bluuebunny/crossref_metadata_2025 huggingface dataset:
Affiliating Green Futures
Authors: Vinayak Siddhi , Dhaundiyal Chandramauli , Bisht Surender Singh , Dhaundiyal Dhriti
Published: March 2024

This century is currently and will continue to be focused on humanity's efforts in combating the climate crisis in all its manifestations. As different industries evolve and expand to include climate science and climate consciousness in their business practices, the hospitality industry in all its multifaceted persona is also embracing sustainability and climate consciousness across board. This chapter discusses the process, methodology, and findings of a research project that was conducted at a private hospitality education university in India. The research agenda was to study and explore possible livelihood pathways for collaboration that can manifest while sustainably managing food waste at hospitality education colleges. The value of this study lies in further building processes for reducing the waste and carbon footprint of hospitality institutions. The proliferation of hospitality education institutions and the growth of the tourism sector bring the problem further in focus. Waste entrepreneurship collaborations are also discussed.
Visual Communication Design Method in Folk Art Based on Multimedia Data Transmission Technology
Authors: Sun Linran , Kwak Nojun
Published: March 2024

With the rapid development of science and technology and China's economy, the internet, big data, computers, and multimedia technology are widely used in all walks of life to promote the application and improvement of visual communication design concepts, the gradual implementation of multimedia technology, and the continuous improvement of innovation. In this paper, from the multimedia transmission technology based on network coding, some key technologies in the network communication of data and video streams are studied in depth and, based on the transmission-quality assessment model, the working effect of the jitter-buffering algorithm and WebRTC jitter-buffering algorithm is compared in different network environments. The experimental results show that the jitter-buffering algorithm proposed in this paper has better working effect. This research is of great significance for the realization of multimedia transmission technology in next-generation networks.
Applying the National Institute on Minority Health and Health Disparities Research Framework to Social Determinants of Health in the Context of Sport-Related Concussion: A Clinical Commentary
Authors: Ingram Brittany M. , DeFreese J. D. , Kerr Zachary Yukio , Oyesanya Tolu O. , Picha Kelsey J. , Register-Mihalik Johna K.
Published: March 2024

Sport-related concussion (SRC) is a prevalent injury. Significant disparities in SRC outcomes exist across racial and ethnic groups. These disparities may be attributed to the unequal distribution of political power (or influence) and resource allocation in various communities, shaping individuals’ social determinants of health (SDOH). However, the influence of SDOH on SRC outcomes remains understudied. In this clinical commentary, we use the National Institute on Minority Health and Health Disparities Research Framework and describe how its application can help address gaps in our understanding of SDOH and SRC. This framework provides a comprehensive approach to investigating and addressing health disparities by considering SDOH along multiple levels and domains of influence. Using this framework, athletic trainers can identify areas requiring intervention and better understand how SDOH influence SRC outcomes. This understanding can help athletic trainers develop tailored interventions to promote equitable care for patients with SRC.
Athletic Trainers’ Beliefs Regarding Professionalism
Authors: Mansell Jamie L. , Moffit Dani M. , Miller Sydnee , Burns Scott , Neil Elizabeth R.
Published: March 2024

Context

Limited research exists regarding athletic trainers’ (ATs’) perceptions of professionalism.

Objective

To explore the lived experiences of ATs and their perceptions of professionalism.

Design

Qualitative study.

Setting

Participants were ATs who completed a semistructured interview protocol via audio-only recording conferencing.

Patients or Other Participants

Seventeen participants (age = 33 ± 8 years; range = 25–56 years) who were certified ATs with an average of 10 years of experience (SD = ±8; range = 1–33 years) were interviewed.

Data Collection and Analysis

Individuals self-identified their interest in participating in a follow-up interview recruitment located within a survey. Interviews occurred until saturation was met and included a variety of participants. Demographic information was gathered from the survey for each person. All transcripts were audio recorded, transcribed verbatim, and coded using a 3-person coding team following the consensual qualitative research protocol. Member checking, auditing, and triangulation established trustworthiness and credibility in the data-analysis process.

Results

A total of 4 domains with supporting categories were identified. Athletic trainers spoke of the employee environment that affected perceptions of what was determined to be professional, specifically in various settings or situations. They shared their personal determination of outward appearance and expression when differentiating what was deemed professional, including references to cleanliness, judgment of self-expression, and implicit bias. Whether intentional or unintentional, participants made comments that demonstrated a bias toward sex or race and ethnicity when determining outward appearance appropriateness. They noted various cultural awareness situations, including progression of perceptions over time, external pressure, and internal dialog. Respondents shared discourse regarding an internal struggle of what was right and wrong in their responses. They discussed professionalism based on the provider’s conduct, mainly in terms of communication and patient care. Participants shared that communication occurring through both verbal and nonverbal means is vital to the perceptions of professionalism for ATs.

