bluuebunny/crossref_metadata_2025_split huggingface dataset:
Une diplomatie territoriale complexe pour connecter les territoires de l’Union européenne
Authors: Moullé François 
Published: April 2024

Le concept de diplomatie territoriale est récent en géographie, il a été développé en relations internationales. L’enjeu est de caractériser les acteurs qui travaillent ensemble malgré des différences institutionnelles fortes ; cela nécessite des compétences spécifiques dans le cadre de gouvernances multiniveaux très souvent asymétriques. Le concept est particulièrement intéressant pour analyser et comprendre les coopérations entre les États à l’échelle de l’Union européenne et entre les États membres. La diplomatie est un outil pour comprendre avec précisions les relations entre les acteurs et mieux définir en quoi les transformations à la frontière sont des innovations territoriales, là où les acteurs cherchent à transformer les discontinuités en opportunités.
La guerre d’Ukraine révélateur du choix de l’UE pour l’influence contre la puissance
Authors: Kahn Sylvain 
Published: April 2024

L’invasion d’un pays associé à l’UE et possiblement alors considéré comme susceptible de la rejoindre amène les Européens à prendre pleinement conscience de ce qui les caractérise et ce qui les différencie radicalement de la Russie actuelle : la politique de la Russie est une politique de puissance ; elle témoigne que son gouvernement se représente la Russie comme une puissance. Par contraste, car cette puissance menace l’UE, les Européens prennent pleinement conscience que leur construction territoriale et politique supranationale européenne n’est pas une puissance car ce n’est pas leur projet ni leur vocation. Face à la guerre d’agression de l’Ukraine par la Russie, les décisions des dirigeants de l’UE sont d'une part une confirmation du rapport que l’Europe entretient avec la puissance et d’autre part la révélation qu’avec cette UE supranationale de pays souverains les Européens construisent des capacités étatiques.
L’Union européenne et les Régions : comment les instruments de la politique de cohésion ont promu l’échelon régional
Authors: Baudelle Guy , Charles-Le Bihan Danielle 
Published: April 2024

La construction européenne a contribué à valoriser l’échelle régionale en dépit du défaut de compétence de l’Union européenne (UE) en aménagement du territoire. L’état de l’art montre que les modalités de cette affirmation du niveau régional en lien avec l’UE restent toutefois imparfaitement éclairées. On défend ici l’idée selon laquelle la reconnaissance de l’échelon régional passe par la mise en place d’instruments politiques, juridiques et techniques. On l’illustre à partir de deux exemples : la politique de cohésion d’une part et la coopération territoriale transfrontalière d’autre part, qui ont fait des Régions des acteurs reconnus de la mise en œuvre des actions de l’UE.
Quand les opportunités se transforment en trappe de développement : des injustices spatiales à la frontière franco-luxembourgeoise
Authors: Evrard Estelle 
Published: April 2024

Les notions de « région laissée pour compte » et de « trappe de développement » mettent en lumière les défis structurels, significatifs et persistants expliquant pourquoi certaines régions peinent à retrouver leur dynamisme. Mobilisées à l’échelle européenne ou nationale, ces notions n’ont pas spécifiquement exploré le contexte transfrontalier. En empruntant la dualité lisse/striée à Deleuze et Guattari, nous exposons la nature imbriquée de la territorialité Européenne, avant de conceptualiser le frottement des territorialités lisse et striée et l’impossibilité pour les acteurs de faire face aux disparités en résultant comme des expressions d’injustice spatiale. En nous appuyant sur 52 entretiens semi-directifs menés dans le périmètre du GECT Alzette Belval (frontière franco-luxembourgeoise), nous exposons pourquoi les réponses institutionnelles mobilisées pour faire face aux manques de services publics restent infructueuses et exposent les usagers et acteurs publics locaux à des situations d’accès inégal à des droits, opportunités ou ressources. Nous concluons avec des pistes pour de futures recherches.
Des conglomérats électoraux et leurs bases sociales intra-urbaines
Authors: Rivière Jean 
Published: April 2024

