bluuebunny/crossref_metadata_2025 huggingface dataset:
Forced waves and their asymptotic behaviors in a Lotka-Volterra competition model with spatio-temporal nonlocal effect under climate change
Authors: Yang Yong , Li Zunxian , Xia Chengyi
Published: June 2023

In this paper, we propose a modified Lotka-Volterra competition model under climate change, which incorporates both spatial and temporal nonlocal effect. First, the theoretical analyses for forced waves of the model are performed, and the existence of the forced waves is proved by using the cross-iteration scheme combining with appropriate upper and lower solutions. Second, the asymptotic behaviors of the forced waves are derived by using the linearization and limiting method, and we find that the asymptotic behaviors of forced waves are mainly determined by the leading equations. In addition, some typical numerical examples are provided to illustrate the analytical results. By choosing three kinds of different kernel functions, it is found that the forced waves can be both monotonic and non-monotonic.
Stratified Post-Reproduction: An Analysis of Black Women’s Barriers to Postpartum Depression Treatment
Authors: Brockey Beatriz Leal
Published: June 2023

Stratified reproduction is defined as a systemic devaluation of one group’s reproductive
capacity over another’s (Harris & Wolfe, 2014). This article seeks to analyze the effects of
stratified reproduction on the experiences of Black women with postpartum depression.
Beginning with a thorough analysis of postpartum depression, its prevalence, and its methods of
treatment, the paper then goes on to evaluate the existing research done on postpartum
depression in Black women specifically. After analyzing evidence that indicates higher rates of
mental illness among Black mothers, the paper examines stratified reproduction and a new term
“stratified post-reproduction” is defined. In comparison, stratified post-reproduction, a term
coined by the author, serves to elucidate the ways in which the prioritization of and concentration
on white women’s post birth experiences by the medical community at large leads to a lower
quality of treatment of non-white women and mothers of other marginalized groups (Primm et
al., 2010). This creates a system that increases the rates of postpartum depression among Black
women and keeps Black women from seeking post-birth care for this depression. The paper
concludes by offering community based, feminist, and Black centered approaches to treating and
caring for Black mothers in the period directly after birth. It is important to center Black voices
and experiences in conversations about systemic oppression and thus the article cites research
analyzing interviews done with Black mothers and focuses on research conducted by people of
color and women.
Listening to the Voices of Gay and Bisexual Men and Other Men Who Have Sex with Men in Kenya: Recommendations for Improved HIV Prevention Programming
Authors: Lyons Myla , Harper Gary W. , Jadwin-Cakmak Laura , Beyer Adrian , Graham Susan M.
Published: June 2023

Young gay and bisexual men and other men who have sex with men (GBMSM) are a key
population at high risk for new human immunodeficiency virus (HIV) infections in Kenya, thus
increased efforts are necessary to reduce their health risks. This qualitative study describes
recommendations offered by young GBMSM in Kenya regarding the development and delivery

2
of culturally appropriate HIV prevention services. Both young GBMSM Community Members
and Peer Educators recommend that future HIV prevention efforts enhance economic
empowerment, provide mental health and substance use services, and incorporate arts-based
health promotion strategies. In addition, participants recommended that public health
professionals increase ease of access to HIV prevention services for GBMSM, and that
researchers disseminate findings from HIV prevention research back to the community.
Chinese Imagination?
Authors: Chou Joyce Ying-Ching
Published: June 2023

Canton enamel painters of the Qing Dynasty (1644-1911) created a witty style of Western figures in response to Chinese perception and market demand. Western figures were one of the main decorative motifs of Qing-painted enamel on copperware in Guangdong (commonly known as Canton enamels), with a diverse range of images and a wide variety of characters, making it a major attractive feature of Canton enamels. Since Western subjects were unfamiliar to Chinese painters, enamel painters in Guangdong often used European paintings as reference for their drawings. In response to the diverse demands of the domestic and export markets for Canton enamels, they developed a wide range of pictorial expressions, thus creating a style unique to the Guangdong region. In order to illustrate the characteristics of Western figures on Canton enamels, we will first compare them with the figures on painted enamels produced at the Qing court, as Guangdong and the imperial court were the two major centres of production of painted enamels during the Qing dynasty. The comparison will highlight and help to identify their stylistic characteristics.
Tracer l’utilisation de recettes et/ou d’ingrédients européens dans les objets émaillés : stratégie et premiers résultats
Authors: Colomban Philippe
Published: June 2023

Différentes recettes d’émaillage peuvent donner un même résultat visuel. Identifier les agents colorants et la matrice silicatée des émaux est nécessaire pour comparer les techniques de production des porcelaines et objets métalliques, émaillés, produits spécifiquement pour l’Empereur et sa cour. L’analyse doit être non-invasive et conduite dans les lieux de conservation des objets. Notre expérience de vingt ans d’étude non-invasive des verres, céramiques et objets métalliques anciens a conduit à focaliser les analyses sur les couleurs bleu, blanc, jaune, vert et rouge/rose en utilisant deux techniques d’analyse mobile : la fluorescence des rayons X et la micro-spectroscopie Raman. Ces méthodes complémentaires identifient les éléments (ou les phases) colorants/opacifiants (jaune et vert : pyrochlore à base de plomb, d’étain ou d’antimoine ; rose : nanoparticules d’or ; blanc : arséniates de plomb-calcium ; bleu : cobalt, asiatique ou européen ; rouge : hématite ou nanoparticules de cuivre). Le but est de comparer les dates d’innovation en Europe et en Chine.
Writing and Drawing Inventions: Patents and Technology in France and the United States (18th-19th centuries)
Authors: Baudry Jérôme
Published: June 2023