Conclusions

Current views of professionalism in athletic training were shaped by various lived experiences. With the movement toward athletic training becoming more diverse, equitable, and inclusive, antiquated professionalism ideals need to shift to provide a better work environment for all.
Introduction et sommaire
Authors: Pehrsson S J , Wodicka N , Percival J
A , Rogers N
Published: March 2024

The Geo-mapping for Energy and Minerals (GEM) program was funded between 2008 and 2020 with the aim of advancing geological knowledge of the North to reduce risk for mineral exploration and inform land-use decisions and future management of the North. Twenty-one
regional activities were undertaken across Canada's northern shield, spanning northern Prairie Provinces, northern Quebec, Labrador, along with much of Nunavut and Northwest Territories. A further five activities were thematic in nature. Bulletin 612 presents results from 12 of these endeavours,
including integrated regional bedrock geoscience studies, geophysical surveys, and basin analyses, as well as thematic thermochronology, geochemistry and large igneous province syntheses. The results highlight that GEM has contributed to new era of understanding of the northern Canadian Shield,
expanding its framework substantially and developing an increasingly complex model of Archean cratons, Archean/Proterozoic microcontinents, and juvenile Paleoproterozoic crust that highlights the existence of a dozen new pericratonic to exotic ribbon microcontinents within a mosaic once considered
as mostly large cratonic masses welded by Paleoproterozoic orogens. This emerging picture brings additional questions for future northern studies - particularly in the granularity of subdivision of the largest blocks, the impact of enigmatic earliest Paleoproterozoic orogens, and dynamics of
assembly of exotic and little-known terranes.
Paleoproterozoic dyke swarms and large igneous provinces of northern Canada and their use in understanding extension, rifting, and paleocontinental reconstructions
Authors: Buchan K L , Ernst R E
Published: March 2024

Giant mafic dyke swarms and related large igneous provinces play an important role in the understanding of the tectonic evolution of ancient continents and supercontinents. The information available for well dated Paleoproterozoic dyke swarms and large igneous
provinces in northern Canada is summarized in this synthesis, with an emphasis on their age, geographic distribution, paleomagnetism, and potential linkages to coeval magmatic events. Their tectonic settings, with a focus on links to rifting and continental breakup, are also discussed. Finally, the
use of giant dyke swarms and large igneous provinces for testing paleocontinental reconstructions is considered, based mainly on paleomagnetism or on matching coeval magmatic events or sequences of magmatic events (magmatic barcoding) between cratons.
Thermochronological history of the northern Canadian Shield: a synthesis
Authors: Kellett D , Pehrsson S , Skipton D , Regis D , Camacho A , Schneider D , Berman R
Published: March 2024

This contribution examines the current state of knowledge regarding the postmetamorphic cooling of most Archean to Paleoproterozoic tectonic elements of the northern Canadian Shield. This was achieved by building an extensive data set of over 2000 combined K-Ar
and 40Ar/39Ar cooling ages. The Churchill Province (amalgamated Rae and Hearne cratons) shows a general west to east cooling pattern illustrated by two large-scale thermochronological profiles.
Impact of low-intensity extracorporeal shockwave therapy on vascular parameters and sexual function in patients with arteriogenic erectile dysfunction
Authors: Rubino Matteo , Ricapito Anna , Finati Marco , Falagario Ugo G , Annese Pasquale , Mancini Vito , Busetto Gian Maria , Cormio Luigi , Carrieri Giuseppe , Bettocchi Carlo
Published: March 2024

Previous published studies have shown an improvement of penile hemodynamic parameters after low-intensity extracorporeal shockwave therapy (Li-ESWT). However, the clinical significance of these findings remains unclear, and definitive selection criteria for Li-ESWT based on preexisting comorbidities have yet to be established. This was an observational study of 113 patients with ED, evaluated between January 2019 and December 2021 in Andrology Unit at the Department of Urology and Renal Transplantation, University of Foggia (Foggia, Italy). Penile dynamic Doppler was performed to evaluate vascular parameters and 5-item version of the International Index of Erectile Dysfunction (IIEF-5) questionnaire was administered to assess the severity of ED. This was repeated 1 month after treatment. Patients with a peak systolic velocity (PSV) <30 cm s−1 were considered eligible for Li-ESWT. Our protocol consisted of 8 weekly sessions with 1500 strokes distributed in 5 different locations along the penis. After treatment, a significant mean (±standard deviation [s.d.]) PSV increase of 5.0 (±3.4) cm s−1 was recorded and 52/113 (46.0%) patients reached a PSV >30 cm s−1 at posttherapeutic penile dynamic Doppler. A clinically significant IIEF-5 score improvement was observed in 7 patients, 21 patients, and 2 patients with mild-to-moderate, moderate, and severe pretreatment ED, respectively. No different outcomes were assessed based on smoking habits, previous pelvic surgery, or use of oral phosphodiesterase-5 inhibitor (PDE5i). On the other side, only 1 (6.7%) in 15 patients with diabetes mellitus showed an IIEF-5 score improvement after Li-ESWT. Shockwave treatment determined a significant increase in PSV and correlated IIEF-5 improvement in ED patients. This advantage seemed particularly evident for moderate ED and was not affected by smoking habits, previous pelvic surgery, and use of PDE5i. Conversely, diabetic patients did not benefit from the treatment.
Nutritional Status of Tribal Under-Five Children in a Community Development Block of Birbhum District, West Bengal
Authors: Goswami Prosun , Chakraborty Amitava , Mitra Kaushik , Das Dilip Kumar , Ray Soumalya
Published: March 2024

Introduction:

One of the essential components for maintaining health is having proper and adequate nutrition. The absence of this might affect majorly the physical domain of health, especially in under-five children as it is the age of development. The present study was conducted among the tribal under-five children in a tribal predominant block, Mohammad Bazar in Birbhum District of West Bengal to find out their nutritional status, along with the estimation of prevalence of anemia among them; and the association, if any, between the nutritional status of the study population with their demographic, socioeconomic, and environmental characteristics.

