bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hemophagocytic Lymphohistiocytosis: A Study of 14 Cases
Authors: Harrison Aradhana , Rao Namrata , Hebbar Ankitha , Pavithra P. 
Published: June 2023

Context:
Hemophagocytic lymphohistiocytosis (HLH) is a hyperactive, but ineffective immune response releasing proinflammatory cytokines, culminating in multiorgan failure and death. Clinical mimickers, lack of gold standard tests, equivocal diagnostic criteria, and limited literature delay the diagnosis. After a comprehensive literature review, we surmise that this is the largest study in India involving 14 patients.

Settings and Design:
This was a retrospective observational study.

Subjects and Methods:
Out of 11,272 bone marrow (BM) examinations in 5 years and 3 months, hemophagocytosis was observed in 133 aspirates. Clinical details of these were reviewed.

Results:
Fourteen patients fulfilling HLH-2004 criteria were included in the study. Infection associated HLH was seen in 71.4% patients. Malignancy and autoimmune disease were seen in 14.2% patients each. Fever was the most common presentation. Splenomegaly was seen in only 21.4% cases. Cytopaenia was present in all patients. Hypertriglyceridaemia was seen in 85.7% patients. Hyperferritinaemia was seen in 92.8% patients. Hemophagocytosis was seen in all patients.

Conclusions:
HLH should be suspected in cases with cytopaenia and hyperinflammatory markers. Early BM examination, clubbed with appropriate investigations, points to the diagnosis. Newer diagnostic modalities are available however, not much is known about their efficacy. More research in this field will immensely contribute to timely initiation of therapy and improved outcome of HLH.
Preoperative T Staging of Gastrointestinal Malignancy By MDCT– An Essential Tool for Surgical Management
Authors: Unadkat Bhavik Sunit , Kashikar Shivali Vaibhav , Mishra Gaurav Vedprakash , Parihar Pratapsingh H , Shetty Neha Dinesh , Bhansali Pratik Jayprakash , Gowda K. B. Harshith 
Published: June 2023

Background:
Malignancy with respect to the stomach and small and large intestines can present as a mass or focal/diffuse bowel wall thickening, with associated perienteric abnormalities. The role of multidetector computed tomography (MDCT) in gastrointestinal malignancy is pivotal, as it provides high-resolution images for accurate preoperative staging of gastrointestinal tumors and can help in the surgical management of patients.

Aim and Objectives:
The goal of this study was to evaluate the role of MDCT in the evaluation of gastrointestinal malignancy, to differentiate between benign and malignant gastrointestinal disorders, and to stage a malignant lesion preoperatively.

Materials and Methods:
This study was conducted at the Radiodiagnosis Department of AVBRH, a teaching hospital of DMIHER, Sawangi (Meghe), Wardha. It was a prospective cross-sectional study. A purposive convenience sampling method with a desired sample size of 50 participants for the study was conducted over a duration of 2 years.

Results:
Our study included 51 subjects, of which the majority, 32 (62.75%), were male, and the rest, 19 (37.25%), were female. Among the study population, 46 (90.2%) were malignant lesions, and the rest, 5 (9.8%), were benign, according to the MDCT diagnosis. The majority, i.e. 32 (62.75%) individuals, had colorectal cancer. The majority of individuals with malignancy, i.e. 46 (90.2%), had a heterogeneous pattern of gastrointestinal wall enhancement along with asymmetric wall thickening in 44 (86.27%) individuals. Segmental gastrointestinal wall involvement was seen in 35 (68.63%) individuals.

Conclusion:
MDCT can accurately differentiate benign and malignant diseases based on the pattern of wall thickening and offers information on any accompanying pericolic abnormalities, the existence of nodal or distant metastases, and the invasion of nearby organs. The accurate planning of surgery and patient care is made possible by the preoperative staging of malignant lesions by MDCT.
Sputum Culture Conversion among Patients with Drug-Resistant Tuberculosis: A Study of Various Predictors
Authors: Khan Shafee , Choudhary Sumer , Aurangabadkar Gaurang , Bankar Nandkishor 
Published: June 2023

Introduction:
Conversion of a positive sputum culture to a negative culture is an important parameter in the management of drug-resistant tuberculosis (TB), as the failure to convert was related to dismal posttreatment outcomes and elevated mortality rates by almost eight times when compared to victims of multidrug-resistant TB (MDR-TB) who did so. In the patients of MDR-TB, it is an important sign of treatment success to have sputum culture converted from positive to negative, and helps in determining the duration of treatment. The goal of this study was to examine and compare the length of time it took to convert an initial sputum culture with predictors of treatment outcomes for patients with MDR-TB, as well as to pinpoint the variables that affected the length of time.

