bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparative Study of Two Contrasting Cosmic-Ray Events Caused by Solar Eruptions from NOAA AR 12673 in 2017 September
Authors: Yu Xiao Xia , Zhang Shuang Nan , Lu Hong , Hu Hong Bo , Zhang Ping , Gao Wei Kang 
Published: December 2023

Abstract
Two major solar eruptions on AR 12673 produced a Forbush decrease (FD) event (reduction of cosmic rays) on 2017 September 8 and ground-level enhancement (GLE; enhancement of cosmic rays) on 2017 September 10. The occurrence of two contrasting cosmic-ray events within 2 days that are associated with two similar X-class solar flares (X9.3 and X8.2) and share the same active region on the Sun provides us a rare opportunity to understand the dominant factors in determining the properties of transient cosmic-ray events. Using a suite of modern-day instruments continuously tracking solar eruptions from the Sun to the Earth with ground-based cosmic-ray detectors, we reveal the complete cause–effect chain of activities for these two events. We conclude that the different consequences on the ground arise from two effects of the eruptions near the Sun: (1) the geometric effect of CMEs and (2) the intensity effect of CME-driven shocks. The first eruption, which originated at the heliographic longitude of W34° on 2017 September 6, had its CME ejecta and CME-driven shock intercept the Earth, leading to the FD event. The second eruption, which occurred on September 10 at W88°, only had its far flank reach the Earth. The peak shock speed of 3344 km s−1 of the second eruption, much faster than the 2175 km s−1 of the first eruption, is the dominant factor producing the GLE event, even though the first eruption is better connected magnetically to the Earth and has a similar flare. The results indicate that the production of GLE particles can be dominated by fast-enough CME-driven shocks.
What Holes in the Gas Distribution of Nearly Face-on Galaxies Can Tell Us about the Host Disk Parameters: The Case of the NGC 628 Southeast Superbubble
Authors: Jiménez S. , Silich S. , Mayya Y. D. , Zaragoza-Cardiel J. 
Published: December 2023

Abstract
Here we explore the impact of all major factors, such as the nonhomogeneous gas distribution, galactic rotation, and gravity, on the observational appearance of superbubbles in nearly face-on spiral galaxies. The results of our 3D numerical simulations are compared to the observed gas column density distribution in the largest southeast superbubble in the late-type spiral galaxy NGC 628. We make use of the star formation history inside the bubble derived from the resolved stellar population seen in Hubble Space Telescope images to obtain its energy and demonstrate that the results of numerical simulations are in good agreement with the observed gas surface density distribution. We also show that the observed gas column density distribution constrains the gaseous disk scale height and the midplane gas density if the energy input rate can be obtained from observations. This implies that observations of large holes in the interstellar gas distribution and their stellar populations have the potential power to solve the midplane gas density–gaseous disk scale height degeneracy problem in nearly face-on galaxies. The possible role of superbubbles in driving the secondary star formation in galaxies is also briefly discussed.
Multiscale Dynamical Scenario of High-mass Star Formation in an IRDC Filament G34
Authors: Pan Sirong , Liu Hong-Li , Qin Sheng-Li 
Published: December 2023

Abstract
There is growing evidence that high-mass star formation (HMSF) is a multiscale, dynamical process in molecular clouds, where filaments transport gas material between larger and smaller scales. We analyze here multiscale gas dynamics in an HMSF filamentary cloud, G034.43+00.24 (G34), using APEX observations of the C18O (2−1), HCO+/H13CO+ (3−2), and HCN/H13CN (3−2) lines. We find large-scale, filament-aligned velocity gradients from C18O emission, which drive filamentary gas inflows onto dense clumps in the middle ridge of G34. The nature of these inflows is gravity driven. We also find clump-scale gas infall in the middle ridge of the MM2, MM4, and MM5 clumps from other lines. Their gas infall rates could depend on large-scale filamentary gas inflows since the infall/inflow rates on these two scales are comparable. We confirm that the multiscale, dynamical HMSF scenario is at work in G34. It could be driven by gravity up to the filament scale, beyond which turbulence originating from several sources, including gravity, could be in effect in G34.
Contribution des acteurs de terrain pour une appréhension actualisée des enjeux de l’accès aux soins par la télésanté
Authors: Grandclaude Sabrina , Nobre Thierry , Grandclaude Didier 
Published: December 2023