Materials and Methods:

This community-based cross-sectional study was conducted among 378 tribal under-five children residing in 21 villages of Mohammad Bazar Block during September 2018–August 2020 using Lot Quality Assurance Sampling (LQAS) technique. A predesigned, pretested schedule was used to collect necessary information regarding background characteristics. Anthropometric measurements (height and weight) and biochemical estimation (hemoglobin level in blood) were done to evaluate nutritional status. Ethical permission was obtained from Institutional Ethics Committee, Burdwan Medical College. Data were analyzed using the Statistical Package for the Social Sciences, version 20.

Results:

The present study showed that 31.0% of under-five children were underweight, 16.6% severely underweight, 31.5% stunted, 17.2% severely stunted, 21.7% wasted, and 7.7% severely wasted. Nearly one-third of the study participants were suffering from anemia and most of them (91.5%) had mild anemia. As per LQAS, none of the villages had acceptable nutritional status as far as the weight for age and height for age was concerned.

Conclusions:

This research unveiled that the undernutrition in various forms still persists among the tribal under-five children. Rigorous implementation of various schemes, missions, and programs by both state and Central Government are the need of the hour to overcome this downhearted situation.
Role of Hematological and Inflammatory Markers in Early Diagnosis and Severity of COVID-19 Disease
Authors: Awasthi Seema , Mittal Ankita , Singh Vivek , Kumar Ashutosh , Ahmad Faiyaz , Sharma Nilisha
Published: March 2024

Background:

COVID-19 virus, causing severe acute respiratory illness (SARS-CoV-2), was declared as a pandemic by the WHO in March 2020, after its first outbreak in China at the end of 2019. The major purpose is to establish the role of a hematological and inflammatory markers in early diagnosis of COVID-19 illness and its relationship with the disease severity.

Materials and Methods:

The study was performed in a tertiary care center from April to September 2020. The study included 150 hospitalized COVID-19 Reverse transcription-polymerase chain reaction positive patients. According to ICMR standards, research patients were grouped into mild, moderate, and severe categories depending on clinical evaluation. Different laboratory parameters complete blood counts, prothrombin time (PT), activated partial thromboplastin time (APTT), d-dimer, serum ferritin, C-reactive protein (CRP), and mean results are compared among the patient in three disease severity groups.

Results:

In the studied population, there were 106 (70.7%) males and 44 (29.3%) females. The average age of the research participants was 48.40 ± 11.50 (21–75 years), with majority of patients being old (>60 years). Hematological markers such as total leukocyte count, Neutrophil-to-lymphocyte ratio (NLR), and platelet lymphocyte ratio (PLR) and the levels of PT, APTT, and D-dimer, as well as ferritin and CRP, all were considerably high with different groups of disease severity (P = 0.001).

Conclusion:

The study concluded that patients of severe disease category have significantly higher levels of leukocytosis, neutrophilia, elevated NLR, PLR, PT, APTT, D-dimer, serum ferritin, and CRP. Hematological and coagulation symptoms are associated with COVID-19 illness, and these indicators might be employed as a prognosticator for prediction of early disease severity.
Comparison of the Locoregional Outcome, Toxicities, and Compliance between Hypofractionated and Conventional Chemoradiotherapy for Head-and-Neck Cancers
Authors: Sharma Jyoti , Loyal Anushree , Dhal Shikha , Goyal Sumit , Kapoor Tapan , Rajendra Ishitaa , Singh D. P.
Published: March 2024

Introduction:

Head-and-neck cancer (HNC) treatments are elusive, and the hunt for an appropriate radiation strategy continues. Hypofractionation has the potential to provide several advantages, including a shorter overall duration that reduces rapid repopulation, dosage escalation with a higher biologically effective dose, and patient convenience. Hypofractionation is also beneficial in minimizing the danger of catching an infectious agent by reducing the number of hospital visits during the height of the COVID-19 epidemic.

Materials and Methods:

Between January 2020 and August 2021, 120 patients with squamous cell carcinoma of the head-and-neck subsites were randomly allocated to either the hypofractionated arm A (n = 60) or the standard fractionation arm B (n = 60) with concomitant treatment.

Results:

Locoregional tumor response, acute and late toxicity, and compliance were the study's endpoints. The normal tissue toxicities of each patient undergoing radiation were monitored weekly. Clinical and radiographic evaluations of locoregional control were conducted.

Conclusion:

Hypofractionation effectively overcomes tumor repopulation in rapidly growing tumors such as HNC, and we conclude in our study that the hypofractionated chemoradiation schedule appears to be more efficacious, with relatively superior locoregional control when compared to conventional chemoradiation with comparable normal tissue toxicities and compliance.
Ki-67 Expression in Oral Potential Malignant and Malignant Lesions and Correlation of Mitotic Index with MIB-1 Labeling Index
Authors: Mittal Ankita , Awasthi Seema , Chauhan Rashmi , Ahmad Faiyaz , Kumar Ashutosh , Mitra Nishant
Published: March 2024

Introduction:

Oral cancers are the most serious health issues in underdeveloped countries such as India and considered as the main cause of death. Among them, oral squamous cell carcinoma is the most common type (90%) of all malignancies. Various oral potential malignant lesions (OPMLs) can transform into malignancies. This study was conducted to determine the significance of Ki-67 expression in oral potential malignant and malignant lesions (MLs) as well as correlation of mitotic index (MI) with MIB-1 labeling index (LI) in these lesions.

