bluuebunny/crossref_metadata_2025_split huggingface dataset:
Persistence of SARS-CoV-2 in COVID-19 patients during the second wave of the pandemic in India
Authors: Das Arghya , Vidyarthi Ashima Jain , Khan Salman , Singh Sheetal , Bala Kiran , Wundavalli LaxmiTej , Agarwal Manali , Ahmed Jaweed , Sehgal Amit , Grover Pragati , Parwez  , Narayan Maitrayee , Das Bharat Chandra , Chauhan Amit , Bhatnagar Sushma , Mohan Anant , Singh Urvashi B. , Chaudhry Rama 
Published: July 2022

Introduction: India witnessed the catastrophic second wave of COVID-19 during the summer months of 2021. Many patients with non-resolution of symptoms admitted to dedicated COVID-19 treatment centers required prolonged inpatient care which led to the unavailability of beds for other COVID-19 patients. The objective of this study was to determine the duration of SARS-CoV-2 positivity in moderate and severe COVID-19 patients requiring long-term pulmonary care as well as to find out the association between different variables with the persistence of the virus.
Methodology: A retrospective chart review of clinical and laboratory data of patients with moderate and severe COVID-19 between 1st April 2021 and 15th July 2021 admitted for more than 28 days and requiring long-term pulmonary care was carried out at National Cancer Institute, AIIMS, India. SARS-CoV-2 RNA was detected with real-time reverse transcriptase-polymerase chain reaction-based tests. Data from all consecutively included patients satisfying the selection criteria were presented temporally and analyzed by Fisher’s exact test (p < 0.05).
Results: All 51 patients tested positive for SARS-CoV-2 RNA at the 5th week of initial laboratory confirmation of COVID-19. The majority of the patients (38; 74.5%) remained positive for viral RNA till the 6th week and the median duration of viral positivity was 45 days. The clinical presentation of SARI at admission was significantly higher among patients with viral persistence till the 6th week (p < 0.05).
Conclusions: The median duration of the viral positivity was 45 days and SARI at admission was significantly associated with viral persistence till the 6th week.
Association of abnormal vaginal microflora and HPV infection in cervical precancerous lesions: a retrospective study
Authors: Yu Huan , Ma Li , Bian Meilu , Li Qian , Liang Haiyan 
Published: July 2022

Introduction: The aim of this study was to analyze the correlation between abnormal vaginal microflora and different types of human papillomavirus (HPV) infection and cervical precancerous lesions during the perimenopausal period.
Methodology: This retrospective study included women patients who underwent liquid-based cytologic test (LBC), HPV test, leucorrhea routine test, or routine urine test at the China-Japan Friendship Hospital between October 2019 and January 2020. A cut-off of 45 years was used as the cut-off age for menopause. The positivity and subtypes of HPV were determined using a chip-based assay. Vaginal microflora was determined using an HB-2012a flow-through hybridization instrument.
Results: A total of 132 patients were included in this study. 97 patients were younger than 45 years of age, with a median age of 35 (8.0), and 35 patients ≥ 45 years of age, with a median age of 55 (11.0). There were no significant differences in cytology, type of cervical lesion, HPV type, and common pathogens of the reproductive tract (all p > 0.05). The multivariable analysis showed that only HPV-16 infection lesions (OR: 2.825, 95% CI: 1.121-7.120, p = 0.028), Chlamydia trachomatis infection (OR: 0.142, 95% CI: 0.024-0.855, p =0.033), and Mycoplasma infection (OR: 7.750, 95% CI: 1.603-37.474, p = 0.011) were independent risk factors for cervical precancerous lesions. The menopausal status (with age < 45 or > 45 years as its surrogate) was not associated with cervical precancerous lesions.
Conclusions: Menopause was not associated with cervical precancerous lesions. The results suggest that the prevention and treatment of HPV-16, Chlamydia trachomatis infection, and Mycoplasma infection could be significant to prevent the occurrence of cervical precancerous lesions.
Molecular epidemiology and antimicrobial resistance patterns of Clostridioides difficile isolates in Algerian hospitals
Authors: Boudjelal Youcef , Krutova Marcela , Djebbar Abla , Sebaihia Mohammed , Bekara Mohammed El Amine , Rouabhia Samir , Couturier Jeanne , Syed-Zaidi Rabab , Barbut Frédéric 
Published: July 2022

