bluuebunny/crossref_metadata_2025 huggingface dataset:
A Cloud-Fog Continuum Computing Architecture for Cyber-Manufacturing Systems
Authors: Song Zheng Yi , Moon Young
Published: April 2022

Cyber-Manufacturing System (CMS) is a vision for the factory of the future, where physical components and processes are seamlessly integrated with computing processes to form highly adaptive and responsive manufacturing operations. In CMS, manufacturing resources and capabilities are digitized and shared with users and stakeholders through a local area network (LAN) and the Internet. CMS aims to utilize the manufacturing data obtained during all product lifecycle phases to provide agile and scalable manufacturing solutions. Currently, a centralized cloud-based computing environment supported by the distributed Internet of Things (IoT) devices network is used to enable the typical functionalities—such as manufacturing resource sharing and large-scale manufacturing collaborations. However, facing the explosion of manufacturing data from factory floors, cloud-based computing solutions show limitations in providing low-latency services, performing real-time state analysis, configuring the machines, and controlling other executors in the physical manufacturing end. Furthermore, private production data and technical details cannot be appropriately masked in the public cloud platform. In this research, a Cloud-Fog Continuum Computing Architecture is introduced to better utilize and govern the manufacturing data for manufacturing enterprise stakeholders and customers in CMS. A Hadoop-Raspberry Pi computing system is presented as a proof-of-concept of the proposed continuum computing mechanism to provide machining services in CMS.
Prostaglandin E2–Induced AKT Activation Regulates the Life Span of Short-Lived Plasma Cells by Attenuating IRE1α Hyperactivation
Authors: Wang Wei , Qin Xiaodan , Lin Liang , Wu Jia , Sun Xiuyuan , Zhao Ye , Ju Yurong , Zhao Ziheng , Ren Liwei , Pang Xuewen , Guan Youfei , Zhang Yu
Published: April 2022

The mechanism regulating the life span of short-lived plasma cells (SLPCs) remains poorly understood. Here we demonstrated that the EP4-mediated activation of AKT by PGE2 was required for the proper control of inositol-requiring transmembrane kinase endoribonuclease-1α (IRE1α) hyperactivation and hence the endoplasmic reticulum (ER) homeostasis in IgM-producing SLPCs. Disruption of the PGE2-EP4-AKT signaling pathway resulted in IRE1α-induced activation of JNK, leading to accelerated death of SLPCs. Consequently, Ptger4-deficient mice (C57BL/6) exhibited a markedly impaired IgM response to T-independent Ags and increased susceptibility to Streptococcus pneumoniae infection. This study reveals a highly selective impact of the PGE2-EP4 signal on the humoral immunity and provides a link between ER stress response and the life span of SLPCs.
Measles Elimination Successful and Its Relevant Challenges in Iran
Authors: Hosseinalipour Seyed Abbas , Mohammadbeigi Abolfazl , Mohebi Siamak , Saghafipour Abedin , Arabshahi Amin , Mahdianpour Farzaneh
Published: April 2022

Measles is an infectious childhood disease with some death annually. The expansion of the coverage of vaccination plan has significantly reduced the mortality rate of this disease. Given that the endemic measles virus is not transmitted in the country and based on Regional Verification Commission (RVC) for Measles and Rubella Elimination has declared that measles and rubella have been eliminated in three countries of Eastern Mediterranean Region including Islamic Republic of Iran, Bahrain, and Oman. Therefore, to continue and preventing from reemerging of measles in Iran, it is essential to maintaining the immunization programs, diagnose, and investigate all suspicious cases and outbreaks. This article investigates the challenges facing to measles after elimination declaration in Iran. However, the elimination of these diseases to be sustainable needs a vigorous case identification protocol and contact follow up.
Thyroid Cancer-Specific Health-Related Quality of Life Questionnaire
Authors: Sanjari Mojgan , Esmaeeli Mahsa , Ahmadipour Habibeh
Published: April 2022

Background:

Adverse effects related to treatment negatively affect the quality of life of patients with thyroid cancer. The current study aimed to evaluate the psychometric properties of the Persian version of the thyroid-cancer-specific health-related quality of life (TC-specific HRQoL) questionnaire among patients with thyroid cancer in Kerman province, Iran.

Methods:

This research was a cross-sectional study conducted on 240 patients with thyroid cancer in Kerman province from 2000 to 2015. The patients were selected through the census method and were asked to complete the thyroid-cancer-specific quality of life questionnaire. Data were analyzed by SPSS version 19.0 and LISREL version 8.80. The reliability of the Persian version was determined by Cronbach's α coefficient and the intraclass correlation coefficient (ICC). Exploratory and confirmatory factor analysis (CFA) was also conducted.

Results:

The Cronbach's α and ICCs were determined as 0.92 and 0.88, respectively. Five factors were extracted in the exploratory factor analysis with a total of 55.76% explained variance. Acceptable goodness of fit indices were found in CFA.

Conclusions:

The Persian version of the TC-specific HRQoL has sufficient psychometric properties and can be used to assess HRQoL among patients with thyroid cancer.
Effects of 8-Week Noncontinuous Aerobic Exercise on the Levels of CCL2, CCL5, and their Respective Receptors in Female BALB/C Mice Suffering from Breast Cancer
Authors: Esmailiyan Mehrnoosh , Kargarfard Mehdi , Esfarjani Fahimeh , Vaseghi Golnaz
Published: April 2022

Background:

Recently, the importance of chemokines and their receptors in carcinogenesis and the protective role of aerobic exercise in primary cancer development and progression is highlighted. Based on the facts that endurance exercise may result in hypoxia condition, and in addition, the effect of exercise therapy on the levels of CCL2, CCR2, and their related receptors in breast cancer (BC) model has not been investigated so far, therefore we aimed to evaluate the effect of eight-week noncontinuous aerobic training on the levels of CCL2, CCL5, and their related receptors; CCR2 and CCR5 in female BALB/C mice with BC.

