bluuebunny/crossref_metadata_2025_split huggingface dataset:
La construction d’une éthique de vie à travers l’apprentissage transformationnel : la Franc-maçonnerie comme espace d’éducation au « savoir-exister » ?
Authors: Alsina Ivan 
Published: October 2023

La Franc-maçonnerie comme instance organisationnelle cherche à construire des sujets dotés d’une conscience accrue de leur potentialité et désirant agir avec implication aux transformations sociétales. Son évolution au fil des siècles a façonné une idéologie fondée historiquement sur des principes religieux et plus tard humanistes. Les sujets l’intégrant doivent s’imprégner progressivement des différents apprentissages formels et informels propres à l’espace maçonnique afin d’intégrer une idéologie fondée sur une recherche de la vertu semblant questionner les paradigmes et les visions du monde des apprenants. Cet apprentissage transformationnel se fonde sur la restructuration des perspectives cognitives à travers une réflexion critique des présupposés épistémiques. En se basant sur une recherche qualitative et des tests psychométriques mesurant l’évolution du niveau de compétences émotionnelles, les résultats montrent que cette restructuration biographique semble impacter le développement du capital émotionnel. En effet, l’appropriation de nouveaux comportements fondés sur la réflexivité, la connaissance de soi et la rencontre de l’altérité semble permettre au sujet de tendre vers l’appropriation du concept de « savoir-exister » dont nous d’exposerons les contours et les bienfaits d’un point de vue psychosociologique et organisationnel
Pragmatic and Early Usage of Statin in Patients with Diabetes for Prevention of Atherosclerotic Cardiovascular Disease
Authors: Kalra Sanjay , Kumar Surender , Pandit Kaushik , Anantharaman R. , Dhingra Atul , Periyandavar I , Chawla Manoj , Magdum Mohan , Desai Piyush , Deb Prasun , Rajasekaran Senthil Kumar , Nair Ramesh N. , Shaikh Shehla , Banzal Subodh , Kota Sunil , Shah Tejas , Revankar Santosh Y. , Gupta Amit 
Published: October 2023

Background:
An early initiation of statins in the diabetes population helps in prevention of atherosclerotic cardiovascular disease (ASCVD). However, there is a paucity of data on its use in young Indian patients with diabetes. This survey report aimed to provide opinion-based recommendations for pragmatic usage of statin in diabetes population of India.

Material and Methods:
Discussion and virtual survey (a questionnaire of 18 questions) was conducted at 16 round table meetings (RTMs) which included participation of health-care practitioners (HCPs) from India. On the basis of their opinions and discussion, general recommendations about early usage of statins in diabetes for prevention of ASCVD were derived.

Results:
Out of 261 HCPs participated, 56.1% recommended initiating statins in patients aged 41–50 years irrespective of their total/low-density lipoprotein cholesterol (LDL-C) levels. Among people with diabetes aged between 20 and 39 years, 38.9% of HCPs considered LDL-C >100 mg/dL and 77% of HCPs considered history of ASCVD as a risk factor for early statin initiation. Overall, 98.9% of HCPs agreed that early initiation of statin in people with diabetes and ASCVD risk factors will help reduce ASCVD. The majority of HCPs recommended initiating moderate-intensity (51.2%) and low-intensity (43.8%) statins and assess every 3 months for tolerance and compliance in people with diabetes (aged 20–39 years) and additional ASCVD risk factors. The use of rosuvastatin (78.5% of HCPs) was preferred for early initiation in people with diabetes. Majority of HCPs agreed (57.3%) or strongly agreed (36.2%) that rosuvastatin has more clinical utility compared to other statins due to better LDL-C-lowering effect and other pleiotropic effects. Physician's inertia limits the effective use of statins among young adults with diabetes (55.8%), and 65.8% of HCPs recommended screening of people with diabetes for additional ASCVD risk factors.