Introduction: Clostridioides difficile is a major pathogen responsible for hospital-associated diarrhoea. This study investigated the molecular epidemiology and antibiotic resistance of C. difficile isolates in five Algerian hospitals.
Methodology: Between 2016 and 2019, faecal specimens were collected from in-patients and were cultured for C. difficile. Isolates were characterised by toxin genes detection, Polymerase Chain Reaction (PCR)-ribotyping, Multilocus Sequence Typing (MLST), antimicrobial susceptibility testing against a panel of antibiotics, and screened for antimicrobial resistance genes.
Results: Out of 300 patient stools tested, 18 (6%) were positive for C. difficile by culture, and were found to belong to 11 different ribotypes (RT) and 12 sequence types (ST): RT 085/ST39, FR 248/ST259, FR 111/ST48, RT 017/ST37, RT 014/ST2, RT 014/ST14, FR 247/new ST, RT 005/ST6, RT 029/ST16, RT 039/ST26, RT 056/ST34 and RT 446/ST58. MLST analysis assigned the isolates to two clades, 1 and 4. Clade 4 was more homogeneous, as it mainly included non-toxigenic isolates. Three toxin gene profiles were detected, two toxigenic, A+B+CDT- (33.3%) and A-B+CDT- (11%); and one non-toxigenic, A-B-CDT- (55.5%). All C. difficile isolates were susceptible to metronidazole, vancomycin and moxifloxacin.
Conclusions: Overall prevalence of C. difficile in our healthcare settings was 6%. Antibiotic resistance rates ranged from 72.2% (clindamycin) to 16.6% (tetracycline). This study highlighted a relatively high genetic diversity in term of ribotypes, sequence types, toxin and antibiotic resistance patterns, in the C. difficile isolates. Further larger studies are needed to assess the true extent of C. difficile infections in Algeria.
Fatal invasive candidiasis in COVID-19 patient with severe bleeding and extensively drug-resistant Klebsiella enterobacter
Authors: Adzic-Vukicevic Tatjana , Velickovic Jelena , Radovanovic-Spurnic Aleksandra , Velickovic Dejan , Milenkovic Sara , Petrovic Filip , Micic Jelena , Dragutinovic Natasa 
Published: July 2022

Introduction: Multi-organ dysfunction caused by thromboembolic complications may complicate the course of SARS-CoV-2 infection. Most patients require anticoagulant therapy which predisposes them to the development of hemorrhagic syndrome. In critically ill COVID-19 patients secondary infections due to opportunistic pathogens are associated with a high mortality rate.
Case report: Herein, we present a COVID-19 patient with severe hemorrhage at unusual sites complicated with invasive candidiasis and an extensively drug-resistant (XDR) strain of Klebsiella enterobacter.
Conclusions: Clinicians should be aware of the possibility for invasive fungal infections in severely ill patients with SARS-CoV-2 infection due to pre-existing conditions, risk factors, and COVID-19 associated pathological mechanisms. Management of invasive candidiasis is challenging because of the high prevalence of comorbidities, risk of toxicities, and drug interactions.
In vitro and in vivo bioactivities of Ambrosia maritima and Bituminaria bituminosa organic extracts from Algeria
Authors: Ramli Iman , Zerizer Sakina , Gali Lynda , Sakhri Fatma Zahra , Kabouche Zahia , Usai Donatella , Sechi Leonardo Antonio 
Published: July 2022

Introduction: Two medicinal plants, Ambrosia maritima and Bituminaria bituminosa, growing in Algeria were investigated for their flavonoids content and their biological activities.
Methodology: Different organic extracts were prepared from the aerial parts of each plant using maceration method followed by liquid/liquid type extractions. The anti-antioxidant activity was tested using the β-carotene bleaching method. The anti-inflammatory activity was tested by performing the protein anti-denaturation assay. Acute toxicity and immunostimulatory effect were tested in mice, while the antimicrobial activity was tested according to the minimal inhibition concentration technique.
Results: In term of flavonoids content, ethyl acetate extract of B. bituminosa was the highest (193.39 ± 24.1 µg QE/mg). Ethyl acetate extract of A. maritima showed antioxidant activity with IC50 value of 11.72 ± 0.79 µg/mL. The hydroethanolic extract of A. maritima showed the best anti-denaturation effect in a dose-dependent manner with the IC50 value of 131.07 ± 0.027 µg/mL. The studied plants showed no toxicity or mortality in vivo. Both plants showed a significant immunostimulatory effect; while the Butanolic extract of B. bituminosa demonstrated the best antimicrobial activity against Staphylococcus aureus and Candida albicans strains.
Conclusions: We recommend A. maritima and B. bituminosa as potent sources of antioxidants and as antimicrobial agents for further assays to better elucidate their actions on the immune system.
Les open badges : d’une dynamique de reconnaissance à la mise en pratique de connaissances
Authors: Verquin Savarieau Béatrice 
Published: July 2022