Materials and Methods:
The mixed method (records review and qualitative approach) was used to understand the patient’s perspective for accepting the Programmatic Management of Drug-resistant TB (PMDT) services and the provider’s perspective for rendering services in a public-private mix model setup. This study was undertaken as a retrospective analysis and studied the patients drug-resistant TB who were admitted to a tertiary care hospital in central India. This study was carried out on the patients of Rifampicin-Resistant TB (RR-TB) and MDR-TB (Resistant to both INH and Rifampicin) with positive baseline culture, pretreatment evaluation, and appropriate anti-MDR-TB treatment. As per the PMDT guidelines, sputum smear and culture reports were collected and analyzed.

Results:
In this study, the time and predictors to convert an initial positive sputum culture to negative and factors influencing treatment outcome were evaluated, compared, and identified. A total of 163 patients were evaluated and analyzed. Of these, 111 (68.09%) were rifampicin and INH-resistant (MDR-TB), whereas 52 (31.90%) were rifampicin resistant (RR-TB) only. Overall 68 (41.71%) patients with baseline positive culture were converted within 3 months.

Conclusions:
It was concluded that malnourishment, human immunodeficiency virus positivity, associated extra pulmonary TB, and bilateral cavitation were found to be significant predictors of longer time of sputum culture conversion and thereby treatment outcome.
Role of Strain Elastography in the Diagnosis of Superficial Soft-Tissue Lesions
Authors: Gowda K. B. Harshith , Mishra Gaurav Vedprakash , Parihar Pratapsingh H , Dhande Rajasbala Pradeep , Luharia Anurag 
Published: June 2023

Background:
Elastography, recent progress in the field of imaging, is an innovative approach which provides information pertaining to tissue elasticity. Charting the stiffness can be performed either by assessing the same, using the evaluation of the strain i n the mass of cells in the presence of stress or assessment of shear waves, the propagation of which is dependent on the tissue stiffness, using imaging tools. This study was done to investigate the validity of strain elastography in the diagnosis of superficial soft-tissue lesions in contrast to histopathological examination (HPE) due to the dearth of studies comparing strain elastography and HPE, particularly in the Indian context.

Materials and Methods:
The present longitudinal study was conducted by the Department of Radiology at AVBRH, Sawangi, Wardha, from the year 2020 to 2022. Ninety-six subjects who were diagnosed or clinically suspected superficial soft-tissue lesions irrespective of age and gender were included. All patients underwent ultrasound, elastography, and final diagnosis was confirmed with HPE. Institutional Ethical Clearance (No: DMIMS [DU]/IEC/2022/340) and before the initiation of the investigation and the recruitment of patients into the study, informed consent was obtained. Chi-square test, Mann–Whitney U-test, and Kruskal–Wallis test were the tests of significance.

Results:
The subjects’ average age was 40.38 ± 18.95 years, and 57.3% of them were women. On HPE, 21 lesions (21.8%) were categorized as malignant and 75 lesions (77.2%) as benign. The mean strain ratio (SR) was 11.7 ± 4.8 for malignant lesions and 2.5 ± 4.6 for benign lesions. Malignant and benign lesions had a noticeable change in SR. To distinguish between malignant and benign soft-tissue lesions, an SR of >3 had a sensitivity of 95.24%, specificity of 91.89%, positive predictive value of 87.0%, and negative predictive value of 97.1%.

Conclusion:
SR of malignant lesions was higher than that of benign soft-tissue lesions. SRs performed better as a diagnostic tool than elasticity scores hence, SRs can be utilized as a marker to foretell a soft-tissue tumor’s propensity for malignancy.
Efficacy of Closed and Open Endotracheal Suction on Prevention of Ventilator-Associated Pneumonia on Patients Admitted to Critical Care Unit at Tertiary Care Hospital
Authors: Mulla Ruksar Jainuddin , Mohite Vaishali Rajsinh 
Published: June 2023

Background:
Endotracheal suctioning is a method commonly used to clean airway secretions in patients under mechanical ventilation. This study aimed to compare the effects of open and closed suction methods on the occurrence of ventilator-associated pneumonia (VAP). In the open endotracheal suction, the approach necessitates the participation of two nurses and may result in a momentary interruption of ventilation and oxygen supply due to the patient’s disconnection from the ventilation device during suctioning. In the closed endotracheal suction, the approach can be performed through connections in a closed suction set while the patient is ventilated without separating the patient from the ventilator.