Materials and Methods:

The study was performed on 60 cases in a tertiary care center over a period of 2 years. Ki-67 expression, MI and MIB-1 LI were calculated and correlated.

Results:

In the studied population, there were 49 (81.7%) males and 11 (18.3%) females. The mean age was 46.60 ± 9.94 (23–68 years), with majority of patients in 41–60 years of age group (46/60 cases). Anterior 2/3rd tongue is the most affected site, presented ulcer as the most common lesion. Smoking, tobacco, and betel nutchewing addiction were presented in 72% of the patients. Among 60 cases, 45 (75%) were OPMLs, while 15 (25%) cases were MLs. MI increases in OPMLs and MLs and comparison was significant (P < 0.01). MIB-1 LI was significant (P < 0.01) on comparison to dysplasia III and MLs. A positive correlation (0.01) was established between MI and MIB-1 LI of OPMLs and MLs.

Conclusion:

Ki-67 expression was found correlated with the progression of disease from OPMLs to MLs. Therefore, it is considered a proliferative marker that corresponds with disease progression. Both proliferative indices (MI and MIB-1 LI) are positively correlated.
Estimation of plasma soluble interleukin-2 receptor alpha chain level in adults with acute myeloid leukemia
Authors: Abd-Alabass Yusur Zaher , Mohammed Najlaa Bader
Published: March 2024

BACKGROUND:

Acute myeloid leukemia (AML) is a clonal malignant condition of immature hematopoietic cells, characterized by clonal proliferation of abnormal cells (blasts) in the marrow leading to impairment of the normal blood cell production giving rise to failure of the bone marrow. Soluble interleukin-2 (IL-2) receptor alpha chain is a protein that is involved in the assembly of the high-affinity IL-2 receptor, and it has a critical role in controlling immune system homeostasis. The overexpression of sIL-2RA was investigated in many hematopoietic malignancies, and it was correlated with poor outcome.

OJECTIVES:

The aim of this study was to assess the sIL-2RA level as a prognostic factor and assess its impact on survival and if it can be used as a targeted treatment for a better outcome.

MATERIALS AND METHODS:

Sixty newly diagnosed adults with AML before starting therapy were included in the study, and they were followed up for 6 months to document survival status. Thirty healthy adults were taken as a control group. Using an enzyme-linked immunosorbent assay, the plasma sIL-2RA level was measured. Statistical analysis was done using Microsoft Excel 2019 and version 26 SPSS statistical software.P<0.05 was considered statistically significant.

RESULTS:

A considerable difference in the plasma sIL-2RA level between AML patients and controls also was more elevated in patients who died after 6-month follow-up. According to the blast percentage, total white blood cell count, and M0-M2 subgroups, the sIL-2RA level correlated positively. Irrelevant association was found regarding the patients’ age, the count of platelet, and the hemoglobin.

CONCLUSIONS:

Plasma sIL-2RA level is higher in AML patients than the control group at the time of diagnosis. Patients with a high level of plasma sIL-2RA have an inferior (overall survival) and poor outcome. SIL-2RA level is higher in M0-M2 subgroups than other subtypes. There is a significant association between sIL-2RA level and the absolute count of leukemic blasts.
A comparison of the shear bond strength of orthodontic brackets bonded after enamel conditioning with sodium hypochlorite and papain gel
Authors: Fathima Ferin , Shantaraj Ravi , Pradeep Subbaiah , Rajashekar Dhakshaini Mysore , Kumar I. Girish
Published: March 2024

Objectives:

The objective of this research was to evaluate the effect of conditioning the enamel surface with 10% papain gel and 5.25% sodium hypochlorite (NaOCl) on the shear bond strength (SBS) of orthodontic brackets and correlate it with the conventional bonding mechanism utilizing a universal testing machine.

Materials and Methods:

Ninety extracted human premolars divided into three groups: In Group 1, treatment with 5.25% NaOCl for 60 s on enamel surface followed by etchant and primer application. In Group 2, treatment with 10% Papain gel for 40 s followed by etching and primer application. In Group 3, etching was followed by primer application. A universal testing machine was used to record the SBS of the orthodontic brackets.

Results:

About 5.25% NaOCl (15.10 ± 2.66) and 10% papain gel (15.66 ± 2.83) treatment on enamel before acid etching when compared to the control group (12.82 ± 2.03) increased the SBS with a statistically significant difference between them (P = 0.002, P < 0.001). The experimental groups, NaOCl (15.10 ± 2.66) and papain gel (15.66 ± 2.83) group, were comparable but did not show any statistically significant difference between them (P = 0.665).