Methods:

Thirty-two BALB/C mice (4–5 weeks old) were randomly divided to four 8-member groups of control and experimental. The experimental group received 8 weeks of noncontinuous aerobic exercises (AEs) while the control group did not receive any exercises during these 8 weeks. After last of experiment, 5 ml of blood was taken from each rat's lower inferior vein. The plasma levels of CCL2 and CCL5 were measured by ELISA and CCR2 and CCR5 by western blot. Tumor volume also measured in each step. Data were analyzed using the ANOVA test and the SPSS v. 0.24 Software.

Results:

After 8 weeks of participation in noncontinuous AEs, a statistically significant decrease was made between the control and experimental groups in terms of CCL2, CCL5, and CCR2 levels, as well as tumor volume. However, there was no significant difference between groups in terms of CCR5 level.

Conclusions:

It can be concluded that the 8 weeks of noncontinuous AEs did not result in CCR5 reduction while resulting in a statistically significant decrease in CCL2, CCL5, CCR2, and tumor volume.
Pseudo Green Hair
Authors: Tomas Xavier , Nogueras Marina , Bartolome Alvaro , Ferrando Juan
Published: April 2022

Green hair is due to insoluble copper deposits in the hair of blonde people. Although it is most frequently due to an increase in the copper content of algaecides in swimming pools, other causes have been recognized. Herewith, we present a case of a blonde girl who had previously commercially highlighted her hair and the hair had turned green following a swim in a pool with excess copper content in the water. Lifeguard swimming pool commented another previously affected blonde female swimmer 2 days ago. To date, <10 cases involving swimming pools with clearly increased copper concentrations have been published, and to the best of our knowledge, no similar case without traces of copper in X-ray microanalysis has been reported in the literature.
Role of Smoking in Androgenetic Alopecia
Authors: Kavadya Yatra , Mysore Venkataram
Published: April 2022

Smoking and its role in Androgenetic Alopecia has long been debated. Smoking may lead to hair loss by vasoconstriction, by forming DNA adducts, free radical damage to hair follicle, by enhancing senescence and hormonal effects. We have reviewed the available literature on AGA and smoking. Data available show that there is a significant association between smoking and AGA. However, studies demonstrating the benefit of avoidance of smoking in improving hair loss are lacking. Furthermore, large controlled studies with histological documentation are still unavailable to affirm the findings.
Alopecia Areata Universalis in the Onset of Autoimmune Polyendocrine Syndrome Type III C
Authors: Neagu Nicoleta , Morariu Silviu Horia , Grama Alina
Published: April 2022

Alopecia areata (AA) is an organ-specific autoimmune disease which affects hair follicles. It usually presents as a transient patchy hair loss, but it can sometimes progress into more severe forms such as AA totalis or AA universalis (AAU). Different autoimmune diseases, as well as autoimmune polyglandular syndromes (APS), have been associated with AA, especially with Type I and Type II APS. Herein, we describe the case of a 16-year-old boy with a severe form of AAU and early onset of adult APS, Type III C. As far as we are aware, this combination of AAU, Hashimoto thyroiditis, and Type I diabetes in a teenager has not been previously described in the literature. Furthermore, the early onset of AAU followed by a premature debut of adult APS Type III is again unique, which is why we report this case.
Lady with Long Eyelashes…!
Authors: Inamadar Soumya S. , Kumar N. S. Praveen
Published: April 2022

A sixty years postmenopausal lady presented with growing longer eyelashes for 8 years. She had thick, dark, curly eyelashes measuring 23 mm and 15 mm at the centre and periphery respectively suggesting marked trichomegaly. Increased vellus hair was noticed above lips and chin suggesting hypertrichosis. An important clue in history was the use of chemotherapeutic agent Erlotinib after bronchoscopic surgery for non-small cell lung carcinoma for the past 8 years. Erlotinib competitively binds to the tyrosine kinase domain of Epidermal Growth Factor Receptor inhibiting receptor activation and blocking the signal transduction. Thus, disrupting the transition of hair growth from anagen to telogen phase, leading to aberrant anagen phase and consequently abnormal hair growth. Trichomegaly is seen after 2–5 months of treatment. Mostly innocuous, it can lead to eyelid infections and rarely corneal ulceration. EGFR inhibitors are associated with hypertrichosis in other areas, as was the case in this patient. This case highlights the significance of detailed history including drugs, thus abating additional work-up for trichomegaly.
Do intra operative brain conditions during clipping for ruptured intra cranial aneurysms affect the outcome? Being devil's advocate
Authors: Singla Navneet , Reddy K. Ramanadha , Aggarwal Ashish , Chhabra Rajesh , Bhagat Hemant
Published: April 2022

Introduction:

For a disease like aneurysmal subarachnoid haemorrhage (aSAH) which continues to have high morbidity and mortality, prognostication is imperative. This gives realistic goals to both the health-care worker and the patient. Unfavourable brain conditions during surgery like dural bulge, brain swelling, petechial haemorrhages, need for ventricular tap are conventionally thought to be harbingers of poor outcomes. But is it really so?