Conclusion:
The participating HCPs opined that early initiation of statin therapy in people with diabetes and ASCVD risk factors will help reduce ASCVD. Rosuvastatin is mostly recommended for early initiation of statin therapy among the diabetes population for prevention of ASCVD. There is a necessity of using a proactive approach to screen for additional ASCVD risk factors in young individuals with diabetes and further increase the awareness about benefits of initiating statin therapy from an early stage.
Exploring the self-control efficacy of risk factors using self-management program in patients with acute coronary
Authors: Yang Yi-Chun , Wang Hsiang-Ping , Wu Bao-Tzung , Chiang Tsay-I , Chang Kuang-Hsi 
Published: October 2023

Abstract

Background:
Cardiovascular diseases are a major cause of death and disability. Research shows that self-management is better than routine care for improving patients’ awareness of diseases, self-care, and self-efficacy, thereby reducing the recurrence and mortality rates of cardiovascular diseases.

Objectives:
This study examined the self-control efficacy of risk factors in patients with acute coronary syndrome (ACS) before and after a self-management program.

Methods:
Purposive sampling was used in this quasi-experimental study. Thirty-eight participants were enrolled from January 1, 2020, to June 30, 2020. The case manager utilized a self-management program as the intervention and developed the “Questionnaire on Self-management of ACS.” Measurements were conducted for each sample before, during, and after the intervention.

Results:
Each participant in the sample had at least three risk factors for ACS, with an average of 5.3 risk factors. The overall self-management scores before and after the intervention were notably different (F = 135.842, P < 0.001), with significant differences in two dimensions: disease awareness (F = 159.752, P < 0.001) and behavior compliance (F = 111.63, P < 0.001).

Conclusion:
Controlling the risk factors for ACS requires continuous adjustment and maintenance of lifestyle. Exercise-related behaviors before and after the self-management program showed the worst compliance. Thus, appropriate interventions should be combined with intelligent devices to assist patients in integrating health management into their lifestyles, thereby reducing risk factors and preventing disease recurrence.
Situational analysis of medical care for heart failure patients in a regional hospital in central Taiwan
Authors: Yang Yi-Chun , Lin Pin-Chun , Chiao Chun-Hui , Lin Cheng-Sheng 
Published: October 2023

Abstract

Background:
Heart failure (HF) is a complex clinical syndrome and a leading cause of morbidity and mortality worldwide. Its symptoms are the ultimate severe results of all heart diseases.

Objectives:
To assess the situation of medical care for patients with HF in a regional hospital in central Taiwan.

Methods:
This retrospective study was conducted from June 1, 2019, to September 30, 2021, collecting basic information of patients, hospitalization and medication after discharge, emergency room visit, readmission, and mortality.

Results:
This study included 101 patients with HF with reduced ejection fraction, of which 71.3% were males. Their mean age was 64.9 ± 15.4 years, and the mean body mass index was 26.4 ± 5.6 kg/m2. Moreover, 89.1% of them had chronic diseases, such as hypertension, diabetes, and heart disease; the mean left ventricular ejection fraction was 27.4% ± 7.7%. During hospitalization and at 1, 6, and 12 months after discharge, the administration rates were 61.4%, 39.6%, 26.7%, and 22.8% for angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker/angiotensin-neprilysin inhibitor; 64.4%, 41.6%, 27.7%, and 35.6% for beta-blocker; 47.5%, 26.7%, 14.9%, and 17.8% for mineralocorticoid receptor antagonist; and 4.9%, 2.0%, 1.0%, and 3.0% for sodium-glucose cotransporter-2 inhibitor, respectively. The rates of emergency room visit, readmission, and mortality due to cardiac reasons within 12 months after discharge were 18.8%, 20.8%, and 8.9%, respectively.

