bluuebunny/crossref_metadata_2025_split huggingface dataset:
Les terres rares d’Afrique, un potentiel recours pour l’Union européenne dans le respect du droit international
Authors: Ngom Abdoulaye 
Published: November 2022

Pour sa transition énergétique et écologique à l’ère du numérique, l’Union européenne (UE), face au monopole chinois et aux limites de ses capacités de recyclage et de substitution, doit sécuriser son approvisionnement en terres rares. L’Afrique peut quant à elle s’ériger en producteur et fournisseur de l’UE. Pour cela, les pays d’Afrique producteurs de terres rares doivent s’appuyer sur le droit international pour maîtriser les enjeux liés à la pollution délocalisée. Émerge ainsi un besoin face aux enjeux géo-économiques, aux défis géopolitiques ou aux dangers écologiques liés à l’exploitation des terres rares africaines : celui d’une conscience écologique globale et d’un encadrement juridique international, qui sont toujours en gestation.
L’évolution normative de la CEDEAO en matière d’investissement : une analyse des règles substantielles de l’ECOWIC
Authors: Tossa Mawuto 
Published: November 2022

La Communauté Économique des États de l’Afrique de l’Ouest (CEDEAO) a toujours nourri l’ambition de construire un marché commun des investissements susceptible de stimuler le flux des investissements dans la région. Or, l’édification d’un tel marché commande la production de normes communautaires d’investissement. Cette communauté économique régionale s’est alors engagée dans un processus d’harmonisation des règles et politiques d’investissement de ses États membres, lequel s’est soldé par l’adoption, en 2008, de l’Acte additionnel portant sur les règles communautaires d’investissement et leurs modalités d’application. Une décennie plus tard, attentive aux évolutions économiques et socio-politiques dans ses États membres, la CEDEAO va adopter un Code communautaire des investissements : l’ECOWIC. La présente étude ambitionne de décrypter les aspects substantiels des nouveautés apportées par ce nouvel instrument juridique d’investissement. De par ses dispositions novatrices, l’ECOWIC marque une rupture avec les accords internationaux d’investissement « à l’ancienne » et mérite dès lors une attention particulière.
La sagesse philosophique à l’épreuve des incertitudes contemporaines
Authors: Greisch Jean 
Published: November 2022

En ces temps d’incertitude généralisée, la sagesse, pratique ou théorique, est une denrée rare. La formule « sagesse de l’incertitude », par laquelle Milan Kundera caractérise l’art du roman, peut recevoir un sens philosophique qui ne se limite pas à un scepticisme ravageur, si la philosophie, qui affronte les multiples formes de la violence, se donne pour tâche de « devenir raisonnablement raisonnable » (E. Weil).
American College of Radiology Thyroid Imaging Reporting and Data System Score has High Diagnostic Value in the Diagnosis of Malignant Thyroid Nodules
Authors: Biswas Souvik , Sureka Binit , Kaushal Darwin , Elhence Poonam , Goyal Amit , Yadav Taruna , Goel Akhil , Khera Pushpinder Singh 
Published: November 2022

Introduction:
A palpable thyroid swelling is a very common finding and is seen in almost 12% of Asian Indian population. Thyroid imaging reporting and data system (TI-RADS) can be used as a risk stratification system to determine malignant or benign thyroid nodules and necessity of further intervention.

Objective:
The objective of this study was to determine the positive predictive value (PPV) of TI-RADS category/ultrasound using TI-RADS categories in the diagnosis of malignancy in clinically suspected thyroid nodule and necessity for further intervention in the case of malignant thyroid nodules.

Materials and Methods:
We conducted a prospective study evaluating 110 patients (140 thyroid nodules) from March 2018 to April 2020 including patients with thyroid swelling. Ultrasound was performed by a radiologist on the patients, and targeted fine-needle aspiration cytology from thyroid nodules was interpreted by an experienced pathologist. Ultrasound features and TI-RADS category were compared with cytology and surgical histopathology. Sensitivity, specificity, PPV, and positive likelihood ratio in different categories of TI-RADS nodules were calculated.