Methods:

Fifty-four consecutively operated patients of aSAH were studied. Clinical grade at admission (H and H, World Federation of Neurosurgical Societies (WFNS)), Dural bulge, brain swelling, petechial haemorrhages, need for ventricular tap, and brain pulsatility were studied for outcome parameters like Glasgow outcome scale (GOS) at 1 and 3 months and development of focal deficits.

Results:

H and H and WFNS grades had a significant correlation with GOS. We found that the need for augmentation duraplasty had a significant association with the outcome and appearance of focal deficits. However, unfavourable brain conditions like–dural bulge, brain swelling, petechial haemorrhages, need for ventricular tap, absence of brain pulsatility during surgery did not have a significant impact on the outcome.

Conclusions:

Clinical grading by far remains the best predictor of outcome. Intra-operative brain conditions did not have a bearing on the outcome. The mechanism by which poor grade patients exhibit poor outcomes remains elusive. At least in the present study, it was not by way of manifesting as unfavourable brain conditions. A word of caution–further large studies are required before definite conclusions can be drawn.
Thrombolysis beyond the time window in takayasu's arteritis
Authors: Karri Madhavi , Ramasamy Balakrishnan , Swamiappan Elango , Perumal Santhosh , Kannan Karthik Thamarai
Published: April 2022

Takayasu's arteritis (TA) is chronic inflammatory vasculopathy preferentially affecting the aorta and its major branches. It is one of the potential causes of stroke in young adults. Here, we report a young female who presented to us with an acute-onset right hemiparesis with motor aphasia after 10 h of symptoms onset. Her National Institute of Health Stroke Scale (NIHSS) score at admission was 12. The stroke imaging showed acute infarct in the left middle cerebral artery territory with arterial spin labelling perfusion sequence showing diffusion perfusion mismatch with good penumbra. She underwent intravenous thrombolysis with tenecteplase, based on imaging findings and despite being out of window period. She had an excellent clinical recovery and was discharged with oral anticoagulant and azathioprine. After 3 months of stroke and recovery, follow-up was unremarkable with minimal residual deficits with an NIHSS score of 4 and Modified Rankin Scale of 1. Hence, appropriate early interventions in acute stroke in TA individuals are highly beneficial and timely considered for a good outcome and better quality of life.
A concise operative atlas of microvascular decompression – Different intraoperative scenarios and technical nuances
Authors: Kumar Roopesh V. R. , Karthikayan Arunkumar
Published: April 2022

Background:

Trigeminal neuralgia is one of the most common facial pain syndromes. Although there are many postulated hypotheses explaining the pain, microvascular compression of the root entry zone (REZ) of the trigeminal nerve is commonly accepted to be the pathology for neuralgia. Various medical and surgical treatments are available to relieve the pain and microvascular decompression of the trigeminal nerve at the REZ is considered as the most successful modality and the gold standard.

Methods:

In this video atlas on operative nuances, we have described nine common scenarios that could be encountered during this surgery.

Conclusion:

Thorough knowledge of the different intraoperative scenarios is crucial for a complete microvascular decompression that translates into a good post-operative outcome.
Clinical Significance of Serial Measurements of Interleukin-6 and High-Sensitivity C-Reactive Protein as Early Predictor of Poor Neurological Outcome in Aneurysmal Subarachnoid Haemorrhage
Authors: Sharma Amit Kumar , Mamualiya Ruhi , Inganal Rahul , Singh Daljit , Mahajan Bhawna
Published: April 2022

Introduction:

The inflammatory events are implicated in the pathophysiology of subarachnoid haemorrhage (SAH) and secondary brain injury. The goal of this study was to determine the role of interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) as an early predictor of the poor neurological outcome at 6 months in individuals with SAH.

Methods:

In this prospective, observational study of consecutive patients with aneurysmal SAH included over 1 year. Peak IL-6 and hsCRP were used as an indicator of the inflammatory response. Initial IL-6 and hs-CRP levels were collected within 12 h from admission and then for the next consecutive 7 days. The primary outcome was neurological status at 6-month follow-up assessed with the Modified Rankin Scale (0–6) with a score with or higher than 3 labelled as poor outcome. Logistic regression analyses were used to evaluate the associations between the peak serum IL-6 and hs-CRP levels and the neurological outcome.

Results:

The median peak levels of both markers were significantly higher in the poor outcome group on all 7 days. A significant correlation was seen between peak IL-6 and poor Hunt and Hess grade (P = 0.006), infarction (0.033) and systemic infection (0.03), whereas peak hsCRP had a correlation with rebleed (P = 0.017) and clipping (P = 0.032). Significant risk factors for the poor outcome were poor Hunt and Hess grade (P < 0.000) and high Fisher grades (P = 0.021) and peak IL-6 levels (P = 0.014) on regression analysis.

