bluuebunny/crossref_metadata_2025_split huggingface dataset:
L’importance de la nature vue par les pédagogues à travers les siècles
Authors: Moussy Bernadette 
Published: November 2022

Comment les pédagogues à partir du xvii e siècle ont-ils parlé de la nature de l’enfant et de sa place dans la nature ? À partir de la période humaniste, un pédagogue tchèque, Comenius, né à la fin du xvii e siècle, a déclaré que l’enfant était comme une graine, c’est-à-dire acteur de son développement, et qu’il possède tout le connaissable en puissance. Ce renversement du regard que l’on avait sur l’enfant jusque-là est essentiel. Il est à la base de ce qui s’intitulera, au début du xx e siècle, l’Éducation nouvelle ou les Méthodes actives. Il s’agit de la nature de l’enfant, notion qui sera reprise et développée par J.-J. Rousseau et qui influencera les pédagogues des siècles suivants. Comenius ajoute qu’il y a un parallélisme entre l’humain et la nature, et que l’enfant doit être en contact avec elle pour mieux se connaître et devenir « jardinier » à son tour. Il y découvrira de multiples connaissances intellectuelles et morales.
A clinicopathological study of perianal paget disease
Authors: Hou Ping-Chen , Lee Chaw-Ning , Wong Tak-Wah , Hsu Tzu-Chien , Wu Cheng-Lin , Lee Julia Yu-Yun 
Published: November 2022

Background:
Perianal Paget disease (PPD), an uncommon extramammary Paget disease, is characterized by intraepidermal pagetoid spread of atypical Paget cells in the perianal skin. PPDs can be primary or secondary. Secondary PPDs have poorer prognosis due to progression of the underlying anorectal carcinoma.

Objectives:
We analyzed the clinicopathological features of PPDs to determine the primary versus secondary PPD.

Methods:
We reviewed the clinicopathological features, including evidence of underlying anorectal carcinomas, tumor immunoprofiles, treatments, and outcomes of 8 cases of PPD diagnosed in our department during 1992–2019.

Results:
Colonoscopy was performed in 6 cases; rectal adenocarcinoma and anal canal adenocarcinoma were detected in 2 cases each. Three patients had local recurrence(s). Based on the detection of underlying anorectal cancers and immunoprofiles, 2 cases were classified as primary (one with perianal squamous cell carcinoma), 4 secondary, and 2 inconclusive for primary or secondary PPD. The immunoprofiles were CK7(+)/CK20(−)/GCDFP-15(−)/CDX2(−) in the primary PPDs; CK7(+/−)/CK20(+)/GCDFP-15(−)/CDX2(+) in the secondary and inconclusive PPDs. Eventually, all patients with secondary PPD died of the disease; one primary PPD and one inclusive PPD cases died of unrelated causes.

Conclusion:
We report the clinicopathological features of 8 cases of PPD in Taiwanese and first describe differential CK7 expression in the epidermal and dermal tumor cells in 2 cases of secondary PPDs, which may provide a clue to the diagnosis of secondary PPD. Since an underlying anorectal carcinoma in PPDs may be undetectable by colonoscopy, it is essential to consider anoscopy and/or anal canal mucosal biopsy to search for an occult anorectal carcinoma.
Evaluation of forkhead-box C1 expression in breast cancer
Authors: Mahfouz Mena , Abdel-Rahman Manar A. , Habashy Hany O. 
Published: November 2022

Background
Forkhead box C1 (FOXC1) is considered an important member of forkhead-box transcription factors. Previous studies have shown that FOXC1 is associated with tumor progression and represents a poor prognostic indicator in triple-negative basal-like breast cancer.

Method
This is a retrospective study conducted on 187 cases of invasive breast carcinoma obtained from Histopathology Laboratory in Oncology Center, Faculty of Medicine, Mansoura University, starting from 2012.

Aim and objectives
In this study, we aimed to study FOXC1 protein expression in molecular subtypes of breast cancer and to correlate its expression with other prognostic parameters using immunohistochemistry and tissue microarrays.

