bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ventilator-associated Pneumonia in the Intensive Care Unit of the Institute of Oncology Ljubljana in 2021 and the Role of Nurses in its Prevention
Authors: Medjedovic Sabina , Jurca Tomaž , Povšič Milena Kerin 
Published: May 2023

BACKGROUND: Ventilator-associated pneumonia (VAP) is the most common infection in critically ill patients and has the highest mortality. It prolongs ventilation time and length of stay, increases antibiotic consumption, increases the likelihood of death, increases the cost of treatment, and is difficult to diagnose.
AIM: At the intensive care unit (ICU) of the Institute of Oncology, Ljubljana, we prospectively monitor risk factors for VAP and its incidence. It is a mixed surgical/internal ICU.
METHODS: A centers of disease control and prevention VAP diagnosis criteria and strategies to prevent VAP were used. Registered nurses recorded risk factors in all intubated patients in all three shifts, and the diagnosis protocol was completed by the physician in case of antibiotic administration in suspected VAP.
RESULTS: The expected incidence of VAP is around 18/1,000 ventilated days. In 2021, 67 patients were mechanically ventilated in our ICU (patients who completed ventilation in that year). The total time spent on ventilation was 17,143 h or 714.3 days. As the criteria for ventilator-assisted pneumonia (VAP) is >48 h of ventilation, we excluded 19 patients who had been ventilated for 48 h or less. Among 48 patients who were ventilated for > 48 h, the total ventilation was 16,765 h or 698.5 days. We recorded 8 VAP in 714 days, which is 1 VAP per 89 days of ventilation or 11.2/1,000 ventilation days. Healthcare staff, especially registered nurses, play a major role in VAP prevention, providing care every day, all days of the week. Most prevention interventions and strategies are part of routine nursing care. Lack of knowledge about infection prevention and appropriate nursing care among nurses can become a barrier to adherence to evidence-based guidelines for the prevention of VAP.
CONCLUSION: This study will help nurses to learn about VAP and its prevention in detail so that they can apply the knowledge in clinical practice. Understanding the pathophysiology of VAP, its risk factors and the nursing care bundle is essential for appropriate prevention and treatment of VAP. Specific protocols, strategies, and active control should be available in each ICU regarding the care bundle.
The Effect of Prophylactic Central Neck Dissection during Total Thyroidectomy on Locoregional Recurrence in Patients with Papillary Thyroid Carcinoma: An Updated Meta-Analysis
Authors: Alayaaf Abdullah 
Published: May 2023

AIM: The current systematic review was conducted to update the existing evidence regarding the association between prophylactic central neck dissection (pCND) and locoregional recurrence (LRR) in patients undergoing total thyroidectomy (TT).
METHODS: Studies were identified through systematic searches of electronic databases (PubMed, Scopus, Cochrane Library, and Clinical Trials.gov) between November and December 2022. The primary outcome was the unadjusted pooled estimate for LRR using an inverse variance – a weighted random-effects meta-analysis of odds ratios (ORs).
RESULTS: Twenty-two studies comparing pCND + TT and TT alone in cN0 PTC patients were analyzed. The meta- analysis included 6918 patients, 2796 cases in the combined group, and 3402 controls in the TT-alone group. The summary OR for overall LRR was not statistically significant, indicating a lack of additional benefit for pCND (OR = 0.76 95% CI [0.5–1.14], p = 0.18). Results were consistent for studies with an experimental or nonexperimental design. The rates of transient (OR = 1.81, 95% CI [1.36–2.41], p < 0.001) and permanent (OR = 2.56, 95% CI [1.72–3.8], p < 0.001) hypoparathyroidism were significantly higher in patients who underwent pCND. The rates of transient (OR = 1.71, 95% CI 1.24–2.35, p < 0.001) and permanent (OR = 2.12, 95% CI 1.29–3.45, p < 0.001) RLN nerve injury were also higher in patients who underwent pCND. Contradictory results were observed for adjuvant RAI with RCTs suggesting a lower need for postoperative RAI therapy.
CONCLUSION: The meta-analysis and the systematic review suggest that pCND was not associated with lower odds of LRR in patients with N0 PTC. Moreover, transient and permanent hypoparathyroidism and RLN injury were higher in patients undergoing TT + PCND. TT + pCND should not be routinely recommended except in high-risk patients due to the lack of benefit and lower safety profile than TT only.
L’autonomisation des femmes, une réponse à l’insécurité alimentaire en Afrique ?
Authors: Fall Marie , Jacquemot Pierre 
Published: May 2023