Conclusion:

The serial measurements of inflammatory markers IL-6 and hsCRP may be used to predict the neurological outcome in aSAH patients. The peak IL-6 levels correlated significantly with poor neurological outcome. Although hsCRP was elevated in patients with the poor outcome, it was statistically non-significant, suggesting a non-specific inflammatory stress response.
Optico-chiasmatic hypothalamic cavernomas - A report of three cases and review of literature
Authors: Kumar Roopesh V R , Karthikayan Arunkumar , Rajendran Adhithyan
Published: April 2022

Optochiasmatic hypothalamic cavernous malformations (CMs) are exceedingly rare lesions and can manifest with visual deficits of varying magnitudes. They also can result in sudden-onset visual loss due to apoplexy. Magnetic resonance imaging can delineate the lesions and differentiate it from other common lesions like glioma or craniopharyngioma. Preoperative visual assessment including perimetry and optical coherence tomogram has to be performed whenever possible to assess the degree of deficits and also for prognostication. Microsurgical excision improves the visual deficits in majority of instances as documented by earlier reports and has to be undertaken as an emergency in apoplexy. Various corridors can be used to reach the lesion including anterolateral, midline transbasal anterior interhemispheric approach, and transnasal endoscopic approaches. The aim should be to achieve a gross total excision with minimal manipulation of surrounding white matter tracts to improve the visual outcome. There is a limited role for stereotactic radiosurgery. In the present study, we report three cases of CMs involving optic chiasm and hypothalamus including a case of apoplexy managed by gross total microsurgical resection with good outcome and also review the relevant literature on the natural history and management strategies
Evaluation of Suspected Small Bowel Ischemia Using Contrast-Enhanced Ultrasound with Computed Tomography Fusion
Authors: Koenig George , Tantawi Mohamed , Wessner Corinne E. , Eisenbrey John R.
Published: April 2022

Small bowel ischemia can lead to fatal complications such as necrosis, perforation, and sepsis. Clinical examinations and laboratory tests are usually inconclusive in critically ill patients. The need for surgical exploration is decided based on imaging, examination, and clinical judgment. The decision to operate is time-critical and can be lifesaving, but surgical intervention has the potential to cause additional morbidity, especially in unstable patients. Contrast-enhanced computed tomography (CECT) is the study of choice in suspected small bowel ischemia but has poor specificity. Contrast-enhanced ultrasound (CEUS) provides real-time visualization of the bowel wall vascularity. In this case report, we used a CEUS with CT fusion examination to rule out small bowel ischemia in a critically ill patient with suspected closed loop small bowel obstruction on CECT and in whom surgical exploration would have not been well tolerated. The patient's condition later improved, and an abdominal CT showed no evidence of obstruction.
Outcomes of Trauma Patients Present to the Emergency Department with a Shock Index of ≥1.0
Authors: Chowdhury Sharfuddin , Parameaswari P. J. , Leenen Luke
Published: April 2022

Introduction:

The study aimed primarily to evaluate the association between the initial shock index (SI) ≥1.0 with blood transfusion requirement in the emergency department (ED) after acute trauma. The study's secondary aim was to look at the outcomes regarding patients’ disposition from ED, intensive care unit (ICU) and hospital length of stay, and deaths.

Methods:

It was a retrospective, cross-sectional study and utilized secondary data from the Saudi Trauma Registry (STAR) between September 2017 and August 2020. We extracted the data related to patient demographics, mechanism of injuries, the intent of injuries, mode of arrival at the hospital, characteristics on presentation to ED, length of stay, and deaths from the database and compared between two groups of SI <1.0 and SI ≥1.0. A P < 0.05 was statistically considered significant.

Results:

Of 6667 patients in STAR, 908 (13.6%) had SI ≥1.0. With SI ≥1.0, there was a significantly higher incidence of blood transfusion in ED compared to SI <1.0 (8.9% vs. 2.4%, P < 0.001). Furthermore, SI ≥ 1.0 was associated with significant ICU admission (26.4% vs. 12.3%, P < 0.001), emergency surgical intervention (8.5% vs. 2.8%, P < 0.001), longer ICU stay (5.0 ± 0.36 vs. 2.2 ± 0.11days, P < 0.001), longer hospital stays (14.8 ± 0.61 vs. 13.3 ± 0.24 days, P < 0.001), and higher deaths (8.4% vs. 2.8%, P < 0.001) compared to the patient with SI <1.0.

Conclusions:

In our cohort, a SI ≥ 1.0 on the presentation at the ED carried significantly worse outcomes. This simple calculation based on initial vital signs may be used as a screening tool and therefore incorporated into initial assessment protocols to manage trauma patients.
The Efficacy of Salvage Intervention with Emergency Transient External Arterial Bypass for Traumatic Artery Occlusion of Main Extremities
Authors: Fujioka Masaki , Fukui Kiyoko , Noguchi Miho
Published: April 2022

Even if the vascular repair is successful, the frequency of limb loss is still high when popliteal artery injury is associated with postischemic syndrome due to blunt trauma or a prolonged ischemic time. Because prolonged ischemia interferes with an injured foot rescue, shortening of the ischemic time is a major aim of surgeons. We present two types of transient external arterial bypass and two cases of ischemic extremities due to main arterial injury. Even though the injured extremities had no circulation for more than 6 h, a transient external arterial bypass supplied circulation immediately, and they were reconstructed successfully. Although transient external arterial bypass is a dated technique, it is a recommended option, especially in the management of acute traumatic ischemia of the extremities to shorten the ischemic time and provide immediate reperfusion, which will bring the opportunity to save the ischemic limbs.
The Usefulness of Physician-Staffed Helicopters for Managing Severe Abdominal Trauma Patients
Authors: Jitsuiki Kei , Nagasawa Hiroki , Muramatsu Ken-Ichi , Takeuchi Ikuto , Ohsaka Hiromichi , Ishikawa Kouhei , Yanagawa Youichi
Published: April 2022

Introduction:

We retrospectively investigated prognostic factors for severe abdominal trauma patients evacuated by a physician-staffed helicopter emergency medical service (HEMS) and ground ambulance using the Japan Trauma Data Bank (JTDB).