Conclusion:

SBS of orthodontic brackets can be significantly increased if the enamel is deproteinized with 5.25% NaOCl and 10% papain gel before acid etching with 37% phosphoric acid compared to the conventional bonding technique. Deproteinizing enamel can be considered a cost-effective ally to increase orthodontic brackets' bond strength and thereby reduce the duration of orthodontic treatment.
Glycated hemoglobin as surrogate indicator of dyslipidemias and impending complications in type 2 diabetes patients
Authors: Kumar Sumit , Agarwal Vijender Kumar
Published: March 2024

Introduction:

Prevention of long-term complex metabolic complications of type 2 diabetes mellitus (T2DM) can be achieved by good glycemic control. Different studies have highlighted several biomarkers and their connection with T2D risk and glycated hemoglobin (HbA1c) level is now universally accepted as the most reliable indicator of long-term glycemic control. However, few of them have explored the interconnection of these biomarkers as well as the prospective alterations in the diabetes biomarker correlation between diabetes, blood biochemical markers, age, and body mass index (BMI). Diabetes and dyslipidemia commonly coexist and dyslipidemia is a major risk factor for cardiovascular, neurological, and eye complications but there is a lack of evidence on the pattern of dyslipidemia and whether Hb1Ac level is related with serum lipid profile in T2DM patients.

Aim:

To determine a multi-level approach to establish a relationship between mean Hb1Ac level in the study and correlate its association with the serum lipid profile, age, BMI, and neurological complications in T2DM patients.

Materials and Methods:

A total of 105 T2DM patients with a mean age of 54.1 ± 10.08 years were included in this cross-sectional study. The whole blood and sera were analyzed for fasting blood sugar, HbA1c, total cholesterol, triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), low-DL-C (LDL-C), and very LDL-C (VLDL-C). Neurological assessment done by simple screening methods including the 10 g monofilament and the 128-Hz tuning fork test for the detection of early neuropathies. The correlation of HbA1c with the lipid ratios and individual lipid indexes was done by Pearson correlation test (r) using SPSS version 28.0 software.

Results:

Mean Hb1Ac level was 7.36 ± 1.78 which was abnormal in 61.9% of the total enrolled diabetic patients. Mixed dyslipidemias were common with abnormal TG, LDL and VLDL values followed by abnormal HDL-C values in 83.8% of the total enrolled diabetic patients. The Hb1Ac levels showed significant positive correlation with serum cholesterol, TG, LDL and VLDL levels but showed statistically significant negative correlation with serum HDL levels in the study. Duration of diabetes and Hb1Ac values also showed positive correlation with ophthalmological and neurological complications at presentation in the study.

Conclusion:

Apart from a reliable indicator of long-term glycemic control, HbA1c can also be used as a predictor of dyslipidemia and early diagnosis of dyslipidemia can prevent cardiovascular neurological and eye complications in T2D patients.
A clinicopathological study of lupus nephritis based on the international society of nephrology-renal pathology society 2018 classification system
Authors: Charaya Payal , Solanki Ranjana , Hemrajani Deepika , Agnani Bhawna
Published: March 2024

Background:

Lupus nephritis is one of the most frequent and severe manifestations of systemic lupus erythematosus. The histological class of lupus nephritis, the degree of activity, and chronicity are major determinants of treatment and prognosis. Revised ISN/RPS classification 2018 is designed to improve problematic definitions that form the basis of lupus nephritis classification by using an evidence-based approach by refining definitions for lesions and thereby increasing the interobserver agreement between nephropathologists.

Objective:

To evaluate the clinical and histopathological profile of lupus nephritis as per Revised ISN/RPS guidelines 2018.

Materials and Methods:

Sixty-one patients with the clinical diagnosis of lupus nephritis who underwent renal biopsy were studied. Light microscopy and immunofluorescence study performed. Parametric tests such as the unpaired T-test and Pierson correlation test were used for the analysis of linear variables.

Results:

Out of 61, 49 patients were designated class as per revised International Society of Nephrology-Renal Pathology society guidelines and 12 biopsies were found suboptimal for class evaluation. There was a female preponderance (54/61) with most patients within the first two decades. Class IV was found to be the most common class. Most patients presented with generalized swelling/edema and fever. Anemia and proteinuria showed a significant correlation (p < 0.05) with class.

Conclusion:

The key to improving renal outcomes is early detection of the lesion by proper assessment of renal biopsy. It also aids in the formulation of a treatment plan according to class. However, clinical parameters can be used while following up with the patients for disease activity.
Perception and reflections of second year medical students on attitude, ethics, and communication skills module on patient autonomy and decision making in a tertiary care teaching hospital
Authors: Kamath Latha , Chakraborty Ananya , Asanaliyar Meharban
Published: March 2024

Background:

Attitude, ethics, and communication (AETCOM) module is a new inclusion in the current medical curriculum. It is designed to improve the competence levels of undergraduate medical students with regard to their communication skills, demonstration of empathy, and resolution of ethical dilemmas. This study aims to assess the student’s perspective and reflections on the AETCOM module conducted by the pharmacology department.

Methods:

This was a cross-sectional observational study conducted for1 month involving 2nd year medical students of Vydehi Institute of Medical Sciences and Research Centre. An internally validated questionnaire was used to assess student’s perspective on the AETCOM module. Student’s reflections were obtained from their logbook entry. The data obtained were analyzed in Microsoft Excel.

Results:

The mean score for overall benefit of the AETCOM module for all participants (n = 163) was 4.1 out of 5. In our study, 85.3% of students agreed that the AETCOM module helped them to understand about sociocultural, ethical, and medico-legal aspects related to case scenarios. About 89.6% of students found panel discussion to be effective tool to understand case scenarios better. About 88.3% of students agreed that the inclusion of module in the curriculum was good. The mean score for reflections for students was 6.2 on 10.

