bluuebunny/crossref_metadata_2025 huggingface dataset:
Brownish Green Fired Clay Tiles Produced by Valorizing Green Glass Cullet and Sediment Soil
Authors: Loetchantharangkun Witsanu , Fugsang Anuparp , Wangrakdiskul Ubolrat
Published: September 2024

This paper aims to valorize waste materials for producing eco-friendly fired clay tiles. Green glass cullet and the water supply process waste; sediment soil have been utilized. In addition, local white clay is used to mix with waste materials for promoting the plasticity and easily forming of specimens. The Triaxial diagram has been employed to construct the formulas. Mixture’s formulation of this experiment consists of 23 formulas. Test samples are fired at temperature 950 °C. Physical properties of fired specimens are carried out and compared with Thailand Industrial Standards. The results show that formula A6 can pass TIS. 2508-2555 wall tiles of medium water absorption series. However, A6 only utilize 10% of sediment soil. Therefore, increasing sintering temperature to 1,050 °C for utilizing higher content of sediment soil has been examined. Twelve formulas of group A and C are selected to be further investigated. Results show that formula A6 and C6 can achieve TIS. 2508-2555. Formula C6 utilizing 30% and 60% of sediment soil and green glass cullet obtain the highest strength and lowest water absorption. Analyzing microstructure of this formula by Scanning Electron Microscope has found glassy phases. Furthermore, Wollastonite 2M, Nepheline and Albite are identified by X-Ray Diffractometer. It can be summarized that sediment soil mixed up with green glass cullet and local white clay can develop brownish green color fired clay tiles which can be further applied to the production of local ceramic factory.
Recent Trends in Nitrogen Cooling Modelling of Extrusion Dies
Authors: Pelaccia Riccardo , Negozio Marco , Di Donato Sara , Donati Lorenzo , Reggiani Barbara
Published: September 2024

Nitrogen cooling has been identified as a powerful industrial solution for the hot extrusion process to remove heat in the die and in the profile. The complexity involved in the design of cooling channels depends on many factors, including the cooling path, its position with respect to the hottest zones as well as the nitrogen phase change that strongly affects the heat removal capacity. However, the industrial approach is still stuck in the empirical and based-experience practices that too often strongly limit the possibilities of obtaining a performing cooling solution. In this context, this work intends to summarize and discuss the advanced recent trends in the design of cooling channels for extrusion dies proposed by the authors based on the numerical approaches, with the final aim to propose possible solutions to fill the current gaps of the suboptimal industrial approaches.
Microstructure Evolution and FEM Prediction on AA6XXX Alloys
Authors: Negozio Marco , Pelaccia Riccardo , Donati Lorenzo , Reggiani Barbara , Di Donato Sara
Published: September 2024

The microstructure evolution during the extrusion process of AA6XXX aluminum alloys is getting a significant interest from extruders and researchers because of the effect of the grain structure on the extruded component properties. Several process and material parameters such as chemical composition, homogenization, temperature evolution, extrusion speed, geometries and quenching have a direct impact on the final grain size of extruded profiles. Because there are so many affecting elements, it is extremely challenging to forecast the microstructure evolution and, as a result, research activities are still required to understand and control the aluminum alloy recrystallization behaviour. In this work, a methodology for the microstructural characterization of AA6XXX aluminum alloys is proposed. The methodology involves the experimental investigation of the profile grain evolution during the extrusion process, the development of a AA6XXX recrystallization model optimized to describe the AA6063 recrystallization behaviour and the simulation by means of finite element method of the final microstructure of the extruded profile.
Preparation and Characterization of Urea-Modified Lignin-Derived Porous Carbon Materials and their CO2 Adsorption Properties
Authors: Bao Siriguleng , Gong Ling Zhen , Agula Bao
Published: September 2024

Present study, activated carbon was precarbonised and chemically activated to prepare activated charcoal from different lignins , and their adsorption properties had been investigated. The influences of carbon source selection with urea modification on the CO2 adsorption performance of the materials were investigated. The selectivity, warmth of adsorption and cyclic steadiness of the materials had been in addition tested. The urea-modified porous carbon materials were prepared using dealkylated lignin (LCC), calcium lignosulfonate (CLS) and sodium lignosulfonate (SLS) as carbon precursors, KOH as activator and urea as nitrogen dopant. The CO2 adsorption values of the LCC-0.5N samples had been 5.52 mmol/g and 3.90 mmol/g at 1 bar, 273 K and 298 K, respectively, and were obtained in 10 successive adsorption-desorption cycles. The CO2 adsorption ability remained stable and greater than 110 mg/g after 10 consecutive adsorption-desorption cycles.
Lignocellulose Composition of Preparation of Porous Carbon Materials and CO2 Adsorption Performance Research
Authors: Wurentuya Bhnar , Ren Wu , Agula Bao
Published: September 2024

Porous carbon material adsorbents are one of the effective methods for carbon dioxide (CO2) capture and storage (CCS). In order to realize its application, it is urgent to find economical and efficient raw materials for preparing porous carbon materials. In this study, porous carbon materials were successfully prepared using lignocellulosic components as a carbon source and a mild Kac adsorbent. The CO2 adsorption performance of these materials was then tested. LCH-1 exhibited excellent CO2 adsorption performance and stability in all samples. The microporosity of LCH-1 is as high as 84.48%, and its CO2 adsorption capacity under 1 bar at 273K and 298K is 4.94 mmol/g and 3.31 mmol/g, respectively.
Digital Representation of Materials Testing Data for Semantic Web Analytics: Tensile Stress Relaxation Testing Use Case
Authors: Nasrabadi Hossein Beygi , Skrotzki Birgit
Published: September 2024