Dans les régimes de brevets d’invention qui se mettent en place au xviiie siècle, d’abord en Angleterre puis aux États-Unis et en France, la description (par le texte, l’image, le modèle, l’échantillon) occupe un rôle central. Elle permet d’opérationnaliser l’idée de contrat au fondement du brevet : protection contre divulgation. D’année en année, les « specifications » anglaises et américaines et les « mémoires descriptifs et explicatifs » français viennent alimenter une immense littérature technologique, dont la particularité est d’être (en principe) écrite par les inventeurs eux-mêmes. Cet article explore les styles et les techniques de représentation mis en œuvre dans les brevets d’invention, principalement en France, mais aussi en comparaison avec les États-Unis. L’étude de la diversité et de l’évolution de ces représentations dessine en creux tout à la fois une histoire renouvelée des brevets et de leurs usages, et une histoire de la pensée de la technique au xixe siècle.
The Use of Machine Learning in Libraries
Authors: Khamis Iman
Published: June 2023

This chapter focuses on machine learning algorithms used in real-world applications and the possibilities of using them in libraries. Recommender systems are considered to be very valuable tools as they can be personalized to each user's preferences and needs. The main goal of the recommendation system is to aid users in finding necessary items from an overwhelming number of options. In this chapter, the authors examine two book recommender systems, explain the logic behind the used algorithms, and illustrate the way to adapt the same technologies in other libraries.
Challenges of Using Wireless Sensor Network-Based RFID Technology for Industrial IoT Applications
Authors: Pal Kamalendu
Published: June 2023

In recent decades, wireless sensor networks (WSNs)-based radio frequency identification (RFID) technologies are paving the way for the internet of things (IoT) industrial applications. These applications are the manifestation of new-generation information systems (IS). For example, the automation of supply chain management (SCM) operations, library management systems, and healthcare systems are a few industries specific applications. RFID-based IS helps to identify and track objects, while WSNs cooperate in collecting and providing information from interconnected sensors. It includes technical challenges, such as presenting RFID systems with appropriate identification capabilities into sensing, providing the power of computation, and interconnecting them wirelessly in tags sensing architectures. In this way, the latest advances in WSNs and integrating both technologies have resulted in the opportunity to develop innovative IoT-based industrial applications. This chapter reviews these technologies (i.e., RFID, WSNs) and the challenges that need to resolve for smooth operation.
RFID Tag Anti-Collision Algorithms in Industrial Information Systems
Authors: Pal Kamalendu
Published: June 2023

Radio frequency identification (RFID) technology uses radio frequency signals to identify tagged objects. RFID is an important technology used by the internet of things (IoT)-based applications. It enables communication between the primary devices used in RFID system, the reader, and the tags. The tags share a common communication channel. Therefore, if more than one tag tries to send information simultaneously, the reader cannot differentiate these signals in the case of radio signal interference. This phenomenon is known as tag collision problem. The problem of tag collision is one of the significant disadvantages of fast tagged-object identification in industrial information systems. This chapter describes four binary search algorithms to avoid tag collision and presents a performance measurement mechanism for RFID application systems. Finally, simulation-based experimental results on the performance of these algorithms are presented.
Corruption Levels and Country Cluster
Authors: Garzón Nicolás Rivera , Lozano Miller Rivera
Published: June 2023

The objective of the chapter is to classify countries into different categories of corruption levels using the K-Means algorithm for 2012 and 2021. The sample is made up of an aggregation of 195 countries of different levels of income using data obtained from the World Development Indicators compiled by the World Bank and Transparency International. The optimal number of clusters is chosen at the elbow point, which is the point of the graph where the curve starts to flatten out. The optimal number of clusters chosen is three, which can be qualitatively interpreted as groups of countries with high, medium, and low corruption levels. The results obtained show that corruption has a directly proportional relationship with the number of adolescent pregnancies, gender inequality, overall inequality, and maternal mortality. While corruption levels have a negative relationship with levels of human development and the average years of schooling.
Fraud Prevention, Political Corruption, and Anti-Corruption Strategies
Authors: Saiz-Alvarez José Manuel
Published: June 2023

Along with socioeconomic imbalances and the appearance of world hunger, political corruption is one of the endemic evils in the world. The most corrupt countries suffer the highest levels of inequality and social injustice. Throughout this chapter, the causes of political corruption are analyzed, and possible solutions are proposed to at least alleviate this problem. It is essential to act quickly to prevent bribery from penetrating all social strata and making its eradication even more difficult. The chapter briefly analyzes the anti-fraud office of the European Union, among other existing anti-corruption strategies applied in the European Union to fight this political crime.
Strategies to Combat Hidden Resignation and Disguised Unemployment
Authors: Ince Fatma
Published: June 2023