Objective:
(1). To compare the close endotracheal suction with open endotracheal suction for the prevention of VAP. (2) To assess the incidence of VAP among intubated patients.

Materials and Methods:
The study was conducted among 60 patients who are on mechanical ventilator in the critical care unit in tertiary care hospital. For the study, simple random sampling technique is used for the selection of sample. Using a lottery method of sampling, one in the experimental group and one in the control group on the basis of inclusion criteria.

Results:
The study was done on patients who are on mechanical ventilators in the critical care unit in tertiary care hospitals. The data analysis was done using descriptive and inferential statistics. The study finding revealed that in VAP scoring of the patient’s 1st and 2nd day in open endotracheal suction, there are no significant changes in open endotracheal suction then null hypothesis was accepted (t = 0.9, P = 0.37). VAP scoring of the patient’s 2nd and 3rd day and 3rd and 1st day in open endotracheal suction, there are significant changes in open endotracheal suction method in null hypothesis was rejected (P < 0.05). VAP scoring of the patient’s 1st and 2nd day and 2nd and 3rd day and 3rd and 1st day in closed endotracheal suction, there are significant changes in closed endotracheal suction then null hypothesis was rejected (P < 0.05).

Conclusion:
The study assessed the efficacy of open endotracheal suction versus closed endotracheal suction on age, sex, duration of hospital stays, return of mechanical ventilation, and mode of ventilation are not significant but the duration of mechanical ventilation is significant. The nurses play a vital role in assessing the cardiac monitor while doing suctioning to prevent cardiorespiratory complications.
Methemoglobin and Inflammatory Markers in the Context of Mortality in COVID-19 Disease
Authors: Pawar Vaishali Satyajeet , Sontakke Ajit V. , Pawar Satyajeet K. 
Published: June 2023

Context:
Today, the world is in search of potential biomarkers for assessing the severity and prognosis of coronavirus disease-2019 (COVID-19) disease with its different clinical presentations.

Aim:
The aim of this study was to assess the roles of C-reactive protein (CRP), lactate dehydrogenase (LDH), procalcitonin (PCT), and methemoglobin (Met-Hb) in the clinical outcome of COVID-19 patients.

Settings and Design:
This observational cross-sectional study was conducted in COVID-19 cases admitted in the intensive care unit (ICU) of a tertiary care hospital from June 2021 to October 2021.

Subjects and Methods:
For all selected patients, estimation of CRP, LDH, PCT, and Met-Hb levels was done on the 2nd–3rd days of hospital admission, and definitive outcomes were included sequentially.

Results:
Out of 495 ICU admissions, 69 patients were evaluated in the end. Out of which, 27 patients died during the hospital stay. The mean Met-Hb, LDH, PCT, and CRP levels in nonsurvivors were significantly high. In multivariate bivariate regression analysis, age (odds ratio [OR]–1.06; 95% confidence interval [CI]: 1.01–1.13; P = 0.021), LDH (OR–1.006; 95% CI: 1.001–1.010; P = 0.013), and CRP (OR–1.03; 95% CI: 1.002–1.6; P = 0.047) were independently associated with nonsurvival of the patients. The receiver operating characteristic curve showed a cutoff value of 684 U/L for LDH which predicted mortality due to COVID-19 disease with 66.7% sensitivity and 70.4% specificity. For CRP, a cutoff value of 28.3 mg/L predicted mortality with 73.8% sensitivity and 59.3% specificity.

Conclusions:
In conclusion, higher levels of LDH and CRP were related to mortality due to COVID-19 disease. Slightly raised values of Met-Hb in nonsurvivors suggest nonresponding hypoxia. The research in this context may open new options in the treatment of COVID-19 disease.
Characteristics and Outcomes of Adolescents Requiring Admission to the Intensive Care Unit
Authors: Al-Dorzi Hasan M. , Yaqoub Amirah S. , Aldokhel Fisal T. , Alshuwaier Khalid M. , Almujarri Sarah F. , Alkhaldi Fatima A. 
Published: June 2023

Background:
Critically ill adolescents are not a well-studied patient population. The optimal setting (pediatric or adult intensive care unit [ICU]) for caring for them is not clear. This study assessed adolescents admitted to the adult ICU and compared the characteristics and outcomes of younger versus older patients.