This study aims to represent an approach for transferring the materials testing datasets to the digital schema that meets the prerequisites of the semantic web. As a use case, the tensile stress relaxation testing method was evaluated and the testing datasets for several copper alloys were prepared. The tensile stress relaxation testing ontology (TSRTO) was modeled following the test standard requirements and by utilizing the appropriate upper-level ontologies. Eventually, mapping the testing datasets into the knowledge graph and converting the data-mapped graphs to the machine-readable Resource Description Framework (RDF) schema led to the preparation of the digital version of testing data which can be efficiently queried on the web.
MARCH8 Mediates K27-Linked Polyubiquitination of IL-7 Receptor α to Negatively Regulate IL-7–Triggered T Cell Homeostasis
Authors: Gao Deng , Yi Xue-Mei , Feng Lu , Li Shu , Shu Hong-Bing
Published: September 2024

IL-7 is a cytokine produced by stromal cells, which binds to IL-7Rα and plays an important role for homeostasis of T lymphocytes. Excessive activities of IL-7–triggered signaling pathways causes autoimmune diseases. How IL-7–triggered signaling and immune effects are regulated is not fully understood. In this study, we show that the membrane-associated RING-CH (MARCH) E3 ligase family member MARCH8 mediates K27-linked polyubiquitination of IL-7Rα, leading to its lysosomal degradation. Site-directed mutagenesis suggests that MARCH8 meditates polyubiquitination of IL-7Rα at K265/K266, and mutation of these residues renders IL-7Rα resistance to MARCH8-mediated polyubiquitination and degradation. MARCH8 deficiency increases IL-7–triggered activation of the downstream transcription factor STAT5 and transcriptional induction of the effector genes in human T lymphoma cells. MARCH8 deficiency also promotes IL-7–triggered T cell proliferation and splenic memory CD8+ T cell differentiation in mice. Our findings suggest that MARCH8 negatively regulates IL-7–triggered signaling by mediating K27-linked polyubiquitination and lysosomal degradation of IL-7Rα, which reveals a negative regulatory mechanism of IL-7–triggered T cell homeostasis.
Anxiety, Depression, and Quality of Life in the Postnatal Period: A Cross-sectional Analysis in a Tertiary Care Setting in Khammam, Telangana, South India
Authors: Faizan Md. Adil , Kandhi Sri Divya Reddy , Geethanjali  , Raghuram Macharapu , Babu R. Sateesh
Published: September 2024

Introduction:

The postpartum period is a crucial phase marked by significant physical and emotional changes for women. Mental health issues, especially anxiety and depression, can profoundly affect maternal well-being and maternal–infant interactions. Despite growing recognition, comprehensive research on perinatal mental health in India is lacking.

Materials and Methods:

A cross-sectional study surveyed 236 postnatal women in a tertiary care center in Khammam, Telangana. Participants completed standardized questionnaires for depression (Edinburgh Postnatal Depression Scale), anxiety (Perinatal Anxiety Screening Scale), and quality of life (QOL, World Health Organization QOL-BREF). Data analysis utilized descriptive statistics and inferential tests to examine associations between variables.

Results:

The study revealed a significant prevalence of depression (25.42%) and anxiety (24.57%) among postnatal women, with 11% experiencing both. Demographic analysis highlighted age, residency, and education as significant factors associated with mental health outcomes. Participants without depression or anxiety generally reported a higher QOL across various domains compared to those with mental health disorders. Significant differences were observed in physical, psychological, and social relationship domains between participants with and without depression and anxiety.

Conclusion:

This study provides valuable insights into anxiety and depression prevalence among postnatal women and their impact on QOL. Addressing postnatal mental health is crucial for fostering positive maternal–infant relationships. Future interventions should prioritize comprehensive, culturally sensitive approaches to mental health care for postnatal women in India.
A Case Report on Anti-N-methyl-d-aspartate Receptor Encephalitis in a 52-year-old Female with Schizophrenia
Authors: Murke Mukund Purushottam , Deshmukh Suraj Ajay , Khapri Anurag , Rathod Anupam
Published: September 2024

Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is a complex neurological and psychiatric disorder. It often presents with psychiatric symptoms, leading to misdiagnosis, but can progress to severe neurological manifestations. In this study, we presented a 52-year-old woman with a 30-year history of schizophrenia who suddenly developed mutism, agitation, and incontinence. Electroencephalography showed generalized slowing, and autoimmune testing revealed NMDAR antibody positivity. Treatment with intravenous methylprednisone led to rapid improvement, highlighting the importance of considering autoimmune causes in such cases. NMDAR encephalitis is a condition with both neurological and psychiatric symptoms. It is often initially mistaken for psychiatric issues. Physicians should carefully assess and be vigilant in psychiatric cases. If routine tests show no significant issues, but the neurological state worsens, considers NMDAR encephalitis, and acts promptly. Delayed treatment can be harmful.
A study on meteorological characteristics and its consequences on human mortality in Rajkot City, Gujarat
Authors: Ranpariya Pooja N. , Solanki Harsha M. , Chudasama Rajesh K.
Published: September 2024

Background:

Climate change presents a crucial threat to human health. The health of human is affected by heat waves and extreme weather events. Hence, the present study was planned to explore weather conditions and their consequences on mortality of human being by accessing the meteorological and mortality data.