The issue of unemployment is a struggle that has the potential to directly affect the life welfare of society, although it provides detailed information about the economic levels of the countries. The rapid change and adaptation process experienced in recent years creates direct and indirect pressures in the labor market as in every field. In this part of the book, which deals with the issue of hidden unemployment and resignation beyond visible data, first of all, the economic and sociological effects of the concepts are mentioned. Afterward, it is aimed to present detailed content by including information about different countries in the content where solution proposals are presented. In this way, individual and corporate awareness can be brought to the fore by drawing attention to work-life harmony in different economies and prevent acts of corruption.
Suppression of Experimental Autoimmune Encephalomyelitis in Mice by β-Hydroxy β-Methylbutyrate, a Body-Building Supplement in Humans
Authors: Sheinin Monica , Mondal Susanta , Roy Avik , Gorai Sukhamoy , Rangasamy Suresh B , Poddar Jit , Pahan Kalipada
Published: June 2023

Although several immunomodulatory drugs are available for multiple sclerosis (MS), most present significant side effects with long-term use. Therefore, delineation of nontoxic drugs for MS is an important area of research. β-Hydroxy β-methylbutyrate (HMB) is accessible in local GNC stores as a muscle-building supplement in humans. This study underlines the importance of HMB in suppressing clinical symptoms of experimental autoimmune encephalomyelitis (EAE) in mice, an animal model of MS. Dose-dependent study shows that oral HMB at a dose of 1 mg/kg body weight/d or higher significantly suppresses clinical symptoms of EAE in mice. Accordingly, orally administered HMB attenuated perivascular cuffing, preserved the integrity of the blood–brain barrier and blood–spinal cord barrier, inhibited inflammation, maintained the expression of myelin genes, and blocked demyelination in the spinal cord of EAE mice. From the immunomodulatory side, HMB protected regulatory T cells and suppressed Th1 and Th17 biasness. Using peroxisome proliferator-activated receptor (PPAR)α−/− and PPARβ−/− mice, we observed that HMB required PPARβ, but not PPARα, to exhibit immunomodulation and suppress EAE. Interestingly, HMB reduced the production of NO via PPARβ to protect regulatory T cells. These results describe a novel anti-autoimmune property of HMB that may be beneficial in the treatment of MS and other autoimmune disorders.
Diversity of B Cell Populations and Ig Repertoire in Human Lungs
Authors: Aihara Fumiaki , Wang Yumei , Belkina Anna C , Fearns Rachel , Mizgerd Joseph P , Feng Feng , Kepler Thomas B
Published: June 2023

The human lung carries a unique microbiome adapted to the air-filled, mucous-lined environment, the presence of which requires an immune system capable of recognizing harmful populations while preventing reactions toward commensals. B cells in the lung play a key role in pulmonary immunity, generating Ag-specific Abs, as well as cytokine secretion for immune activation and regulation. In this study, we compared B cell subsets in human lungs versus circulating cells by analyzing patient-paired lung and blood samples. We found a significantly smaller pool of CD19+, CD20+ B cells in the lung relative to the blood. CD27+, IgD−, class-switched memory B cells (Bmems) composed a larger proportion of the pool of pulmonary B cells. The residency marker CD69 was also significantly higher in the lung. We also sequenced the Ig V region genes (IgVRGs) of class-switched Bmems that do, or do not, express CD69. We observed the IgVRGs of pulmonary Bmems to be as heavily mutated from the unmutated common ancestor as those in circulation. Furthermore, we found progenies within a quasi-clone can gain or lose CD69 expression, regardless of whether the parent clone expressed the residency marker. Overall, our results show that despite its vascularized nature, human lungs carry a unique proportion of B cell subsets. The IgVRGs of pulmonary Bmems are as diverse as those in blood, and progenies of Bmems retain the ability to gain or lose residency.
FcRγ− NK Cell Induction by Specific Cytomegalovirus and Expansion by Subclinical Viral Infections in Rhesus Macaques
Authors: Lee Jaewon , Chang W L William , Scott Jeannine M , Hong Suyeon , Lee Taehyung , Deere Jesse D , Park Peter H , Sparger Ellen E , Dandekar Satya , Hartigan-O’Connor Dennis J , Barry Peter A , Kim Sungjin
Published: June 2023

“Adaptive” NK cells, characterized by FcRγ deficiency and enhanced responsiveness to Ab-bound, virus-infected cells, have been found in certain hCMV-seropositive individuals. Because humans are exposed to numerous microbes and environmental agents, specific relationships between hCMV and FcRγ-deficient NK cells (also known as g-NK cells) have been challenging to define. Here, we show that a subgroup of rhesus CMV (RhCMV)-seropositive macaques possesses FcRγ-deficient NK cells that stably persist and display a phenotype resembling human FcRγ-deficient NK cells. Moreover, these macaque NK cells resembled human FcRγ-deficient NK cells with respect to functional characteristics, including enhanced responsiveness to RhCMV-infected target in an Ab-dependent manner and hyporesponsiveness to tumor and cytokine stimulation. These cells were not detected in specific pathogen-free (SPF) macaques free of RhCMV and six other viruses; however, experimental infection of SPF animals with RhCMV strain UCD59, but not RhCMV strain 68-1 or SIV, led to induction of FcRγ-deficient NK cells. In non-SPF macaques, coinfection by RhCMV with other common viruses was associated with higher frequencies of FcRγ-deficient NK cells. These results support a causal role for specific CMV strain(s) in the induction of FcRγ-deficient NK cells and suggest that coinfection by other viruses further expands this memory-like NK cell pool.
Evaluation of Autonomous Ship Landing Systems at the Maneuvering and Seakeeping Basin
Authors:   The Pennsylvania State University, Hendrick Christopher ,   US Naval Surface Warfare Center, Sydney Anish , Jaques Emma , Horn Joseph , Langelaan Jack
Published: June 2023