Dans un contexte de désertification médicale, cette recherche analyse les perspectives d’amélioration de l’accès aux soins par la télésanté. Partant du constat que l’amélioration de l’accès aux soins par la télésanté est toujours analysée selon le même prisme que la médecine pratiquée en présentiel, cette recherche pose la question suivante : quelles peuvent être les perspectives d’amélioration de l’accès aux soins par la télésanté ? Elle vise à proposer une compréhension actualisée, à l’ère du numérique, du concept d’accès aux soins. Pour parvenir à cet objectif, la recherche mobilise, au niveau théorique, une grille d’analyse élargie de l’accès aux soins, développée par Saurman (2016). Au niveau empirique, la recherche propose l’étude de 96 projets d’innovation en santé, ces innovations étant, pour la plupart, soit portées par un cœur de projet numérique de télésanté, soit soutenues par les Technologies de l’Information et de la Communication (TIC). Une approche complémentaire de données primaires, 52 entretiens avec les chefs de projet, et secondaires, les documents relatifs à la description du contenu de ces projets, est proposée. Les résultats soulignent le besoin de changer notre regard, à l’ère du numérique, sur le concept d’accès aux soins. Le rôle majeur de dimensions telles que l’acceptabilité technologique et la sensibilisation pour améliorer l’accès aux soins par la télésanté est identifié dans les discours des acteurs, ce qui montre l’importance d’appréhender l’accès aux soins par une approche managériale propre aux sciences de gestion.
Fundamentos filosóficos y jurídicos de la tolerancia religiosa en Europa (siglos XVI-XVIII) : el camino hacia la libertad
Authors: Solar cayón José Ignacio 
Published: December 2023

La tolérance est un concept historique, dont la signification varie en fonction du contexte et des problèmes abordés. Cet article traite spécifiquement des fondements de la notion de tolérance religieuse tels qu’ils ont été développés à partir de la rupture de l’unité chrétienne en Europe au xvi e siècle. Dans ce contexte, le débat sur la tolérance constituera les premières formes de réflexion philosophique sur les limites de l’action légitime du pouvoir politique, en engageant un processus d’affirmation de l’autonomie individuelle qui débouchera sur l’idée de la liberté religieuse comme un droit naturel. Toutefois, l’analyse des divers groupes politiques et religieux moteurs de ce processus révèle les différentes racines, philosophies et valeurs qui sous-tendent chacune de ces notions, ainsi que les relations complexes qu’elles entretiennent.
Producción, intercambio y comercio en el Bajo Guadalquivir en época prerromana (siglos V–III a.C.)
Authors: Padilla monge Aurelio 
Published: December 2023

Les familles aristocratiques qui formaient les élites de chacune des communautés du Bas Guadalquivir pendant les v-iii e siècles av. J.-C. étaient à la tête des unités économiques répondant à la forme sociale de la « grande maison », qui était le propre des sociétés agraires dirigées par des aristocraties guerrières. À partir de la moitié du v e siècle av. J-.C., certaines de ces aristocraties ont multiplié leurs échanges avec Gadir. Leur participation à ces transactions ne faisait pour autant pas d’elles des aristocraties commerciales, car l’exportation n’était pas leur seule activité ; de plus, elle ne fut probablement pas l’une de leurs plus importantes voies d’enrichissement. Au contraire, on peut défendre l’idée d’une importance croissante de l’activité déployée par des commerçants privés, fondamentalement gadirites, agissant probablement à l’intérieur des coordonnées définies par un commerce administré qui devait toujours contrôler certains aspects importants des échanges.
Être citoyenne dans la République nobiliaire de Pologne au temps des Lumières
Authors: Wiśniewska Dorota 
Published: December 2023