Methodology:

Meteorological data include maximum and minimum temperature, average wind speed, and total rainfall; relative humidity was obtained for January 1, 2017–December 31, 2021, from India Meteorological Department, Pune. Trend analysis of climatic variables was done. Human mortality data were obtained from January 1, 2017, to December 31, 2020, from Health Department, Rajkot Municipal Corporation, Rajkot. The impact of temperature and rainfall on mortality was observed.

Results:

Upward trend of maximum temperature, rainfall, and relative humidity while downward trend for minimum temperature and average wind speed was observed. Human mortality due to communicable and noncommunicable diseases was not affected by maximum temperature. The effect of rainfall on mortality due to vector-borne diseases was observed.

Conclusion:

The effect of rainfall on human mortality was observed. Upward and downward trend of climatic variables was not found to be statistically significant. Further study needs to be conducted by analyzing climate data over a longer duration and across a larger geographical area.
Professionalizing Emergency Medical Service Response Time
Authors: Alshammari Abdulaziz Dhahir , Alobaid Abdullah Mohammed , Azharuddin Ahmed
Published: September 2024

Prompt responses by emergency medical services (EMSs) are crucial in delivering efficient prehospital emergency treatment. The prompt arrival of EMS is strongly correlated with improved patient outcomes and increased chances of survival. To reduce the occurrence of long-term impairment or illness, the majority of EMS companies follow globally acknowledged response time benchmarks. Internationally, EMSs strive to achieve a response time of 8 min or less for 90% of life-threatening incidents. This research examines many variables that influence EMS response times and their subsequent consequences on patient outcomes. The measurement of response time starts with receipt of a clinical complaint call and concludes upon the arrival of EMS at the site. Timely and effective reactions are essential for the survival of patients, particularly in urgent medical situations. In contrast, there are data indicating that longer reaction times are associated with increased death rates. Various obstacles might hinder prompt EMS responses, including geographical obstacles, unfavorable weather and traffic conditions, and patient-specific considerations such as the kind of injury or sickness, medical history, age, and gender. In addition, a lack of staff, including insufficient workers, poor training, and the absence of standardized, up-to-date technology that simplify care delivery, may also cause delays in response times. Due to the crucial importance of EMS response times in prehospital emergency treatment, it is essential for EMS systems to make every effort to meet their response time goals.
Elevations of N-Terminal Mid-Fragment of Osteocalcin and Cystatin C Levels are Associated with Disorders of Glycolipid Metabolism and Abnormal Bone Metabolism in Patients with Type 2 Diabetes Mellitus Complicated with Osteoporosis
Authors: Guo Xiaofang , Shen Yun , Du Teng , He Yan , Lu Jie , Yang Qianhong
Published: September 2024

Type 2 diabetes mellitus (T2DM) patients always develop osteoporosis (OP). We examined correlations of N-terminal mid-fragment of osteocalcin (N-MID) and cystatin C (Cys C) levels with glycolipid metabolism, bone metabolism markers, and bone mineral density (BMD) in elderly T2DM-OP patients. Grouping was performed as per whether T2DM patients developed OP (OP group) or not (N-OP group). N-MID and Cys C were measured using enzyme-linked immunosorbent assay, with correlations with glycolipid metabolism, bone metabolism indicators, and BMD analyzed using Pearson’s correlation coefficient. Elderly T2DM-OP patients showed elevated disease duration, age, body mass index, glycated hemoglobin (HbA1c), Homer’s insulin resistance (HOMA-IR), total cholesterol (TC), beta-carboxy-terminal crosslinked telopeptide of type 1 collagen (β-CTX), tartrate-resistant acid phosphatase 5b (TRACP-5b), N-MID and Cys C levels, and reduced high-density lipoprotein cholesterol (HDL-C), bone alkaline phosphatase (B-ALP), aminoterminal propeptide of type I procollagen (PINP), carboxyterminal propeptide of type I procollagen (PICP), BMD, and calcium supplementation. N-MID and Cys C were positively correlated with HbA1c, HOMA-IR, TC, β-CTX, and TRACP-5b and negatively with HDL-C, B-ALP, PINP, PICP, and BMD in elderly T2DM-OP patients. Conclusively, the abnormal elevations of serum N-MID and Cys C were associated with glycolipid metabolism disorder, abnormal bone metabolism, and decreased BMD in elderly T2DM-OP patients.
Reinforcing simulated vital pulpotomized teeth as an alternate to invasive procedures: An in vitro study
Authors: Hiremath Hemalatha , Kharya Aastha , Shiringi Isha , Mishra Lavanshi
Published: September 2024

Aim:

The aim is to compare and evaluate the fracture resistance of simulated pulpotomy-treated tooth reinforced with different reinforcing materials.

