paudel Deepak 
Published: December 2019

This is a cross-sectional descriptive study aimed to assess the attitude on premarital sex, marriage and family size among school going adolescents in Pokhara valley in 2006. The study included 400 students carried out from 170 from 8 government schools and 230 from 8 private schools of the classes X, XI, and XII of the Pokhara valley. The self administered questionnaire prepared in Nepali method was applied for collecting information from randomly selected students in each selected school. Out of total, 57.5 % students were boys and 91% were in age group of 15-18 years. About two-fifths (41%) of the students did not agree with the statement that “premarital sex is not good”. This attitude was higher in boys than girls (46% versus 34%) and in government school students than private school students (57% versus 33%). More than half (62%) students preferred arranged marriage, and it comprised 73% of girls and 53% of boys. Almost all of the students (97%) were of the opinion that a couple should not have more than two children. Of total, 85% of the students’ preferred to have one son. The preference of a son is slightly higher in girls (87%) than in boys (84%). About half of the students (53%) were aware that biologically male is responsible for the sex of the child. This knowledge was higher in the boys (54%) and those studying in government school (58%) than girl students (51%) and private school students (50%). This concludes that male were more liberal towards premarital sex, self arranged marriage, sex preference than girls.
Key words: Attitude, Premarital Sex, Marriage, Adolescents, Family Size
Medication Adherence and Blood Pressure Control among Hypertensive Patients of Pokhara Valley
Authors: Muhammad Khan Gulam , Kumar Thapa Raj , Khakurel Amrita , Shrestha Gita , Katila Nikita , Bhurtel Sunil 
Published: December 2019

Hypertension is a chronic medical condition which remains inadequately managed everywhere. Medication adherence (MA) is a critical parameter for achieving strict blood pressure (BP) control in patients undergoing antihypertensive therapy (AHT). Good MA is also a key factor determining the success of preventive measures for cardiovascular (CV) risk reduction. So, the objective of this research was to study the medication adherence and blood pressure control among hypertensive patients of Pokhara Valley. A randomized community-based prospective study was conducted in different places of Pokhara. In the study, a structured questionnaire i.e. Brief medication questionnaire (BMQ) with a high sensitivity and specificity was used. Out of 79 respondents enrolled, most of the respondents (n=51, 64.6%) were shown to be non-adherent and only 28 (35.4%) were adherent to the prescribed AHT. The study showed that among adherers, 75% were undergoing monotherapy and 64.3% (n=18) had their BP under control. The comparison between BP control and the different occupation showed that the highest percentage of BP control was achieved in housewives. Most of the respondents were non-adherent to the prescribed AHT which requires special attention of the healthcare providers.
Key words: Hypertension, medication adherence, brief medication questionnaire, anti-hypertensive therapy
Troubles de l’usage de l’alcool et Rorschach : défaut du Moi corporel et évitement psychique
Authors: Gaudriault Pierre , Jacquet Marie-Madeleine 
Published: December 2019

À partir des travaux psychanalytiques portant sur le mécanisme d’évitement psychique évoqué par S. Fraiberg et A. Green d’une part, et sur les troubles du Moi corporel décrits par G. Haag d’autre part, les auteurs font l’hypothèse que ces phénomènes impactent le Rorschach de patients souffrant d’addiction alcoolique (AUD). Les Rorschach de 58 patients AUD comparés à 58 patients souffrants de troubles psychiatriques divers non addictifs (PSY) montrent des signes d’évitement préalable dans un quart des sujets des deux groupes. Chez les patients restants, les kinesthésies mineures, les réponses contre-expressives et les réponses Pénétration sont significativement plus nombreuses chez les AUD. Ces résultats vont dans le sens de l’évitement psychique et des troubles du Moi corporel chez ces patients, éclairant la question de leur engagement dans les soins.
L’addictologie : d’une néo-discipline et de son homogénéité. Conditions historiques de son émergence en France
Authors: Dugarin Jean 
Published: December 2019