Results
FOXC1-positive expression was seen in 26.7% of cases. Positive FOXC1 expression was most common in triple-negative basal-like breast cancer and HER2-enriched subtypes. Positive FOXC1 expression was higher in ER-negative cases than ER-positive cases (39 vs. 21%) with statistical significance (P = 0.01). Similarly, positive FOXC1 was higher in PR-negative cases than PR-positive cases (37.5 vs. 20%), this was statistically significant (P = 0.009). In our series, FOXC1 expression was not associated with survival.

Conclusion
FOXC1 expression is associated with negative hormonal-receptor status in breast cancer. FOCX1 is not a prognostic indicator of disease-free survival in our patient series.
Effect of a single intraoperative dose of dexamethasone on glycaemic profile in postoperative patients - A double-blind randomised controlled study
Authors: Peter Vigil , Shenoy Usha , Rukkiyabeevi Buena 
Published: November 2022

Background and Aims:
The effect of a single intraoperative dose of steroids on perioperative blood sugar levels is uncertain. We hypothesised that a single dose of dexamethasone would not unfavourably alter the glucose levels of non-diabetic patients. This study aimed to evaluate the post-operative glycaemic profile after a single dose of intraoperative dexamethasone in non-diabetic patients. The presence of post-operative nausea and vomiting (PONV), pain, surgical site infection (SSI) and length of hospital stay were also evaluated.

Methods:
This randomised, double-blind, controlled study was done by recruiting 150 non-diabetic adult patients of the American Society of Anesthesiologists physical status I/II undergoing elective surgery. Patients in the study group were administered a single dose of dexamethasone (0.15 mg/kg). Blood glucose levels were assessed at various time points for up to 72 hours post-operatively using point-of-care testing. Secondary outcomes such as PONV, pain, fever and SSI were also documented. Data were compared and analysed using Student’s t-test, Chi-square test, Mann-Whitney test and analysis of variance test.

Results:
There was an earlier, higher and prolonged elevation in blood glucose levels in patients receiving dexamethasone. The mean (standard deviation) of fasting/postprandial blood sugars on the first, second and third postoperative days respectively was significantly higher in the study group 98.04 (21.89)/139.16 (20.59), 96.64 (19.20)/138.17 (18.05), 96.60 (17.40)/138.32 (15.10) mg/dl as compared to control group 86.9 6 (10.28)/128.95 (10.53), 88.81 (8.87)/131.97 (9.68), 88.16 (8.50)/130.88 (9.48) mg/dl. About 10.7% of the patients who received dexamethasone had blood glucose levels greater than 180 mg/dl. There were no significant differences in the secondary outcomes.

Conclusion:
Even a single dose of dexamethasone in non-diabetic adults causes significant and prolonged postoperative hyperglycaemia.
Correlation of digital rectal examination and serum prostate-specific antigen levels for detection of prostate cancer
Authors: Sarkar Debansu , Jain Pritesh , Gupta Piyush , Pal Dilip Kumar 
Published: November 2022

Objective:
The objective of our study was to evaluate the detection rate of prostate cancer by digital rectal examination (DRE) and serum prostate-specific antigen (PSA) levels followed by standard 12-core transrectal ultrasound (TRUS)-guided prostate biopsy.

Materials and Methods:
After screening of patients presenting with lower urinary tract symptoms (LUTS) using DRE and serum PSA level, we enrolled patients for TRUS-guided 12-core prostate biopsy. Indications included PSA level ≥4 ng/ml and/or suspicious DRE findings. A retrospective analysis was done to find out the correlation between suspicious rectal examination and various serum PSA levels in detection of cancer prostate.