Methods:

Forty-five extracted human permanent central incisors were collected of approximately similar dimensions for this in vitro study. To simulate pulpotomy procedure, each tooth was sectioned through the middle third of the crown perpendicular to the long axis of the tooth, resulting in 6 mm cervicoincisal height (mimicking Ellis Class III fracture). Later, all the teeth were divided into four experimental (n = 10 each) and a control group (n = 5), according to the reinforcing materials used: Group A – microhybrid composite, Group B – stainless steel, Group C – polypropylene mesh, Group D – Rebilda post, and Group E – control group (natural tooth). The reinforcing materials were placed parallel to the long axis of the tooth, such that it lies 3 mm into the pulp chamber and 3 mm in the coronal portion, over which the composite restorations were placed. All the specimens were subjected to the universal testing machine for fracture resistance.

Results:

The data obtained were tabulated and statistically analyzed using Kruskal–Wallis and Tukey’s post hoc test. Stainless steel material exhibited statistically significant values among the experimental groups and the control group, whereas the values of polypropylene mesh, microhybrid composite, and Rebilda post were nonsignificant.

Conclusion:

Stainless steel wire can be used as a reinforcing material in pulpotomy treated tooth with extensive loss of tooth structure and could be an effective alternate for crown coverage.
A comparative evaluation of the antimicrobial efficacy of triple antibiotic paste, clindamycin, and linezolid as an intracanal medicament against Enterococcus faecalis: An in vitro study
Authors: Chauhan Priya , Akotiya Bhavya , Surana Anjali , Saha Suparna Ganguly , Agarwal Rolly S. , Saha Mainak Kanti
Published: September 2024

Aim:

The aim of the present study was to evaluate and compare the antimicrobial efficacy of three medicaments, triple antibiotic paste (TAP), clindamycin (CLID), and linezolid (LZ) against Enterococcus faecalis, using spectrophotometry.

Methods:

Seventy-two single-rooted human premolars were collected and prepared using standard protocol and were decoronated to obtain standardized lengths. A pure culture of E. faecalis (ATCC 29212) was procured, grown on blood agar, obtained using a wired loop, and suspended in brain heart infusion (BHI) broth for 24 h. After contaminating the canals with E. faecalis, the prepared samples were divided into three groups, with 24 teeth each, based on the intracanal medicament used, Group A: TAP (ciplox×500 mg, metrogyl 400 mg, minoz 100 mg) + normal saline (NS), Group B: CLID (capsule clid 150) + NS, Group C: LZ (Lizoforce, dry syrup) + NS. The medicaments were syringed into the roots and which were then incubated. After 24 h, 12 samples per group were thoroughly rinsed for removal of intracanal medicaments (ICMs), and instrumented using #4 GG drill to obtain dentinal shavings, which were allowed to fall into sterile BHI broth. The turbidity of the broth was assessed and the optical density (OD) was recorded using spectrophotometer to estimate the concentration of E. faecalis after 1 day. After a period of 7 days, the remaining 12 samples per group underwent identical processing.

Results:

At the end of day 1, all three antibiotics presented comparable values of OD indicating comparable antimicrobial efficacy. Group-wise comparison revealed that TAP continued to be superior to the other two antibiotics even at the end of 7 days. However, the difference was significant only between TAP and LZ with no significant difference between TAP and CLID and between CLID and LZ.

Conclusion:

The present study concludes that the use of single-antibiotic CLID and LZ may serve as an effective alternative to the multidrug combination TAP, as an ICM.
Comparative evaluation of blood contamination on the push-out bond strength of mineral trioxide aggregate, Biodentine, and bone cement in furcation perforation repair: An in vitro study
Authors: Gudapati Swapnika , Satish R. Kalyan , Sajjan Girija S. , Varma K. Madhu , Kumar V. Santosh
Published: September 2024

Aim:

This in vitro study was designed to compare the effect of blood contamination on the push-out bond strength of mineral trioxide aggregate (MTA), Biodentine, and bone cement.

Methods:

Seventy-eight human mandibular molars with furcation were selected and decoronated at the cementoenamel junction. The samples were mounted 3 mm below the furcation area into the acrylic resin. A perforation in the center of the furcation was made using a round carbide bur size 3 with a diameter of 1.2 mm. Then, the perforation was enlarged up to a standardized diameter of 1.3 mm using a size 5 Gates-Glidden drill. The samples were randomly divided into three groups. Based on blood contamination status, each group (n = 26) was further subdivided into two subgroups (n = 13). Whole fresh human blood was obtained from the principal investigator of the research group. A 27-gauge syringe was used to inject blood into the perforated furcal area. A piece of gelatin was packed under the furcal area using a condenser. MTA, Biodentine, and bone cement were mixed according to the manufacturer’s recommendations and compacted into the perforation. A universal testing machine was used to evaluate the push-out bond strength. The results were analyzed using one-way analysis of variance followed by Tukey’s post hoc test (P < 0.05).

Results:

In the experimental groups with blood contamination, Group 2A exhibited statistically significant push-out bond strength values compared with Group 1A and Group 3A. In the groups without blood contamination, Group 2B showed statistically significant push-out bond strength values compared with Group 1B and Group 3B. Irrespective of the blood contamination status, Group 3 exhibited higher push-out bond strength values than Group 1, with no statistically significant difference between the groups. No significant difference was observed within the groups.