À la toute fin du XX e siècle est apparue en France une nouvelle discipline, l’addictologie. L’Université s’en est emparée et nombre d’enseignements ont été proposés, d’inspirations diverses, s’adressant à des publics variés. Ainsi est né un praticien d’un style nouveau, l’addictologue. En miroir, un patient nouveau s’est dessiné « l’addict », avatar récent tout à la fois de l’alcoolique, du toxicomane, du pharmacodépendant et du dépendant comportemental. Son homogénéité conceptuelle tant sur le plan clinique que social continue à être discutée. Les professionnels s’interrogent sur ses définitions et sur les diagnostics différentiels à partir de grilles de lecture d’horizons divers. Les patients eux-mêmes peinent, parfois, tant les stéréotypes sont figés en la matière et les contextes différents, à voir ce qu’il peut y avoir de commun entre un usager de crack, un fumeur de tabac et un « cyberaddict ». Dans le champ de l’addictologie plus qu’ailleurs se pose le problème des statuts alloués à l’« addict », les statuts ontologiques, cliniques, éthiques, juridiques pouvant venir s’interpénétrer. Pour tenter d’y voir un peu plus clair, ce texte va proposer une remise en perspective historique, où nous verrons d’abord comment le XIX e siècle va réunir les conditions d’une problématisation débouchant sur l’apparition progressive de l’image de l’alcoolique et du toxicomane. Puis, au XXe siècle, viendront les textes de loi, et notamment la loi du 31 décembre 1970 qui va logiquement poser la question d’un système de soins spécifique (sa nature, ses acteurs, ses références théoriques).
De la philosophie à l’histoire, en passant par la psychologie : que nous apprennent les archives Foucault des années 1950 ?
Authors: Basso Elisabetta 
Published: December 2019

Cet article s’appuie sur des manuscrits foucaldiens des années 1950 afin d’analyser le chantier théorique à partir duquel le jeune Foucault inaugure la réflexion qui l’amènera à une mise en question radicale des sciences humaines. En particulier, l’article suit la piste d’un ouvrage inédit que Foucault a consacré à l’analyse existentielle de Ludwig Binswanger à l’époque de son enseignement à Lille. Ce manuscrit représente le maillon manquant entre l’« Introduction » à Le rêve et l’existence (1954) et la thèse que Foucault publie en 1961, Folie et déraison. Tout en adjoignant à l’analyse du manuscrit la lecture de notes et fiches de lecture de la même époque, l’article montre que la critique que Foucault finit par adresser à l’anthropologie et la phénoménologie au début des années 1960 serait déjà présente de manière implicite dans l’« Introduction » à Le rêve et l’existence. Dans cette étude, en effet, Foucault aurait déjà abandonné son enthousiasme initial pour l’anthropologie phénoménologique de Binswanger pour focaliser plutôt son attention sur le problème du langage et de l’historicité des formes d’expériences.
Bypassing primary healthcare institutions: Reasons identified by patients’ attending the out-patient department
Authors: Karunaratne N. P. , Kumara G. S. P. , Karunathilake K. T. G. S. , Karunathilake G. V. K. M. , Kaushalya P. G. M. , Kavinda H. W. I. , Keshala A. A. M. , Ponnamperuma T. 
Published: December 2019