Results:
A total of 847 patients were screened for cancer prostate during our study period (May 2012–February 2020). Among them, 823 patients who underwent prostate biopsy were analyzed. Prostate cancer was detected in 330 cases (40.09%). Mean age of patient (years) with and without prostate cancer was 66.25 ± 9.45 and 64.3 ± 8.96 years, respectively. Median value of serum PSA in patients positive for cancer was 33 ± 260 ng/ml compared to patients without cancer, who had a median value of 9 ± 64 ng/ml (P-value of <0.0001). The detection rate of cancer based on suspicious DRE findings irrespective of PSA was 52.18% (251/481), compared to 45.46% (311/684) using a PSA cut-off of ≥4.0 ng/ml alone. Among 330 patients with positive biopsy, 19 (5.75%) had a PSA level <4 ng/ml and they were identified based on suspicious DRE alone.

Conclusion:
Suspicious DRE was significantly associated with detection of prostate cancer across all PSA levels. Patients with PSA <4 can harbor prostate malignancy and such cases can be detected by use of DRE in screening of all patients with LUTS.
A histopathological and immunohistochemistry analysis of endometrial lesions among women presenting with abnormal uterine bleeding
Authors: Walvir Nazia M. , Rana Safia , Jairajpuri Zeeba S. , Jetley Sujata , Nigam Aruna 
Published: November 2022

Objectives:
We aimed to histopathologically evaluate the morphological spectrum, apoptotic index (AI), and mitotic index (MI) of endometrial lesions in patients presenting with abnormal uterine bleeding (AUB).

Methods:
A cross-sectional study was done over a period of 18 months where a total of 60 newly diagnosed cases of perimenopausal women presenting with AUB were included. All H and E stained pathology slides from the specimens were reviewed for initial histopathological evaluation and diagnosis. Immunohistochemistry for Bcl-2 and Bax was done. The study subjects were divided into two groups: Group 1 included 30 cases of histologically proven proliferative endometrium (PE) and endometrial polyps and Group 2 included 30 cases of hyperplasia, endometrial epithelial neoplasia (EIN)/or carcinoma. For all cases, AI and MI were calculated and compared among the two groups.

Statistical Analysis:
Quantitative variables were compared using the Independent t-test/Mann–Whitney test between the two groups and Kruskal–Wallis test for comparison between more than two groups. Qualitative variables were correlated using the Chi-square test. P < 0.05 was considered statistically significant.

Results:
In our study of 60 patients of AUB, the mean age was 45.87 years with a parity of 2 or more in most of the patients. Most of the patients in our study had heavy menstrual bleeding (66.67%) with associated complaints of weakness, pallor, and low backache. Out of 60 patients of AUB, Endometrial carcinoma was diagnosed in 13 (21.67%) patients, with the most common histopathological type being Endometrioid carcinoma. There was a significant difference in the AI, MI, and the ratio of AI/MI among various histopathological diagnoses. AI was highest for Endometrial carcinoma and lowest for hyperplasia and polyps. MI was also highest for Endometrial carcinoma and lowest for hyperplasia and polyps. However, the ratio was incongruent as it was highest for hyperplasia without atypia and lowest for PE with endometrial carcinoma being midway. The Bcl-2 expression of relatively benign conditions (Group 1) was significantly higher than Group 2 (Endometrial epithelial neoplasia/carcinoma). Bax intensity showed an almost inverse pattern, being highest in endometrial carcinoma and lower in hyperplasia and polyps with the lowest expression in PE. Even the Bcl-2:Bax ratio was also highest for PE and lowest for endometrial carcinoma with others falling in between them.

Conclusion:
It can be concluded that the combination of the proliferative and apoptotic markers and the ratio will help as a tool in aiding the diagnosis of endometrial lesions for patients presenting with AUB.
LICENCIATURA EM INFORMÁTICA DURANTE O ENSINO REMOTO: UM RELATO
Authors: Jair Kunzler Edivando , De Lucca Daniela , Radin Arnau Gustavo , Gusmão Moreira Thiago , Pereira Yamanoe Mayara Cristina , Mincov Tenório Marcos , Merkle Lingnau Carina 
Published: November 2022

