bluuebunny/crossref_metadata_2025 huggingface dataset:
Difficulties and distress experienced by Japanese public health nurses specializing in quarantine services when dealing with COVID-19: A qualitative study in peri-urban municipality
Authors: Miyazaki Akari , Deguchi Naoko Kumada , Omiya Tomoko
Published: April 2023

Public health nurses (PHNs) are among the few municipal civil servants who lead community infection control and prevention initiatives in Japanese public health centers (PHCs). This study aims to investigate the distress faced by PHNs and clarify their difficulties and working environment relative to infection prevention control activities during the COVID-19 pandemic. We adopted a qualitative description methodology in this study of 12 PHNs who were involved in COVID-19 prevention and control in PHCs in Prefecture A. The distress during the early phase of the pandemic was due to the uncertainty of the SARS-CoV-2 related disease, which caused panic in medical institutions and among residents. PHNs were overwhelmed, distressed and exhausted by their inability to control the ‘pandemic’, lack of patient cooperation for prevention control and the unsustainable organizational environment. They were also distressed because they were one of the specialized personnel responsible for saving residents' lives with limited medical resources and while having identity crises due to an inability to carry out the PHN's role of controlling infection in the community. For future crises, rapid, drastic innovation defying conventional organizational systems is critical to reform sustainable organizations so that they play an effective role in the community. Innovation in crisis communication and strengthening the medical system will help achieve a resilient community in a health crisis.
Determinants and evolution of financial inclusion in Latin America: A demand side analysis
Authors: Orazi Sofía , Martinez Lisana B. , Vigier Hernán P.
Published: April 2023

The benefits of financial inclusion could be particularly important in Latin America, where the levels of ownership and use of different instruments lag behind those of developed countries. An improvement in the ownership and use of formal financial instruments could result in a reduction in informality, the promotion of formal savings and productive credit, and, therefore, an inclusive economic growth. The objective of this paper is to analyze the financial inclusion of a group of Latin American countries in order to detect the most used financial instruments and the main socioeconomic determinants that explain their ownership or use. At the same time, the evolution of the main variables was also studied for the years 2011, 2014, 2017 and 2021. Micro-data from the Global Findex database was examined (except for 2021, in which only macro-data are available). Statistical models and multivariate econometrics are applied to understand the individual socioeconomic characteristics of people who are still very unlikely to own and use formal financial instruments. Finally, the main reasons for not having an account were analyzed in order to delve into the main restrictions on which the financial market must focus to achieve greater financial inclusion.
Associations Between Indoor Air Pollutants and Risk Factors for Acute Respiratory Infection Symptoms in Children Under 5: An Analysis of Data From the Indonesia Demographic Health Survey
Authors: Santri Ichtiarini Nurullita , Wardani Yuniar , Phiri Yohane Vincent Abero , Nyam Gunchmaa , Putri Tyas Aisyah , Isni Khoiriyah , Suryani Dyah , Sambo Grace
Published: April 2023

Objectives: The study investigated the association between indoor air pollution (IAP) and risk factors for acute respiratory infection (ARI) symptoms in children under 5 years of age.Methods: A cross-sectional study was conducted using data derived from Indonesia Demographic and Health Survey in 2017. Binary logistic regression modeling was employed to examine each predictor variable associated with ARI among children under 5 years of age in Indonesia.Results: The study included a total of 4936 households with children. Among children under 5 years old, 7.2% reported ARI symptoms. The presence of ARI symptoms was significantly associated with the type of residence, wealth index, and father’s smoking frequency, which were considered the sample’s socio-demographic characteristics. In the final model, living in rural areas, having a high wealth index, the father’s smoking frequency, and a low education level were all linked to ARI symptoms.Conclusions: The results revealed that households in rural areas had a substantially higher level of reported ARI symptoms among children under 5 years old. Furthermore, the father’s smoking frequency and low education level were associated with ARI symptoms.
A Peer-support Mini-counseling Model to Improve Treatment in HIV-positive Pregnant Women in Kupang City, East Nusa Tenggara, Indonesia
Authors: Camellia Artha , Swandari Plamularsih , Rahma Gusni , Merati Tuti Parwati , Bakta I Made , Duarsa Dyah Pradnyaparamita
Published: April 2023

Objectives: Low adherence to antiretroviral (ARV) therapy in pregnant women with human immunodeficiency virus (HIV) increases the risk of virus transmission from mother to newborn. Increasing mothers’ knowledge and motivation to access treatment has been identified as a critical factor in prevention. Therefore, this research aimed to explore barriers and enablers in accessing HIV care and treatment services.Methods: This research was the first phase of a mixed-method analysis conducted in Kupang, a remote city in East Nusa Tenggara Province, Indonesia. Samples were taken by purposive sampling of 17 people interviewed, consisting of 6 mothers with HIV, 5 peer facilitators, and 6 health workers. Data were collected through semi-structured interviews, focus group discussions, observations, and document review. Inductive thematic analysis was also performed. The existing data were grouped into several themes, then relationships and linkages were drawn from each group of informants.Results: Barriers to accessing care and treatment were lack of knowledge about the benefits of ARV; stigma from within and the surrounding environment; difficulty in accessing services due to distance, time, and cost; completeness of administration; drugs’ side effects; and the quality of health workers and HIV services.Conclusions: There was a need for a structured and integrated model of peer support to improve ARV uptake and treatment in pregnant women with HIV. This research identified needs including mini-counseling sessions designed to address psychosocial barriers as an integrated approach to support antenatal care that can effectively assist HIV-positive pregnant women in improving treatment adherence.
Le coliving ou la financiarisation des maisons bruxelloises
Authors: Casier Charlotte
Published: April 2023