Conclusion:
Given that HF is a complex disease, the underlying causes must be treated, and the guideline-directed medical therapy must be applied to prevent the recurrence of an acute attack. Given the complexity of this high-functioning disease, it is essential to have a dedicated case manager who can ensure comprehensive integration of care.
Chronic pain syndrome—Fibromyalgia
Authors: Liao Da-Ming , Chen Chieh 
Published: October 2023

Abstract
Fibromyalgia is a systemic disease with multiple muscle and fascia tender points, combined with chronic inflammation or neuropathies. Apart from feeling many tender points all over the body, patients also have many atypical symptoms, such as anxiety and migraine. Pain can be caused by even light activities. Additionally, the incidence rate of women aged 20–50 years is much higher than that of men, and the main clinical symptoms are chronic and extensive pain and tenderness. Patients with fibromyalgia have many common clinical comorbidities, such as depression, anxiety, sleep disorders, chronic fatigue, chronic headaches, temporomandibular joint disorders, general numbness and tingling, irritable bowel syndrome, difficulty concentrating, and so on. The symptoms reduce the patient’s quality of life. Patients with fibromyalgia often have symptoms other than muscle pain. Thus, it is clinically referred to as fibromyalgia syndrome. Moreover, fibromyalgia is similar to the symptoms of many autoimmune diseases, such as rheumatoid arthritis, lupus erythematosus, polymyositis, and so on. Physicians should exclude these diseases to ensure accurate diagnosis.
Evaluating Time in Range as an Outcome Measure for Vildagliptin 100 mg SR OD
Authors: Bhograj Abhijit , Sahay Rakesh , Sawn Pramod , Warrier Sona , Prasad Ashish , Birla Ashish 
Published: October 2023

Background:
Vildagliptin, a dipeptidyl peptidase-4 inhibitor, has shown promising effects in improving glycemic control in patients with diabetes. Glycemic variability, characterized by fluctuations in blood glucose levels, is a common challenge in diabetes management. It has been associated with an increased risk of both acute and chronic complications. Clinical studies evaluating the effects of vildagliptin 50 mg bid have demonstrated its ability to reduce glycemic variability and improve the TIR. Vildagliptin has been shown to decrease postprandial glucose excursions and nocturnal glycemic fluctuations, leading to a smoother glycemic profile.

Aims and Objectives:
This pilot study highlights the relationship between vildagliptin 100 mg sustained release once daily (SR OD) therapy and its potential impact on reducing glycemic variability and promoting a better time in range (TIR) for patients with diabetes.

Materials and Methods:
In this study, patients were enrolled in a prospective, multicentric, and observational study to assess the real-world experience of vildagliptin 100 mg SR OD in terms of glycemic variability.

Results and Conclusions:
At the end of the pilot study period of 14 days, the results demonstrated that in real-life experience, vildagliptin 100 mg SR OD was associated with a clinically meaningful reduction in hemoglobin A1c, and a higher proportion of patients maintained their average blood glucose levels between 70 and 180 mg/dL for almost three-fourth of a day.
Vitamin D status & bone health in patients with liver cirrhosis
Authors: Grover Indu , Singh Namrata , Gunjan Deepak , Benjamin Jaya , Ramakrishnan Lakshmy , Pandey R.M. , Sati Hem Chandra , Saraya Anoop 
Published: October 2023

Background & objectives:
Vitamin D plays an important role in bone metabolism, and liver is the intermediary site of vitamin D metabolism. The purpose of this study was to study the prevalence of vitamin D deficiency and bone health in patients with cirrhosis.

Methods:
Prospectively, serum 25-hydroxy vitamin D [25(OH)D] level were assessed in cirrhotics by chemiluminescence method. Endocrine Society Clinical practice guideline was used to define deficiency and insufficiency of vitamin D. Bone mineral density (BMD) was assessed using dual-energy X-ray absorptiometry and the World Health Organization criteria was used to define osteoporosis and osteopenia. The lowest T score at the left hip neck or lumbar spine was taken as osteoporosis or osteopenia. The Child-Turcotte-Pugh score was used to assess the severity of cirrhosis.