Conclusions:

Our analysis of student’s perspective and reflection about the AETCOM module showed that students understood about patient autonomy and decision-making better when case scenarios, role-play and panel discussion were used to teach them the module. Inclusion of the module into the regular curriculum increases the student’s participation and awareness regarding different clinical scenarios and equips them in a better way for future clinical practice.
Assessment of depression and suicidal risk in patients with psoriasis
Authors: Dey Pranjal , Zaman Rezib Uz , Nath Jyoti
Published: March 2024

Background:

Psoriasis is one of the common psychosomatic illnesses which have impairment of physical, psychological, social functioning of an individual. This impairment may lead to psychiatric morbidities such as anxiety disorders and depressive disorder which increase the suicidal risk in these patients. The present hospital-based comparative study was carried out to evaluate the depression and suicidal risk in patients with psoriasis and to compare them with healthy control.

Methods:

This was a hospital-based cross-sectional study. Fifty patients with psoriasis were enrolled for the study after their informed consent with purposive sampling method from the department of dermatology in a tertiary care hospital in the northeastern part of India and compared them with those of the control group. The severity of psoriasis was assessed using the Psoriasis Area and Severity Index scale. The same patients were evaluated by the International Classification of Mental and Behavioral Disorders tenth revision research criteria along with the Hamilton Rating Scale for Depression and suicidal risk assessment form to diagnose and grade depression and assess for suicidal risk. Data were analyzed in SPSS version 16.0.

Results:

The incidence of depression was significantly higher in the psoriasis patient group (44%) in comparison to the control group. Among them, 50% of the depressed patients had mild depression and 31.9% of the patients had very severe depression with death wish with suicidal ideation. Furthermore, 4.6% of the depressed patients have a high risk of suicide.

Conclusions:

These findings indicate the need of early recognition of depression and suicidal risk among these patients and their early intervention will improve the primary disease process and will prevent a devastating outcome like suicide.
Elevated circulating levels of matrix metalloproteinase-9 and its association with cardiovascular risk in young smokers
Authors: Nath Dinesh , Shivasekar Meera , Vinodhini V. M.
Published: March 2024

Background:

Smoking causes cardiovascular risk which may alter the stability between the production and degradation of the extracellular matrix. Matrix metalloproteinase-9 (MMP-9) is a zinc-containing endopeptidase that degrades extracellular matrix and plays a vital role in tissue remodeling. As a result, elevated serum MMP-9 levels produced by smoking, particularly in younger age, raise the risk of future coronary heart disease (CHD).

Aim and Objective:

Our aim is to find out the possible relationship between circulating MMP-9 and the risk of cardiovascular disease in young smokers.

Materials and Methods:

The study contains three groups. Group 1 includes 60 young active smokers with diabetic CHD, Group 2 includes 60 young active smokers with CHD, and Group 3 includes 60 healthy controls as nonsmokers who were attending SRM Medical College Hospital in Tamil Nadu for cardiology and medicine OP. Enzyme-linked immune sorbent assay was used to measure serum MMP-9, high-sensitivity C-reactive protein (hsCRP), and apolipoprotein E (APO-E) levels, and enzymatic techniques were employed to quantify lipid levels.

Results:

When compared to the controls, the mean serum MMP-9, hsCRP, and APO-E levels were significantly higher in both the groups. The study also shows a significant positive association between MMP-9 with hsCRP, APO-E, smoking burden, and smoking intensity.

Conclusion:

The study concludes that increased MMP-9 levels, particularly in inflammatory conditions caused by smoking, are associated with an increased risk of future cardiovascular disease.
Myotonic Dystrophy Type 1 (DM1): Clinical Characteristics and Disease Progression in a Large Cohort
Authors: Chawla Tanushree , Reddy Nishanth , Jankar Rahul , Vengalil Seena , Polavarapu Kiran , Arunachal Gautham , Preethish-Kumar Veeramani , Nashi Saraswati , Bardhan Mainak , Rajeshwaran Jamuna , Afsar Mohammad , Warrier Manjusha , Thomas Priya T , Thennarasu Kandavel , Nalini Atchayaram
Published: March 2024

Background:

DM1 is a multisystem disorder caused by expansion of a CTG triplet repeat in the 3’ non-coding region of DMPK. Neuropsychological consequences and sleep abnormalities are important associations in DM1.

Objective:

To describe the clinical phenotype, disease progression and characterize the sleep alterations and cognitive abnormalities in a sub-set of patients.

Materials and Methods:

A retrospective study on 120 genetically confirmed DM1 cases. Findings in neuropsychological assessment and multiple sleep questionnaires were compared with 14 age and sex matched healthy individuals. All 120 patients were contacted through letters/telephonic consultation/hospital visits to record their latest physical and functional disabilities.

Results:

The mean age at symptom onset was 23.1 ± 11.4 years, M: F = 3.8:1, mean duration of illness = 14.3 ± 9.5 years. Clinically 54.2% had adult onset form, juvenile = 27.5%, infantile = 10.8%, late adult onset = 7.5%. Paternal transmission occurred more frequently. The predominant initial symptoms were myotonia (37.5%), hand weakness (21.7%), lower limb weakness (23.3%) and bulbar (10%). Twenty patients completed sleep questionnaires (SQ). Abnormal scores were noted in Epworth sleepiness scale (55%); Pittsburgh sleep quality index (45%); Berlin SQ (30%); Rapid eye movement sleep Behaviour Disorder SQ (15%); Restless leg syndrome rating scale (10%). Neuropsychological assessment of 20 patients revealed frontal executive dysfunction, attention impairment and visuospatial dysfunction. Frontal lobe was most affected (72%) followed by parietal (16%) and temporal lobe (12%).