Le coliving à Bruxelles consiste en la location, au sein d’un même bâtiment, de chambres accompagnées d’espaces communs et de services, opérée par des sociétés privées. Par sa formule tout-inclus meublée et flexible, cette offre de niche mais en croissance rapide s’adresse particulièrement aux jeunes expatrié·es présent·es à Bruxelles. L’analyse du développement de cette offre immobilière récente montre comment la financiarisation du secteur résidentiel locatif privé s’appuie sur la création de nouveaux produits formatés afin que les investisseurs puissent facilement y injecter leurs capitaux et en tirer des rendements élevés. À Bruxelles, le coliving est établi avant tout dans des maisons unifamiliales des quartiers du sud-est de la première couronne urbaine.
« Un “soviet” de grévistes à Belfast » ? La Grande Grève de Belfast de 1919
Authors: Coquelin Olivier
Published: April 2023

La Grande Grève de Belfast de janvier-février 1919 s’inscrivait dans le mouvement de réduction du temps de travail hebdomadaire qui toucha les grands centres industriels britanniques au lendemain de la Première Guerre mondiale. Outre sa longévité (quatre semaines), ce conflit social se caractérisa par son mode organisationnel que certains, notamment dans la presse, allèrent jusqu’à assimiler à celui d’un « soviet ». Étant donné que l’Irlande révolutionnaire allait connaître une centaine d’expériences d’autogestion ouvrière sous le nom de « soviet », principalement dans le sud et le sud-ouest de l’île, on peut se demander si le comité de grève de Belfast comprenait « certains des attributs d’un soviet industriel », comme le soutenait le correspondant du Manchester Guardian et, auquel cas, dans quelle mesure il ouvrit la voie aux soviets irlandais. À cette fin, cet article propose une étude comparative en utilisant la « méthode des soviets irlandais » – telle que définie par l’un des protagonistes du soviet de Drogheda de septembre 1921 – comme outil analytique.
A New Paradigm for Blended Learning
Authors: Mir Nazir Ahmad , Fathima Afrah , Suppala Srinivas
Published: April 2023

The world has witnessed changes in teaching and learning attitudes ever since the dawn of the technological revolution. Additionally, the overwhelming propensity for technology among Indian teachers and pupils has had a great effect on the country's educational system. On this basis, a study was done to determine how much teachers and students could gain from sharing precursory e-lessons through a messaging app. The main objective of this study was to investigate how to bring each student to one level, and how to focus parallelly while teaching. First, a pre-test was administered to the experimental group and the control group. After pre-testing, the experimental group underwent the intervention procedure. The benefits of precursory e-lesson sharing combined with face-to-face training were then evaluated using a post-test. It was concluded that this study not only made information transfer easier, more interesting, and more permanent, but also created a balance in the learning levels of the majority of students.
A Hybridized Deep Learning Strategy for Course Recommendation
Authors: Deepak Gerard , Trivedi Ishdutt
Published: April 2023

Recommender systems have been actively used in many areas like e-commerce, movie and video suggestions, and have proven to be highly useful for its users. But the use of recommender systems in online learning platforms is often underrated and less likely used. But many of the times it lacks personalisation especially in collaborative approach while content-based doesn't work well for new users. Therefore, the authors propose a hybrid course recommender system for this problem which takes content as well as collaborative approaches and tackles their individual limitations. The authors see recommendation as a sequential problem and thus have used RNNs for solving the problem. Each recommendation can be seen as the new course in the sequence. The results suggest it outperforms other recommender systems when using LSTMs instead of RNNs. The authors develop and test the recommendation system using the Kaggle dataset of users for grouping similar users as historical data and search history of different users' data.
A Multimodal Approach to Teaching Chinese as a Foreign Language (CFL) in the Digital World
Authors: Han Jinghe , Liu Qiaoyun , Sun Ruiyan
Published: April 2023

This research investigates a cohort of bilingual Chinese teachers' use of a multimodal approach in their Chinese as a foreign language (CFL) teaching. The data include the participants' CFL teaching practices and their reflections on multimodal teaching as recorded in their theses and a focus group discussion. The theoretical underpinning of this paper is based on Paivio's dual coding theory (DCT) and Kress's social-semiotic theory (SST). This research found that the teachers' multimodal use in CFL teaching demonstrated their research-informed committed endeavour in designing content specific activities to achieve pedagogical purposes, utilizing some digital technologies as a resource. The uniqueness of the written form of the Chinese language availed these teachers the opportunity to engage the multiple modes and advance their own understanding of multimodality as a concept. This research also found the teachers' meaning making through the multimodality did not always equate to that of their students' due to their social and cultural differences.
Investigating Behavior Intention Toward S-Commerce Adoption by Small Businesses in Saudi Arabia
Authors: Alotaibi Haifa Ghazzai , Aloud Monira Essa
Published: April 2023