Methods:

The study period was from January 2004 to May 2019. The subjects were divided into two groups, according to the type of outcome: the Mortality group, which included patients who ultimately died, and the Survival group, which included patients who obtained a survival outcome.

Results:

There were 2457 in the Mortality group and 11,326 in the Survival group. When variables that showed statistical significance in the univariate analysis were included in a multivariate analysis, the following variables were identified as significant positive predictors of a fatal outcome: evacuation from the scene, blunt injury, injury severity score, and age; significant negative predictors of a fatal outcome were transportation by the HEMS and revised trauma score.

Conclusions:

The present study described the usefulness of the HEMS for severe abdominal trauma patients in comparison with ground ambulance transportation using the JTDB.
Central Diabetes Insipidus
Authors: Shekhawat Vikram Singh , Das Amit Kumar , Pan Somnath , Sudhan M. D.
Published: April 2022

Central diabetes insipidus (CDI) is a rare disorder of water homeostasis characterized by the excretion of a large volume of hypotonic urine resulting from deficient secretion of arginine vasopressin. It is the most common form of diabetes insipidus and manifests when more than 90% of the vasopresinergic magnocellular neurons have been destroyed. The correct diagnosis is always a challenge as it is not always possible to differentiate the different etiologies of CDI based on clinical, hormonal, and radiological examination alone. Histopathology may have to be resorted to at times to provide a definitive diagnosis. In this case series we describe five patients of CDI with varied aetioogies who presented to our tertiary centre. The case series describes and discusses the clinical presentation, evaluation and management of these patients who presented with diabetes insipidus. The aetiologies discussed are extremely rare and required histopathological examination for the final confirmation of diagnosis.
Scleroderma – Lupus Erythematosus Overlap or Lupoderma
Authors: Tripathy Durga Madhab , Sinha Preema , Hegde Arun , Neema Shekhar
Published: April 2022

Overlap syndromes are distinct entities with manifestations of rheumatic diseases in a patient that are not restricted to a particular disease. Rheumatoid arthritis, systemic lupus erythematosus (SLE), scleroderma, Sjogren's syndrome, and idiopathic inflammatory myositis (IIM) are definite connective tissue diseases that can have symptoms with significant overlap. If the clinical, biochemical, and serological parameters do not fulfill the criteria of any of the four diseases, it is termed as undifferentiated connective tissue disease. On the contrary, mixed connective tissue disease is a distinct clinical entity with specific parameters and positive U1RNP titers. Although scleroderma and SLE have their overlap profiles with other inflammatory rheumatic conditions, overlap with IIMs has been the commonest co-association in both the conditions. SLE-scleroderma overlap has been infrequently reported in the literature and can be considered as the rarest overlap as far as prevalence is concerned. We report a case of SLE-scleroderma overlap in a 21-year-old female along with discussing various aspects of the manifestations and complications of the overlap along with the challenges faced by the clinician in managing this relatively rare entity.
Phenotypic Detection and Molecular Characterization of Carbapenem-Resistant Enterobacteriaceae at a Tertiary Care Center
Authors: Bhatt Puneet , Tandel Kundan , Das (Civilian) Nikunja Kumar , Grover Naveen , Ranjan Praveer , Rathi K. R.
Published: April 2022

Background:

Carbapenem-resistant Enterobacteriaceae (CRE) is of utmost clinical importance because they challenge the armamentarium of the treating clinicians, hampering current treatment strategies.

Aim:

The aim of the study is to detect carbapenemase-producing Enterobacteriaceae by phenotypic and molecular methods.

Materials and Methods:

Nonrepetitive isolates of Enterobacteriaceae were identified by conventional phenotypic methods from various clinical samples. All these isolates were screened for carbapenem resistance by meropenem (10μg) or ertapenem (10μg) disc. All the isolates which were found to be carbapenem-resistant by screening test were subjected to phenotypic confirmatory test in the form of modified Hodge test (MHT). These isolates were then subjected to polymerase chain reaction for the detection of various carbapenemase-producing genes, namely New Delhi metallo-β-lactamase 1 (NDM), verona integron-encoded metallo-β-lactamase (VIM), imipenem-resistant Pseudomonas (IMP), KPC, and OXA-48.

Results:

Out of 1254 isolates of Enterobacteriaceae, 230 isolates (18.3%) were found to be positive for carbapenemase production by screening test. A total of 150 out of 230 isolates (65.2%) tested positive for carbapenemase production by MHT. Out of these 150 phenotypically confirmed carbapenemase-producing isolates, blaNDM gene was found in 85, blaVIM in 32, and blaIMP in 22 isolates. blaOXA-48 and blaKPC genes were not found in any isolate. Moreover, there were 19 isolates, in which no gene was detected.