Conclusions:

The current study provides a comprehensive account of the clinical characteristics in Indian patients with DM1. Hypersomnolence was most commonly seen. Excessive daytime sleepiness and Sleep disordered breathing were the most common sleep related abnormality. Cognitive impairment comprised predominantly of frontal lobe dysfunction.
Sexual Dysfunction after Clipping of Ruptured Intracranial Aneurysms
Authors: Tripathi Manjul , Wankhade Lomesh , Mohindra Sandeep , Kumar Santosh , Chauhan Rajeev
Published: March 2024

Background:

Sexual dysfunction significantly affects interpersonal relationships and overall quality of life. It remains a matter of concern for risk assessment and counseling in patients with ruptured intracranial aneurysms.

Objective:

To assess the sexual dysfunctions in patients undergoing clipping for ruptured intracranial aneurysms and comparative evaluation among different anterior circulation aneurysms.

Method:

We prospectively included 40 male patients of ruptured intracranial aneurysms of anterior circulation (age range: 20–60 years; sexually active preoperatively), managed with craniotomy and clipping. We evaluated the sexual outcome in patients with excellent Glasgow outcome score (GOS) five at a minimum one year of follow-up. Patients with GOS-5 status at follow-up were broadly classified into two groups: Anterior communicating artery aneurysm (Acom), and non-Acom) aneurysms. We valued sexual outcome with Subjective Sexual Arousal Scale for Men at follow-up, and compared in the two groups.

Results:

Mean age of patients was 44.78 ± 9.51 years. Besides 20 Acom aneurysms, other groups included 11 middle cerebral artery aneurysms, five internal carotid artery aneurysms, three posterior communicating artery aneurysms, and one distal anterior cerebral artery aneurysm. The mean follow-up was 24.45 ± 13.58 months. Patients with non-Acom aneurysms had an overall better outcome in the sexual performance domain “P = 0.015,” mental satisfaction domain “P = 0.009,” and sexual assertiveness domain “P = 0.007.” However, there was no statistical difference in partner communication domain “P = 0.593,” and partner relationship domain “P = 0.378.” Overall, the sexual outcome was inferior in patients treated for Acom aneurysms compared to other anterior circulation aneurysms.

Conclusions:

In cases of aneurysmal subarachnoid hemorrhage, sexual dysfunctions are common even after good clinical outcomes. The study revealed prominent differences in outcomes on the sexual quality of life in patients harboring Acom aneurysms as compared to anterior circulation aneurysms located off-midline.
Delineating the Spectrum of Pituitary Adenoma Based on the WHO 2017 Classification
Authors: Paramita Paul , Shilpa Rao , Nandeesh B N , Yasha T C , Vani Santosh
Published: March 2024

Background:

The WHO 2017 classification of endocrine tumors incorporates lineage-specific transcription factors (TF) and hormone expression for the classification of pituitary adenoma (PA). There is paucity of reports describing the spectrum of PA based on this classification.

Objective:

The aim of this study was to delineate the spectrum of PA based on WHO 2017 classification of endocrine tumors.

Materials and Methods:

PA diagnosed in the year 2018 were studied. H and E and hormonal immunohistochemistry (IHC) for GH, PRL, ACTH, TSH, FSH, LH, CK, T-Pit and MIB-1 were performed and the results were analyzed.

Results:

The cohort included 88 cases. M: F ratio was 2:1. Clinically, 22 (25%) were functional and 66 (75%) were non-functional adenomas. Amongst the clinically functional adenomas, GH secreting adenomas were the commonest (68%). Majority (83%) of non-functional adenomas were hormone positive with gonadotroph adenomas being the commonest (72.7%). Eleven (12.5%) PA were clinically and hormonally silent. Three of these showed intense nuclear T-Pit positivity, classifying them under silent corticotroph adenoma. Lineage of the remaining eight adenomas remained undetermined, since, IHC for Pit-1 and SF-1 was not performed. The aggressive adenomas identified by IHC included sparsely granulated somatotroph adenoma, Crooke cell adenoma, silent corticotroph adenoma, densely granulated lactotroph adenoma in men and constituted 17% of the PA. Four (4/88) cases were clinically invasive.

Conclusion:

A large majority of PA including aggressive adenomas can be identified by IHC. Addition of T-Pit helped to identify silent corticotroph adenoma. Pit -1 and SF-1 TF would help identify plurihormonal Pit-1 PA and null cell adenomas.
IgG4-Related Neurological Disease: A Single Center Ambispective Study from South India
Authors: Reddy Y Muralidhar , Parida Subhendu , Pidaparthi Lalitha , Jaiswal Shyam Kumar , Tourani Vijaya , Osman Syed , Kumar B Santosh , Murthy Jagarlapudi M K
Published: March 2024