Conclusion:

Biodentine showed promising results as a better perforation repair material irrespective of the status of blood contamination. Bone cement can be a viable alternative material for furcation perforation repair compared with MTA.
Unmasking Hepatitis C Infection: A Case Report of Interstitial Lung Disease as a Potential Extrahepatic Manifestation
Authors: Morcos Zeina , Lahoud Chloe , Azam Waleed , Tawfik Mark , Grabie Yisroel , Acharya Sudeep , Kilkenny Thomas
Published: September 2024

ABSTRACT

Hepatitis C virus (HCV) is the most common blood-borne infection in the United States and is a significant public health concern worldwide. There is a potential association between HCV infection and the development of interstitial lung disease (ILD) as an extrahepatic manifestation. This report details the case of a 77-year-old female who presented with a chronic productive cough and chest discomfort, initially suspected to be indicative of atypical pneumonia. Despite an initial course of antibiotics, her symptoms persisted, leading to further investigations. Imaging revealed features consistent with ILD prompting additional testing. The patient was noted to have positive results for hepatitis C antibodies and antinuclear antibodies (ANAs), alongside evidence of minimal liver fibrosis. She received 12-week course of antivirals sofosbuvir-velpatasvir for the treatment of hepatitis C infection. Several studies published in the literature have reported a high incidence of HCV infection among patients with ILD. Although definitive clinical and pathological causality remains elusive, the case presented and the literature reviewed strongly suggest a possible role of HCV infection in the onset of ILD. Further research is needed to provide early diagnosis, develop targeted therapeutic strategies, and improve patient outcomes.
An Unusual Case of Pulmonary Mucormycosis
Authors: Sharafudeen Thasneem , Rohith S. , Arjun P. , Ameer K. A. , Palangadan Shaji , Rajalakshmi A. , John Kalpana Elizabeth
Published: September 2024

ABSTRACT

We report the case of a female who presented with nonresolving pneumonia and was found to have uncontrolled diabetes mellitus. She was given multiple antibiotics and antivirals from multiple hospitals. No organism was isolated from sputum/bronchoalveolar lavage/pleural fluid. Finally, she underwent Video assisted thoracoscopic surgery (VATS) and drainage of lung abscess and was diagnosed to have pulmonary mucormycosis.
Penetrating Neck Trauma with Bilateral Pneumothorax and Pneumomediastinum: A Case Report and Review of Literature
Authors: Thodi Nasma Mankara , Ramachandran Rinoop , Moideen Fabith
Published: September 2024

ABSTRACT

Penetrating neck trauma presents a complex and challenging scenario in clinical practice. We present the case report of a 31-year-old male who suffered a neck injury due to a small iron rod piercing the anterior aspect of the neck in a road traffic accident. The patient presented with hoarseness of voice and air bubbling from the neck wound when speaking. Diagnostic assessments, including imaging, revealed extensive subcutaneous emphysema and pneumomediastinum. Positive response was observed in the patient with symptomatic treatment and chest tube insertion. This case highlights the rarity and intricacies of traumatic neck injuries, emphasizing the importance of prompt diagnosis and treatment serving as a valuable contribution to the understanding and management of traumatic neck injuries resulting in pneumomediastinum and pneumothorax.
Pidotimod – Current Role and Evidence
Authors: Kedia Yash Sanjay , Ish Pranav , Rathi Vidushi
Published: September 2024

Recurrent respiratory infections (RRIs) are common in the pediatric age group and in patients with chronic respiratory disorders, leading to frequent hospitalization and poorer quality of life. Studies have shown that an immature immune system in childhood can predispose to RRIs, leading to adult life. Immunomodulators are drugs which modulate the immune system of the host to increase resistance against various infections. They interact with specific receptors and cellular components of innate and adaptive response to modulate the immune response. Pidotimod (PDT) is one such immunomodulator which has shown emerging evidence in the past 2 decades, to reduce the recurrence of lower respiratory tract infections and help in faster recovery from the same. This review highlights the evidence behind the potential role of PDT in the prevention and management of RRIs.
The Usefulness of Strain Echocardiography as Diagnostic and Prognostic Index of Cardiac Dysfunction in Septic Patients in Correlation with Cardiac Biomarkers
Authors: El Mokadem Mostafa , El Maraghi Sameh , El Hosseiny Rania , Moawad Amr , Yassin Ahmed
Published: September 2024

Background:

Compared to standard echocardiography, speckle tracking echocardiography (STE) looks more accurate for the detection of subclinical dysfunction of the myocardium. The aim of our work was to assess the value of STE in the diagnosis of subclinical ventricular dysfunction and as a prognostic index in sepsis patients.

Patients and Methods:

An observational prospective study involving critically ill patients aged ≥ 18 years diagnosed with sepsis or septic shock. All patients were subjected to full history-taking, clinical assessment, and scoring system, including Acute Physiology and Chronic Health (APACHE) II score and quick sequential organ failure assessment score. Investigations were done for all patients, including laboratory (complete blood count, C-reactive protein, N-terminal pro-brain natriuretic peptide [NT-proBNP], and troponin-I and serum lactate level), ECG, and echocardiographic examination (conventional and speckle tracking) for measurement of global left ventricular strain.

Results:

This study involved 50 patients, nine patients with sepsis and 41 patients with septic shock. Regarding cardiac biomarkers, the mean value of troponin-I was 0.18 ± 0.05 ng/L and for NT-proBNP was 1228.2 ± 832.9 pmol/L. All patients in the study had elevated lactate levels. There was a significant correlation between global longitudinal strain (GLS) and troponin I, NT-proBNP, and lactate levels after 3 days of admission. GLS, lactate, NT-proBNP, troponin levels, and APACHE II Score were significant predictors of mortality with a sensitivity of 76.5%, 88.2%, 88.2%, 76.5%, and 88.2%, respectively.