This paper presents the results of an extensive model-scale experimental evaluation of autonomous ship landing guidance and control modes, with flight tests performed in the Maneuvering and Seakeeping (MASK) Basin at the U.S. Naval Surface Warfare Center Carderock Division. The experiments were performed using a commodities-based multirotor UAV operating from a 20-foot-long model scale ship subject to scaled wave conditions. During testing, two separate guidance algorithms were evaluated: a quadratic programming (QP) based landing algorithm that plans the trajectory to a forecasted deck state, and a simpler 'baseline' method that tracks deck motions while closing the distance between the aircraft and deck at a constant rate. Both algorithms commanded a Froude scaled explicit model following control law, and the control laws were used to progressively degrade aircraft tracking bandwidths. The results showed the QP algorithm to be capable of good performance despite poor long term deck state predictions, though several landings with the QP algorithm did terminate with significant velocity and attitude errors. In these cases, however, it is shown that the major factor contributing to degraded performance was not poor deck predictions, giving confidence in the feasibility of incorporating deck predictions directly in path planning. The results also showed that the predictive capabilities of the QP algorithm allowed more direct landing paths to be planned when compared to the baseline algorithm, and also allowed the QP algorithm to land with lower tracking bandwidths. The baseline guidance algorithm, on the other hand, proved to be both simple and reliable when the UAV was in high bandwidth configurations but is sensitive to increased lag in the system.
Safety and tolerability of biodegradable balloon spacers in patients undergoing radiotherapy for organ-confined prostate cancer
Authors: Topazio Luca , Narcisi Federico , Tana Fabio , Ciotta Cosimo , Iossa Vincenzo , Perna Pasquale , Chiaramonti Francesco , Romantini Federico
Published: June 2023

Introduction: Radiotherapy is a common treatment for prostate cancer, and can be administered in various ways, including 3D conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT) and hypo-fractionated radiation therapy. During treatment the gastrointestinal tract may be exposed to radiation and the rectal wall may be exposed to high doses of ionizing radiation, which can lead to rectal bleeding, ulcers or fistulas, and an increased risk of rectum cancer. Various strategies to minimize these complications have been developed in the last decade; one of the most promising is to use a rectal balloon to fixate the prostate gland during treatment or to inject biodegradable spacers between the prostate and rectum to reduce the rectal dose of radiation. Aim of our paper is to evaluate the safety and tolerability of spacers implantation. Materials and methods: From January 2021 to June 2022 all patients with a diagnosis of prostate cancer with unfavorable/ intermediate risk - poor prognosis and programmed hypofractionated radiation therapy were enrolled. In all patients biodegradable balloons spacers were placed posteriorly to the prostate to increase the separation between prostate and rectum. The duration of the procedure, observation time, the appearance of early and late complications and their severity (according to Charlson comorbidity index) and tolerability of the device were recorded at the time of positioning and after 10 days. Results: 25 patients were enrolled in our study. Two patients (8%) underwent acute urine retention resolved with catheterization and one patient (4%) developed a mild perineal hematoma that did not require any treatment. As regards late complications 1 patient (4%) developed hyperpyrexia (> 38°C) the day after the procedure requiring continuation of antibiotic regimen. At T1 visit we recorded no medium-high grade complications. As for the tolerability of the device, it was optimal with no perineal discomfort or alterations of bowel function. Conclusions: Biodegradable balloon spacers appears to be safe and well tolerated and its positioning does not present any technical difficulties or risks of major complications.
Environmental factors in autoimmune bullous diseases with focusing on seasonality: new insights
Authors: D'Astolto Roberto , Quintarelli Lavinia , Corrà Alberto , Caproni Marzia , Fania Luca , Di Zenzo Giovanni , Didona Biagio , Gasparini Giulia , Cozzani Emanuele , Feliciani Claudio
Published: June 2023

Autoimmune bullous diseases are a heterogeneous group of rare conditions clinically characterized by the presence of blisters and/or erosions on the skin and on the mucous membranes. Practically, they can be divided into two large groups: the pemphigoid group and the pemphigus group, depending on the depth of the autoimmune process on the skin. Family history of autoimmune disease can often be found, and demonstrating that genetic predisposition is crucial in the development of them. Moreover, numerous environmental risk factors, such as solar radiation, drugs and infections, are known. This study aimed to evaluate how seasonality can affect the trend of BP and PV, especially considering the number of hospitalizations recorded over the course of individual months. The total number of hospitalizations in the twelve months of the year was evaluated. Further, blood chemistry assay and, for some patients, enzyme-linked immunosorbent assay were executed in order to evaluate antibodies. Regarding the severity of the disease BPDAI (Bullous Pemphigoid Area Index) and PDAI (Pemphigus Disease Area Index), score systems were used. Results showed a complex interplay between environmental factors such as seasons and autoimmune conditions.
A Single-Blind Randomized Control Trial on the Effectiveness of Adjunct Cognitive Stimulation Therapy on Cognitive Outcomes in Dementia
Authors: Bhowmik Soumya , Chandra Mina , Anand Kuljeet , Dahuja Shrishti
Published: June 2023

Background:

Dementia is characterized by neurocognitive decline which interferes with daily function and independence. Cognitive stimulation therapy (CST) is an evidence-based cognitive psychosocial intervention for people with dementia.