IgG4-related disease (IgG4-RD) is an immune-mediated multi-system disorder. The nervous system (IgG4-RND) is rarely affected. We describe a short case series. We performed an ambispective analysis of IgG4-RND patients admitted at our centre between January 2016 and December 2022. Eight patients (M: F-2:6) were included with a mean age at presentation of 40.63 ± 17.88 years and disease duration of 5.16 ± 4.08 years. The common diseased sites were pachymeninges (7), orbits (4), paranasal sinuses (3), frontal lobe (1), hypophysis (1), leptomeninges (1), and middle ear (1). Common symptoms were headache and cranial neuropathy. The common nerves involved were the optic nerve, followed by the third, fifth, sixth, and seventh. Cerebrospinal fluid showed lymphocytic pleocytosis. Histopathology showed lymphoplasmacytic infiltrate (8), fibrosis (5), >10 IgG4 + cells (7), and IgG4/IgG >40% (6). Six had a relapsing course. The rituximab-based treatment regimen showed a favourable response.
Exercise Reverses Immune-Related Genes in the Hippocampus of Multiple Sclerosis Patients
Authors: Qiu Jiaying , Gu Jiajia , Chang Shiyi , Zhang Zhenyu , Zhang Haibo , Liu Tianqing , Jie Jing , Wei Jinhuan
Published: March 2024

Background:

Multiple sclerosis (MS) is an autoimmune disease characterized by inflammatory demyelinating lesions in the white matter of the central nervous system. Studies have shown that exercise is beneficial for multiple sclerosis (MS). However, the molecular basis is largely unknown.

Materials and Methods:

We integrated multiple blood and hippocampus transcriptome data from subjects with physical activity or MS. Transcription change associations between physical activity and MS were analyzed with bioinformatic methods including GSEA (Gene Set Enrichment Analysis) and GO (Gene Ontology) analysis.

Results:

We find that exercise can specifically reverse immune-related genes in the hippocampus of MS patients, while this effect is not observable in blood. Moreover, many of these reversed genes encode immune-related receptors. Interestingly, higher levels of physical activity have more pronounced effects on the reversal of MS-related transcripts.

Conclusions:

The immune-response related genes or pathways in the hippocampus may be the targets of exercise in alleviating MS conditions, which may offer new therapeutic clues for MS.
Imaging diagnostic criteria for pulmonary tuberculosis
Authors: He Yulin , Xu Chuanjun , Lu Puxuan , Li Hongjun
Published: March 2024

Pulmonary tuberculosis (TB) is a chronic infectious disease of the lungs caused by Mycobacterium tuberculosis. TB poses a serious health risk to people and is recognized as a major public health problem worldwide, and its treatment and control remain challenging.Mycobacterium tuberculosis is transmitted by respiratory droplets and most often affects the lungs. Nearly 10 million people worldwide develop pulmonary TB each year, and China has the second highest burden globally. Delayed diagnosis and treatment can cause large numbers of patients with infectious pulmonary TB to become a new source of infection; this in turn increases the incidence of TB, creating a vicious circle. Early and accurate diagnosis and timely treatment can significantly reduce the spread of pulmonary TB and reduce patient morbidity and mortality. As an important component of pulmonary TB diagnosis, imaging is the main and most common means of clinical diagnosis, differential diagnosis, efficacy evaluation, and pulmonary TB screening. Therefore, the development of imaging diagnostic criteria for pulmonary TB is of major significance for accurate hierarchical imaging and differential diagnosis, efficacy evaluation, and other aspects of pulmonary TB. Imaging diagnostic criteria can also complete and effectively supplement the national diagnostic criteria for pulmonary TB and the expert consensus on the imaging and hierarchical diagnosis for pulmonary TB.
Development of predictive biomarkers for transarterial chemoembolization efficacy in hepatocellular carcinoma
Authors: Wang Dandan , Zhang Jinfeng , Jiang Huijie
Published: March 2024

Transarterial chemoembolization (TACE) is widely acknowledged as the first-line therapeutic strategy for hepatocellular carcinoma (HCC), one of the most common malignant tumors of the liver. Despite its established efficacy, the responses of TACE are subject to significant variability due to the inherent tumor heterogeneity and patient-specific physiological and genetic factors. This creates a challenge in treatment standardization and demands a tailored approach for each patient. What’s more, multiple TACE sessions are often required, particularly for larger tumors. However, redundant repeated treatments without proper patient selection may lead to TACE resistance or liver function damage, potentially foreclosing other therapeutic options. This clinical landscape underscores the pressing need for developing precise and minimally invasive tools for predicting TACE efficacy. Biomarkers are emerging as particularly promising tools in this context. Defined as quantifiable variables, biomarkers can be objectively measured to reflect the biological impact of treatment or exposure, which is widely employed in disease diagnosis, monitoring, curative effect evaluation, prognosis prediction, and drug development. In this review, we delve into the current research progression on predictive biomarkers for TACE efficacy. These include standard laboratory tests, advanced imaging techniques, and emerging technologies such as liquid biopsy and artificial intelligence (AI). Laboratory assays may involve measuring liver function or cancer markers, while imaging studies can offer insights into tumor size and metabolic activity. Liquid biopsy captures circulating tumor DNA to provide real-time information, and AI applications have begun to offer more nuanced predictive analytics. Looking to the future, the incorporation of big data and multi-omics studies could revolutionize the field. These integrative analyses promise to refine the existing predictive models for TACE efficacy, enabling more personalized and effective treatment strategies for patients suffering from HCC. As we move forward, these advancements will undoubtedly have a profound impact on clinical decision-making processes, ultimately improving patient outcomes.