Les femmes occupent sur le continent africain une place centrale dans l’agriculture vivrière. Elles sont incontournables dans les activités de transformation, de conservation et de commercialisation des produits vivriers. Elles sont au cœur de l’économie domestique et jouent un rôle social essentiel au bien-être des communautés rurales et urbaines. Pourtant, les femmes disposent de moins de droits sur la terre ; elles ont un accès plus limité aux informations et aux services ruraux ; et elles sont moins mobiles en raison des charges familiales. Plusieurs observations sur le rôle des femmes dans les périodes critiques, comme celle associée à la pandémie de la Covid-19 ou du bouleversement des marchés internationaux des produits agricoles et des intrants, éclairent d’un jour nouveau la réalité de la capacité des femmes à réagir pour lutter contre l’insécurité alimentaire avec une forte dose d’inventivité. Cette capacité est étroitement associée aux opportunités d’autonomisation économique et sociale qui leur sont offertes et qu’elles savent saisir et capitaliser. Une révolution silencieuse est peut-être en cours.
La contribution des femmes dans l’approvisionnement en produits vivriers dans le département de San-Pedro (Côte d’Ivoire)
Authors: Hien Victorine , Adechina Olayossimi , Diomandé Souleymane 
Published: May 2023

L’étude consiste dans un état des lieux des provenances des produits vivriers à San-Pedro en Côte d’Ivoire. Cinquante commerçantes ont été interrogées. L’analyse des fiches d’enquêtes a révélé qu’elles s’approvisionnent dans 26 villes pour les 22 produits vivriers les plus commercialisés. Parmi ces produits vivriers, 9 ont des lieux d’approvisionnement diversifiés, parfois lointains. La dégradation des produits vivriers, par manque de véhicules de transport appropriés, est un facteur très péjoratif. L’une des innovations mises en avant par les commerçantes, pendant et après la pandémie, est que les négociations d’achats et les commandes se font toutes désormais par téléphone.
Les combats ardus des femmes pour le contrôle des terres
Authors: Rédaction Afrique contemporaine  
Published: May 2023

Alors que les stratégies de développement du monde rural ont intégré la présence des femmes dans des unités de production, l’idéologie localement dominante, d’essence patriarcale, établit encore souvent une autorité masculine sur l’attribution et la gestion des facteurs de production. La prééminence sexiste sur la gestion du foncier, des intrants, du crédit et des équipements se retrouve encore dans presque tous les contextes africains. Même lorsque la loi garantit l’égalité des droits, les femmes subissent souvent une discrimination de facto. La recherche de solutions repose sur un constat, celui de l’existence d’une corrélation entre trois éléments : les pouvoirs de décision dont jouissent les femmes, la quantité (et la qualité) des droits fonciers qu’elles détiennent et l’augmentation de la disponibilité locale en denrées alimentaires.
La « liberté des Argiens » (Tite-Live, XXXIV, 41) sous l’ imperium Romanum
Authors: Weber-Pallez Clémence 
Published: May 2023

La cité argienne entre dans l’orbite de Rome dès 195 avant J.-C. en reconnaissant qu’elle doit aux autorités romaines la jouissance d’une « liberté » au sens encore controversé. Si les Argiens profitent de leur relation privilégiée avec Rome, qui les place comme intermédiaires principaux dans le monde achéen, ils n’en sont pas pour autant des acteurs passifs. Une étude de l’accueil fait aux Romains et une analyse des représentations mythologiques diffusées par les Argiens permettent de dégager une stratégie politique globale de la cité pour mieux intégrer et contribuer à façonner le nouveau système qu’est l’ imperium Romanum .
Les communautés de Romains sont-elles solubles dans la cité ? Cités égéennes, Rhômaioi et l’ imperium Romanum aux II e et I er siècles avant notre ère
Authors: Vlamos Alexandre 
Published: May 2023