IntroductionSri Lanka has a hierarchy of health services, from health care units with fewer facilities to hospitals with specialized care. Due to the absence of well demarcated draining areas and lack of clear referral policies, patients tend to bypass the primary health care units and attend much superior health care institutions without referrals. This practice has caused congestion in hospitals and deterioration of efficacy and quality of care provided to needy patients. This study was designed to identify the reasons for bypassing primary health care institutions by patients. MethodA cross sectional study was done among conveniently selected sample of patients attending outpatient department of Teaching Hospital Karapitiya (THK). Data were collected by an interviewer administered questionnaire that assessed their socio demographic status and reasons for bypassing their nearest hospital. Patients whose nearest hospital are THK and referred patients were excluded from the study. ResultsAmong 344 patients, 60.2% were females, mean age was 41 years. Most were educated up to GCE O/L, unemployed, and had an average income<Rs 30,000. More than half (52%) of the patients had a primary health care unit less than 5km from their residence. In average, patients spent nearly 1 & 1/2 hours for traveling and paid Rs. 186 to reach tertiary care hospital. According to the participants’ understanding, most of their nearest hospitals had adequate supply of medicine (72%) and staff (79%), but not the laboratory facilities (48%).Poor quality of service represented by of doctors, delayed service, lack of essential facilities and lack of laboratory facilities and specialized services were reported as main reasons for by passing their nearest health care institutions. ConclusionsFindings confirmed that averagely educated people with low middle-income avoid primary health care services due to unavailability of specialized care, inadequate facilities and poor quality of service. Improving facilities and building trust on primary care service will therefore improve utilization of primary health care institutions in the country.
Self-Antigens Displayed on Liposomal Nanoparticles above a Threshold of Epitope Density Elicit Class-Switched Autoreactive Antibodies Independent of T Cell Help
Authors: Chen Zhilin , Wholey Wei-Yun , Hassani Najafabadi Alireza , Moon James J. , Grigorova Irina , Chackerian Bryce , Cheng Wei 
Published: December 2019

Abstract
Epitope density has a profound impact on B cell responses to particulate Ags, the molecular mechanisms of which remain to be explored. To dissect the role of epitope density in this process, we have synthesized a series of liposomal particles, similar to the size of viruses, that display a model self-antigen peptide at defined surface densities. Immunization of C57BL/6J mice using these particles elicited both IgM and class-switched IgG1, IgG2b, and IgG3 autoreactive Abs that depended on the epitope density. In C57BL/6 gene knockout mice lacking either functional TCRs or MHC class II molecules on B cells, the liposomal particles also elicited IgM, IgG1, IgG2b, and IgG3 responses that were comparable in magnitudes to wild-type mice, suggesting that this B cell response was independent of cognate T cell help. Notably, the titer of the IgG in wild-type animals could be increased by more than 200-fold upon replacement of liposomes with bacteriophage Qβ virus-like particles that displayed the same self-antigen peptide at comparable epitope densities. This enhancement was lost almost completely in gene knockout mice lacking either TCRs or MHC class II molecules on B cells. In conclusion, epitope density above a threshold on particulate Ags can serve as a stand-alone signal to trigger secretion of autoreactive and class-switched IgG in vivo in the absence of cognate T cell help or any adjuvants. The extraordinary immunogenicity of Qβ viral-like particles relies, in large part, on their ability to effectively recruit T cell help after B cell activation.
Real-World Experience on the Effectiveness and Tolerability of Apremilast in Patients with Plaque Psoriasis in India
Authors: Parasramani Shrichand , Thomas Jayakar , Budamakuntla Leelavathy , Dhoot Dhiraj , Barkate Hanmant 
Published: December 2019

Introduction:
Apremilast, a phosphodiesterase-4 inhibitor, has been recently approved for the management of plaque psoriasis in India in 2017. However, no real-world experience pertaining to apremilast has been documented.

Materials and Methods:
A retrospective review of medical records was conducted of all patients across India who were prescribed apremilast for an entire 16 weeks. The primary endpoint was the percentage of patients achieving the Psoriasis Area and Severity Index (PASI) 75 at 16 weeks. The secondary endpoints were as follows: (i) change in mean PASI; (ii) change in mean body surface area (BSA); (iii) percentage of patients who achieved PASI 50, 90, and 100; and (iv) adverse events (AEs) reported.