L’article caractérise la citoyenneté des femmes nobles dans la République nobiliaire de Pologne dans la seconde moitié du xviii e siècle. Il décrit les rapports des femmes des élites avec l’État, leurs sentiments d’appartenance à la nation et leur attachement aux lieux, où elles vivent. Il met en lumière la perception qu’ont les hommes de l’engagement des femmes dans la vie publique et de leur citoyenneté, ainsi que les similarités et les particularités du contexte polono-lituanien par rapport à l’Occident. Centré sur la correspondance féminine, l’article montre que les femmes nobles en Pologne-Lituanie non seulement se voient officiellement accorder le statut de citoyennes, mais aussi elles se sentent inclues à la nation politique et manifestent leur patriotisme. Elles agissent pour le bien commun qu’elles considèrent en accord avec les intérêts privés et familiaux. Le régime républicain, l’influence des Lumières et les circonstances particulières liées aux partages facilitent leur inclusion, mais elles ne contestent pas leur position sociale. Elles sont bien conscientes de leur subordination face aux hommes, mais vu que leurs familles et l’Église leur inculquent la vision patriarcale du monde dès le plus jeune âge, il ne vient pas à l’esprit des femmes de s’y opposer. Et car la « révolution polonaise » (1788-1792) est menée par la noblesse, la question de l’octroi de la citoyenneté à toutes les femmes ne se pose pas dans le débat public.
Analysis of microbial colonies from the first-pass meconium of healthy neonates: Comparison of vaginally and cesarean section born
Authors: Fan Hueng-Chuen , Pan Ying-Ru , Lai Pei-Ling , Yeh Win-Lin , Hu Shu-Wei , Hsu Ming-Yuan , Chua Wei-Kian 
Published: December 2023

Abstract

Background:
The colonization and diversification of early microbes in the infant digestive tract are crucial to the health and pathophysiology of all neonates. Fundamentally, whether the gut is sterile at birth is the key question in understanding human microbial colonization. Although the gut of an infant at birth has long been believed sterile, this paradigm has been challenged.

Objectives:
To confirm or reject the fist-pass meconium is sterile.

Methods:
The first-pass meconium of healthy term infants was collected and examined by the bacterial inoculation and identification, and molecular analysis. Results were correlated with their delivery modes. First-pass meconium was immediately collected from 60 full-term newborns. Fresh meconium was examined by the bacterial inoculation and identification. DNA was extracted from the meconium samples for real-time polymerase chain reaction. The comparisons of fecal bacterial counts by the mode of delivery were calculated by using unpaired Student’s t test. Differences in the detection rate of bacteria were calculated by Fisher’s exact probability test (Statistical Package for the Social Sciences [SPSS], version 10). P < 0.05 was considered statistically significant.

Results:
In the vaginally born (VB) group, 46.34% of meconium samples had detectable microbes, which were associated with vaginosis and existed in the urine and stool. In the cesarean-section born (CB) group, although microbes could not be isolated by the traditional bacterial culture methods, the bacterial counts and bacterial DNAs were detected by molecular technology.

Conclusion:
Meconium is not sterile. Bacteria were present in the first-pass meconium of term, healthy, VB and CB infants.
An Unusual Cause for Sudden Massive Hematochezia in Intensive Care Unit
Authors: Manmohan U. S. , Arun R. S. , Damle Aditi 
Published: December 2023

Abstract
Gastrointestinal (GI) mucormycosis is a life-threatening infection caused by fungi of the subphylum Mucoromycotina, order Mucorales. GI mucormycosis is rarely seen in immunocompetent patients. The symptoms of GI mucormycosis are varied and depend on the affected site. Nonspecific abdominal pain and distention associated with nausea and vomiting are the most common symptoms. They rarely presents as hematochezia.
Isolated Tuberculosis of the Thyroid Gland: A Common Disease at an Uncommon Location
Authors: Yadav Abhilasha , Jain Manjula , Agarwal Charu , Pujani Mukta , Sidam Dipti , Wadhwa Ruchira 
Published: December 2023

Abstract
Tuberculosis (TB) of the thyroid gland is extremely rare, even in areas where the prevalence of TB is very high. Only a few such cases have been reported in the literature. The clinical course may resemble toxic goiter or acute thyroiditis. We report the case of a 23-year-old male who presented with painless swelling of the thyroid gland associated with mild fever and weight loss. On ultrasound neck, a large echogenic solid lesion was seen. Fine-needle aspiration cytology was suggestive of colloid goiter, but histopathology study suggested TB of the thyroid gland along with colloid goiter. We report this case to emphasize that TB of the thyroid gland, although rare, should be kept in the differential diagnosis of thyroid nodules, especially in countries such as India which are endemic for TB.
Empathy Quotient and Self-esteem among Medical/Nursing Students and Health-care Staff Working in the Labor Room of a Teaching Hospital in India
Authors: Sastry Jayagowri , Chandrasekaran Nithya , Dasari Papa , Karthikeyan Kayathri , Fisher Jane , Thulasingam Mahalakshmy 
Published: December 2023

Abstract

Context:
Empathy and self-esteem are essential in delivering quality health care, particularly for women in labor and giving birth.