Conclusion:

GLS measured by speckle tracking echocardiography looks to be a sensitive diagnostic tool for early detection of subclinical left ventricular dysfunction in patients with sepsis in addition to be a sensitive predictor of in-hospital mortality.
Noninvasive Assessment of Left Ventricle Filling Pattern in Patient with Severe Tricuspid Regurgitation, Pulmonary Regurgitation, Atrial Septal Defect, and Pulmonary Embolism
Authors: Ghazal Sami , Alaqaili Mohammed , Alqrinawi Shurouq H. , Albahar Zahra , Ouf Shady G.
Published: September 2024

Background:

Severe tricuspid regurgitation (TR), pulmonic regurgitation (PR), large atrial septal defect (ASD), and large pulmonary embolism (PE) will lead to decreased left ventricular preload, and therefore, might alter left ventricle (LV) filling diastolic parameters. Significant LV preload reduction might preclude LV diastolic function assessment indeterminate.

Methods:

This is a controlled study where patients with severe TR, PR, ASD, PE, and without significant LV disease were included in the study group. Stroke volume (SV), E-wave velocity, A-wave velocity, E/A, septal e’, lateral e’, average E/e’, deceleration time, and isovolumic relaxation time (IVRT) were captured from the study group and the control group. The difference of mean of the diastolic parameters in both groups was evaluated as well as the correlation between the SV and the diastolic parameters of the pooled data from both groups.

Results:

E wave velocity, E/A ratio, IVRT, deceleration time, septal and lateral e’, and SV were significantly lower in the study group while E/e’ was significantly higher in the study group. IVRT showed a strong positive correlation with SV. Lateral and septal e’ showed a moderate positive correlation to SV while the average E/e’ showed inverse correlation to SV.

Conclusion:

Standard diastolic parameters should be interpreted with caution in assessing diastolic function in patients with severely decreased preload. However, a significant preload reduction might preclude diastolic function assessment indeterminate.
Prominent Crista Terminalis Mimicking Right Atrial Thrombus in a Case of Permanent Pacemaker Implantation – Role of Two- and Three-Dimensional Transesophageal Echocardiography
Authors: Nalawade Digvijay D. , Wadhokar Pratik Satyajit , Jadhav Ajitkumar Krishna , Manade Vivek V.
Published: September 2024

Crista terminalis is a crescent-shaped fibromuscular ridge in the posterolateral wall of the right atrium (RA) which separates the smooth posterior region of RA from a more muscular anterior region. When prominent, it frequently mimics RA thrombus, vegetation, or tumors such as myxoma. Differentiation of such anatomical structural variations from other masses is vital to minimize misdiagnosis and avoid disease-related apprehension. Different diagnostic modalities may be needed which have their own imaging characteristics as well as limitations. Our case emphasizes the differentiating features of prominent crista terminalis using two-dimensional and three-dimensional transesophageal echocardiography.
A Long Atrial Electromechanical Interval is Associated with Arrhythmic Recurrence after Catheter Ablation: How to Find What Has Been Lost
Authors: Barletta Valentina , Canu Antonio Maria , Parollo Matteo , Di Cori Andrea , Segreti Luca , De Lucia Raffaele , Bongiorni Maria Grazia , Zucchelli Giulio
Published: September 2024

Background:

Atrial fibrillation (AF) results in electrical and structural remodeling of the atria, which extent is known to be associated with a higher AF recurrence rate after catheter ablation (CA). Recently, a novel echocardiographic parameter derived from tissue Doppler imaging (TDI) [PA-TDI] has been introduced to assess the total atrial activation time, as a noninvasive surrogate of fibrosis and remodeling. The aim of the study is to investigate the role of PA-TDI interval as a predictor of AF ablation efficacy.

Methods:

We retrospectively included patients with paroxysmal symptomatic drug-refractory AF referred to our institution for CA procedure, who presented sinus rhythm at admission. A complete transthoracic echocardiogram was performed before the ablation procedure, including the assessment of PA-TDI interval.

Results:

From January 2015 to April 2018, 128 patients (mean age: 61.86 ± 9.08 years, 68% male, body surface area: 1.97 ± 0.21 mq, body mass index: 26.98 ± 3.86 kg/mq, and ejection fraction: 59% ±6.06%) with symptomatic drug-refractory AF who received radiofrequency CA were enrolled. During the follow-up of 15.80 ± 6.7 months, 30 patients (23%) developed AF recurrence out of the blanking period. Compared with those without recurrence (group 1), patients with recurrence (group 2) had a larger left atrium (LA) size (Group 1 vs. Group 2: mean LA area: 22.2 ± 4.6 cmq vs. 25 ± 6.6 cmq, P = 0.015; mean indexed LA volume: 35 ± 10 mL/mq vs. 40 ± 12 mL/mq, P = 0.04) and longer PA-TDI interval (Group 1 vs. Group 2: 162 ± 33 ms vs. 133 ± 26 ms, P < 0.0001). A cutoff of PA-TDI > 150 ms identified patients with recurrence after ablation with a sensibility of 82% and specificity of 83% (area under the curve 0.879).