Results:
We analyzed the records of 105 patients. Mean age was 41 years and mean disease duration was 6.75 years. All the patients had previously received some forms of systemic treatment. Forty-three patients (41%) achieved ≥ PASI 75 of which four patients (3.8%) and five patients (4.76%) achieved PASI 100 and PASI 90, respectively at week 16. Moreover, 28 patients (26.7%) demonstrated PASI 50 response. Baseline mean PASI score of 14.78 reduced to 4.5 (−69.55%), whereas mean BSA score of 24.4 reduced to 8.24 (−66.3%). Nine patients discontinued apremilast due to adverse effects. Thirty-five patients (33.3%) had one or more AEs, diarrhea being the most common (30.5%) followed by nausea (20.3%). Most AEs were mild to moderate in severity.

Conclusion:
These results, from a real-world setting in India, confirm the effectiveness and tolerability of apremilast as seen in clinical trials.
Assessment of Knowledge and Attitude Towards Sun Exposure and Photoprotection Measures Among Indian Patients Attending Dermatology Clinic
Authors: Dey Vivek Kumar 
Published: December 2019

Background:
Many skin diseases are known to be either initiated or aggravated by excessive ultraviolet (UV) exposure. High cumulative levels of UV radiation may lead to tanning, burning, photoaging, photoallergic and phototoxic reactions, immunosuppression, and even skin cancers. Many international studies have found that the level of knowledge, attitudes, and practices of the general public toward sun exposure and sun protection measures is good in the Western countries, especially in countries with high incidence of skin cancers compared to Asian countries and Middle East. In India, the incidence of skin cancer is not very high, but UV exposure has definitely increased in the past few decades. Little is known about the knowledge and attitude of Indians toward sun exposure and sun protection due to the paucity of research in this arena.

Aims and Objectives:
This study was aimed at exploring the knowledge and attitudes of Indians toward sun exposure and sun protection measures.

Materials and Methods:
A cross-sectional survey was conducted using a predesigned questionnaire related to the knowledge, behavior, and attitudes toward sun exposure and sun protection of the participants visiting a dermatology outpatient clinic for various dermatological problems.

Results:
A total of 324 patients were studied. Participants were divided into five age groups of equal number of male and female participants. Mean age was 37.7 ± 13.15. Overall awareness and knowledge was poor and only 14% were using regular sunscreen. Females had better knowledge and attitude toward sun exposure and protection. The most commonly used sun protection measure was avoiding sun during peak hours of the day.

Conclusion:
The level of knowledge regarding sun exposure hazards was very low among the study population, and sun prevention behaviors were also very poor. Regular use of sunscreen was practiced only by a small fraction of our population. Knowledge of sun exposure and photoprotection was better in urban, young participants, female gender, and also positively associated with higher education and socioeconomic status. Participants from urban background, females, and middle-aged participants had better attitude toward photoprotection.
Reference crop evapotranspiration database in Spain (1961–2014)
Authors: Tomas-Burguera Miquel , Vicente-Serrano Sergio M. , Beguería Santiago , Reig Fergus , Latorre Borja 
Published: December 2019

Abstract. Obtaining climate grids describing distinct variables is important for developing
better climate studies.
These grids are also useful products for other researchers
and end users.
The atmospheric evaporative demand (AED) may be measured in terms of the
reference evapotranspiration (ETo), a key variable for
understanding water and energy terrestrial balances and an important variable in
climatology, hydrology and agronomy.
Despite its importance, the calculation of ETo is not commonly undertaken, mainly because datasets consisting of
a high number of climate variables are required and some of the required variables are not
commonly available. To address this problem, a strategy based on the spatial interpolation of climate
variables prior to the calculation of ETo using FAO-56
Penman–Monteith equation was followed to obtain an ETo database for
continental Spain and the Balearic Islands, covering the 1961–2014 period at a
spatial resolution of 1.1 km and at a weekly temporal resolution.
In this database, values for the radiative and aerodynamic components as well as the
estimated uncertainty related to ETo were also provided. This database is available for download in the Network Common Data Form (netCDF) at
https://doi.org/10.20350/digitalCSIC/8615 (Tomas-Burguera et al., 2019).
A map visualization tool (http://speto.csic.es, last access: 10 December 2019) is available to help users
download the data corresponding to one specific point in comma-separated values (csv) format. A relevant number of research areas could take advantage of this database.
For example, (i) studies of the Budyko curve, which relates
rainfall data to the evapotranspiration and AED at the watershed scale, (ii) calculations of drought indices using AED data, such as the Standardized Precipitation–Evapotranspiration Index (SPEI) or Palmer Drought Severity Index (PDSI), (iii) agroclimatic studies related to irrigation requirements, (iv) validation of
climate models' water and energy balance, and (v) studies of the impacts of climate
change in terms of the AED.
“Suitable Feminine Companionship”: On Mamie Burns and Fat Violet in Long Day's Journey Into Night
Authors: King William Davies 
Published: December 2019