Aims:
The aim of this study was to determine the empathy quotient and self-esteem of the second-year and final-year medical and nursing students and labor room staff.

Settings and Design:
This cross-sectional study was conducted at a teaching hospital in southern India between September and December 2021.

Materials and Methods:
The inclusion criteria for the study were (i) nursing or medical students currently in their second or final year and (ii) obstetrician or nursing officer or intern currently posted in the labor room. Empathy quotient and self-esteem were measured using the Cambridge Behavioral Scale and Rosenberg’s Self-Esteem Scale, respectively.

Statistical Analysis Used:
The scale scores were summarized as mean (standard deviation), percentages, and 95% confidence intervals. The association between empathy quotient, self-esteem, age, gender, designation, and experience duration was analyzed. We performed multivariable analysis using binary logistic regression. P <0.05 was considered statistically significant.

Results:
Of the 400 participants included in the study, 36.8% (42.7% – medical, 26.2% – nursing personnel) had lower than average empathy quotient scores, and 13.3% (18.4% – medical, 4.1% – nursing personnel) had low self-esteem. Self-esteem had a statistically significant, independent effect on empathy quotient, as noted in the multivariable analysis among medical and nursing personnel. There was a significant difference between empathy quotient and self-esteem scores in medical and nursing personnel across various designations (P < 0.05).

Conclusion:
A third of the participants had empathy quotient ratings that were below average, and one-eighth of participants had low self-esteem. Self-esteem and empathy quotient are interdependent; hence has to addressed together. The empathy quotient and self-esteem vary across different designations emphasising the need to take measures to nurture it.
Coagulation Profile in Patients with Autoimmune Thyroiditis: A Cross-sectional Exploratory Study
Authors: Mishra Swati , Singh Anshul , Srivastava Anubha , Mishra Ravi Rani , Wati Chandra , Misra Vatsala 
Published: December 2023

Abstract

Background:
The association between the hemostatic system and thyroid diseases is a subject of investigation that can shed light on various abnormalities ranging from subclinical laboratory findings to thromboembolic events.

Aim:
The aim of this study was to evaluate the potential association between various thyroid disorders and coagulation profiles in patients with no apparent bleeding abnormalities.

Materials and Methods:
An analytical case–control study was carried out between April 2020 and November 2021. Adults presenting with symptoms suggestive of thyroid dysfunction/palpable goiter without any apparent bleeding disorder were included in the study. Thyroid function tests were categorized as euthyroid, hyperthyroid, and hypothyroid. Antithyroid antibodies, prothrombin time, activated partial thromboplastin time, fibrinogen, factor VIII, and D-dimer were assessed. Comparison of cases and controls and between various subgroups of cases was carried out by Student’ t-test and P ≤ 0.05 was considered significant.

Results:
We recruited 20 controls and 46 cases, including 18 with overt hypothyroidism, 13 with overt hyperthyroidism, 3 with subclinical hyperthyroidism, and 12 with subclinical hypothyroidism. On comparison with controls, those with overt hypothyroidism showed a hypocoagulable state with decreased fibrinogen, factor VIII, and raised D-dimer values. The converse was true in patients with hyperthyroidism and subclinical hypothyroidism, both, showing a hypercoagulable state. Only factor VIII and fibrinogen values showed statistically significant differences (P ≤ 0.05 for both) between the subgroups of cases and between those who were antibody-positive versus negative.

Conclusion:
Our findings support the assertion that there is a deranged coagulation profile in autoimmune thyroiditis.
Trends in keratoplasty from central and northern India. Part II: Types of keratoplasty
Authors: Chatterjee Samrat , Parmar Gautam Singh , Kapur Neha , Gomase Sharad Nivruti , Khurana Ashi , Borde Prashant , Acharya Manisha , Sangwan Virendra , Majumdar Atanu 
Published: December 2023

Purpose:
To report the types of keratoplasty and analyze trends over a period of two decades in central and northern India.

Methods:
This was a retrospective review of eye bank registries of six tertiary eye care centers located in central and north India from 2005 to 2021. The indications and various keratoplasty procedures were compared between 2005–2012 and 2013–2021 to analyze the trend.