With recent developments in e-commerce and social networking sites, social commerce has emerged as a new business model. S-commerce refers to the purchasing and selling of goods and services through social networking sites while utilizing users' social behavior. Several studies in the s-commerce field have explored adoption behaviors from the perspective of consumers. This study focuses on the business perspective, specifically studying s-commerce adoption in small businesses in Saudi Arabia. The study used the C-TAM-TPB model to identify the factors that positively influence small businesses' intention to adopt s-commerce. An online questionnaire was used to collect data from 392 small businesses. The study applied PLS-SEM to test the hypothesis. Findings show that all factors–attitude, perceived usefulness, perceived behavioral control, and subjective norms–significantly impacted the behavior intention of small businesses to adopt s-commerce. This study provides insights into small businesses' adoption of s-commerce by focusing on sole entrepreneurs and microenterprise owners.
A Study on Usage of Agricultural Engineering Equipment for Various Crops and Yields in South Tamilnadu
Authors: Chandrakumar Thangavel , Sakthipriya Dhinakaran , Devi Mahalakshmi S.
Published: April 2023

Agriculture is one of the unique fields to contribute a major part of Indian economic growth. Engineering machinery plays a vital role in the farming culture in India. The focal point of this research is fully concentrated with Agri engineering equipment and crop yield based on the repository taken from various sources like the internet, agri departments, government agencies, etc. The research study shows statistical proof of crop production and machinery used for farming in the south zone of India. In particular, southern components of Tamilnadu state are taken as a sample for this research. It has been identified paddy is widely cropped in the majority of the districts like Madurai, Theni, Dindigul, etc. Machine learning techniques are now being used in the Agri sectors for the prediction of crop yields and as a result visualization of data done in this research for the various crops and machinery used. It is to conclude that Agri machinery is nowadays used for farming for better yield of the crops.
Design of a Closed-Loop Error-in-Variable System Controller and Its Application in Quadrotor UAV
Authors: Zhang Yunfeng , Chen Peng , Wang Jianhong , Azar Ahmad Taher , Ibraheem Ibraheem Kasim , Kamal Nashwa Ahmad , Abdulmajeed Farah Ayad
Published: April 2023

In view of the fact that the output is only disturbed by error in most of the current system studies, this article proposes a closed-loop variable system model with error (both input and output signals are disturbed by noise) and designs the controller of the system. In this study, minimum variance controller and self-correcting minimum variance controller are designed using minimum variance control. Then an example is given to evaluate the performance of the designed controller using minimum variance performance evaluation. Finally, the closed-loop variable error system is combined with the quadrotor UAV (unmanned aerial vehicle), and the position controller in the position control loop of the quadrotor UAV is designed. The experimental results show that the controller has good performance and can well meet the design needs.
Presentation of Human Neural Stem Cell Antigens Drives Regulatory T Cell Induction
Authors: Greilach Scott A , McIntyre Laura L , Nguyen Quy H , Silva Jorge , Kessenbrock Kai , Lane Thomas E , Walsh Craig M
Published: April 2023

Transplantation of human neural stem cells (hNSCs) is a promising regenerative therapy to promote remyelination in patients with multiple sclerosis (MS). Transplantation of hNSCs has been shown to increase the number of CD4+CD25+Foxp3+ T regulatory cells (Tregs) in the spinal cords of murine models of MS, which is correlated with a strong localized remyelination response. However, the mechanisms by which hNSC transplantation leads to an increase in Tregs in the CNS remains unclear. We report that hNSCs drive the conversion of T conventional (Tconv) cells into Tregs in vitro. Conversion of Tconv cells is Ag driven and fails to occur in the absence of TCR stimulation by cognate antigenic self-peptides. Furthermore, CNS Ags are sufficient to drive this conversion in the absence of hNSCs in vitro and in vivo. Importantly, only Ags presented in the thymus during T cell selection drive this Treg response. In this study, we investigate the mechanisms by which hNSC Ags drive the conversion of Tconv cells into Tregs and may provide key insight needed for the development of MS therapies.
Combining Simultaneous Density and Velocity Measurements of Rotor Blade Tip Vortices under Cyclic Pitch Conditions
Authors:   German Aerospace Center (DLR), Braukmann Johannes , Goerttler Andreas , Raffel Markus , Schwarz Clemens , Wolf C.
Published: April 2023

An investigation on blade tip vortices of a sub-scale rotor under cyclic pitch conditions is carried out. Background oriented schlieren (BOS), Particle image velocimetry (PIV), and computational fluid dynamics (CFD) are applied to the same test cases. This approach enables to combine the velocity data from PIV in a measurement plane, the density related data from BOS in a measurement volume and the comprehensive set of flow variables provided by unsteady detached eddy simulations. Vortices up to an age of Ψv = 70° in case of PIV and CFD, and up to Ψv = 200° in case of BOS are considered. The vortex locations are obtained from all three techniques. The unsteadiness of the vortices was obtained from the experimental results, whereas the CFD provides an average solution. An increased position scatter was observed during the downstroke of the pitch cycle by both experimental methods and in good agreement. In the second part, the PIV velocity data are compared to common vortex models. A link between the density distribution and the swirl velocity is applied to the measured data. Based on the CFD results it is shown that the assumption of isothermal flow yields better agreement between velocity and density than isentropic flow.
Embedded Software: Automating Tests From Hand-written Requirements
Authors:   CS Group USA, Tkac Matthew
Published: April 2023