Methods:
This was a retrospective study of adolescent patients aged 14–19 years who were admitted to an adult tertiary care ICU between January 1, 2015, and December 31, 2020. Patients were divided into two groups, younger (14–16 years old) and older adolescents (17–19 years old).

Results:
The study included 276 patients; 105 patients were aged 14–16 years and 171 patients 17–19 years. Most patients were males (69.9%); only nine patients had body weights < 30 kg. Trauma was the most common reason for admission (36.2% of the younger group and 49.7% of the older group, P = 0.03) with sepsis being also common (19% of the younger group and 20.5% of the older group). Vasopressor therapy was required for 39.1% of patients and invasive mechanical ventilation for 58% (no between-group difference). The hospital mortality was 16.7% (odds ratio in younger versus older group adjusted for illness severity, 0.804; 95% confidence interval, 0.358–1.802). Mechanical ventilation duration and stay in the ICU and hospital were similar in both groups.

Conclusions:
Trauma was the most common reason for admission of adolescents aged 14–19 years to the adult ICU. The hospital mortality of younger and older adolescents was similar, suggesting that the management of younger adolescents in the adult ICU is safe.
Evaluación del procedimiento operativo en un centro de emprendimiento público del Cantón Quevedo, Ecuador
Authors: Carpio Byron Andres Burgos , Rivas Carmen Alexandra Sinchi , Cañarte Carlos Alberto Nieto , Moran Evelyn Gabriela Perez 
Published: June 2023

​La presente investigación se realizó con el fin de conocer la gestión operativa y su incidencia en la zona norte del centro de emprendimiento de la prefectura de Los Ríos en el cantón Quevedo. El objetivo general es “Analizar la gestión Operativa en el centro de emprendimiento de la zona norte de la prefectura de Los Ríos en el cantón Quevedo, año 2021”. La investigación tiene un enfoque mixto, se centrará en realizar un análisis de datos mediante entrevistas y encuestas para determinar la situación sobre gestión operativa del centro, se aplicará una matriz de Vester y metodología de marco lógico para presentar una propuesta de mejora. La muestra estuvo constituida por 15 colaboradores y 100 emprendedores asociados al centro. Los resultados permitieron conocer que dentro centro de emprendimiento existen debilidades como su planificación presupuestaria generalizada donde no se detalla valores asignados para cada rubro; sus colaboradores consideran que la gestión operativa es excelente en un 60%, siendo un aspecto negativo que solo reciben capacitaciones dos veces por año, y también que un 40% de las actividades destinadas en atención al usuario solo se planifican de forma ocasional; la propuesta se realizó a empleado un matriz de Vester para identificar el problema crítico central, y a partir de ello se aplicó la matriz de marco lógico cuyo fin es mejorar el aprovechamiento y distribución de recursos tiempo e insumos para beneficio de los usuarios del centro.
Arnavutça Kur’an Meali Bağlamında Kādiyânîliğin Mesihlik/Mehdilik Anlayışı
Authors: DURGUTİ Abdylkader 
Published: June 2023

Kādiyânîlik, Mirza Gulam Ahmed’in fikirleri çerçevesinde, 19. yüzyılın sonlarında Hindistan’da ortaya çıkmış bir mezheptir. Gulam Ahmed, müceddid, mehdi, mesih ve nebi gibi mesiyanik iddialarla ortaya çıkmıştır. Gulam Ahmed’in kendini kurtarıcı ilan ettiği dönem, İngilizlerin Hindistan’ı işgal etme planları nedeniyle toplumda yaşanan büyük ümitsizlik ve hayal kırıklığının meydana geldiği 18. yüzyıla denk gelmektedir. Gulam Ahmed, cihadın kılıçla değil barışla gerçekleşeceğini söylemiştir. Bunun için de kendisinin Allah tarafından görevlendirildiğini iddia etmiştir.
Gulam Ahmed’in bu iddiaları nedeniyle Kādiyânîlik İslam dünyasında “İslam dışı” bir mezhep olarak ilan edilmiştir. Bu nedenle mezhep taraftarları Hindistan dışında başka ülkelere gitmek zorunda kalmışlardır. Gittikleri yerler arasında Balkan ülkeleri de bulunmaktadır. Balkanlarda Kādiyân Ahmedîlerin izlerine ilk olarak 1929’da rastlanmıştır. Balkanlarda sosyal organizasyonlar, kitap tercümeleri, insani yardımlar ve eğitim gibi birçok alanda faaliyetler yürütmüşlerdir. 1990 yılında Kādiyânî Muhammed Zakaria Khan tarafından Kur’ân Kādiyânî mezhebi görüşleri çerçevesinde Arnavutçaya çevrildi. Bu durum onlar için dönüm noktası olmuştur. Khan, bu mealiyle Balkanlarda Kādiyânî mezhebinin önemli bir şahsiyeti haline gelmiştir. Bu çalışmada Khan’ın, Kādiyânî mezhebinin mehdilik ve mesihlik konuları açısından yorumladığı ayetler ele alınmaktadır. O, söz konusu ayetlerde Gulam Ahmed’in mehdi ve mesih olduğunu ispat etmeye çalışmaktadır. Yöntem olarak Kādiyânî kaynakları ve konuyla ilgili bilgi veren klasik İslam kitapları kullanılmıştır.
Small Venues
Authors: Whiting Sam 
Published: June 2023