Materials and Methods:

A prospective interventional study of single-blind RCT design conducted in the Department of Neurology at ABVIMS and Dr RML Hospital amongst patients with DSM-V major neurocognitive disorder aged more than 50 years. Participants were randomized to CST and control groups using a block-randomized design. The control group participants received treatment as usual while the CST group delivered 45-min virtual group CST sessions for a total of 14 sessions over seven weeks. All participants in both groups were assessed at baseline and eight weeks using the Montreal Cognitive Assessment Scale (MoCA), Alzheimer’s Disease Assessment Scale Cognitive Subscale (ADAS-Cog), neuropsychiatric inventory, instrumental activities of daily living, and Zarit Burden Interview for Caregiver Burden (ZBI) by a rater blind to group randomization.

Results:

Total MoCA scores improved significantly in the CST group, compared to the control group which showed a statistically significant decrease. The mean total ADAS-Cog score in the CST group improved significantly compared to controls. The Lawton Instrumental Activities of Daily Living Scale showed a statistically significant change in the control group compared to the intervention group. From the comparison of the mean total neuropsychiatric inventory scale, it was observed that there was a statistically significant decrease in the severity of Behavioural and Psychological Symptoms of Dementia (BPSD) symptoms in the CST group. The mean total ZBI score decreased significantly in the CST group favoring less caregiver burden.

Conclusion:

This study proved that CST has a significant impact on cognitive outcomes in dementia and it also proved its effectiveness in controlling the BPSD outcomes and caregiver burden in dementia.
An Observational Study of Respiratory Dysfunction in Parkinson’s Disease at a Tertiary Care Hospital in Delhi
Authors: Ali Alfarid Shahid , Garg Jyoti , Anand Kuljeet Singh , Suri Amit , Gulati Kartika
Published: June 2023

Objectives:

The purpose of this study is to evaluate the impact of Parkinson’s disease (PD) on respiratory function using spirometry. In addition, the study aims to investigate the relationship between the severity of PD and any impairments in a respiratory capacity as measured by forced vital capacity (FVC%).

Methods:

This case–control study (40 cases of PD vs. 40 healthy controls) was conducted from July 1, 2021, to October 31, 2022, in a tertiary care hospital of New Delhi. Clinical symptoms and severity (Movement Disorder Society Unified Parkinson’s Disease Rating Scale [MDS-UPDRS] part-III score and Modified H and Y Scale) of the patients of PD were noted. A pulmonary function test (by spirometry) was performed and parameters such as forced expiratory volume in 1 s (FEV1), FVC, FEV1/FVC, and peak expiratory flow rate (PEFR) were noted. Mann–Whitney U-test (for two groups) and Chi-square test were used for the comparison of variables. Spearman rank correlation coefficient was used for the correlation of FVC (% predicted) with MDS-UPDRS part-III score and Modified H and Y stage.

Results:

Compared to controls, cases had significantly lower FVC% (70.5 vs. 88, P < 0.01), significantly lower FEV1% (68 vs. 83.5, P < 0.01), comparable FEV1/FVC (% predicted) (97 vs. 96, P = 0.805) and significantly lower PEFR (% predicted) (80.5 vs. 92, P < 0.01). The pattern of lung involvement was restrictive, normal, and obstructive in 72.50%, 20%, and 7.50% of cases, respectively. FVC (% predicted) showed a significant negative correlation with MDS-UPDRS part-III score (r = −0.895, P < 0.01) and with Modified H and Y Scale (r = −0.792, P < 0.01).

Conclusion:

Patients with PD had significantly more deranged respiratory dysfunction and there was significantly higher respiratory dysfunction with increasing severity of PD. A proper screening of lung functions may allow an early detection of respiratory dysfunction, thereby helping to initiate an early pulmonary rehabilitation to prevent respiratory complications.
Shelf life estimation of Saraswata ghrita – A preliminary evaluation
Authors: Badal Robin , Kaushik Shreshtha , Yadav Pramod , Prajapati Pradeep Kumar
Published: June 2023

BACKGROUND:

Saraswata ghrita (SG), a multicomponent ayurvedic formulation is well-known for its cognitive properties. Although it is a very effective classical formulation, there is no appropriate data available on its stability study till date. The shelf life of certain Ayurvedic medications is specified in official Gazette, Government of India. However, it is necessary to revalidate the shelf life of each formulation following parameters prevalent in concerned scenario. Hence, an attempt has been made to determine the shelf life of SG through accelerated stability study.

OBJECTIVES:

The objective is to evaluate shelf life of SG.