As the complexity of systems and software increase, the need to determine specific test cases for the requirements as well determining a complete test suite become more complex and time consuming. Additionally, testing typically comes at the end of the process, increasing cost and schedule pressures in an effort to get to market. This paper will introduce a technique, process and toolset that can assist in making reducing the cost and schedule pressures of testing a system. According to an article written by Ricardo Queiroz, “One of the big questions tormenting all managers since the start of any project is: "when should we start testing?" (Another usual big question is "why should we care?" - because of the money involved, obviously) the question seems hard, if you do not find serious arguments to select the starting date. Let me help you. So, when should you start testing after months of hard work developing the product? The answer is simple: the test team should be involved from the beginning right to the end! And this recommendation is based on many factors: testing saves time, effort and (you guessed it!) - Money!"
Numerical Investigation of Autonomous Camber Morphing of a Helicopter Rotor Blade using Shape Memory Alloys
Authors:   Rensselaer Polytechnic Institute, Ferede Etana ,   Texas A&M University, Karakalas Anargyros , Gandhi Farhan , Lagoudas Dimitris
Published: April 2023

Design and development of modern air vehicles seeks to produce airborne structures that are able to fly in a wide range of operational conditions with increased fuel efficiency and reduced environmental impact. To be able to operate efficiently throughout the operational envelop these structures need to be able to adapt their aerodynamic characteristics, a process achievable through the introduction of morphing regions. In this study, a numerical investigation of an autonomous camber morphing helicopter blade is presented considering Shape Memory Alloy materials able to undergo the Two-Way Shape Memory Effect. A series of designs and respective finite element analyses is employed to identify the effect of various parameters on various configurations that include the number of intermediate spars, the extend of the morphing section along the blade and the boundary condition between the pristine and the morphing portion. Overall, eliminating the need for pre-stress of the SMA component before being embedded in the host structure leads in significant reduction of the maximum strain and stress developed on the upper skin (passive component).
Evaluation of Short Chain Fatty Acids (SCFAs) intestinal absorption, following digestion and fermentation of a novel medical device containing partially-hydrolyzed Guar gum plus simethicone
Authors: Benetti Federico , Micheletto Marta , Tedesco Erik , Gaio Elisa , Ciprandi Giorgio
Published: April 2023

Irritable Bowel Syndrome (IBS) is a common disease characterized by alternate symptoms (diarrhea and constipation) and intestinal gas overproduction. A new medical device (Fibergone®), containing Partially Hydrolyzed Guar Gum (PHGG) and Simethicone (SM) has been proposed for managing patients with bowel disorders. PHGG acts also as a prebiotic so increasing the Short-Chain Fatty Acid (SCFA) production, useful for intestinal physiology. This in vitro study investigated the effects exerted by PHGG+SM on SCFA production and their intestinal absorption following in vitro digestive process and fermentation model. An in vitro model evaluated the digestive process and fermentation using simulated digestive fluids and a human intestinal epithelium in vitro model derived from based on intestinal adenocarcinoma Caco-2 cells (ATCC, HTB-37TM) and organized as a functional monolayer on Transwell® inserts. PHGG+SM was added in experiments and compared with a control (non-treated). SCFA production and absorption were assessed. Viability and barrier integrity of the intestinal epithelium model were also evaluated. PHGG+SM significantly (p<0.05) increased SCFAs content after fermentation, indicating that this medical device is effectively fermented at the large intestine level. However, in relation to SCFAs bioavailability, their absorption did not increase compared to the non-treated condition in the light of the physiological contribution of SCFAs resulting from the microflora. PHGG+SM did not affect intestinal epithelium apparent permeability (Papp) and viability. This in vitro study documented that partially hydrolyzed guar gum combined with simethicone significantly affects short-chain fatty acids production and consequently could be fruitfully employed in managing patients with intestinal disorders.
Determinants of knowledge associated with occupational hazards and perceived health problems among dye workers in Abeokuta, Nigeria
Authors: Thomas Olusegun Emmanuel , Adefolarin Adeyinka , Ana Godson , Odaibo Georgina
Published: April 2023

Background. Identification of potential hazards, their adverse health effects, and predisposing factors in the workplace are critical to improving safety. The objective of the study was to assess the knowledge of occupational hazards, the prevalence of perceived health problems and their predictors among textile dye workers in Abeokuta Nigeria who work in unsupervised settings.Materials and Methods. In this cross-sectional study, data were collected from 199 participants using a validated semi-structured interviewer-administered questionnaire. Multiple linear regression analysis was used to determine the predictors of knowledge while Pearson Chi-square was employed to test the association between perceived health problems, sociodemographics and work environment characteristics.Results. The mean age of the respondents was 40 (SD=12) years with an average work experience of 19 years. The majority of respondents 139 (69.8%) had lower than average scores on knowledge of 25 questions on chemical hazards. There was no correlation between knowledge score and work experience (P=0.492) or age (P=0.462) but the knowledge was significantly associated with exposure score (P=0.004), gender (P=0.002) and adherence to instructions on chemicals usage (P=0.041) after adjusting for safe practice. The most frequent health problems among the dye workers were respiratory disorders (53.8%), allergies (51.8%), and skin disorders (24.1%). Airborne gaseous pollutants from the mixing of chemicals were associated with allergies (P=0.045), circulatory (P=0.02) and skin disorders (P=0.049) while air-borne textile fiber/dye particles could predict allergies (P=0.028).Conclusions. Findings revealed that exposure, gender and adherence to instruction labels on dye/chemical containers could determine knowledge of chemical hazards while physical work environment characteristics could determine health problems.
Factors affecting exclusive breastfeeding practices among working-class women in Osun State, Nigeria
Authors: Kayode Olariike O. , Oyedeji Ayobami S. , Alabi Quadri K.
Published: April 2023