Results:
A total of 113 thyroid nodules were assessed. Out of 113 nodules (right lobe – 64, isthmus – 6, and left lobe – 43), 84 nodules were benign and 29 nodules were malignant. Eleven (10%) patients were found to have metastatic cervical lymphadenopathy. There was no significant difference in the occurrence of malignant nodules according to gender, location of the nodule, or size of the nodule. The mean anteroposterior and transverse diameter of benign nodule was 14.1 ± 6.9 mm and 20.9 ± 9.9 mm, respectively, whereas in the case of malignant nodules, it was 15.6 ± 7.1 mm and 19.5 ± 9.0 mm, respectively. A TI-RADS score of ≥4 had 84% PPV for malignancy. The PPV for malignancy was 32.2%, 49.1%, and 100% for TI-RADS 2, 3, and 5 categories.

Conclusion:
TI-RADS is a simple, practical, and cost-effective tool for assessing the malignancy rates of thyroid nodules. TI-RADS categories 4 and 5 have high PPV for malignancy in thyroid nodules.
Obstructive Sleep Apnea in Hypothyroidism
Authors: Pancholi Chitranshu , Chaudhary Shyam Chand , Gupta Kamlesh Kumar , Sawlani Kamal Kumar , Verma Sudhir Kumar , Singh Abhishek , Verma Ajay Kumar , Usman Kauser , Atam Virendra 
Published: November 2022

Introduction:
Obstructive sleep apnea (OSA) and hypothyroidism are closely linked as hypothyroidism has been shown to lead to the development of OSA through multiple mechanisms. With the changing lifestyle patterns worldwide and increased prevalence of obesity, the burden of OSA has substantially increased. The association of OSA with hypothyroidism is essential to establish. If identified early, treatment of OSA and associated hypothyroidism can be done timely to minimize the potential harmful complications of OSA on all aspects of the patient's health.

Aims:
This study was done to find out the prevalence of OSA in hypothyroidism patients.

Setting and Designs:
It was a cross-sectional study, done over a period of 1 year in a tertiary care hospital.

Materials and Methods:
A total of 100 hypothyroidism patients were enrolled after taking written consent. All patients were subjected to STOP-Bang questionnaire and patient falling in intermediate-high risk (score3-8), were taken for overnight polysomnography to confirm the diagnosis of OSA (AHI ≥5).

Statistical Analysis Used:
The Statistical Package for the Social Sciences version 21.0 statistical analysis software.

Results:
Out of 100 patients, who underwent polysomnography, 74 (74%) cases had OSA (AHI ≥5). Out of total 74 OSA cases, 29 (39.2%) cases had mild OSA (AHI 5–14), 15 (20.3%) cases had moderate OSA (AHI 15–30), and 30 (40.5%) cases had severe OSA. The age of the study population ranged between 24 and 78 years and the mean age was 58.28 ± 11.22 years. The mean age of the patients in the OSA group (59.27 ± 11.17 years) was higher than the non-OSA group (55.46 ± 11.09 years). Majority (64%) of our cases were male, and the proportion of males was found to be higher than females in both the groups (OSA/non-OSA). The body mass index (BMI) of the OSA group was found to be statistically higher as compared to that of the non-OSA group (P = 0.040). The BMI was found to be higher in severe OSA, but it was not statistically significant (P = 0.128). The mean value of FT4 was lower and thyroid-stimulating hormone (TSH) was higher in the OSA group as compared with the non-OSA group. However, no significant association was found between FT4 and TSH values in both the groups. Out of 100 cases, 41 patients were treatment naïve with mean TSH value of 13.1 ± 7 and 59 were on treatment with mean TSH of 8.3 ± 4. Treatment-naïve patients had a statistically higher number (85.3%) of OSA cases in comparison to patients on treatment (66.1) (P = 0.030).

Conclusions:
Prevalence of OSA is quite high in hypothyroidism. Patients with hypothyroidism should be screened for OSA for early diagnosis, especially in individuals with higher BMI. Treatment of hypothyroidism reduces the prevalence of OSA.
Perception and Assumptions of Young Waterpipe Smokers in Mumbai, India
Authors: Nimma Vijayalaxmi , Lingam Amara Swapna , Gaffar Aibani Saddik , Kadam Sonali , Ramaswami Easwaran , Ramchandani Amit 
Published: November 2022

Background:
Hookah smoking has been on raise all over the world, including India, especially among youngsters. There is growing evidence suggesting the high school children experimenting this form of tobacco.

Objective:
The objective of this study was to investigate the characteristics, behavior, and perceptions related to hookah smoking among the hookah smokers in Mumbai.