Cet article se propose de saisir la constitution et la composition des principaux conglomérats électoraux qui se sont cristallisés à l’occasion du premier tour du scrutin présidentiel de 2022, et ce en raisonnant à partir du cas nantais, emblématique des dynamiques sociales et électorales du haut de la hiérarchie urbaine française. À travers ce cas, il plaide pour une socio-géographie électorale quantitative et analyse les résultats à l’échelle fine des 475 bureaux de vote de Nantes Métropole, en les éclairant à l’aide d’indicateurs de la statistique publique permettant d’approcher les propriétés sociales des habitants de manière multidimensionnelle. La première partie s’attache à décrire la structuration de l’espace électoral local, ses correspondances avec l’espace social et ses traductions dans l’espace géographique. Cet espace électoral se révèle structuré autour de trois grands pôles, que les parties suivantes de l’article prennent ensuite le temps d’explorer.
Le socialisme municipal à l’épreuve du déclin urbain
Authors: Guéraut Élie , Warnant Achille 
Published: April 2024

Cet article se propose d’analyser les causes et les conséquences de la crise du socialisme municipal à Nevers, une ville moyenne du centre de la France. Conquise par les socialistes en 1971, la commune connaît une alternance à l’occasion des élections municipales de 2014, à l’occasion desquelles un candidat « sans étiquette » remporte la victoire. Nous montrons que si ce changement s’explique par des facteurs nationaux, tels que la diminution des votes à gauche chez les classes populaires et la « cartellisation » du PS, certaines particularités locales en ont amplifié ces effets. La décroissance démographique et l’appauvrissement qui se sont amplifiés dans les années 2000 ont modifié les bases sociales du pouvoir local, affaiblissant la capacité des socialistes et de leurs alliés à mobiliser leurs soutiens en raison de la réduction des ressources publiques et/ou de la baisse de leur efficacité.
Course and Outcome of Depressive Disorders among Patients with Alcohol Dependence
Authors: Rout Deepak Kumar , Awasthi Snigdha , Sahoo Manoj Kumar 
Published: April 2024

Abstract

Introduction:
Alcohol dependence is likely to influence treatment processes and outcomes in depressive patients. This co-occurrence of alcohol use disorder (AUD) and depressive disorder has been previously associated with greater severity and a worse prognosis for both entities. However, there is a dearth of Indian studies on this issue.

Objective:
To examine the course and outcome among alcohol-dependent/nondependent depressive patients.

Materials and Methods:
Semistructured pro forma for demographic details, International Classification of Diseases 10 Diagnostic Criteria for Research criteria for diagnosis, and Hamilton Depression Rating Scale (HAM-D) for severity of depression were administered to 124 persons at baseline, 6 weeks, and 3 months.

Results:
The differences between the groups’ HAM-D scores were found to be statistically significant at all time points (i.e., at baseline, 6 weeks, and 3 months) (P < 0.001), with overall worst scores among patients with bipolar depression with alcohol dependence (Group IA) (P < 0.05 at all follow-up points), indicative of slower remission of depression and poorer course in these patients. Among patients of unipolar depression, those with alcohol dependence scored worse on the HAM-D scale at 3 months of follow-up indicative of worse outcomes in the long term.

Conclusions:
Patients with mood disorder and AUD were found to have worse outcome on follow-up as compared to those without. Furthermore, bipolar patients with AUD were found to have the worse depression at the end of follow-up thus indicating a poorer outcome in the long term. However, future studies should incorporate study of associated factors and how it contributes to worse outcomes.
Clinicomycological Study of Dermatophyte Infections in Patients Attending Dermatology Outpatient Department in a Tertiary Care Hospital
Authors: Vernekar Prajna P , Prabhu Sweta R , Jain Pavithra A , Naveen Kikkeri N 
Published: April 2024

Context:
Dermatophytosis is a fungal disease characterized by the infection of skin, hair, and nails. There is an upsurge of complicated superficial dermatophytosis and an increase in the incidence of chronic, relapsing, recurrent cases in India that are also often unresponsive to conventional doses of drugs.

Aims:
The aim of this study was to study the prevalence of dermatophyte species in the particular study area and it is susceptibility to itraconazole, terbinafine, and fluconazole.

Settings and Design:
All dermatophytes isolates obtained were subjected to 10% KOH mount, fungal culture, and antifungal sensitivity testing for fluconazole, itraconazole, and terbinafine.