Este artigo é um relato de experiência sobre o ingresso na última turma do primeiro semestre do curso de Licenciatura em Informática da Universidade Tecnológica Federal do Paraná, campus Francisco Beltrão (UTFPR-FB). O objetivo deste relato é comunicar a experiência de entrada no curso de Licenciatura em Informática, em meio ao fechamento do curso no campus. Este relato ocorreu através da experiência com a linguagem acadêmica na disciplina de Comunicação Linguística, em um momento de reinício da oferta presencial dos cursos de graduação da UTFPR-FB, após uma melhora dos casos no quadro pandêmico que se instaurou no mundo desde o ano de 2020. Para a metodologia reunimos as experiências durante o tempo de pandemia e transição do período remoto para o presencial, tendo por mediação a orientação da disciplina, leituras de trabalhos científicos e discussões. Como resultados verificamos que dos dez colegas que se matricularam na disciplina, apenas quatro finalizaram as atividades e um teve seus créditos consignados, nesta perspectiva, retomar a vida acadêmica de forma presencial em meio ao fechamento de um curso de graduação, em um grupo que está com um número reduzido, se torna um desafio, o que demanda um olhar inovador para a situação. Desse modo, percebemos que iniciar uma carreira via ensino remoto já foi, de modo geral, um estímulo à criatividade e à persistência de alcançar objetivos e produzir conhecimentos, no entanto também vivenciar este processo aliado ao fechamento do curso que escolhemos como formação profissional pode ser mais desafiador do que havíamos cogitado.
IMPACT OF LOW-DOSE SACUBITRIL-VALSARTAN ON HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH HEART FAILURE AND REDUCED EJECTION FRACTION
Authors: Sheikh Kaleemullah , Sarfaraz Abeer , Sarfaraz Sana , Janjua Amna , Shoaib Sana , Devi Sanjana 
Published: November 2022

Objectives: The present study aimed to observe the beneficial effects of sacubitril-valsartan at a lower dose of 24/26mg BID in a third-world country (Pakistan).
Methodology: This was a randomized, prospective, observational cohort study conducted at a tertiary care hospital in patients diagnosed, managed, and discharged as a case of heart failure with reduced ejection fraction and followed up in the cardiac outpatient department 6 weeks post-discharge. The required information was collected from the patients by means of a designed questionnaire containing minimal personal information, including age and gender. The questionnaire used was an FDA-approved KCCQ indicated for the use of assessing the quality-of-life change before and following the therapy indicated for HF with reduced ejection fraction. The data was analyzed using SPSS version 26.
Results: This study included a total of 77 patients out of which 49 were male (63.6%) and 28 were female (36.4%). The mean age of the patients included was 60.05± 11.80 years. 68.8% of them were hypertensive and 51.9% were diabetic. All patients included were those with reduced Ejection Fraction out of which 29.9% had EF between 20-25%, 49.3 % had it between 30-35% whereas 20.8% of patients had an EF of 40%. In the case of NYHA class before starting Sacubitril/Valsartan approximately 84.4% of patients were in class 3 and 15.6% of them belonged to class 4. The functional class was improved 6 weeks post-treatment in which 79.2% of patients had functional class 2 and 20.8% of them had class 3. The comparison between KCCQ scores of heart failure patients before treatment and after treatment with sacubitril/valsartan at the dosage of 24/26mg BID were statistically significant.
Conclusion: It was thus concluded from the study that even a low dose of sacubitril-valsartan results in improved quality of life as assessed by KCCQ scoring in patients with heart failure with reduced ejection fraction.
FREQUENCY OF RIGHT VENTRICULAR INFARCTION WITH ACUTE INFERIOR WALL MYOCARDIAL INFARCTION ON THE BASIS OF ECG
Authors: Danish Naveed , Ullah Shafi , Akhtar Shakeel , Ashraf Amber 
Published: November 2022