MATERIALS AND METHODS:

SG was manufactured in a pharmaceutical laboratory, All India Institute of Ayurveda, New Delhi following classical reference. The samples were subjected to an accelerated stability study maintaining temperature and humidity 40°C ± 2°C and 75 ± 5% respectively. Relevant analytical parameters were performed at an interval of 0, 1, 3, and 6 months to check the degradation levels in the formulation.

RESULTS:

Insignificant changes were observed in physicochemical constants and chromatographic assay at different stages of analysis. The product was free from microbial contamination and heavy metals were within the prescribed limits. On extrapolation of the observations, the shelf life of SG is found to be 1 year and 5 months.

CONCLUSION:

The shelf life of SG corresponds to the classical standards for oleaginous preparations. However, it is less than the specifications set in the official gazette, Govt. of India. This decreased shelf life may be due to milk and salt component present in its composition which possibly speeds up the process of degradation, shortening its shelf life.
A cross-sectional study on quality of life and stress among medical students and interns in Central Karnataka
Authors: Sindhu B. M. , Kumar Prianka Shashi , Kumbar Abhinandan S. , Rashmi B. M.
Published: June 2023

INTRODUCTION:

Studies have shown the lower quality of life (QoL) and higher levels of stress among students of health-care courses compared to others. The present study was done to assess the QoL and perceived stress levels among medical students and interns and the correlation between them. Symptoms experienced in the case of stress and coping strategies for stress were also studied.

METHODOLOGY:

All students and interns in a medical college in Central Karnataka were interviewed. WHOQoL-BREF scale and Perceived Stress Scale-10 were used to assess the QoL and perceived stress levels, respectively.

RESULTS:

A total of 94 students participated. Psychological domain and environment domain scores (52.3 and 59.02, respectively) were lower. A significant negative correlation was observed between all the domains of QoL and stress scores. More than half of the students (60.6%) were under moderate stress.

CONCLUSION:

Efforts should be made to improve the QoL and reduce stress levels among medical students and interns. Various better-coping methods for stress should be taught to them.
Postoperative Pregnancy Outcomes Following Laparoscopic Surgical Management in Women with Stage III/IV Endometriosis: A Single-Center Follow-Up Study
Authors: Fujii Maya , Koshiba Akemi , Ito Fumitake , Kusuki Izumi , Kitawaki Jo , Mori Taisuke
Published: June 2023

Objectives:

The effects of laparoscopic surgical management in women with stage III/IV endometriosis remain controversial. The standard extent of resection for stage III/IV endometriosis with deep endometriosis to treat endometriosis-associated infertility is debatable. This study aimed to assess the postoperative pregnancy outcomes following a routine surgical intervention for stage III/IV endometriosis patients.

Materials and Methods:

Patients with stage III/IV endometriosis who underwent conservative laparoscopic surgery at our hospital between January 2010 and December 2018 were retrospectively analyzed. Statistical analyses were performed to determine the correlations between endometriosis features and postoperative pregnancy outcomes.

Results:

Of 256 patients enrolled, 94 wished to conceive. Exclusion criteria: ≥40 years, adenomyosis, partners with infertility issues. Finally, 71 women were included. The overall postoperative pregnancy rate was 76.1% (n = 54): 49 and five from non-assisted reproductive technology (ART) and ART, respectively. The postoperative pregnancy rate in patients diagnosed with infertility presurgery (40/71) was 70.0% (n = 28): 24 (non-ART) and four (ART). The endometriosis fertility index (EFI) score was higher in the pregnant than in the nonpregnant group (P = 0.03). The EFI score and surgical score of EFI were higher in the non-ART than in the ART group (P = 0.04; P = 0.02); in the infertile group, they were higher in the pregnant than in the nonpregnant group (P = 0.018; P = 0.027).

Conclusion:

Our postoperative pregnancy rate after conservative laparoscopic surgery for patients with stage III/IV endometriosis compared favorably with previous reports. EFI was a significant predictor of postoperative pregnancy. Our surgical approach to maintain a high surgical score of EFI might help treat endometriosis-associated infertility.
Predicting postoperative pain by using preoperative pain threshold in response to electrical stimulus in women undergoing gynaecological cancer surgery - Single-arm, prospective, observational study
Authors: Bakshi Sumitra G. , Kadam Sonal , Shylasree T. S.
Published: June 2023

Background and Aims:

Individual variability leading to different pain experiences makes pain prediction challenging. This study aimed to evaluate whether preoperative electrical pain threshold testing is predictive of postoperative pain.

Methods:

Following ethics committee approval and registration of the trial, 40 consenting patients undergoing open laparotomy (interval debulking surgery) for ovarian cancer were included in the study. Electrical stimulus (maximum of 256 μA) was used preoperatively to determine the current perception threshold (CPT) and pain equivalent current (PEC). A numerical rating scale (NRS; 0–10, with 0 indicating no pain and 10 indicating severe pain) was used to assess pain. All patients received intravenous paracetamol in accordance to body weight, diclofenac (1 mg/kg, maximum 50 mg), and tramadol (1 mg/kg, maximum 50 mg) eight hourly for 24 hours. The preoperative PEC was compared with worst pain score (PS) at movement at the end of 24 hours. PEC was also compared with average PS at rest, at movement, and with opioid requirement (24 hours).