L’article s’intéresse aux relations entre les communautés de Rhômaioi installées dans les îles de la mer Égée et les cités qui les accueillent. En étudiant les banquets publics, je montre que ces cités, libres pour la plupart, ont la maîtrise des catégories d’étrangers, mais qu’il y a une évolution en lien avec l’installation de l’ imperium Romanum : les Romains, d’abord intégrés aux autres étrangers, s’en affranchissent pour être inclus dans une catégorie à part. L’étude de la communauté romaine de Cos montre que les relations entre les Romains installés dans l’île et la cité dépendent de l’état de l’ imperium Romanum , entre violence des guerres civiles et pacification impériale.
Roman Power and the Memorial Turn in Civic Honourability in Western Asia Minor, ca 85 BCE-14 CE
Authors: Chin Marcus 
Published: May 2023

Résumé Les honneurs accordés par les poleis hellénistiques à leurs bienfaiteurs ont longtemps constitué un moyen de créer une distance idéologique, intégrant le pouvoir des rois et des étrangers puissants, tout en maintenant l’action civique et l’autonomie. Quelles sont les évolutions sous la domination romaine ? Cet article suggère que les honneurs pour les magistrats romains, et plus tard l’empereur, ont contribué au cours du i er siècle avant J.-C. à modifier progressivement la conception des honneurs pour les citoyens locaux en Asie mineure occidentale : les objectifs traditionnels d’exemplarité et de reproduction sociale ont fini par être éclipsés, sinon remplacés, par celui de la commémoration individuelle. Ce processus s’est produit en deux phases dans la période allant de 85 avant J.-C. à 14 après J.-C. Dans la première, les bienfaits et honneurs accordés aux magistrats Romains en tant que représentants des intérêts civiques ont empiété sur ceux des notables civiques, entraînant une élévation du statut honorifique de ces derniers, et une tendance à souligner la mémorabilité de leurs accomplissements. Dans un second temps, l’apparition du principat et du culte impérial a imposé des limites au statut honorifique local et créé des hiérarchies honorifiques parmi les citoyens, autour des titres et de la primauté familiale, ce qui a mis l’accent sur l’individualité, au détriment de l’exemplarité.
Dévolution et politique extérieure du Royaume-Uni dans le contexte du Brexit : le cas de l’Écosse
Authors: Camp-Pietrain Edwige , Camp-Pietrain Edwige 
Published: May 2023

Entre 1999 et 2016, les relations entre institutions centrales britanniques et institutions écossaises décentralisées étaient relativement apaisées grâce à des mécanismes informels de coopération et ce, alors que des partis politiques d’obédiences différentes étaient au pouvoir à Londres et à Édimbourg. Le gouvernement écossais avait un droit de regard sur certaines politiques européennes. Le référendum de 2016 a fait voler en éclat cette bonne volonté, creusant l’écart entre les gouvernements conservateurs britanniques désireux de contrôler le Brexit, et les autorités dévolues soucieuses de protéger leur autonomie. Cet article analyse la détérioration de ces relations, tant pendant les négociations avec l’Union européenne que depuis le Brexit, et montre que les mécontentements dépassent les rangs des indépendantistes. Le gouvernement écossais poursuit néanmoins sa propre para-diplomatie.
Prenol, but Not Vitamin C, of Fruit Binds to SARS-CoV-2 Spike S1 to Inhibit Viral Entry: Implications for COVID-19
Authors: Paidi Ramesh K , Jana Malabendu , Raha Sumita , Mishra Rama K , Jeong Brian , Sheinin Monica , Pahan Kalipada 
Published: May 2023

Abstract
Fruit consumption may be beneficial for fighting infection. Although vitamin C is the celebrity component of fruit, its role in COVID-19 is unclear. Because spike S1 of SARS-CoV-2 binds to angiotensin-converting enzyme 2 (ACE2) on host cells to enter the cell and initiate COVID-19, using an α-screen–based assay, we screened vitamin C and other components of fruit for inhibiting the interaction between spike S1 and ACE2. We found that prenol, but neither vitamin C nor other major components of fruit (e.g., cyanidin and rutin), reduced the interaction between spike S1 and ACE2. Thermal shift assays indicated that prenol associated with spike S1, but not ACE2, and that vitamin C remained unable to do so. Although prenol inhibited the entry of pseudotyped SARS-CoV-2, but not vesicular stomatitis virus, into human ACE2-expressing HEK293 cells, vitamin C blocked the entry of pseudotyped vesicular stomatitis virus, not SARS-CoV-2, indicating the specificity of the effect. Prenol, but not vitamin C, decreased SARS-CoV-2 spike S1–induced activation of NF-κB and the expression of proinflammatory cytokines in human A549 lung cells. Moreover, prenol also decreased the expression of proinflammatory cytokines induced by spike S1 of N501Y, E484K, Omicron, and Delta variants of SARS-CoV-2. Finally, oral treatment with prenol reduced fever, decreased lung inflammation, enhanced heart function, and improved locomotor activities in SARS-CoV-2 spike S1–intoxicated mice. These results suggest that prenol and prenol-containing fruits, but not vitamin C, may be more beneficial for fighting against COVID-19.
Twist1–IRF9 Interaction Is Necessary for IFN-Stimulated Gene Anti-Zika Viral Infection
Authors: You Yuan , Grasso Esteban , Alvero Ayesha , Condon Jennifer , Dimova Tanya , Hu Anna , Ding Jiahui , Alexandrova Marina , Manchorova Diana , Dimitrova Violeta , Liao Aihua , Mor Gil 
Published: May 2023