ABSTRACT
In act 4 of Long Day's Journey Into Night, Jamie tells Edmund a sentimental story of the evening he has just spent with a prostitute, Fat Violet, in the establishment of Mamie Burns. Burns has previously been identified as based on Addie Burns, a madam in the red-light district of New London, Connecticut. Newspaper reports from the period make it clear that Burns was in prison for statutory rape in 1912, when the play is set, and they also lead to the identification of Viney Malady as the original Fat Violet. The idea of the abettor of rape being convicted as the rapist opens a new perspective on what Carlotta Monterey O'Neill and O'Neill's biography have told us about his actual brother's complicity in his traumatic sexual initiation at an early age. This material opens new perspective on O'Neill's Strange Interlude, Exorcism, and “The Ballad[e] of Old Girls.”
The Politics of Friendship: Hannah Arendt and the Organizing of the Industrial Areas Foundation
Authors: May Daniel 
Published: December 2019

Abstract
This article puts the political thought of Hannah Arendt into conversation with the organizing of the Industrial Areas Foundation, the oldest community organizing network in the United States. Arendt is often read as critical of politics that is instrumental in purpose, and the IAF is sometimes criticized for an overly instrumental approach to political life. In this article, however, I argue that Arendt illuminates what is particularly distinctive about the IAF and its place in American public life, namely its attention to politics as a space for disclosure and plurality. The encounter between the theorist and the organizing, however, reveals dissonance as well as resonance, revealing limitations in Arendt's conception of the factors that motivate political life. I conclude by reflecting on some of the implications that the work of the IAF and the thought of Arendt raise for the practices of organizing and citizenship in America more broadly.
Deliberative Democracy and the Problem of the Second Best
Authors: Lafont Cristina 
Published: December 2019

Abstract
In Democracy When the People Are Thinking Fishkin offers a wholehearted defense of the possibilities of realizing the democratic ideal of self-government within contemporary societies. However, there is a fundamental tension in the book between participatory and non-participatory interpretations of deliberative democracy. Although Fishkin defends the desirability of mass participation in a deliberative democracy, he also defends a non-participatory conception as our second-best option under non-ideal conditions. Against this proposal, I argue that it fails to take the so-called “problem of the second best” into account. Once we recognize this problem it becomes clear that, under non-ideal circumstances, the second-best option is not the improvement of some democratic values to the detriment of the others. To the contrary, our second-best strategy is to use institutional innovations such as Deliberative Polls with the aim of improving on all democratic values in ways that are optimally suited toward securing each of them.
James Fishkin's Unconventional Challenge to Thinking about Elections and Representation
Authors: Levinson Sanford 
Published: December 2019

Abstract
Jim Fishkin's important book sets out a number of challenges to the conventional wisdom of political scientists and lawyers (and, for that matter, pundits and politicians) about what would count as serious “reform” of a now much-criticized system of elections and political representation within the United States and elsewhere. Drawing from both ancient Athens and the findings of contemporary political philosophy and empirical political science, Fishkin's work is essential reading for anyone interested in the health of our polities, at home and abroad, especially as they come under ever more challenges that are calling the maintenance of liberal constitutionalism into doubt.