Results:

The median values of CPT and PEC were 12.51 (45 [10.1–14 .6]) μA and 94.75 (174 [48.8–94.7]) μA, respectively. A moderate correlation was observed between PEC and worst PS (P = 0.01, r = −0.402), with patients having PEC less than 60 μA being associated with moderate-to-severe PS. There was no correlation between PEC and average PS at rest (P = 0.16, r = 0.225), at movement (P = 0.46, r = 0.119), and the postoperative opioid consumption in the first 24 hours (P = 0.50, r = −0.110).

Conclusion:

There is a moderate association between preoperative pain threshold in response to electrical stimulus and worst PS in the postoperative period following interval debulking surgery for ovarian cancer.
Comparative preoperative sonological assessment of gastric contents in patients with chronic kidney disease versus those with normal renal function - A prospective observational study
Authors: Sharma Sadhvi , Raman Padmalatha , Deo Alka S.
Published: June 2023

Background and Aims:

Though the role of fasting preoperative gastric ultrasound has been validated in different patient populations, namely, obese, pregnant and diabetics, it has not been explored in patients with chronic kidney disease (CKD). This prospective, observational study compared the fasting sonological assessment of gastric contents in patients with CKD versus those with normal renal function scheduled for elective surgery.

Methods:

After ethical approval and trial registration were obtained, preoperative gastric ultrasound was done in 115 CKD patients and 115 with normal renal function. Qualitative and quantitative assessment of residual gastric volume was done. Also, the patients were administered the Porto Alegre Dyspeptic Symptoms Questionnaire (PADYQ) to evaluate gastroparesis objectively. The researcher was not blinded to the patient groups. Data analyses were done using the Statistical Package for Social Sciences (SPSS) for Windows software (version 22.0).

Results:

Gastric volumes exceeding 1.5 ml/kg or particulate or solid contents were found in 57 patients with CKD and 36 patients with normal renal function (P = 0.004). The PADYQ scores were 6.54 ± 8.49 for CKD and 2.15 ± 5.71 for normal renal function (P < 0.0001) groups. CKD patients had a higher age (P < 0.001), lower body mass index (P = 0.005) and higher incidence of diabetes mellitus (P < 0.001). There were no incidents of gastric aspiration.

Conclusion:

Renal dysfunction contributes to delayed gastric emptying. PADYQ can also help identify those at high risk of gastroparesis. Combining the questionnaire and preoperative gastric ultrasound must be considered in these patients to ensure optimum safety.
Efficacy and safety of supraclavicular versus infraclavicular approach for subclavian vein catheterisation: An updated systematic review and meta-analysis of randomised controlled trials
Authors: Imai Eriya , Watanabe Jun , Okano Hiromu , Yokozuka Motoi
Published: June 2023

Background and Aims:

Subclavian vein catheterisation (SVC) is more effective than internal jugular or femoral catheterisation and is linked to a lesser incidence of infection and patient discomfort. Whether the supraclavicular (SC) or infraclavicular (IC) approach is more effective for SVC is unclear in the previous systematic review. This updated review is designed to search the efficacy and safety of both approaches adopting the Grading of Recommendations Assessment, Development and Evaluation approach.

Methods:

In May 2022, we explored the databases of Embase, MEDLINE, CENTRAL, ClinicalTrials.gov and WHO-ICTRP for randomised controlled trials to compare the two approaches.

Results:

Seventeen trials (2482 cases) were included. In the primary outcomes, the SC approach likely reduces the failure proportion (relative risk [RR], 0.63; 95% confidence interval [CI], 0.47–0.86; I
2 = 5%) and the incidence of malposition (RR, 0.23; 95% CI, 0.13–0.39; I
2 = 0%) with moderate evidence and may slightly reduce the incidence of arterial puncture and pneumothorax (RR, 0.59; 95% CI, 0.29–1.22; I
2 = 0%) with low evidence. In the secondary outcomes, the SC approach may decrease the access time and may increase the first-attempt success proportion.

Conclusion:

The SC approach for SVC should be selected after considering the clinician’s expertise.
Comparing two techniques of performing an epidural catheter-assisted epidural blood patch using a 20 ml syringe versus a 5 ml syringe and its effect on clotting time, the strength of clot retraction and haemolysis – A prospective in vitro study (EC-EBP study)
Authors: Mariappan Ramamani , Kumar Snehil , Raju Krishnaprabhu , Daniel Dolly , Nair Sukesh Chandran , Subramani Sathya
Published: June 2023

Background and Aims:

Epidural blood patch (EBP) is performed by injecting autologous blood into the epidural space using a Tuohy needle. Certain clinical scenarios mandate an epidural catheter (EC)-assisted EBP. Collecting blood in a 20-ml versus 5-ml syringe appears to influence the quality of the clot. This in vitro study compared the techniques of performing the EC-assisted EBP using 20-ml versus 5-ml syringe on clotting time (CT), clot retraction (CR) and haemolysis.

Methods:

This in vitro study was performed in a haematology laboratory. Five consented adult healthy male volunteers donated blood. In the 5-ml syringe technique, blood was injected through an EC, and as it flowed out of the tip, it was collected at the beginning and the end of 1 min. With the 20-ml technique, blood was collected at the beginning and end of the first, second and third minute. The samples were tested for CT, CR and haemolysis by measuring the plasma-free haemoglobin (PFHb).