Materials and Methods:
A cross-sectional survey was conducted among 200 randomly selected young adults between the age group of 15–35 years in Mumbai who visited different dental clinics. The questionnaire was distributed as Google Forms online in the month of November and December 2019 and those who submitted completed responses were included in the study.

Results:
Only 114 participants returned with the completed forms in the time period of 2 months. The results showed that the majority of participants were between 20 and 24 age, comprising 58% who were having the habit of hookah smoking. Among which 24% females, 76% males had history of hookah habit. Eight percent of males started smoking hookah from very young age. Males (29.89%) shared one hookah pot with four members. Forty percent of the participants stated that they are interested to smoke again because of hookah flavor.

Conclusion:
Easy availability of newer forms of smoking at online markets could play a role in promoting the use of hookah among youngsters. Most products are being sold without any warnings, and there is no means to control the selling of the products to minors. Educational intervention is urgently needed to create awareness among youth about the harmful effects of hookah smoking.
Comparative Efficacy of Coronally Advanced Flap with and Without Guided Tissue Regeneration in the Management of Gingival Recession Defects
Authors: Potharaju Santhi Priya , Prathypaty Santha Kumari , Chintala Ravi Kanth , Kumar D. Sunil , Bai Y. Durga , Bolla Vijaya Lakshmi , Koppolu Pradeep , Barakat Ali , Lingam Amara Swapna 
Published: November 2022

Background:
The gingival recession causes tooth sensitivity, poor esthetics, and tooth mobility in severe cases. Scientific documentation revealed effective root coverage (RC) and increased keratinized tissue heights acquired with the coronally advanced flap (CAF) for multiple recession defects.

Objectives:
This research evaluates and compares the efficacy of CAF procedures with and without Type I collagen bio-absorbable membrane in guided tissue regeneration (GTR) in the treatment of Miller's Class I and II gingival recession.

Materials and Methods:
A total of 30 sites from 15 patients were selected for the study after fulfilling the presurgical phase of treatment. The chosen sites were randomly allocated into Group A CAF and Group B (CAF + Resorbable GTR membrane). The clinical variables such as plaque index, gingival index, recession depth (RD), recession width (RW), width of keratinized gingiva (WKG), clinical attachment level (CAL), and surface area of the defect were recorded at the baseline and 6 months postoperatively.

Results:
Both therapies resulted in a notable gain in RC with a mean of 73.13% and 71.60%, respectively, but it was not statistically significant when compared between the groups. Both the RD and RW were significantly reduced from baseline to 6 months postoperatively. Although there was a gain in WKG and CAL in both experimental sites, no significant difference was observed between both the groups.

Conclusion:
Although there are several RC procedures, CAF furnishes a foreseeable, straightforward, and appropriate perspective for treating Miller's Class I and II recessions. Integrating this approach with placing a bio-absorbable membrane does not seem to improve the results following surgical treatment of such defects. However, both groups showed the potential advantage of achieving RC.
Pattern of Eye Diseases in Adults at the General Outpatient Clinic of a Tertiary Hospital in Nigeria
Authors: Onyiaorah Adaora Amaoge , Kizor-Akaraiwe Nkiru N. , Nwosu Sebastian N. N. 
Published: November 2022

Objective:
To determine the pattern of eye diseases at the general outpatient department (GOPD) of a Nigerian tertiary hospital.

Materials and Methods:
Patients selected by systematic random sampling at the GOPD of a Nigerian tertiary hospital were studied. Information on sociodemographics and ocular complaints were obtained using interviewer-administered questionnaire. Ocular examination included visual acuity measurement and anterior and posterior segments examinations. Data analysis was with Statistical Package for the Social Sciences.

Results:
Three hundred and eighty-two patients, comprising 124 (32.5%) males and 258 (67.5%) females, aged between 18 and 86 years, mean 44.8 ± 15.4 years, were studied; 112 (29.3%) had eye diseases but only 88 (78.6%) patients complained of ocular disorder(s). Common complaints were poor vision 53 (60.4%), red eye and grittiness 15 (17.0%) each. Common eye diseases were lens 52 (13.6%) and conjunctiva 46 (12.0%) disorders. Attaining higher education was protective against eye diseases (P < 0.05).