Results:
Cirrhotics (n=350, male: 278, compensated: 210) were included. Mean serum 25(OH)D level was 8.75 ng/ml. The prevalence of vitamin D deficiency (VDD) and low-BMD (osteopenia and osteoporosis) was 89.4 and 86 per cent, respectively. VDD, insufficiency and osteoporosis was found in 86.7, 11.9 and 33.8 per cent, respectively, in patients with compensated cirrhosis; and 93.6, 3.6 and 40 per cent, respectively, in patients with decompensated cirrhosis. Body mass index of >25 kg/m2 was protective for bone health.

Interpretation & conclusions:
VDD and low-BMD is prevalent in Indian patients with cirrhosis and should be looked for in patients with cirrhosis for its prevention.
Lipid profile abnormalities & 10 yr risk of CVD assessment among adult in North East India: A cross-sectional study
Authors: Majumder Nilratan , Das Rituparna , Debbarma Ripan , Majumder Nilanjan , De Suranjana 
Published: October 2023

Background & objectives:
In India, lifestyle changes have contributed to increase in the number of people suffering from lipid profile abnormalities, which is a major risk factor for coronary artery diseases. The present study was aimed to estimate the prevalence of lipid profile abnormalities and 10 yr risk of cardiovascular disease (CVD) among the adult population in west Tripura district and to study the association of lipid profile abnormalities and increased CVD risk with sociodemography, body mass index (BMI), hypertension, random blood sugar (RBS) and haemoglobin level.

Methods:
This cross-sectional study was conducted amongst 445 adults of 20 to 60 yr of age from a randomly selected block in west Tripura district. The 10 yr risk of CVD was estimated using the Framingham Risk Assessment Tool.

Results:
The study revealed that overall 83.4 per cent adult population had lipid profile abnormalities, with 22.2, 42 and 70.3 per cent of participants having hypercholesterolaemia, hypertriglyceridaemia and low high-density lipoprotein level, respectively. Gender (P=0.02) and BMI (P<0.001) were the significant determinants of dyslipidaemia. Only 3.8 per cent of participants had intermediate or high risk of CVD, with all of them being males. Gender, age, occupation and RBS were significantly associated with increased CVD risk.

Interpretation & conclusions:
The study revealed a high burden of lipid profile abnormalities in the study population, with males having more risk of CVD. Hence, periodic screening of lipid profile abnormalities and risk of CVD should be incorporated at the primary care level to combat the CVD epidemic in India.
Transfusion trigger in the critically ill with sepsis or septic shock: A prospective study
Authors: Mustahsin Mohd. , Maitra Souvik , Anand Rahul Kumar , Soneja Manish , Madan Karan , Darlong Vanlal , Baidya Dalim Kumar 
Published: October 2023

Background & objectives:
Current practice around transfusion trigger in critically ill sepsis patients is not clear. Moreover, any association of haemoglobin trigger and other transfusion parameters such as age of red blood cells (RBCs) at transfusion and number of units of RBCs transfused with mortality and other adverse outcomes need further assessment.

Methods:
In this prospective study, patients aged 18-70 yr and admitted to intensive care with a diagnosis of sepsis were included (n=108). Baseline demographic, clinical and laboratory parameters were noted and various transfusion data, i.e., haemoglobin trigger, number of units of RBCs and the age of RBCs were recorded. Following outcome data were collected: 28 and 90 day mortality, duration of mechanical ventilation, vasopressor therapy, intensive care unit (ICU) and hospital stay and requirement of renal replacement therapy.