Pratique récente évoquée dans les domaines de l’apprentissage, de la formation et de l’éducation, la pratique des open-badges ou« badges ouverts » contribuerait notamment à la reconnaissance des apprentissages informels et non formels, soient ceux que l’on acquiert au sein d’une organisation de travail et/ou d’une culture professionnelle.Entre logique de reconnaissance des attributs d’une forme de professionnalisation principalement issue de l’expérience, les open-badges constitueraient un attracteur à questionner, symptomatique des changements accélérés du travail et de la formation et du souhait d’une plus grande reconnaissance des compétences issues du domaine de la pratique.
Transformations de soi et professionnalisation par l’écriture d’un mémoire en première personne
Authors: Boutrais Magali 
Published: July 2022

Cette contribution s’intéresse à la manière dont les professionnels se formant dans un master « métiers de l’enseignement, de l’éducation et de la formation » expriment les changements que provoque l’écriture en première personne du mémoire. L’article aborde, en appui sur leurs écrits, les interrelations de cette écriture en « je » avec l’identité professionnelle, la professionnalisation et la transformation de soi de ces adultes issues des domaines du travail social, de la santé et de l’éducation.
Protection de l’environnement et justice conflictuelle : une nouvelle équation pour le droit international privé ?
Authors: Guillard Charlotte 
Published: July 2022

Le contentieux environnemental international est en plein essor. La présente étude propose une analyse des enjeux qui gravitent autour de ces questions fondamentales, sous le prisme de la distinction – traditionnelle chez les internationalistes – entre la justice conflictuelle et la justice matérielle. Que ce soit sur le terrain du conflit de lois ou sur celui de la compétence internationale, le mouvement global de matérialisation qui gagne le droit international privé est très visible en matière environnementale. Or, le phénomène n’est pas anodin : les résultats substantiels portés par les règles de droit international privé, tournés vers la protection de l’environnement, peinent à sa réaliser, tandis que la coordination des ordres juridiques sur ces questions pourtant cruciales est rarement atteinte. En dépit d’une forte volonté politique, force est de constater la stagnation importante de ces contentieux aux questions préalables de droit international privé, au détriment de la réalisation de l’objectif commun de lutte contre les atteintes faites à l’environnement, que s’est fixé la communauté des États. Les ressources de la justice conflictuelle – justice de conciliation, du vivre ensemble – peuvent, dans cette perspective, être utilement exploitées aux fins de promouvoir cet objectif, dont la réalisation est urgente, au regard des défis qu’il sous-tend.
La guerre et la consommation d’alcool. Vestiges archéologiques de la Première Guerre mondiale
Authors: Desfossés Yves 
Published: July 2022

La question de la consommation d’alcool au front durant la Grande Guerre a suscité une littérature abondante et souvent polémique, notamment sur l’alcoolisation et l’abrutissement « organisé » des combattants. Plusieurs ouvrages récents permettent d’aborder côté français le sujet de manière plus distanciée et objective. À l’occasion de fouilles archéologiques, les vestiges liés à la Grande Guerre livrent en assez grandes quantités les témoins de cette consommation « supposée abondante » de boissons alcoolisées. Il n’en faut pas moins garder à l’esprit que les observations faites à l’occasion de ces quelques fouilles ne sont que d’infimes tests sur des secteurs très restreints d’un front qui court sur 700 km. Par le biais de quelques exemples issus de fouilles récentes, cet article est une première approche des problématiques liées à l’étude de la consommation d’alcool sur le front.
Cross-cultural Adaptation of the Begley and Glacken’s Assertiveness Scale for Use Among Sinhala Speaking Nursing Students in Sri Lanka
Authors: Kumara W.G.C. , Warnakulasuriya S.P.P. 
Published: July 2022