Conclusion:
Nearly a third of patients at the GOPD have eye diseases. Therefore, primary eye care should be integrated into the GOPD service with provision of relevant manpower and facilities for care of the ophthalmic patients.
Knowledge, Awareness, and Attitude Among Dental Students Regarding Oral Cancer in Saudi Arabia
Authors: Tarakji Bassel 
Published: November 2022

Background:
Oral cancer awareness among junior and seniors' dental undergraduate students may have an impact on the early detection and prevention of oral cancer.

Aims and Objectives:
To assess oral cancer awareness, knowledge and attitude among undergraduate dental students in government and private colleges in Saudi Arabia.

Material and Methods:
A cross-sectional survey was undertaken to assess oral cancer knowledge, awareness and attitude among undergraduate dental students in government and private colleges in Saudi Arabia. All junior and senior students enrolled during the 2020– 2021 academic year, were eligible to participate (n=189).

Results:
The study shows that dental Students at private and government colleges in Saudi Arabia are generally knowledgeable regarding Knowledge, awareness, attitude and management of oral cancer. There was no significant difference between knowledge, awareness, attitude, and management of oral cancer between students in either private and government colleges. Results shows that 99 (88.9%) of dental students in government colleges considered human papilloma virus as a risk factor, higher than dental students in private colleges 48 (73.3%). My results indicated that dental students considered (87%) tobacco, and alcohol (83.6%) as main risk to oral cancer, whereas, 100 (53%) identified limited consumption of fruit and vegetables and 124 (65.6%) considered old age as risk factor for oral cancer.

Conclusion:
The variation in correct answers indicate to need to reinforce the undergraduate dental curriculum with regards to oral cancer education; particularly in its prevention and early detection. Revision of knowledge senior students in oral cancer is highly recommended.
Diabetes Mellitus Foot Ulcer and Associated Factors Among Type 2 Diabetes Patients in a Tertiary Institution in Southwest Nigeria
Authors: Salawu Adedayo Idris , Ajani Gbadebo Oladimeji , Soje Michael Osisiogu , Ojo Owolabi Dele , Olabinri Eunice Oluremi , Obajolowo Omotola Olawale , Babalola Olakunle Fatai , Ipinnimo Tope Michael , Oguntade Hameed Banjo , Adediran Olufemi Olusola 
Published: November 2022

Aim:
This study aims to assess the proportion of diabetic foot ulcer (DMFU) and associated factors among patients with type 2 diabetes in a tertiary hospital in Southwest Nigeria.

Methods:
A pretested semi-structured interviewer-administered questionnaire adapted from the STEPwise Approach to Surveillance of Noncommunicable Disease Risk Factors of WHO.14 was used for data collection from a sample of 181 patients with type 2 diabetes mellitus. Sociodemographic, behavioral, clinical, and laboratory variables were collated from the participants. Chi-square test and logistic regression were used to identify the predictors of DMFU.

Results:
A total of 166 patients had their questionnaires completed. The mean age (standard deviation) of the respondents was 62.6 (14.3) years. The proportion of DMFU was 18.7%. More than two-third (71.1%) of our respondents had clinical symptoms suggestive of peripheral neuropathy while 34.3% of the patients seen in the study had evidence of peripheral vascular disease on duplex Doppler ultrasound. Male patients were about five times more likely to have DMFU than female patients (adjusted odds ratio [AOR] =5.27; 95% confidence interval [CI] = 1.001–27.841). Those with duration of diabetes ≥10 years were more likely to have DMFU than those with disease duration <10 years (AOR = 15.47; 95% CI = 1.201–199.314). Patients with fasting blood glucose (FBG) of ≥ 7.2 mmol/L were about four times more likely to have DMFU than those with FBG of <7.2 mmol/L (AOR = 4.19; 95% CI = 1.618–18.463).

Conclusions:
The proportion of DMFU was 18.7%, and the predictors identified included sex, duration of disease, and FBG level.
Effect of Scalp Infiltration with Bupivacaine on Analgesic Requirement Following Elective Craniotomy
Authors: Abdullahi Abdulkareem A. , Aliyu Abdulrahman 
Published: November 2022

Background:
Postcraniotomy pain and perioperative assessment of patients' neurological function are some of the issues associated with craniotomy surgeries. Cost-effective pain control will result in good clinical outcome, decrease the length of hospital stay, and reduce total cost. Infiltration anesthesia is a recognized modality of cost-effective pain control.