Breastfeeding has been accepted as the most vital intervention for reducing infant mortality and ensuring optimal growth and development of children. However, studies on the factors affecting exclusive breastfeeding, especially, among working-class women are sparse. This study determined the factors affecting exclusive breastfeeding among working-class women in Osun state. Multistage sampling was used to select a total of 316 respondents for this cross-sectional study and a pretested, interviewer-administered questionnaire was used to elicit information. More than half (57.6%) of the respondents were between the ages of 26-35 years. Ninety-eight percent (98.1%) of the respondents had good knowledge of exclusive breastfeeding (EBF). Sixty-six percent (66.8%) had good exclusive breastfeeding practices. The study showed that there was a significant relationship between knowledge and practices of exclusive breastfeeding among the respondents (P0.05). Identified factors affecting exclusive breastfeeding among the respondents are: duration of maternity leave, availability of crèche near the place of work, breastfeeding break at work, husband and family support, health conditions that could hinder EBF, and engagement in other activities with work. Breastfeeding breaks at work (AOR=4.717; P=0.000), husband and family support (AOR=2.944; P=0.000), and one-month maternal leave (P=0.000) were factors significantly associated with EBF practices. We conclude that good knowledge and good practices of exclusive breastfeeding were found among the study group. Improved policies around maternity leave and the provision of breastfeeding friendly work environment are needed to increase exclusive breastfeeding practices. Husbands and family members should be educated on the need to provide support to breastfeeding mothers.
Study of Analytical Error in Lipase Assay
Authors: Kumari Sweta , Shekhar Ravi , Kumari Rekha , Prakash Pritam
Published: April 2023

Background:

Lipase and amylase are the most frequently used biomarker for the diagnosis of pancreatic diseases, especially acute pancreatitis. Lipase has better diagnostic accuracy in comparison to amylase for the analysis of acute pancreatitis. However, lipase assay in random access analyzer is sometimes difficult to perform as it is exposed to different types of samples or reagents which may act as interference.

Materials and Methods:

In our laboratory, we found the raised values (>500 IU/L) of lipase with normal amylase in some samples. However, the immediate rerun of these samples for lipase only showed normal (<80 IU/L) lipase level. To root out this fallacy, we performed reagent and sample carryover studies.

Results:

The cause of the falsely raised value of lipase was revealed by reagent carryover studies. All samples which assayed triglyceride (TGL) followed by lipase immediately after it showed elevated (>500 IU/L) lipase value. This is due to the interference of microbial lipase used in TGL reagents. This was corrected by separating the analysis of lipase and TGL into two different instruments.

Conclusion:

If interference testing is not done, the laboratories are prone to have an analytical error in reporting and hence lead to diagnostic error. Hence, after analyzer installation, interference testing should be included in the validation protocol.
Brain Stem Auditory Evoked Potentials in Type 2 Diabetes Mellitus Patients at Varying Frequencies
Authors: Mishra Indira Sushil , Shingne Ranjana , Roy Nitu Kumari
Published: April 2023

Introduction:

As per the World Health Organization, in 2005, more than 180 million people had diabetes worldwide. This figure will be more than double by 2030. Neuropathy is common and late complication of diabetes mellitus (DM). Sensory neural hearing loss which is severe at higher frequencies has been reported in Type 2 DM patients. Auditory nerve tract damage increases the latency and reduces the amplitude of the response. Evoked potential recordings evaluate the neural pathways in the central nervous system. Brainstem auditory evoked potentials (BAEP) localize anatomic structures using different waves and detect acoustic and central neuropathy (CN). Hence, brainstem evoked response of audiometry (BERA) is used widely in clinical set up.

Aims: Primary:

1. To record BERA waves in normal subjects with normal blood sugar levels (hemoglobin A1C [HbA1C] <5.4. 2. To record BERA waves in Type 2 DM patients. (HbA1C >6.5).

Secondary:

To study the BERA parameters with the normal subjects with blood sugar subjects and compare them with Type 2 DM patients.

Materials and Methods:

n = 30, Type 2 DM patients between the age of 35–50 years of either sex were chosen from the Diabetic Clinic of GMC, Aurangabad, Maharashtra. HbA1C test for glycemic control and BERA waves to assess CN were recorded. n = 30 normal subjects with normal blood sugar with age and sex-matched above tests were performed.

Statistical Analysis:

Unpaired Student's t-test.

Results:

Mean ± Standard deviation of the absolute latency and interpeak latency of BERA waves at 2, 4, and 6 KHz at 80 dB in Type 2 DM patients were delayed and found to be significant as compared to control group.

Conclusion:

The above study explains that if BAEP is recorded at higher frequencies like 6 KHz and at 80 dB, CN involvement can be detected earlier in diabetic patients. Hence, it is recommended to carry out BERA in diabetic patients at least once in a year.
Nontubercular Bacterial and Fungal Infections in Patients of Chronic Obstructive Pulmonary Disease
Authors: Khandelwal Akash , Chaudhary Shyam Chand , Verma Ajay Kumar , Sawlani Kamal Kumar , Gupta Kamlesh Kumar , Himanshu Dandu , Sonkar Satyendra Kumar , Verma Sudhir Kumar
Published: April 2023

Introduction:

Acute exacerbation of chronic obstructive pulmonary disease (COPD), frequently due to respiratory tract infection is the major cause of morbidity and mortality, and estimate suggests that it is currently the third leading cause of death worldwide.