Background and Objective: Assertiveness is a crucial skill in the nursing profession to reinforce interprofessional relationships, prevent workplace violence, reduce work stress, improve professional efficacy, develop leadership skills, autonomy and job satisfaction. Assertiveness when inculcated among nursing students will immensely contribute to their professional development and a sustainable career. Since no standard tools are available to measure assertiveness among Sinhala speaking students, this study is aimed to cross-culturally adapt the Sinhala version of Begley and Glacken’s Assertiveness Scale among nursing students in Sri Lanka. Methods: Permission to translate, cross-culturally adapt and use the 28-item Begley and Glackens’ Assertiveness Scale were obtained from its developers. The content and consensual validity of translated version was assessed with a two round Delphi process using five experts and a consensus evaluation. If 70% or more of the ratings for an item are in categories 0-3 the item was removed or reworded. The process was repeated for the reworded items and those were retained if 70% or more of the ratings were in categories 4-6 and /or 7-9. Subsequently, Content Validity Index (CVI) was evaluated using I-CVI, Universal Agreement (S-CVI/UA) and Average CVI (S-CVI/Ave). Finally, the scale’s reliability was evaluated using Cronbach’s alpha in a randomized sample of 140 nursing undergraduates from the University of Colombo. Results: All the items in category 4-6 and 7-9 were retained. Sinhala version of the assertiveness scale showed maximum CVI of all individual items (I-CVI=1.0) and maximum overall CVI (S-CVI/UA = 1.0; S-CVI/Ave = 1.0). The reliability analysis indicated Cronbach’s alpha of 0.753. Conclusions: The Sinhalese version of the Begley and Glacken’s assertiveness scale is a culturally adapted, valid and reliable instrument to measure assertiveness among nursing students.
Public Health Midwives’ Perceptions, Challenges and Attitudes Towards Health Education on Vulvovaginal Discharge
Authors: Ilankoon I.M.P.S. , Goonewardena C.S.E. , Fernandopulle R.C. , Perera P.P.R. 
Published: July 2022

Background and Objective: Public Health Midwife (PHM) is the grass root level health care provider in the Sri Lankan health care system. This study was carried out to assess perceptions, challenges and attitudes of PHMs’ in educating women on vulvovaginal discharge (VVD) and their current health education activities on hygienic practices and behaviour changes among females aged 18 to 49 years. Methods: This cross-sectional study was conducted among all volunteering PHMs who work in the Colombo district, Sri Lanka. A self-developed, content validated, pre-tested, self-administered questionnaire was used to collect data. Descriptive statistics were used to analyse data using SPSS software version 21. Results: A total of 308 PHMs participated and the mean age of the participants was 40 years (SD = 10). Thirty-six percent of the participants had work experience of more than 11 years. Majority of PHMs have performed health education activities during home visits (72.7%) and at clinics (66.2%). Most (97%) agreed that educating females on VVD is one of their primary responsibilities. Majority (70.7%) disagreed that “for most patients, health education does little to promote health-seeking behaviour” indicating positive attitudes towards health education. Nearly 17% of the participants rated their competency in providing health education on VVD as poor. Lack of available time (84.7%), teaching aids (75%) and women’s anxiety and shyness in asking questions or revealing health problems in the community (73.4%) were the major challenges faced during their health education on gynaecological health conditions. Conclusions: The majority of the PHMs had positive attitudes towards health education on VVD. It is recommended that learning opportunities should be created in the form of training programmes. This will help in updating knowledge, skills and attitudes to meet the growing demand for quality health education and referral activities at the community level.
Does Serum Kidney Injury Molecule-1 Predict Early Diabetic Nephropathy
Authors: Balu Divya , Krishnan Vasanthan , Krishnamoorthy Vengadakrishnan , Singh R. B. Sudagar , Narayanasamy Senthil , Ramanathan Gnanasambandan 
Published: July 2022

Introduction:
Diabetic nephropathy (DN) is a multifactorial disease, one of the most common complications of diabetes and a major cause of chronic kidney disease. Kidney injury molecule-1 (KIM-1) is a sensitive and specific marker of kidney injury as well as a predictor of prognosis.

Objective:
The present study aimed to investigate the usefulness of serum KIM-1 as an early marker of DN.

Patients and Methods:
The present study included total 75 participants, among whom 25 nondiabetic participants were chosen as controls. The 50 diabetic participants were divided into two groups according to urine protein/creatinine ratio (UPCR) as participants with normoalbuminuria (T2DM patients without nephropathy) and microalbuminuria (T2DM patients with nephropathy). The complete blood count, blood glucose, HbA1c, serum electrolytes, and creatinine levels were measured using standard laboratory techniques, and serum KIM-1 levels were measured by sandwich enzyme-linked immunosorbent assay.

Results:
There was a significant difference in the mean serum KIM-1 between the control and diabetics without microalbuminuria (P = 0.0001). Patients with longer duration of diabetes had a higher serum KIM-1 values (P = 0.05 in DM without microalbuminuria; P = 0.007 for DM with microalbuminuria). Serum KIM-1 did not correlate with UPCR in controls (P = [FIGURE DASH]0.167), in diabetics with microalbuminuria (P = 0.487). However, there was a significant correlation observed between UPCR and serum KIM-1 in diabetics without microalbuminuria (P = 0.04).