Results:
Of the total 108 participants, 78 (72.2%) survived till 28 days and 66 (61.1%) survived till 90 days. Transfusion trigger was 6.9 (6.7-7.1) g/dl [median (interquartile range)]. On multivariable logistic regression analysis, acute physiology and chronic health evaluation (APACHE) II [adjusted odds ratio (aOR) (95% confidence interval {CI}): 0.86 (0.78, 0.96); P=0.005], cumulative fluid balance (CFB) [aOR (95% CI): 0.99 (0.99, 0.99); P=0.005] and admission platelet count [aOR (95% CI): 1.69 (1.01, 2.84); P=0.043] were the predictors of 28 day mortality [model area under the receiver operating characteristics (AUROC) 0.81]. APACHE II [aOR (95% CI): 0.88 (0.81, 0.97); P=0.013], CFB [a OR (95% CI): 0.99977 (0.99962, 0.99993); P=0.044] and transfusion trigger [aOR (95% CI): 3 (1.07, 8.34); P=0.035] were the predictors of 90 day mortality (model AUROC: 0.82).

Interpretation & conclusions:
In sepsis, patients admitted to the ICU, current practice suggests transfusion trigger is below 7 g/dl and it does not affect any adverse outcome including 28 day mortality.
Differential invasiveness & expression of antimicrobial peptides in Shigella serotypes
Authors: Narayan Chandradeo , Kant Vishal , Mahajan Jai Kumar , Mohan Balvinder , Taneja Neelam 
Published: October 2023

Background & objectives:
The study of Shigella pathogenesis at present is severely hampered by the lack of a relevant animal model that replicates human bacillary dysentery. Different Shigella serogroups cause varying severity of clinical illness. Ex vivo colonization of Shigella flexneri, S. dysenteriae and S. sonnei were characterized in human paediatric colonic pinch biopsies in the in vitro organ culture (IVOC) model to study the invasiveness of Shigella by gentamicin protection assay (GPA). Furthermore, the expression of antimicrobial peptides (AMPs) in response to different serotypes of Shigella was also studied in IVOC model.

Methods:
IVOC explants were inoculated with 109 colony forming units of different serotypes of Shigella and recovery of bacteria studied. Histopathological analysis was carried out to study inflammatory immune responses. GPA was done to elucidate the invasiveness of different serotypes of Shigella. Secretions of AMPs were measured by enzyme-linked immunosorbent assay (ELISA). Western blotting was performed to check the expression of AMPs and nuclear factor kappa B in IVOC explants.

Results:
After 24 h post-infection, the colon biopsies showed intense inflammatory reaction. In both IVOC and GPA, S. dysenteriae 1 was the most invasive as compared to S. flexneri and S. sonnei. S. sonnei was the least invasive. ELISA demonstrated that S. sonnei dampened the HBD (human β-defensin)-2 responses whereas there was augmentation by S. dysenteriae and there was a modest but non-significant increase by S. flexneri. A modest increase in HBD-3 by S. sonnei and S. flexneri was observed but was not found to be significant. However, western blotting data showed upregulation of all AMPs by all serotypes. Western blotting is more sensitive than ELISA.

Interpretation & conclusions:
In the present study, differences in invasiveness and AMP production induced by different serotypes of Shigella were found. Human intestinal IVOC represents a model system to investigate early interaction between pathogenic bacteria and the human gut.
Total ablative stereotactic body radiotherapy to primary and oligometastatic renal cell carcinoma in medically inoperable cases: An institutional analysis
Authors: Bisht Shyam Singh , Kataria Tejinder , Shishak Sorun , Gupta Deepak , Kaliyaperumal Venkatesan , Wadhwa Jyoti , Suryavanshi Manav , Banerjee Susovan , Narang Kushal , Goyal Shina , Rathi Deepak , Mayank Mayur , Selvaraj Rajesh , Khandelwal Anubhav 
Published: October 2023

ABSTRACT

Introduction:
Stereotactic body radiotherapy (SBRT) has been found to be an effective and safe modality with excellent oncological outcome in medically inoperable primary renal cell carcinoma (RCC) and oligometastases. There is scarcity of data on the synchronous delivery of SBRT to primary and oligometastatic RCC in patients unfit for nephrectomy. Here, we report the findings of a retrospective study of prospectively collected data on “total ablative SBRT.”