Aims and Objectives:

This study aims to study the prevalence of nontubercular bacterial and fungal infections in patients of COPD.

Materials and Methods:

It is an observational study done for 1-year period from August 2017 to July 2018. A total of 100 COPD patients who fulfilled the inclusion and exclusion criteria were analyzed in the present study. These cases were classified according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) combined assessment criteria and subjected to sputum or in some cases Bronchoalveolar lavage (BAL) fluid examination for nontubercular bacterial and fungal pathogens. Serum galactomannan assay, bronchoscopy, and computed tomography chest were done in selected cases.

Results:

The age of the study population ranged from 40 to 85 years and the mean age was 60.01 ± 9.85 years. Majority of the patients were male (81.0%) and most (78.0%) of them were smokers. Most of the patients belonged to GOLD Grades 2 and 3. Forty-six percent of the patients did show pathogenic organisms in sputum examination. Out of these, 80.4% were bacterial, mainly Gram-negative organisms (Acinetobacter, Pseudomonas, Escherichia coli, Enterobacter, Proteus, and Citrobacter) and 19.6% of cases were having fungal infections (Candida and Aspergillus).

Conclusions:

Increasing patient age, smoking habit, and severity of COPD were related to an increasing frequency of bacterial and fungal infections. Early detection and proper treatment could help in preventing the morbidity and mortality related to COPD.
Tenofovir as a Cause of Acquired Fanconi's Syndrome
Authors: Simon Monisha , Meah Ameena
Published: April 2023

Fanconi's syndrome is a disorder that results in generalized involvement of the proximal tubule of the kidney. It is characterized by variable degrees of phosphate, glucose, and amino acid wasting in the urine and a hyperchloremic normal anion gap metabolic acidosis – secondary to defective hydrogen ion excretion and bicarbonate ion absorption. There are hereditary variants such as cystinosis (most common), hereditary fructose intolerance, galactosemia, tyrosinemia, Dents disease, and acquired variants of Fanconi's syndrome. Toxins, drug-induced diseases, and systemic diseases (multiple myeloma, Sjogren's syndrome) are the most common acquired causes of Fanconi's syndrome. The case report describes a middle-aged female patient, a known case of human immunodeficiency virus (HIV)-positive status who developed tenofovir disoproxil fumarate-induced Fanconi's syndrome, an increasingly recognized cause of acquired Fanconi's syndrome in HIV-positive patients.
Prevalence and Knowledge of Kidney Disease Risk Factors among Nigerians Resident in Lagos State Metropolitan District, South West Nigeria
Authors: Akokuwebe Monica Ewomazino , Idemudia Erhabor Sunday
Published: April 2023

Objective:

The objective is to determine the prevalence of kidney disease (KD) risk factors and their knowledge among Nigerians aged 15–64 living in the Mainland and Island metropolitan districts of Lagos State, South West Nigeria.

Materials and Methods:

A total of 1171 respondents between 15 and 64 years of age were recruited for the measurements of prevalence and knowledge of KD risk factors using a structured questionnaire. Descriptive, bivariate, and logistic regression statistical analyses were employed.

Results:

The respondents’ mean age was 33.83 ± 11.54, with a male-to-female ratio of 0.54:0.46. Respondents without KD have lower knowledge of KD risk factors (38.26; 37.27[FIGURE DASH]39.25) than those with KD (45.00; 38.84[FIGURE DASH]50.16) with an overall knowledge score of 38.39 (37.41[FIGURE DASH]39.36). The prevalent risk factors include indiscriminate use of analgesics and frequent use of traditional remedies (P < 0.05). Knowledge predictors of KD risk factors among respondents were older age (≥30 years) (with KD–Adjusted Odds Ratio (AOR) 1.06: 95% confidence interval [CI]: 0.82[FIGURE DASH]1.98; without KD–AOR 2.10: 95% CI: 1.52[FIGURE DASH]2.25) and chronic ailments (with KD–AOR 1.51: 95% CI: 0.28[FIGURE DASH]2.93; without KD–AOR 3.03: 95% CI: 0.04[FIGURE DASH]7.49).

Conclusion:

The study revealed a lower knowledge of KD risk factors exists in respondents without KD, but the prevalence of risk factors was higher among both cohorts of respondents. Therefore, concerted efforts should be made to sensitize strategic public health programs to expand accurate and adequate awareness and understanding of KD risk factors and their implications for well-being, and to possibly avoid the risk of the disease later in life.
Hepatocellular Carcinoma Presenting as Right Shoulder Pain
Authors: Tagboto Senyo
Published: April 2023

We report an uncommon presentation of liver cancer in a 33-year-old woman who presented with persistent right shoulder pain with a normal physical examination of her shoulder and normal X-rays. An abdominal ultrasound scan and a computed tomography scan subsequently revealed a large liver cancer in this patient who was subsequently found to be hepatitis B positive. Extrinsic causes of shoulder pain should be considered when shoulder movement is normal and does not alter the character of the pain. Subdiaphragmatic liver lesions should be considered in the differential diagnosis of right shoulder pain. In any geographical area with a high incidence of hepatitis B infection, hepatocellular carcinoma should be included in the differential diagnosis of shoulder pain if a clear local cause is not identified.
Spatiotemporal Analysis and Seasonality of Tuberculosis in Algeria
Authors: Selmane Schehrazad , L'hadj Mohamed
Published: April 2023

Background:

This study aimed to describe the spatiotemporal distribution, to build a forecasting model, and to determine the seasonal pattern of tuberculosis (TB) in Algeria.