Conclusions:

The total activation time assessed by PA-TDI is an independent predictor of AF recurrence and can be used to predict the efficacy of transcatheter ablation.
Clinical Applications of Myocardial Work in Echocardiography: A Comprehensive Review
Authors: Trimarchi Giancarlo , Carerj Scipione , Di Bella Gianluca , Manganaro Roberta , Pizzino Fausto , Restelli Davide , Pelaggi Giuseppe , Lofrumento Francesca , Licordari Roberto , Taverna Giovanni , Paradossi Umberto , de Gregorio Cesare , Micari Antonio , Di Giannuario Giovanna , Zito Concetta
Published: September 2024

Left ventricular (LV) global longitudinal strain (GLS) has recently garnered attention as a reliable and objective method for evaluating LV systolic function. One of the key advantages of GLS is its ability to detect subtle abnormalities even when the ejection fraction (EF) appears to be preserved. However, it is important to note that GLS, much like LVEF, is significantly influenced by load conditions. In recent years, researchers and clinicians have been exploring noninvasive myocardial work (MW) quantification as an innovative tool for assessing myocardial function. This method integrates measurements of strain and LV pressure, providing a comprehensive evaluation of the heart’s performance. Notably, MW offers an advantage over GLS and LVEF because it provides a load-independent assessment of myocardial performance. The implementation of commercial echocardiographic software that facilitates the noninvasive calculation of MW has significantly broadened the scope of its application. This advanced technology is now being utilized in multiple clinical settings, including ischemic heart disease, valvular diseases, cardiomyopathies, cardio-oncology, and hypertension. One of the fundamental aspects of MW is its correlation with myocardial oxygen consumption, which allows for the assessment of work efficiency. Understanding this relationship is crucial for diagnosing and managing various cardiac conditions. The aim of this review is to provide an overview of the noninvasive assessment of myocardial by echocardiography, from basic principles and methodology to current clinical applications.
Affected by Surgery, Healed by Medicine a Successful Story
Authors: Chintala Vaasanthi , Parvathareddy Krishna Malakonda Reddy , Konda Bharath , Motkar Ankith Reddy , Nagula Praveen
Published: September 2024

ABSTRACT

Infective endocarditis (IE) is relatively less common in children compared to adults but can result in significant morbidity and mortality. The epidemiology of IE has shifted in recent years, from rheumatic heart disease (less prevalence) to congenital heart disease (increased survival) and an increase in the use of central venous catheters in children with chronic illness. Children with no preexisting cardiac disease can be affected rarely. We present a case of a 13-year-old boy with no cardiac disease, presented with a fever. He had a history of surgery for hypospadias 3 weeks before presentation. He was diagnosed with IE according to modified Duke criteria. The blood cultures grew methicillin-resistant Staphylococci aureus. The case was surgically deferred in view of his clinical condition and was managed medically. We emphasize the importance of having a high index of suspicion for endocarditis in children with fever even without cardiac disease.
Recurrent Infective Endocarditis and Its Complication in an Individual with Two Different Organisms – A Rare Presentation
Authors: Ghosh Ratul , Majumder Biswajit , Sarkar Shibsankar , Maji Somnath
Published: September 2024

ABSTRACT

Fungal endocarditis is rare and does not usually occur in structurally normal hearts. The most common causative agent is Candida albicans. We report a 30-year-old male presenting with low-grade fever and shortness of breath. Two-dimensional echocardiography revealed ostium secundum atrial septal defect with vegetations over tricuspid and mitral valves. Blood culture showed the growth of Enterococcus sp. which was successfully managed by antibiotic therapy. 1.5 months after, the patient again presented with fever and features of heart failure. Echocardiography showed large mobile vegetations over tricuspid and mitral valves. This time blood culture showed growth of Candida tropicalis. The patient developed septic embolization in the right leg which was promptly managed with surgical intervention. The patient was further managed with medical and surgical intervention and was discharged in stable condition.
Sociodemographic Background and Psychosocial Behaviors of Perpetrators of Intimate Partner Violence: A Hospital-based Retrospective Study
Authors: Vadysinghe Amal Nishantha , Nayakarathne Tharanga Bandara , Banda Y. M. G. Ilangarathna , Ekanayake Kasun Bandara , Perera Isuru , Wijesiriwardena Yomal
Published: September 2024

Background:

Intimate partner violence (IPV) is a worldwide issue with a high prevalence rate seen in Asia.

Aims and Objectives:

To plan and implement preventive measures, it is important to understand the characteristics, background, and medico-legal significance, especially from the perspective of perpetrators.

Materials and Methods:

This study is a questionnaire-based retrospective study conducted among perpetrators of IPV who presented to a tertiary care hospital in Sri Lanka.

Results:

Out of 325 subjects, 97.2% were males and 64.0% were aged 26–45 years. Most (80.9%) perpetrators were older than the victimized partner, with a mean age gap of 4.3 years. Only 2.8% had achieved higher education and 78.5% had been married to the victim for more than5 years. Alcohol and/or other substances were abused by 75.4% and 11.1% of them were diagnosed with a psychiatric illness. Perpetrators have been exposed to child abuse (CA) as minors (50.1%), with physical CA being the most common, whereas 42.5% had witnessed IPV during their childhood. Ill-treatment by the spouse (odds ratio [OR] = 24 [95% confidence interval (CI):5.6, 99.9]) and substance use (OR =22 [95% CI: 5.1, 91.5]) were significantly associated with perpetrating emotional violence. A victim having an extramarital affair was 5.1 times more likely to be subjected to sexual IPV, whereas previous IPV, parental deprivation, and affairs of perpetrator were proved to be protective factors. IPV had negatively affected the economy of 71.3% of families. Legal procedures were expected by 22.4%, whereas 60% wanted to negotiate with their spouses.