Objective:
The study determined the effect of scalp infiltration with 0.25% plain bupivacaine on pain control following craniotomy.

Methods:
A prospective randomized study recruited 50 consenting patients scheduled for craniotomy under general anesthesia into two study groups. All patients received routine general anesthesia as per local protocol and received scalp infiltration after skin closure. Group A received 20 ml of 0.25% plain bupivacaine, while Group B received 20 ml normal saline. Pain scores were assessed using the Visual Analog Scale (VAS) on admission into the intensive care unit (ICU) then at 4, 8, 12, 16, 20, 24, and 48 h after surgery. The interval between the end of surgery and the first request for analgesia, 4 hourly intervals pentazocine and the cumulative doses of pentazocine given for postoperative pain relief.

Results:
The presenting VAS at the ICU and total postoperative analgesic consumption at 48 h were significantly lower in the bupivacaine group compared to the saline group. In addition, the increase in time to the first analgesic request was statistically significant between the two. There was a trend toward the reduced incidence of sedation and postoperative nausea and vomiting in the bupivacaine group compared to the saline group.

Conclusions:
Postoperative scalp infiltration with plain 0.25% bupivacaine reduced pain intensity and opioid analgesic consumption among the studied patients. Resultantly, it can be regarded as an effective technique of pain management after an elective craniotomy.
Distribution of IcaA and IcaB Genes in Biofilm-Producing Methicillin-Resistance Staphylococcus aureus
Authors: Malik Nitisha , Bisht Dakshina , Aggarwal Juhi , Rawat Ashutosh 
Published: November 2022

Background:
Biofilm-producing methicillin-resistance Staphylococcus aureus (MRSA) strains may reduce the penetration rate of antibiotics which leads to treatment failure; therefore, the aim of our study was to assess the presence of icaA and icaB biofilm-producing genes in clinically isolated MRSA strains.

Materials and Methods:
All pus samples received in the microbiology laboratory were processed as per the standard microbiological procedure for the isolation of S. aureus. Detection of MRSA is done by the cefoxitin disc diffusion method. Phenotypic detection of biofilm in all MRSA strains was accessed by tissue culture plate (TCP) method and polymerase chain reaction as genotypic method was used for detection of icaA and icaB genes.

Results:
A total of 222 S. aureus were isolated from pus specimens. Out of these, 127 isolates were MRSA (57%). TCP method demonstrated that 68% of MRSA were biofilm producers, on the other hand, 52 (41%) strains showed the presence of icaA gene, and 39 (31%) strains showed the presence of icaB genes in 127 MRSA strains.

Conclusion:
The detection of biofilm in S. aureus should be considered as essential for better management of diseases caused by biofilm-producing S. aureus strains.
Evaluation of the Quality of Online Colon Cancer Patient Information in the Arabic Language
Authors: Alnaim Lamya 
Published: November 2022

Background and Study Aims:
With the ever-expanding reach of Internet information, more people than ever are using online searches to obtain medical information, often before consulting a medical professional. This study aims to assess the quality of available Internet information on colon cancer in the Arabic language.

Materials and Methods
A cross-sectional study was performed to assess the quality of Arabic language websites on colon cancer in Arabic using the DISCERN instrument, a validated 16-item questionnaire, and our assessment of the correctness, completeness, and transparency of each website.

Results
A total of 24 websites were identified, of which 12 (50%) were commercial, 9 (37.5%) were university-sponsored, 2 (8.3%) were governmental, and 1 (4.2%) was from a nonprofit organization. The DISCERN instrument had an overall mean score of 42.5 (fair) out of a maximum score of 80, with 50% of commercial websites scoring 41 or below (poor), and only 11% scoring in the good range. Two-thirds (66.7%) of the university-sponsored sites were rated poor, the single nonprofit website scored fair, and the two governmental sites were rated poor. The most accurate topics covered by the websites were surgical treatment, screening, and colonoscopy. Regarding correctness, 94.6% of the websites were accurate in the information provided, while only 55% scored high in completeness, meaning that they provided comprehensive information. Transparency was poor for most websites, with only two providing sufficient information to verify their sources.

Conclusion
This study demonstrated that while people use the Internet to access medical information about colon cancer, much of this information is incomplete in the Arabic language. This raises the question of how much benefit versus harm individuals receive from using websites to learn about colon cancer, and what can be done to improve the information available.