Objectives: To determine frequency of RVI in patients with acute IWMI presenting to Cardiology department Khyber Teaching Hospital Peshawar.
Methodology: This cross-sectional study (descriptive) was conducted at department of Cardiology, Khyber Teaching Hospital, Peshawar from 05 Sept, 2019 to 05 Mar, 2020. A thorough history was taken and detail systemic examination was performed. A proforma was filled showing demographics of the patients. Two sets of ECGs were performed. One for diagnosis of IWMI and other for diagnosis of RV infarction. ECG was done through Fuduka-ME-C110-ECG machine at a standard paper speed of 25mm/sec with 0.1 mV/mm. The ECGs were looked for diagnosis of IWMI and RV infarction in leads II, III, aVF for ST segment elevation and also ST segment elevation in V3R, V4R, V5R, and V6R respectively. Furthermore, the ECGs findings were verified by a team of consultant cardiologists.
Results: Mean and SDs for age was 64±8.97. (Table No. 1). 100 (38.46%) patients were recorded in 30-50 years age group and 160 (61.53%) patients were recorded in 51-70 years age group. 141 (54.23%) male patients and 119 (45.76%) female patients were recorded. 63 (24.23%) patients were recorded with RV infarction (RVI). In age group 30-50, 16 (6.15%) patients had RVI and in age group 31-70, 47 (18.07%) patients experienced RV infarction. P Value: 0.01. 37 (14.2%) males had RVI and 26 (10%) female patients had RV infarction. P Value: 0.410.
Conclusion: We have come to this conclusion that diagnosis of RVMI is highly probable, therefore, specific treatment includes fluid loading and vasopressors, which should be administered immediately. In addition, patients with RV involvement should be given/kept under continuous monitoring and observation because they are at a significantly higher risk for ventricular fibrillation, sustained ventricular tachycardia and high-degree AV blockade, any of which can further aggravate the overall prognosis of this disease.
A PROSPECTIVE STUDY TO IDENTIFY THE BEST PREDICTOR OF IN-HOSPITAL MORTALITY IN PATIENTS UNDERGOING EMERGENT PERCUTANEOUS CORONARY REVASCULRIZATION; COMPARATIVE ANALYSIS OF FOUR WELL ESTABLISHED RISK SCORES
Authors: Rasool Muhammad , Kumar Rajesh , Sial Jawaid Akbar , Karim Musa 
Published: November 2022

Objectives: This study was conducted to compare the predictive power of Shock Index (SI), TIMI Risk Index (TRI), LASH Score, and ACEF Score for the prediction of in-hospital mortality in a contemporary cohort of ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) at a tertiary care cardiac center of a developing country.
Methodology: Consecutive patients diagnosed with STEMI and undergoing primary PCI were included in this study. SI, TRI, LASH, and ACEF were computed and their predictive power was assessed as the area under the curve (AUC) on the receiver operating characteristics (ROC) curve analysis for in-hospital mortality.
Results: A total of 977 patients were included in this study, 780 (79.8%) of which were male, and the mean age was 55.6 ± 11.5 years with 149 (15.3%) under 45 years of age. At presentation, 101 (11.4%) patients were in Killip class III/IV, 121 (12.4%) had arrhythmias, 59 (6%) were in cardiac arrest, and 130 (13.3%) were intubated. The in-hospital mortality rate was 4.3% (42). AUC for TRI was 0.669 (cut-off: ≥17.5, sensitivity: 76.2%, specificity: 45.6%). AUC for SI was 0.595 (cut-off: ≥0.9, sensitivity: 21.4%, specificity: 89.8%). AUC for LASH score was 0.745 (cut-off: ≥0, sensitivity: 76.2%, specificity: 66.9%). AUC for the ACEF score was 0.786 (cut-off: ≥1.66, sensitivity: 71.4%, specificity: 73.5%).
Conclusion: In conclusion, ACEF showed sufficiently high predictive power with good sensitivity and specificity compared to other three scores. These simplified indices based on readily available hemodynamic parameters can be reliable alternatives to the computational complex scoring systems for the risk stratification of STEMI patients.
INTRAVASCULAR ULTRASOUND DERIVED MINIMAL LUMINAL AREA AND PLAQUE BURDEN OF CORONARY VESSELS IN OUR LOCAL POPULATION
Authors: Khan Muhammad Ishaq , Ullah Abid , Jan Rafiullah , Ullah Shafi 
Published: November 2022