Throughout the history of popular music, the careers of many culturally significant artists and groups began on the small stages of local bars clubs, pubs, and discotheques. When the stories of The Beatles, Jimi Hendrix, and the New York punk hardcore and post punk scenes are told, iconic venues such as The Cavern, The Marquee and CBGB’s serve as the settings of their early chapters Small live music venues such as these are pivotal in the narratives and history of popular music. However, very few of them survive.
This book focusses on the role of small live music venues as incubators for emerging talent and social hubs for music scene participants. Such venues are grassroots spaces of cultural labor and production that often struggle with issues of financial precarity yet are fundamental to the live music ecology of a city, acting both as platforms for emergent performers and spaces of sociality for local music scenes.
The Story of Victorian Film
Authors: Dixon Bryony 
Published: June 2023

In this vivid and accessible new account of the dawn of film in Britain, internationally respected film historian and curator Bryony Dixon introduces us to Britain's first cinematic pioneers – an eclectic mix of chemists, engineers, photography enthusiasts, fairground showmen and magicians – who in a few short years built a vibrant new industry. As she chronicles the emergence of the first embryonic film forms and genres, she reveals often surprising innovations, from cutting-edge science to ingeniously witty tricks and comedies, with filmmakers reflecting existing entertainment forms as well as advancing editing and cinematography in ways that shaped the art of film for many decades after.
Dixon offers fresh insights by focusing on the films themselves – many of them only recently available to view – while building on the work of generations of scholars. In the process, Dixon makes a compelling case for the British filmmakers of the era as inventive and creative figures, every bit as influential as their more celebrated contemporaries in France and the US.
Le leader populiste, catalyseur de violence verbale et pyromane de la révolte
Authors: Buchart Mélanie 
Published: June 2023

Dans cet article, nous proposons d’étudier la construction du discours médiatique de Florian Philippot, ancien vice-président du FN. Lors de la pandémie de Covid-19, Philippot réapparaît sur la scène politique en figure de proue de l’« anti-système » et de la contestation anti-pass sanitaire, en relayant nombre de publications flirtant avec les théories du complot. Il multiplie les appels à la résistance, à la libération face à la tyrannie et à la dictature, ou encore parle d’ « apartheid » sanitaire. Ces excès langagiers, usant d’une terminologie belliqueuse, pourraient favoriser des passages à l’acte violents chez les co-énonciateurs dont les colères sont captées et exacerbées par un discours populiste de victimisation, de satanisation et de construction de la figure du sauveur providentiel. Les actes illocutoires et valeurs illocutoires de l’énonciation – d’autant plus en période de crise et relayés en masse sur les réseaux sociaux – peuvent en effet avoir des effets perlocutoires dangereux et concrets dans la vie réelle, tout en disculpant légalement les locuteurs-catalyseurs de ces outrances langagières publiques parfois dissimulées (analogies, double-sens, etc). Nous nous efforcerons de dévoiler certaines stratégies discursives du politicien (figures de rhétorique, positionnement discursif), dans une approche « pragmatique de la perlocution » (Oswald, 2020), à travers l’analyse d’un corpus de vidéos publiées par Philippot en​ 2021, lors de la crise sanitaire. Enfin, nous verrons dans quelle mesure ce discours de radicalité et de radicalisation de l’auditoire relève du discours de haine.