Abstract
An efficient immune defense against pathogens requires sufficient basal sensing mechanisms that can deliver prompt responses. Type I IFNs are protective against acute viral infections and respond to viral and bacterial infections, but their efficacy depends on constitutive basal activity that promotes the expression of downstream genes known as IFN-stimulated genes (ISGs). Type I IFNs and ISGs are constitutively produced at low quantities and yet exert profound effects essential for numerous physiological processes beyond antiviral and antimicrobial defense, including immunomodulation, cell cycle regulation, cell survival, and cell differentiation. Although the canonical response pathway for type I IFNs has been extensively characterized, less is known regarding the transcriptional regulation of constitutive ISG expression. Zika virus (ZIKV) infection is a major risk for human pregnancy complications and fetal development and depends on an appropriate IFN-β response. However, it is poorly understood how ZIKV, despite an IFN-β response, causes miscarriages. We have uncovered a mechanism for this function specifically in the context of the early antiviral response. Our results demonstrate that IFN regulatory factor (IRF9) is critical in the early response to ZIKV infection in human trophoblast. This function is contingent on IRF9 binding to Twist1. In this signaling cascade, Twist1 was not only a required partner that promotes IRF9 binding to the IFN-stimulated response element but also an upstream regulator that controls basal levels of IRF9. The absence of Twist1 renders human trophoblast cells susceptible to ZIKV infection.
A study of neutrophil-to-lymphocyte ratio in patients with metabolic syndrome
Authors: Mohan Manjushree , Kavya S T , Kumar H. R. Sanjay 
Published: May 2023

Background and Aim of the Study:
Numerous studies have shown an association of metabolic syndrome (MS) and insulin resistance with inflammation. The prevalence of MS as defined by the National Cholesterol Education Programme, Adult Treatment Panel III (NCEP, ATP), and other criteria indicates ranges from 11% to 41% in India. Neutrophil-lymphocyte ratio, which is calculated from a routine complete blood count with differential, is an easily obtained, inexpensive, can be used as a widely available marker of inflammation. This ratio can also aid in the risk stratification of patients with various cardiovascular diseases in addition to the traditionally used markers.

Materials and Methodology:
In this cross-sectional study, 210 patients with and without MS were included after detailed history and examination. Patients were considered as cases based on the NCEP, ATP III criteria for MS. Both groups of patients were subjected to routine investigations which included complete blood counts, total white blood counts, neutrophil and lymphocyte levels, HbA1c levels, serum glucose levels, fasting lipid profile, and electrocardiography. Logistic regression analysis was done to look for the association of neutrophil-lymphocyte ratio with MS.P< 0.05 was considered as statistically significant.

Results:
It was seen that the neutrophil-lymphocyte ratio in participants without MS was found to be 1.57 ± 0.728 and the ratio in participants with MS fulfilling 3 out of the 5 criteria, 4 out of 5 and 5 out of 5 criteria were, respectively, 2.65 ± 1.003, 3.59 ± 1.258, and 4.79 ± 2.143. This association was statistically significant with aP= 0.00.