Methods:

The Box–Jenkins methodology was used to develop predictive models and GeoDa software was used to perform spatial autocorrelation.

Results:

Between 1982 and 2019, the notification rate per 100,000 population of smear-positive pulmonary TB (SPPTB) has dropped 62.2%, while that of extrapulmonary TB (EPTB) has risen 91.3%. For the last decade, the mean detection rate of PTB was 82.6%. At around, 2% of PTB cases were yearly reported in children under 15 years old, a peak in notification rate was observed in the elderly aged 65 and over, and the sex ratio was in favor of men. Between 52% and 59% of EPTB cases were lymphadenitis TB and between 15% and 23% were pleural TB. About two-third of EPTB cases were females and around 10% were children under the age of 15. The time series analysis showed that (1,1, 2) × (1, 1, 0)4 (respectively (0, 1, 2) × (1, 1, 0)4, (3, 1, 0) × (1, 1, 0)4) offered the best forecasting model to quarterly TB (respectively EPTB, SPPTB) surveillance data. The most hit part was the Tell followed by high plateaus which accounted for 96.6% of notifications in 2017. Significant hot spots were identified in the central part for EPTB notification rate and in the northwestern part for SPPTB.

Conclusions:

There is a need to reframe the set objectives in the state strategy to combat TB taking into account seasonality and spatial clustering to ensure improved TB management through targeted and effective interventions.
Tuberculous Peritonitis Complicated by Immunologic Cerebral Vasculitis
Authors: Abdulla Mansoor C.
Published: April 2023

A 53-year-old female was admitted with ascites for 3 weeks, decreased response, and weakness of right upper and lower limbs for 1 day. Peritoneal biopsy showed necrotizing granulomatous inflammation, and cartridge-based nucleic acid amplification test for tuberculosis (TB) of biopsy was positive without rifampicin resistance. Magnetic resonance imaging brain showed multiple foci of diffusion restriction in bilateral cerebral hemisphere and cerebellum, suggestive of acute infarcts. After ruling out the secondary causes of cerebral infarction by appropriate tests and demonstrating that there was no evidence for tuberculous meningitis or direct injury, it was concluded that the reason for multiple cerebral infarctions in this patient is likely to be immunologic injury secondary to TB. Multiple cerebral infarctions secondary to immunologic injury in TB were reported only once previously.
Evaluation of Intracranial Vasculitis in Tuberculous Meningitis using Magnetic Resonance Vessel Wall Imaging Technique
Authors: Vanjare Harshad Arvind , Gunasekaran Karthik , Manesh Abi , Mishra Ajay Kumar , Mannam Pavithra , Iyadurai Ramya , Jasper Anitha , Mani Sunithi
Published: April 2023

Background:

Tuberculous meningitis (TBM) is a global health problem with important complications such as acute infarcts secondary to vasculitis contributing to adverse outcomes. The objective of this study is to assess intracranial vasculitis in patients with TBM, either during their initial diagnosis or during follow-up while on standard antituberculous therapy.

Methods:

Ten patients with TBM underwent magnetic resonance (MR) based vessel wall imaging (VWI) to identify intracranial vasculitis (five patients during their initial presentation and the other five patients during their follow-up visit).

Results:

Vasculitis was seen in 60% of the patients wherein 70% of their intracranial vessels were affected. Acute and chronic infarcts were seen in four and two patients respectively, one of whom had both acute and chronic infarcts. Leptomeningeal enhancement and basal cisternal tuberculomas were frequently seen in patients with vasculitis. Vasculitis was also seen many days after the commencement of the antituberculous therapy thus explaining late-onset infarcts in this disease.

Conclusion:

Intracranial vasculitis is common in the patient with TBM. MR-based VWI technique has the potential for infarct risk assessment and to help guide the treatment for its possible prevention.
Prediction of Treatment Failure of Tuberculosis using Support Vector Machine with Genetic Algorithm
Authors: Kanesamoorthy Keethansana , Dissanayake Maheshi B.
Published: April 2023

Background:

Tuberculosis (TB) is a disease that mainly affects human lungs. It can be fatal if the treatment is delayed. This study investigates the prediction of treatment failure of TB patients focusing on the features which contributes mostly for drug resistance.

Methods:

Support vector machine (SVM) is a relatively novel classification model that has shown promising performance in regression applications. Genetic algorithm (GA) is a method for solving the optimization problems. We have considered lifestyle and treatment preference-related data collected from TB-positive patients in Yangon, Myanmar to obtain a clear picture of the TB drug resistance. In this article, TB drug resistance is analyzed and modelled using SVM classifier. GA is used to enhance the overall performance of SVM, by selecting the most suitable 20 features from the 35 full feature set. Further, the performance of four different kernels of SVM model is investigated to obtain the best performance.