Conclusion:

Families having low income and alcohol/substance abuse should be targeted to plan preventive programs at the community level. Proper counseling and follow-up of victims of CA can be used as a primary preventive measure of IPV.
Forensic Significance of Touch Deoxyribonucleic Acid
Authors: Devika G. , Vaishnavi S. , Mane Manashree
Published: September 2024

Touch deoxyribonucleic acid (DNA) refers to the DNA that is left behind from skin cells when a person touches or comes into contact with an object. In crimes where the identification of suspects becomes a challenge, touch DNA has been a proven investigative tool. The present study aims to provide a systematic review of the role of touch DNA in criminal cases which discusses the nature and importance of touch DNA evidence at crime scenes; various phenomena including the transfer and persistence of touched samples; different factors affecting the touch sample deposition and DNA shedding; the best recovery methods and collection of samples from different substrates; and the interpretation of profiles through advanced techniques that identify the suspects. The present study also aims to optimize standard protocols in the laboratories for touched samples appropriate to the substrates that improve the success rate of profiles from touched items.
A Case of Two Full Sisters Share Identical Genotypes on the X Chromosome
Authors: Zhang Jinpei , Zhao Guangbin , Hao Shicheng , Chen Chong , Shi Yan , Xiao Xinyue , Wang Le , Yuan Li
Published: September 2024

X-chromosomal genetic markers are frequently employed in forensic parentage determination owing to their distinctive inheritance patterns. The kinship analysis revealed that two sisters who were not identical twins had identical genotypes on the X chromosome, encompassing 36 X-chromosomal short tandem repeats (X-STRs) and 29 X-chromosomal single-nucleotide polymorphisms (X-SNPs) that spanned the whole X chromosome from the p-telomere to the q-telomere. The identical X-STRs and X-SNPs in the daughters could be the result of linkage or a rare chance of occurrence. This highlights the need for careful analysis and interpretation when dealing with X chromosome markers and that in individual cases, even if two women share an allele at each locus, this does not necessarily mean that they are paternal sisters. The likelihood of random concordance due to maternal alleles must be taken into account.
A Review on Dental Age Estimation in Children and Adolescents
Authors: Singhal Ishita , Dave Aparna , Arora Manpreet , Rai Radhika , Saluja Pulin
Published: September 2024

Children are seen as beings who exist from birth through puberty, while teenagers are regarded as existing from puberty until around the age of 20 years. For a number of legal processes, including child labor, employment, the age of majority, rape, adoption, marriage eligibility, and situations where the birth certificate is unavailable, age estimation in children and adolescents is crucial. Despite the wide range of methods available, dental age estimation techniques that take into account tooth maturation are thought to be the most reliable predictors of chronological age in subadults. This is because genetic factors predominate and environmental factors, particularly between birth and age ten, tend to have little impact on tooth maturation. The eruption of teeth holds greater significance in the deciduous dentition, where genetic factors predominantly govern the process, compared to the permanent dentition. Conversely, tooth calcification serves as a viable indicator for estimating dental age in both primary and permanent dentitions. Current dental age estimation methods are based on age-related changes in teeth, such as tooth growth and development, changes that occur after teeth form, and biochemical changes. Therefore, in this review article, we will explore the several methodologies used for dental age assessment in children and adolescents.
Composite Iodine-gold Nanoparticles as a Contrast Agent in Computed Tomography
Authors: Haghighi Rezvan Ravanfar , Zarei Fariba , Moshiri Samira , Jafari Anahita , Chatterjee Sabyasachi , Akondi Vyas , Chatterjee Vani Vardhan
Published: September 2024

Purpose:

Solutions of iodine-based compounds, due to their high X-ray attenuation coefficient, are widely used as contrast agents in computed tomography (CT) imaging. This paper investigates the attenuation properties of iodine and gold to develop nanoparticle-based contrast agents, for example, composite nanoparticles (NPs) with layers of iodine and gold or a mixture of NPs of gold and iodine.

Materials and Methods:

A theoretical formula is derived that gives the Hounsfield Unit (HU) for different weight-by-weight (w/w) concentrations of a mixture of blood + iodine + gold. The range of compositions for which iodine + gold mixture can give a suitable HU ≥250 upon being mixed with blood, is formulated. These estimates are derived from experiments on the variation of HU values in different compositions of aqueous solutions of iodine and available data for gold.

Results:

It is seen that for an aqueous solution of iodine, the suitable HU of 250 (hence giving sufficient gray level to the CT image) can be obtained with w/w concentrations of iodine being 0.0044, 0.008, and 0.0097 for observations at 80, 100, and 120 kVp, respectively. The corresponding w/w concentrations of gold NPs would be 0.0103, 0.0131, and 0.0158. With these basic results, compositions of suitable mixtures of iodine and gold are also specified.

Conclusion:

Aqueous suspensions of gold NPs are suitable as contrast materials for CT imaging and can also be used as a component of a composite contrast material consisting of an iodine and gold mixture.