Materials and Methods:
Newly diagnosed cases of dermatophytosis without treatment for the past 3 months were included in the study. KOH preparation was observed and subjected to fungal culture. Then, the susceptibility of the dermatophytes to oral antifungals (itraconazole, terbinafine, and fluconazole) was done.

Results:
Out of 28 patients with tinea, 14 males and 12 females were tested KOH positive. Out of them, 23 patients showed positive for dermatophyte growth. In them, 15 isolates were Trichophyton mentagrophytes and 8 isolates were Trichophyton rubrum. Antifungal drug susceptibility testing data indicated that, for the two species, MIC of itraconazole ranged between 0.03 and 16 μg/ml, terbinafine between 0.03 and 16 μg/ml, and fluconazole between 0.25 and 64 μg/ml.

Conclusions:
The study provided information regarding the prevalent species of dermatophyte in our study area and it is high sensitivity to itraconazole compared to terbinafine and the lowest for fluconazole. This gives us guidance as to which antifungal to use empirically in our clinical practice to treat tinea infection.
Cutaneous Malignancies: A Prospective Study of Demographic Patterns, Risk Factors, and Clinical Spectrum at a Tertiary Care Center in South India
Authors: Kanathur Shilpa , Rajesh Supriya , Shanmukhappa Asha Gowrappala , Loganathan Eswari , Suryanarayan Shwetha 
Published: April 2024

Background and Objectives:
The incidence of skin cancer is increasing worldwide and is causing a massive burden to the health-care system. It arises as a result of interplay between various predisposing factors. We intend to study the various clinical presentations of cutaneous malignancies and the demographic pattern and risk factors associated with them.

Methodology:
The study was done over a period of 7 years, 181 patients were diagnosed with cutaneous malignancy in the department of dermatology of our tertiary care hospital. A diagnosis was done based on history, clinical and histopathological examination.

Results:
Of 181 patients, majority of the patients belonged to 7th decade (n = 56, 31%) with the mean age being 55 years. The study group had 105 males (58%) and 76 (42%) females. The most common site was the head-and-neck region (n = 105, 58%). The most important associated condition/predisposing factor was ultraviolet (UV) radiation exposure (n = 79, 44%). Keratinocytic tumors formed the largest group (n = 131, 72%) in which basal cell carcinoma (BCC) was the most common (n = 75, 41%). Surgical excision was the main modality of treatment and was done in 111 (61%) patients.

Conclusion:
BCC was the most common skin cancer with head-and-neck region being the most common location in our study. Important risk factors were increasing age, male sex, and prolonged exposure to UV radiation. Early diagnosis helps in planning effective management strategies.
Comparison of Visual Inspection Methods with Pap Smear as Screening Test for Premalignant Lesions of the Cervix
Authors: Yadav Jyoti , Agarwal Shubhra , Jain Aayushi 
Published: April 2024

Aim and Objectives:
The present study was done to compare the visual inspection methods with Pap smear as a screening test for premalignant lesions of the cervix.

Materials and Methods:
The present observational prospective study was done at the Department of Obstetrics and Gynecology at Teerthanker Mahaveer Medical College and Research Center for 18 months. All study subjects were subjected to Papanicolaou smear, VIA, and VILI examination. If any of these tests were found positive, then a colposcopy and cervical biopsy were done.

Results:
The sensitivity of Pap, VIA, VILI, and colposcopy was 52.63%, 84.21%, 73.68%, and 84.21%, respectively. The specificity of Pap, VIA, VILI, and colposcopy was 60.0%, 80.0%, 60.0%, and 80.0%, respectively. The accuracy of Pap, VIA, VILI, and colposcopy was 54.17%, 83.33%, 70.83%, and 83.33%, respectively.

Conclusion:
It is well known that VIA and VILI are very easy to carry out and apply. Even technically they do not cost much, consume less tax and can be applied to all the patients. Even the results are calculated in a faster manner which helps in chalking out the plan in an easy way.
Sleep habits and its associated factors among medical students of a medical college in Telangana, India
Authors: Ali Fathima Shoukath , Jha Punam Kumari , Bhavani R. 
Published: April 2024

Abstract

Background:
Sleep is vital for cognitive function and physical and mental well-being. Medical students are prone to reduced sleep because of extensive curriculum, competitive exam, tireless night duties, fear of failure, and countless other responsibilities.

Objective:
This study aims to assess the sleep quality and daytime sleepiness and to determine their associated factors related to poor sleep quality among medical students.