Conclusion:
The present study observed significantly increased levels of serum KIM-1 in both the diabetic groups compared to controls. Moreover, serum KIM-1 positively correlated with the duration of diabetes. Therefore, serum KIM-1 may be used as an early diagnostic marker to predict nephropathy among diabetes in our population.
Dura-to-Spinal Cord Distance at Different Vertebral Levels in Indian Children
Authors: Garg Heena , Kumar Shailendra , Hemachandran Naren , Goel Prabudh , Kandasamy Devasenathipathy , Bajpai Minu , Khanna Puneet 
Published: July 2022

Background:
Neuraxial techniques provide good postoperative analgesia for painful procedures in the pediatric population. However, any injury to the spinal cord can lead to irreversible long-term effects.

Aims:
We aimed to evaluate dura-to-cord (DTC) distance from computerized tomography (CT) images of thoracolumbar spine in pediatric age group (1–16 years) at T8–9, T9–10, and L1–2 interspaces to identify the safe space for epidural insertion in Asian children.

Settings and Design:
It was a retrospective study including 141 children aged 1–16 years who underwent routine CT scan of the thoracolumbar region for unrelated diagnostic indications.

Materials and Methods:
Patients with spinal abnormalities were excluded. Sagittal CT images of the thoracolumbar spine were obtained to calculate the DTC at T8–9, T9–10, and L1–2 interspaces. The measurements at all levels were obtained perpendicular to the long axis of the vertebral body.

Statistical Analysis Used:
Continuous data were depicted as mean with standard deviations. The categorical data were presented as counts with percentages.

Results:
The mean DTC distance at T8–9, T9–10, and L1–2 interspaces was 3.51 ± 0.98 mm (95% confidence interval [CI]: 3.35–3.67), 2.73 ± 0.94 mm (95% CI: 2.57–2.89), and 2.83 ± 1.08 mm (95% CI: 2.66–3.02), respectively. A significant difference was found between the genders at T9–10 (P = 0.02) and L1–2 levels (P = 0.04). No difference in DTC was found in toddlers, preschool children, school-going children, and adolescents. DTC at T8–9 showed a significant correlation with age (R
2 = 0.0479; P = 0.04), weight (R
2 = 0.038; P = 0.02), and height (R
2 = 0.037; P = 0.03).

Conclusion:
Thoracic epidural space can be used in children and adolescents for epidural catheter placement. T8–9 level showed maximum DTC distance and significant correlation with age, height, and weight in CT imaging in the present study.
Effect of Different Doses of Buprenorphine in Combination with Bupivacaine in the Management of Postoperative Analgesia
Authors: Borkotoky Smitirupa , Karan Daisy , Banerjee Swarna , Biswal Prerna , Moda Nupur 
Published: July 2022

Background:
Longer duration of analgesia, ceiling effect on respiratory depression, and the antihyperalgesia property make buprenorphine a good adjuvant for managing moderate-to-severe postoperative pain.

Aims:
The aim of this study is to evaluate the onset and duration of postoperative analgesia of three different doses of buprenorphine of 60, 100, and 150 μg given intrathecally along with hyperbaric bupivacaine in patients undergoing lower limb surgeries.

Setting and Design:
This prospective observational study was carried out in the anesthesia department of a tertiary care hospital.

Materials and Methods:
The study included 90 patients of either sex, aged 18–60 years, scheduled for elective lower limb surgery under subarachnoid block. Patients were randomly allocated into three groups (30 each) receiving different doses of buprenorphine. In addition, all patients received 3 mL of 0.5% hyperbaric bupivacaine.

Statistical Analysis Used:
The Chi-square test or Fisher's exact test was used to find out the association between the categorical variables. The association of quantitative variables between the groups was assessed by Kruskal–Wallis test while within the groups was assessed by repeated-measures analysis of variance test.

Results:
Baseline characteristics such as age, gender, and American Society of Anesthesiologist physical status classification were comparable among the three groups. Sensory block, motor block, and total duration of analgesia were significantly higher with higher doses of buprenorphine. The mean difference in the duration of analgesia was comparable in patients receiving 100 μg (720 min) and 150 μg (825 min) of buprenorphine. Bradycardia as a side effect was only in patients receiving 150 μg of buprenorphine.

Conclusion:
Risk–benefit of different doses of buprenorphine suggests that 100 μg may be the ideal dose for a better quality of spinal block and maintaining hemodynamic stability.