Results:

Once the model is trained with SVM and GA, we have feed unseen data into the model to predict the treatment resistance of the patient. The results have shown that SVM with GA is capable of achieving 67% of accuracy in predicting the treatment resistance in unseen data with only 20 features.

Conclusion:

The findings would in turn, assist to develop an effective TB treatment plan in future based on patients' lifestyle choices and social settings. In addition, the model developed in this research can be generalized to predict the outcome of drug therapy for many diseases in future.
Microbiome in Sputum as a Potential Biomarker of Chronicity in Pulmonary Resistant to Rifampicin-Tuberculosis and Multidrug-Resistant-Tuberculosis Patients
Authors: Wiqoyah Nurul , Mertaniasih Ni Made , Artama Wayan Tunas , Matsumoto Sohkichi
Published: April 2023

Background:

Cases of tuberculosis (TB) and multidrug-resistant TB (MDR-TB) in South-east Asia including Indonesia are still high. The presence of mixed infections in TB cases has been reported. Several studies revealed the role of the human microbiome in TB. This study purposes to characterize microbiome which can be a potential biomarker of chronicity in TB or MDR-TB.

Methods:

Sputum samples of pulmonary TB patients confirmed MDR-TB and resistant to rifampicin TB (RR-TB) were conducted Metagenomic next-generation sequencing. Principal coordinate analysis of UniFrac's showing the community structure of microbiome in MDR-TB comorbid diabetes mellitus (DM) is different from RR-TB noncomorbid DM (P = 0.003).

Results:

Proteobacteria microbiome in MDR-TB comorbid DM was more abundant than in RR-TB noncomorbid DM. Actinobacteria found in the small quantity in RR-TB and MDR-TB. Diversity of microbiome genera was greater in RR-TB. The linear discriminant analysis effect size analysis represents a genus biomarker whose abundance shows significant differences between groups, genus Rothia as a potential biomarker for RR-TB noncomorbid DM.

Conclusions:

Interesting findings is the community structure of microbiome in MDR-TB and RR-TB. In chronic TB such as recurrent, associated MDR-TB should attention to the findings of a small number of Actinobacteria could be a biomarker of TB which is also a determinant in patient taking combined anti-TB drugs of choice.
Sera from Patients with Tuberculosis Increase the Phagocytic-Microbicidal Activity of Human Neutrophils, and ESAT-6 is Implicated in the Phenomenon
Authors: Rojas-Espinosa Oscar , Rivero-Silva Miguel Angel , Hernández-Solís Alejandro , Arce-Paredes Patricia , Arce-Mendoza Alma Yolanda , Islas-Trujillo Sergio
Published: April 2023

Background:

It has been reported that sera from patients with active pulmonary tuberculosis (APT) induced nuclear changes in normal neutrophils that included pyknosis, swelling, apoptosis, and production of extracellular traps (NETs). Similar changes were observed with some sera from their household contacts but not with sera from healthy, unrelated individuals. It was suggested that those sera from household contacts that induced neutrophil nuclear changes might correspond to people with subclinical tuberculosis. Thus, our experimental approach might serve to identify individuals with early, ongoing disease.

Methods:

Nuclear changes in neutrophils were fully evident by 3 h of contact and beyond. Circulating mycobacterial antigens were the most likely candidates for this effect. We wanted to know whether the nuclear changes induced on neutrophils by the sera of APT patients would negatively affect the phagocytic/microbicidal ability of neutrophils exposed to APT sera for short periods.

Results:

We now provide evidence that short-term contact (30 min) with sera from patients with pulmonary tuberculosis increases several phagocytic parameters of normal neutrophils, including endocytosis, myeloperoxidase levels, production of free reactive oxygen species, phagolysosome fusion, and microbicidal activity on Staphylococcus aureus, with these effects not being observed with sera from healthy donors. We also give evidence that suggests that ESAT-6 and CFP-10 are involved in the phenomenon.

Conclusion:

We conclude that activation is a stage that precedes lethal nuclear changes in neutrophils and suggests that autologous neutrophils must circulate in an altered state in the APT patients, thus contributing to the pathology of the disease.
Computer-Assisted Screening of Mycobacterial Growth Inhibitors
Authors: Kuriki Kohei , Taira Junichi , Kuroki Masato , Sakamoto Hiroshi , Aoki Shunsuke
Published: April 2023

Background:

The emergence of frequent hitters (FHs) remains a challenge in drug discovery. We have previously used in silico structure-based drug screening (SBDS) to identify antimycobacterial candidates. However, excluding FHs has not been integrated into the SBDS system.

Methods:

A dataset comprising 15,000 docking score (protein–compound affinity matrix) was constructed by multiple target screening (MTS): DOCK–GOLD two-step docking simulations with 154,118 compounds versus the 30 target proteins essential for mycobacterial survival. After extraction of 141 compounds from the protein–compound affinity matrix, compounds determined to be FHs or false positives were excluded. Antimycobacterial properties of the top nine compounds selected through SBDS were experimentally evaluated.

Results:

Nine compounds designated KS1–KS9 were selected for experimental evaluation. Among the selected compounds, KS3, identified as adenosylhomocysteinase inhibitor, showed a potent inhibitory effect on antimycobacterial growth (inhibitory concentration [IC]50 = 1.2 M). However, the compound also showed potent cytotoxicity.

Conclusion:

The MTS method is applicable in SBDS for the identification of enzyme-specific inhibitors.