Materials and Methods:
A cross-sectional study was done among 435 students among undergraduates and postgraduates in Kakatiya Medical College, Warangal, Telangana, from January 2023 to April 2023. After obtaining informed consent, the data were collected using a self-administered questionnaire, in which sleep quality and excessive daytime sleepiness was assessed using Pittsburgh Sleep Quality Index and Epworth Daytime Sleepiness Scale, respectively. The collected data were entered into Excel sheet and exported to SPSS V 20. Data analysis was done using Chi-square test, Fisher’s exact test, and Pearson’s correlation coefficient. P < 0.05 was considered statistically significant.

Results:
Poor sleep quality and excessive daytime sleepiness were present in 297 (68.3%) and 105 (24.1%) students, respectively. Department of postgraduates, smoking, mobile phone use, academic performance, tea, coffee intake, and excessive daytime sleepiness had a significant association with poor sleep quality. Excessive daytime sleep and sleep quality had strong positive correlation (r = 0.823).

Conclusion:
Poor sleep quality was quite high among medical students. Daytime sleepiness was predominant among students with poor sleep.
Using an anatomic model to teach female stress incontinence to gynecologic residents-in-training: A prospective cohort study
Authors: Lim-Navarro Lilibeth , Aguinaldo Joanne Karen S. 
Published: April 2024

BACKGROUND:
Stress urinary incontinence (SUI) is a complex condition with a multifactorial etiology that makes its concepts challenging to teach. This study aimed to assess the efficacy of simulation-based training (SBT) with an anatomic teaching model in improving the understanding of SUI among gynecologic residents-in-training.

OBJECTIVE:
The primary objective of this study was to evaluate the efficacy of SUI simulation-based teaching in enhancing the learning experience for gynecologic residents-in-training. The secondary objective was to gather feedback from participants with the intent to further enhance existing teaching methodologies.

MATERIALS AND METHODS:
This was a descriptive prospective study within a single institution, involving gynecologic residents-in-training. Participants were given an anatomic teaching tool to construct, followed by an SUI lecture. Pre- and posttest Multiple Choice Questions were administered to assess the efficacy of the teaching tool in improving the participants’ understanding of SUI. Frequency and percentages were used to describe the categorical variables, whereas continuous variables were described using mean and standard deviation. Paired t-test was used to compare the pre- and posttest scores. ANOVA was used to compare the pre- and posttest scores of participants by year level. A P < 0.05 is statistically significant. A separate Likert-scale questionnaire, to evaluate changes in participant’s self-assessment on learning, response to teaching content and resources, and overall feedback of the SBT was used.

RESULTS:
There were 50 gynecologic residents-in-training that were included in the study. The mean posttest score is significantly higher (6.4 vs. 3.48) than the pretest score, with a mean difference of 3.48. The mean posttest score is significantly different between the year levels with a P < 0.05, with senior residents-in-training performing best. Although participants with only gynecologic conferences as SUI reference performed best, the mean pre- and posttest scores were not statistically different with respect to SUI education exposure. With the use of an anatomic SUI model, the number of correct answers for questions pertaining to anatomy, physiology, and pathophysiology was consistently higher in the posttest scores as compared to the pretest scores but did not reach statistical significance. The majority of participants strongly agree to recommend the course to a colleague.

CONCLUSION:
This study supports the use of simple, low-fidelity physical teaching tools in improving the understanding of SUI in gynecologic residents-in-training. Considering the ease of production, improved test scores, and participants’ enthusiasm, the incorporation of the anatomic teaching tool for its use in SUI education should be encouraged.
Barriers to enrolment of clients into community client led anti-retroviral therapy delivery (CCLAD) in selected health facilities in Kasese District, Uganda
Authors: Omona Kizito 
Published: April 2024