Objectives: To report the average IVUS derived MLAs and plaque burden of coronary arteries of our local population.
Methodology: It was a retrospective observational study. A total of 64 patients having IVUS done from January 2022 to September 2022 was enrolled in this study. IVUS images were acquired using 40 MHz, 3.1 French Opticross IVUS catheter (OptiCross™, Boston Scientific, USA).
Results: Out of 54 patients, 39 (72%) were males with a mean age of 53.7 ± 14.1 years. The left main (LM) disease was found in n = 43 (79.6%) on coronary angiogram. The LM mean minimal luminal area was 6.68 ± 1.9 mm2 and mean minimal luminal diameter was 3.83 mm ± 1.02. Mean LM plaque burden was 57% (range 0-57). In proximal LAD mean MLA was 5.04 ± 2.7mm2, mean proximal reference diameter was 3.97 ± 0.64 mm and plaque burden was 53.88 ± 16.5%. The pattern of the plaque was diffuse with more calcified in the LAD than in the left main stem. The mean minimal stent area achieved in patients who had received stenting was 13.05 ± 2.88mm2 in LM (n = 15), and 9.71 ± 2.88 mm2 in proximal LAD (n = 30).

Figure 1: (a). IVUS image of left main artery with minimum plaque. (b) well apposed stent in LAD of a patient, (c). heavy plaque burden with calcification causing drop out.
Conclusion: Our local population has Coronary sizes comparable to those reported in the international literature. The stent size in major vessels like LM and proximal LAD should be guided by the use of IVUS to achieve maximum MSA to reduce adverse outcomes.
PPCI OUTCOMES
Authors: Khan Muhammad Ishaq , Jan Rafiullah , Waleed Muhammad , Saleem Wali 
Published: November 2022

Objectives: Primary percutaneous coronary intervention (PPCI) is the standard of care for ST-elevation myocardial infarction (STEMI) worldwide. Recommended by the latest guidelines (1). In Pakistan only a handful centres offer PPCI services, many others rely on thrombolysis as the reperfusion strategy for STEMI patients which has been shown to be inferior to primary PCI (2). In our province the PPCI facility is even harder to offer where infrastructure and economic conditions of the public is lagging behind many areas in the country. Ours is a study from a public sector hospital in its infancy. We present our data of a single centre and believe that it will help shape the policy of the government in favour of expanding PPCI facilities. To share the primary PCI data of our centre.
Methodology: It was a retrospective observational study. All comers who underwent PPCI for STEMI in Peshawar Institute of Cardiology from March 2022 to August 2022were enrolled. All procedures were performed by experienced interventional cardiologists or their fellows under their direct supervision.
Results: A total of 337 patients were enrolled in the study. The mean age was 53 ± 16 years. 73 % (n = 246) were males. Most commonly involved culprit artery was LAD (47%) followed by RCA (34%). 16.9% (n = 57) patients had triple vessel disease, 35 % (n = 119) double vessel disease and 47.7% (n = 161) had only one vessel disease. LMS disease was diagnosed in 18 (5.3%) patients, out of which 4 (1.1%) were stented during the index procedure. In-hospital mortality was 3% (n = 10), out of which 6 (1.8 %) patients were in cardiogenic shock and all were on inotropic support. Four patients (1.1%) needed intubation and balloon pump was used in another 4 (1.1 %) patients. Second and third generation DES were used in 86% (n = 290), POBA in 08% (n = 27), urgent surgical referral was done in 03 % (n = 10) while in 03% (n = 10) patients no stenting was done. Intravascular ultrasound was used in 4 (1.1%) cases.
Conclusion: Primary PCI can be offered in public sector hospital to our population. The need of the hour is to delegate more resources to this life saving procedure.