Conclusion:

The prevalence of phenotypically confirmed carbapenemase resistance among Enterobacteriaceae is 11.96% (150/1254). Genes responsible for carbapenemase production are widely prevalent in Enterobacteriaceae Routine detection will help in the management of these broadly-resistant pathogens and implementation of appropriate infection control measures, thus limiting their spread.
Telemedicine – A Way Forward for Medical Consultation at High Altitude
Authors: Sud Saurabh , Bhardwaj Saurabh , Jairam Anatharam , Dwivedi Deepak , Garg Archit
Published: April 2022

The recent advances in telemedicine have offered real and practical opportunities to health-care providers in sharing expertise and resources in health care over distances. In India, telemedicine has revolutionized the health-care system by minimizing the cost, avoiding the long-distance travels and in timely providing specialist care in remote areas. The Indian Army is also reaping the benefits of telemedicine, by providing round-the-clock medical care to the troops deployed in high-altitude areas.
Hyperbaric Oxygen Therapy for Recalcitrant Macular Edema Following Branch Retinal Vein Occlusion
Authors: Oli Avadhesh , Bhirud Rupali , Solanki Kartikey P. , Joshi Dattakiran
Published: April 2022

Cystoid macular edema (CME) is the most common cause of reduced vision in branch retinal vein occlusion (BRVO). The treatment protocols for macular edema in BRVO have changed considerably in the previous decade because of the increased popularity of the wide use of optical coherence tomography (OCT) and intravitreal drugs. Intravitreal injection of anti-vascular endothelial growth factors (anti-VEGF) and steroids result in the reduction of CME. However, the effect is transient, and multiple injections may be required. On repeated use, few patients become non-responders to these drugs. Nonetheless, anti-VEGF drugs may have potentially life-threatening complications because of systemic absorption. Intravitreal steroids may lead to severe ocular side effects such as cataract and glaucoma. Chances of endophthalmitis, retinal tear, and inflammation can occur with any of the intravitreal injections. We present a case of BRVO with recalcitrant CME following focal laser, multiple intravitreal anti-VEGF, and steroid injections. However, he had cardiovascular risk factors, so repeated anti-VEGF injections were not given. He was planned for hyperbaric oxygen therapy and showed favorable response. His visual acuity improved and macular edema reduced to more than half from baseline values on OCT.
Learning Behavior and Perspective of Medical Students in India on COVID-19 Pandemic
Authors: Kapoor Suraj , Anand Vivek , Kaushik S K , Yadav Arun Kumar
Published: April 2022

Introduction:

Medical colleges in India are opening gradually for resumption of medical education. Assessment of learning behavior and perspectives of students toward COVID-19 pandemic is essential for effective medical education as well as to assess their role in pandemic if need arises. Hence, the present study aims to assess learning behavior and perspective of medical students on COVID-19 pandemic.

Materials and Methods:

A descriptive cross-sectional study was conducted from September to December 2020 among 392 medical students at various medical colleges of the country. An online self-administered questionnaire was designed to assess learning behavior of medical students about infection prevention and control practices in COVID-19 adopted during the course of pandemic. Snowball sampling method was used for data collection.

Results:

On assessment of 392 medical students about preventive measures during COVID-19 pandemic, more than 80% of medical students were aware of the importance of facemask, social distancing, frequent hand washing, and use of digital tools such as Aarogya Setu app in surveillance. Majority of students were aware of the symptoms, testing, and treatment protocols along with importance of self-reporting. Most of the students were aware of various sources of getting scientific and relevant information about pandemic. While majority of students were aware of rationale of quarantine, appropriate waste management technique, and post-COVID precautions, there was a lack of knowledge about appropriate disinfection measures.

Conclusions:

Medical students are an asset to health care; learning behaviors adopted by them can certainly help to assist health-care system in COVID times.
Sexual Behavior and Increasing Vulnerability of Elderly Population to Sexually Transmitted Infections
Authors: Kandpal Renu , Viswanath H. M. , Phulari Yoganand S , Kumar Mukesh , Hiremath Ravishekar N , Patil Chetan , Sumathi Arumugam , Binakka Paramarthalingam , Sarkar Tapoti
Published: April 2022

Objective:

The objective of the study was to study the pattern of sexual behavior and sexually transmitted infections (STIs) among the patients attending the STIs clinic in a tertiary care hospital in Western Uttar Pradesh.

Materials and Methods:

A cross-sectional study was carried out among all confirmed STI cases attending the STI clinic during the period of 1 year. Data were collected by means of personal interview using pretested pro forma with questions related to their sexual behavior and STIs. Relevant investigations were carried out for all cases. Data were entered in Excel sheet and analyzed by means of Epi Info version 7.

Results:

A total of 373 patients were reported with anogenital lesions. Out of these, 310 were confirmed cases of STI. Surprisingly, in the clinic, the attendance of elderly was 41 (13% of total cases). The attendance of older adults (>40 years of age) was more (178, 57.41%) in comparison to the younger population (132, 42.58%). Among the older population, males outnumbered female patients. Out of the total lesions, the most common genital lesion was herpes genitalis followed by balanoposthitis.

Conclusion:

We generally assume that, with increasing age, the chances of acquiring STIs are less, but in our study, most of them admitted to having regular sexual activity and this clearly indicated the vulnerability of the elderly population to STIs. We definitely need to focus on their sexual needs and sex education to prevent the increased rate of infections among them.
Combating New Challenge in Coronavirus Disease-2019 Management
Authors: Kansara Nikunj , Kumar Surinder , Yadav Arun Kumar
Published: April 2022

Background:

The coronavirus disease-2019 (COVID-19) pandemic has introduced new ethical challenges in the care of patients and people who may have been exposed to severe acute respiratory syndrome coronavirus-2 or have mild to moderate COVID-19. Refusal to get tested for COVID-19 and having poor adherence to infection prevention protocols are the areas of concern for the ongoing pandemic. Such situations increase the risk of infection to other patients and staff. The factors affecting testing refusal were studied with the help of the Google questionnaire.

Methodology:

The cross-sectional survey tool was developed and distributed after pilot testing. The study population was selected using mix sampling method, snowball, and random sampling using the mobile number of the participants. All the participants were informed about the purpose of the study and included after taking consent.