Methods:
Oligometastatic RCC patients with intact primary tumors were enrolled between May 2021 and June 2022. SBRT was synchronously delivered to the primary tumor and metastases. Demographics, treatment, oncologic outcomes, and toxicity were assessed. Kaplan–Meier estimates were generated for oncologic outcomes. The primary endpoint of this study was feasibility and tolerability.

Results:
Eleven patients were enrolled between May 2021 and June 2022. One patient died at 2 months after SBRT due to viral pneumonitis (possibly COVID pneumonia). Nine patients (82%) had metastatic disease, while 2 (18%) were stage II. The average maximal diameter of primary was 68.7 mm (range, 23–128 mm). The SBRT doses for primary and metastasis ranged from 40 to 55 Gray (Gy) in 5 to 7 fractions and 22 to 40Gy in 2 to 5 fractions, respectively. The median follow-up period was 10.5 months (Range: 4–15 months). Response assessment was available for ten patients. Local control, marginal control, regional control and initial oligometastatic control (OMC) rates were 100%. OMC declined to 87.5% as one patient had recurrence in irradiated subcarinal lymphnode at 7 months. The metastatic control rate was 80% and loco-regional progression-free survival was 8 months (range, 4–15 months). Toxicities were minimal and manageable. At the last follow–up, 7 of 11 patients were alive with an overall survival of 63.5%. Six patients received systemic therapy after SBRT.

Conclusions:
Synchronous delivery of SBRT to primary and oligometastatic sites in patients unfit for nephrectomy was feasible and tolerable with good locoregional control. The total ablative SBRT strategy needs to be explored in similar cohorts.
Serum prostate-specific antigen trends and prostate cancer detection on follow-up in men with a prior negative biopsy: A cohort study
Authors: Modi Ankush , Singh Prabhjot , Seth Amlesh , Kumar Rajeev 
Published: October 2023

ABSTRACT

Introduction:
Elevated serum prostate-specific antigen (PSA) is the most common trigger for a prostate biopsy. However, the range of normal PSA is poorly defined in many populations. Men with “elevated” PSA may not harbor cancer, and it is unclear if such men with a prior negative prostate biopsy should be biopsied again. We conducted a cohort study to assess the PSA trends and cancer detection rates in such men.

Methods:
In an Institutional Review Board-approved ambispective study, men who underwent prostate biopsy between January 2016 and December 2021 for PSA > 4 ng/mL were identified. Among them, those whose biopsy was negative for malignancy were contacted either telephonically or reviewed in person, and the most recent PSA and histopathology of any repeat prostate biopsy were determined. These were evaluated to assess the PSA trend, re-biopsy rate, and cancer detection rate.

Results:
During the study period, prostate biopsies were performed in a total of 1260 men; out of which 444 were negative for malignancy and 241 patients fulfilled the inclusion criteria. Their median prebiopsy PSA was 9.81 ng/mL (interquartile range [IQR]: 7.14–15.6), and the median follow-up PSA was 5.08 (IQR: 3.18–8.4). At a median follow-up of 53 months (range: 6–77 months), PSA had decreased in 177 (73.4%) patients, was static in 48 (19.9%) patients, and increased in only 16 (6.6%) patients. Repeat biopsy was performed on 20 patients; of whom seven had cancer (35%) with an overall positivity rate of 2.9% among the 241 patients. Although the positivity rate was higher in men with increased PSA, it was not statistically different from those with lower or similar PSA. No factors could be identified to predict a positive repeat biopsy.

Conclusions:
PSA, the sole trigger for a prostate biopsy, declined in nearly three-quarters of men with a negative first biopsy, and <3% of men were detected to have cancer on a repeat biopsy. This information could help appropriately counsel patients and allay anxiety after a negative biopsy.