Conclusion:
Participants with MS had increased neutrophil-lymphocyte ratio when compared to participants without MS. Participants fulfilling higher criteria of MS had higher neutrophil-lymphocyte ratio suggesting increasing inflammatory state.
C-Reactive Protein and Lactate Dehydrogenase in Intensive Care Unit and Nonintensive Care Unit COVID-19 Patients – A Retrospective Study
Authors: Astagimath Muragendraswami , Aryapu Raviraja , Patil Vishwanath , Doddamani Suman 
Published: May 2023

Background:
Appropriate diagnostic markers play an important role in categorizing COVID-19 patients with respect to the severity of the disease.

Aims and Objectives:
The aim and objective of this study were to compare C-reactive protein (CRP) and lactate dehydrogenase (LDH) in intensive care unit (ICU) and non-ICU patients of COVID-19 disease.

Materials and Methods:
Data was collected from the COVID-19 laboratory (n = approximately 3700). The patients were divided into two groups: ICU and non-ICU. The levels of CRP and LDH were estimated by the microslide method based on an enzymatic heterogeneous sandwich immunoassay.

Results:
In the ICU group, patients above 50 years were four times in number compared to patients below 50 years. COVID-19 infection was twice more common in males than females. The mean CRP levels in the ICU group were higher compared to non-ICU group, and this difference was statistically significant. LDH was elevated significantly in ICU patients compared to non-ICU patients.

Conclusion:
The study concludes that patients aged above 50 years are more prone to develop severe COVID-19. Men are more susceptible to develop severe COVID-19. The most evident finding of this study is that among patients below 50 years, higher CRP levels can be used as an alarming marker in predicting severe COVID-19 disease. We suggest that LDH can be used as a marker to predict the severity of COVID-19 disease in all age groups. We also suggest that in patients above 50 years, it is better to use the combination of CRP and LDH in the assessment of severe COVID-19, rather than using CRP alone.
A Study to Assess Diabetic Distress and Other Factors which Affect Glycemic Control in Patients with Type 2 Diabetes Mellitus
Authors: Nagabhushana Amruthavarshini , Ramaiah Madhumathi , Khan Mumtaz Ali , Nijaguna Siddesh 
Published: May 2023

Objective:
The objective of the study was to assess diabetes distress and other factors, which affect glycemic control in patients with type 2 diabetes mellitus (T2DM) and to assess the relation between hemoglobin A1c (HbA1c) and diabetes distress, duration of illness, educational status and treatment modalities, and body mass index (BMI).

Methodology:
A cross-sectional study conducted at Bangalore Medical College and Research Institute included T2DM patients attending outpatient departments between November 2018 and February 2019, 280 patients were screened for diabetic-related distress using Diabetes Distress Screening Scale (DDS), the patients with diabetes distress were subjected to DDS 17 Questionnaire to determine the type of diabetes distress, and based on score divided into (0–2) little/no distress, (2–2.9) moderate distress, and (3 and more) severe distress.

Results:
Among 280 patients, 184 patients had diabetic distress and among them, 58.2% had severe distress, 7.5% had moderate distress, 34.3% had little/no distress, 83.1% had emotional burden, 59.2% had physician-related distress, 60.4 had regimen-related distress, and 83% had interpersonal distress. The diabetes distress was significantly associated with age (P = 0.032) and medication adherence (P = 0.00) with educational status. 51.4% had poor glycemic control with HbA1c of >7. The factors significantly associated with poor glycemic control included duration of diabetes withP= 0.008, diabetic distress withP= 0.00, and no significant association with educational status, age, BMI, and treatment modalities.

Conclusion:
Among type 2 diabetes patients, diabetic distress is a serious problem and needs to be addressed for better glycemic outcome.
Plasmablastic transformation of a double hit follicular lymphoma: An emerging entity
Authors: Khodaiji Shanaz , Mahajan Vidisha , Satyakam Krishna Sawaimoon , Amare Pratibha Sudhan Kadam 
Published: May 2023

ABSTRACT
Plasmablastic transformation of follicular lymphoma is very rare and has been reported in only 5 cases till date. We report a case of simultaneous identification of extranodal, soft tissue plasmablastic lymphoma in the ankle and bone marrow involvement by follicular lymphoma. This unusual case presentation is a challenge for the treating physician with the patient becoming resistant to chemotherapy and succumbing to the disease within a few months of diagnosis. These cases are known to have an aggressive clinical course with very poor prognosis and survival rate of less than 6 months. This report broadens the spectrum of morphological transformation of follicular lymphoma and it may represent a new category of high-grade transformation of follicular lymphoma.