Background: Community Client Led Anti-retroviral therapy Delivery (CCLAD) Model has been associated with increased community participation and ownership, which leads to better treatment outcomes with reduced workload and increased client satisfaction of health services.
Aim: To explore the barriers to enrolment of eligible clients into CCLAD in selected health facilities in Kasese District, Uganda.
Materials & methods: Analytical cross-sectional study utilizing mixed method approach was conducted among 384 PLWHIV attending public health facilities of Kasese District. Sampling was done by simple random sampling method. Data was collected using researcher-administered questionnaire method and interview guide.
Results: Most of the respondents 253(65.9%) had not yet enrolled into CCLAD. This was due to some client-related factors such as non-disclosure of HIV sero-status (p=0.040), person to whom HIV sero-status was disclosed to (p=0.009), not having ever heard about CCLAD (p=0.000), incorrect description of CCLAD (p=0.000), limited knowledge of advantages of CCLAD (p=0.000) or disadvantages of CCLAD (p=0.003). Other barriers were; failure to have access to organizations or groups that support PLWHIV to get treatment (p=0.025) and duration of ART refills [AOR=1.637, 95% CI (0.820 – 3.270)].
Conclusion: Adoption of CCLAD model among PLWHIV in Kasese District is still low.
Keywords: Community client led anti-retroviral therapy delivery (CCLAD); enrolment; health care and public health.
The Effect of Global and Local Chemical Reactivity Descriptors in the Determination of Properties of Transition Metal Clusters
Authors: Dulla Habte 
Published: April 2024

Recently, research on material properties has got lots of attention because of their promising technological applications. In this paper, the author’s focus is on the global and local chemical reactivity descriptors of some transition metal clusters. In addition, the author also include findings of chemical properties with reactivity descriptors. Furthermore, according to Thomas–Fermi approximation and from the exact formulation of Density Functional Theory by Hohenberg and Kohn’s theorem, the author introduce electronegativity and the theory of hardness and softness for further investigation of chemical properties of the clusters. As a part of investigations, the author also introduce the Fukui functions with an emphasis for the determinations of chemical reactivity descriptors. All the results are obtained by theoretical investigation of electronegativity), Chemical potential (), chemical hardness (), and polarizability () of the given transition metal clusters (Cr and Mn). From the results, the author observed that the ionization potential of the clusters increases with decreasing cluster size as the clusters become more stable and tend towards chemical inertness. In conclusion, determination of the reactivity descriptors of the transition metal clusters show results that are in line with previous experimental and theoretical findings.
Antimicrobial Resistance among neonates with neonatal Sepsis Morogoro Tanzania
Authors: Bakari Abdallah , Kidima Winifrida , Kassuwi Shaaban , Mwang’onde Beda , Matemba Lucas 
Published: April 2024

Background: Neonatal sepsis increases neonatal morbidity and mortality in low- and middle-income nations. however, the prevalence of neonatal sepsis, the etiological agents, and antimicrobial resistance patterns have not been documented in areas with the highest neonatal mortality rates in Tanzania.
Aim: This study aimed to investigate the prevalence of neonatal sepsis, identify the primary causative agents, and understand their resistance patterns at Morogoro Regional Hospital.
Methods: The study involved 252 admitted neonates at Morogoro Regional Hospital and was carried out between March and June 2019. Clinical and demographic information for each neonate was collected using a standardized questionnaire. Blood samples were obtained from all 252 neonates, and 50 swabs were randomly taken from neonates with umbilical pus discharge. The samples were then cultured using aseptic techniques on blood agar, chocolate agar, and MacConkey agar. The identification of the causative agents relied on the characteristics of colony morphology, gram staining, and biochemical tests. Antimicrobial resistance patterns were determined using the disc diffusion method with Muller Hinton agar against Ampiclox, Erythromycin, Gentamycin, Nalidixic acid, Ciprofloxacin, Norfloxacin, Ofloxacin, Kanamycin,Co-trimoxazole, Cephalexin, Ceftriaxone, and Amikacin.
Results: The prevalence of neonatal sepsis, as determined through blood culture, was 40 % (102 /252). The predominant bacteria isolated from blood cultures were E. coli 31 %, Staphylococcus aureus 23 %, and Citrobacter spp 16%. Around 50% of the gram-negative bacteria showed resistance to Ceftriaxone, a third-generation cephalosporin. Both gram-negative bacteria and Staphylococcus aureus displayed resistance to Ampiclox.
Conclusion: E. coli, Staphylococcus aureus, and Citrobacter spp. were shown to be the most frequent bacteria in neonatal sepsis in Morogoro. Many isolates were Ampiclox-resistant. Neonatal sepsis is common in Morogoro, highlighting the need for innovative neonatal care and preventative techniques.