Results:

Of the 176 study participants, the majority were male (112, 63.6%), with a mean age of 37.2 years (standard deviation 10.4). Forty-one (23.3%) were health-care workers and 74 (42.1%) were private company employees. Seventy-one (40.3%) refused to get tested for COVID-19 when asked whether they will get tested in the presence of any COVID-19 symptoms and 81 (46.8%) refused to get tested in the absence of any symptoms.

Conclusion:

Health policy-makers should utilize the study results to formulate the policy regarding any future pandemic to reduce the level of stigma associated with an unknown disease. These clarifications and excuses asked to the study participants are meant to provide a deeper understanding to address the pandemic better.
Factorization homology and 4D TQFT
Authors: Kirillov, Jr. Alexander , Tham Ying Hong
Published: April 2022

In 2010, B. Balsam and A. Kirillov, Jr. showed that the Turaev–Viro invariants defined for a spherical fusion category

\mathcal{A}

extends to invariants of 3-manifolds with corners. In 2021, A. Kirillov, Jr. described an equivalent formulation for the 2-1 part of the theory (2-manifolds with boundary) using the space of “stringnets with boundary conditions” as the vector spaces associated to 2-manifolds with boundary. Here we construct a similar theory for the 3-2 part of the 4-3-2 theory by L. Crane and D. Yetter (1993).
Estrategia discursiva sobre los MENA en YouTube. Construcción de un discurso de odio
Authors: Gómez de Travesedo Rojas Ruth , Gil Ramírez Marta
Published: April 2022

Introducción: En el último año el fenómeno migratorio relacionado con los menores extranjeros no acompañados (en adelante MENA) ha obtenido un especial eco mediático en el contexto español, motivado, entre otras cuestiones, por la publicidad negativa hacia este colectivo que el partido ultraderechista Vox ha utilizado durante la campaña de las elecciones madrileñas de 2021. En ausencia de literatura previa, esta investigación se propone determinar la representación que, en YouTube, se construye y transmite sobre los MENA. Metodología: Se propone un estudio de corte exploratorio-descriptivo, en el que se emplean el análisis de contenido y el análisis crítico del discurso para examinar los vídeos más populares, en la red social propuesta, bajo la etiqueta MENA-España. Resultados: Prevalece una caracterización de los MENA configurada en base a la subjetividad, al uso de un lenguaje peyorativo, denigrante e incriminatorio que gira en torno a la asociación de estos menores con el concepto de amenaza. Discusión: Los hallazgos resultan coincidentes con investigaciones precedentes que analizan el fenómeno migratorio en su conjunto, pero supone una novedad en el cuanto al análisis de la tipología especifica de migrantes que constituyen los MENA, cuya representación a través de las redes sociales no ha sido aún explorada a nivel académico. Conclusiones: Los contenidos vertidos en esta red social contribuyen a difundir un discurso de odio hacia los MENA, principalmente en base a sobredimensionar el conflicto y a la homogeneización del colectivo entorno a atributos negativos.
Comparison of 68Ga-DOTATOC and 18F-FDG Thoracic Lymph Node and Pulmonary Lesion Uptake Using PET/CT in Postprimary Tuberculosis
Authors: Rosado-de-Castro Paulo Henrique , Pereira-de-Carvalho Thiago , Menna Barreto Miriam , Kritski Afrânio Lineu , de Oliveira Souza Rebecca , Altino de Almeida Sergio , Cavalcanti Rolla Valéria , Araujo Zin Walter , Roncally Silva Carvalho Alysson , Souza Rodrigues Rosana
Published: April 2022

Tuberculosis (TB) remains one of the world’s leading infectious cause of morbidity and mortality. Positron emission tomography (PET) associated with computed tomography (CT) allows a structural and metabolic evaluation of TB lesions, being an excellent noninvasive alternative for understanding its pathogenesis. DOTATOC labeled with gallium-68 (68Ga-DOTATOC) can bind to somatostatin receptors present in activated macrophages and lymphocytes, cells with a fundamental role in TB pathogenesis. We describe 68Ga-DOTATOC uptake distribution and patterns in thoracic lymph nodes (LN) and pulmonary lesions (PL) in immunocompetent patients with active postprimary TB, analyze the relative LN/PL uptake, and compare this two tracer’s uptake. High uptake of both radiotracers in PL and LN was demonstrated, with higher LN/PL ratio on 68Ga-DOTATOC (P < 0.05). Considering that LN in immunocompetent patients are poorly studied, 68Ga-DOTATOC can contribute to the understanding of the complex immunopathogenesis of TB.
Prevalence of Crimean-Congo Hemorrhagic Fever Virus among Livestock and Ticks in Zhambyl Region, Kazakhstan, 2017
Authors: Bryant-Genevier Jonathan , Bumburidi Yekaterina , Kazazian Lilit , Seffren Victoria , Head Jennifer R. , Berezovskiy Dmitriy , Zhakipbayeva Bakhytkul , Salyer Stephanie J. , Knust Barbara , Klena John D. , Chiang Cheng-Feng , Mirzabekova Gulfaira , Rakhimov Kumisbek , Koekeev Jandar , Kartabayev Kanatbek , Mamadaliyev Seydigapbar , Guerra Marta , Blanton Curtis , Shoemaker Trevor , Singer Daniel , Moffett Daphne B.
Published: April 2022