Results:
A total of 13,223 corneal grafts were performed, of which therapeutic penetrating keratoplasty (TPK) (5719, 43.3%) was the most common procedure, followed by optical penetrating keratoplasty (OPK) (5528, 41.8%), Descemet stripping endothelial keratoplasty (DSEK) (1279, 9.7%), deep anterior lamellar keratoplasty (DALK) (376, 2.8%), Descemet membrane endothelial keratoplasty (DMEK) (215, 1.6%), patch grafts (75, 0.6%), and keratoprostheses (31, 0.2%). Overall, OPK procedures decreased (−14.1%, P < 0.001), but TPK (+3.1%, P < 0.019), DSEK (+7.1%, P < 0.001), and DMEK (+1.9%, P < 0.001) procedures increased. Although there was an increasing trend in the use of DALK (+0.8%, P < 0.083) and keratoprostheses (+0.3%, P = 0.074) procedures, the trends were not statistically significant.

Conclusion:
In keeping with worldwide trends, an increasing trend in lamellar keratoplasties was observed in central and northern India during the past decade. The trend was significant for DSEK. However, as corneal ulcers and scars were the major indications for keratoplasty, TPK and OPK remained the most common procedures.
Impact of Mild-Level Exercises on Gait, Balance, and Functional Status to Prevent Fall among Elderly in Selected Areas of Belagavi District, Karnataka: A Pilot Study
Authors: Mujawar Shakeelahmed Rafiq , Zagade Tukaram , Naregal Prakash 
Published: December 2023

Abstract

Background:
Falls, a frequent and preventable cause of morbidity, raise the likelihood of functional independence loss and the requirement for hospitalization and institutionalization, placing a strain on the health-care system. The annual expenses for acute care linked to fractures from falls are estimated at $10 billion, despite the fact that the entire expenditures for acute care connected to falls remain unclear.

Objectives:
The objective of this study was to administer the mild-level exercise program of the elderly among the experimental group and to determine the effect of the mild-level exercise program on the improvement of gait, balance, and functional status of the elderly among the experimental group.

Methodology:
A quantitative approach with posttest-only control group design was adopted for the study. The samples from the selected rural areas of Belagavi district were selected using convenient sampling technique. The sample consisted of 26 elderly people 13 in each experimental and control group. The tools used for data collection was Berg Balance Scale and Performance-Oriented Mobility Assessment Scale for gait and Functional Status Scale.

Results:
The mean difference between posttest gait, balance, and functional status scores of elders in the experimental and control group is 3.69, 14.07, and 4.75, respectively. The independent “t” test obtained values are “t” (24) =6.65, 7.39, and 4.75, respectively, for gait, balance, and functional status at P > 0.05 is found to be significant inferring that there is a significant difference in posttest gait, balance, and functional scores of elders among experimental and control groups after intervention indicating improvement of gait among the participants of experimental group after undergoing mild-level exercises program.

Conclusion:
The mild-level exercise program was very much effective and the elders had great interest to learn and to do the exercises to improve their gait, balance, and functional and to reduce the incidence of fall. Continuing nursing education programs can be conducted in hospitals and communities regarding the importance of low-intensity exercise programs in improving gait, balance, and functional status and in reducing the incidence of falls in elderly people.
Self-Evaluated Ethical Competence in Fresh Physiotherapy Practitioners: An Observational Study
Authors: Ronghe Rashmi , Singh Richa , Khairkar Prajakta 
Published: December 2023

Abstract

Background:
Ethics-related concerns are the main focus of health-care services. The main element in all successful professional results of health-care services, including physiotherapy, is ethical competence.

Methodology:
This is a questionnaire-based survey which was done using self-modified form of the Physiotherapist’s Ethical Competence Evaluation Tool (PECET) Tool, conducted on 170 fresher physiotherapists working in various private and public clinics. Responses to the questionnaire were collected and analyzed.

Results:
In the study, we found a majority of the therapists to be ethically aware though there are a small percentage of therapists who are not scoring well and needs further education or further uplift in ethical practices and official ethical education in all ethical aspects.

Conclusion:
In our study, we found that a very less percentage of fresher physiotherapists scored well and a large percentage need an update in the ethical education. The clinical practices followed by the physiotherapists while treating their patients demonstrate their self-esteem. Assurance and promotion of ethical practices at work can be made better through increased participation in various interventions such as ethics rounds, ethics clubs, ethics-based simulations, web-based ethics resources.