Crimean-Congo hemorrhagic fever (CCHF) is a highly fatal zoonotic disease endemic to Kazakhstan. Previous work estimated the seroprevalence of CCHF virus (CCHFV) among livestock owners in the Zhambyl region of southern Kazakhstan at 1.2%. To estimate CCHFV seroprevalence among cattle and sheep, we selected 15 villages with known history of CCHFV circulation (endemic) and 15 villages without known circulation (nonendemic) by cluster sampling with probability proportional to livestock population size. We collected whole blood samples from 521 sheep and 454 cattle from randomly selected households within each village and collected ticks found on the animals. We tested livestock blood for CCHFV-specific IgG antibodies by ELISA; ticks were screened for CCHFV RNA by real-time reverse transcription polymerase chain reaction and CCHFV antigen by antigen-capture ELISA. We administered questionnaires covering animal demographics and livestock herd characteristics to an adult in each selected household. Overall weighted seroprevalence was 5.7% (95% CI: 3.1, 10.3) among sheep and 22.5% (95% CI: 15.8, 31.2) among cattle. CCHFV-positive tick pools were found on two sheep (2.4%, 95% CI: 0.6, 9.5) and three cattle (3.8%, 95% CI: 1.2, 11.5); three CCHFV-positive tick pools were found in nonendemic villages. Endemic villages reported higher seroprevalence among sheep (15.5% versus 2.8%, P < 0.001) but not cattle (25.9% versus 20.1%, P = 0.42). Findings suggest that the current village classification scheme may not reflect the geographic distribution of CCHFV in Zhambyl and underscore that public health measures must address the risk of CCHF even in areas without a known history of circulation.
Calidad de vida laboral en empleados de una empresa distribuidora de bebidas de Santander, Colombia
Authors: Rojas-Torres Andrea Carolina , Tiga-Loza Diana Carolina , Bello-Pinto Wilber
Published: April 2022

Introducción: Es deber de las organizaciones preocuparse por el bienestar físico, mental y social de los trabajadores. Evaluar la calidad de vida laboral puede indicar cómo el empleo cubre las necesidades de seguridad, satisfacción, bienestar y desarrollo personal/laboral del trabajador.

Método: estudio transversal en 122 trabajadores con labores de conducción de vehículos, cargue/descargue, entrega/recepción de mercancía y dinero, seleccionados a conveniencia en una empresa distribuidora de bebidas. La calidad de vida laboral se evaluó mediante CVT-GOHISALO y se exploró su relación con variables sociodemográficas y laborales.

Resultados: se encontró un alto nivel de satisfacción en el soporte institucional para el trabajo y la seguridad en el trabajo, un nivel medio en la integración al puesto y el desarrollo personal, un nivel bajo en la satisfacción a través del trabajo y un nivel de satisfacción en riesgo en el bienestar logrado y la administración del tiempo libre. La calidad de vida laboral se relacionó con el número de horas y días trabajados, también con la antigüedad en las dimensiones de integración al puesto y seguridad en el trabajo; el nivel educativo, la jornada laboral, las pausas activas y el cargo se relacionaron con todas las dimensiones excepto con soporte institucional y administración del tiempo libre.

Conclusiones: La calidad de vida laboral fue valorada por cómo el empleador brinda los elementos e indicaciones necesarias para realizar el trabajo; pero con deficiencias en el bienestar y el manejo del tiempo. La calidad de vida fue más baja en trabajadores con secundaria, que laboran más días/horas y en la jornada diurna, tienen mayor antigüedad, son conductores y no realizan pausas activas.
Condiciones de trabajo y estado de salud en conductores de transporte público: una revisión sistemática
Authors: Arias-Meléndez Camila , Comte-González Paulina , Donoso-Núñez Adriana , Gómez-Castro Geraldine , Luengo-Martínez Carolina , Morales-Ojeda Ismael
Published: April 2022

Objetivo: Realizar una revisión sistemática de la literatura sobre condiciones de salud y trabajo en conductores de transporte público.

Métodos: Revisión sistemática bibliográfica con búsqueda de información entre los años 2015-2020 ajustado a los requerimientos establecidos para las revisiones sistemáticas en la declaración PRISMA.

Resultados: La condición laboral tiene influencia directa sobre el estado de salud pesquisándose alteraciones tales como: sobrepeso, enfermedades cardiovasculares, osteomusculares, sintomatología de tipo ansiosa- depresiva y tendencia al consumo de alcohol y tabaco.

Conclusiones: Los artículos revisados, evidenciaron que los conductores de transporte público presentan condiciones de trabajo desfavorables, con presencia de riesgos físicos y psicológicos.
THE EFFICIENCY OF EARTHWORMS AS A BIOMARKER FOR ENVIRONMENTAL POLLUTION
Authors: Singh Keshav , Fatima Nishat
Published: April 2022

Pollution from various sources is currently regarded as one of the most severe issues everywhere. However, certain biological indicators can detect a variety of contaminants, and each one is used to identify a specific pollutant or a group of pollutants. The use of molecular and biochemical biomarkers is one of the ecotoxicological approaches in assessing pollutant bioavailability and sublethal effects. One of the most rapidly growing fields in ecotoxicological research is biomarkers in soil invertebrates, such as earthworms. Due to the widespread use of biocides and fertilizers in agriculture, industrial operations, urban trash, and air deposition, soil contamination has risen in recent decades. Earthworms serve as an excellent bio indicator for monitoring soil pollution. There are a variety of biomarkers of toxic substances in earthworm ecotoxicology. The present review is focused on the use of earthworms as a biomarker to analyze the impact of toxicological substances.