Results:

Five injections were made using a 5-ml syringe, and another five with a 20-ml syringe. Injection time was shorter in the 5-ml technique (80.80 ± 5.89 vs. 272 ± 28.4 s, P < 0.0001). With the 20-ml technique, CT progressively increased (>15 min), whereas, with the 5-ml syringe, the CT was normal. Both techniques caused mild, insignificant haemolysis (PFHb >0.005 g/dl), without affecting the quality of CR.

Conclusion:

EC-assisted EBP using a 5-ml syringe technique shortens the injection time and deposits fresh blood quickly without affecting CT and CR.
Impact of inverted internal limiting membrane-flap technique on functional outcome and structural restoration of small and medium size macular holes
Authors: Singh Deependra Vikram , Reddy Raja Rami , Sharma Ajay , Gaur Sandhya , Sharma Yog Raj
Published: June 2023

Purpose:

To evaluate the impact of the inverted internal limiting membrane (ILM)-flap technique on the visual outcome and anatomical recovery for small (<250 μ), medium (<400 μ), and large (>400 μ) macular holes (MHs).

Methods:

Retrospective study included consecutive idiopathic MH cases operated on using the inverted ILM-flap technique. Clinical data were retrieved from electronic medical records (EMRs), surgical videos, and optical coherence tomography (OCT) machines. Eyes with axial length >25 mm, coexisting macular diseases, and follow-up <6 weeks were excluded. Data included the presence or absence of ILM flap and restoration of External Limiting Membrane (ELM), Ellipsoid Zone (EZ) lines. Mean visual improvement and structural recovery were compared between eyes showing ILM flap and those showing no flap in three MH size groups.

Results:

Forty eyes of 38 patients with a mean age of 62.7 ± 10.1 years and a mean MH diameter of 348 ± 152 μm were included. The mean follow-up was 527 ± 478 days with anatomical closure observed in all eyes. Mean best-corrected visual acuity (BCVA) improved significantly from 0.87 ± 0.38 to 0.35 ± 0.26. ILM flap was visible in 29 (72.5%) all MHs, 7 (53.8%) small MHs (n = 13), 8 (61.5%) medium MHs (n = 13), and 14 (100%) large MHs (n = 14). The mean BCVA change was 0.47 ± 0.34, 0.53 ± 0.48, and 0.56 ± 0.20 in large, medium, and small MHs, respectively, and the difference between eyes showing ILM flap versus no flap in each MH size group was not statistically significant (P > 0.05). However, for medium MHs, it was higher in the ILM flap (0.66 ± 0.52) group compared to the no flap (0.32 ± 0.37) group. One eye with small MH developed significant gliosis resulting in reduced BCVA. ELM was restored in all eyes with small and medium MHs.

Conclusion:

We observed that the ILM flap did not adversely affect anatomical and visual outcomes for MHs <400 μm. Restoration of ELM suggests minimal interference in structural recovery by an ILM flap.
Qualitative ultrasound biomicroscopy in glaucoma
Authors: Mansoori Tarannum
Published: June 2023

Background:

UBM is a high-resolution ultrasound technique which allows non-invasive, in vivo imaging of the anterior segment and iridocorneal angle.

Purpose:

This video is compilation of short video clips and images which gives description on identification of angle closure due to pupillary block, peripheral anterior synechiae, iris bombe, plateau iris, supra ciliary effusion, and malignant glaucoma. It also shows video demonstrating partially and fully patent iridotomy and features of trabeculectomy bleb.

Synopsis:

This video summarizes importance of UBM application in angle closure glaucoma to understand its pathophysiology by showing the relationship between the peripheral iris, trabecular meshwork and ciliary processes.

Highlights:

UBM provides two-dimensional, grayscale images of the angle structures and allows identification of non-pupillary block mechanism in angle closure glaucoma, which can be recorded for qualitative and quantitative analyses.

Video Link:
https://youtu.be/prsmGnR8jYc

Key words: Angle closure glaucoma, pupillary block, UBM
Enzymatic and biochemical properties of lens in age-related cataract versus diabetic cataract: A narrative review
Authors: Mishra Deepak , Kashyap Anurag , Srivastav Tanmay , Yadav Archana , Pandey Swasti , Majhi Madan Mohan , Verma Kirti , Prabu A , Singh Vibha
Published: June 2023

Cataract is the leading cause of blindness worldwide. There is an increased incidence of cataract formation in the diabetic population due to several factors. Diabetes mellitus accelerates the development of cataract. Oxidative stress results in most of the diabetic complications including diabetic cataract. Oxidative stress leading to the expression of various enzymes has also been proven as crucial for cataractous changes in the lens in old age. A narrative review was undertaken to investigate the expression of different biochemical parameters as well as enzymes in diabetic and senile cataracts. Identification of these parameters is crucial for the prevention and treatment of blindness. Combinations of MeSH terms and key words were used to do literature search in PubMed. The search resulted 35 articles and among them, 13 were relevant to the topic and were included in synthesis of results. Seventeen different types of enzymes were identified in the senile and diabetic cataracts. Seven biochemical parameters were also identified. Alteration in biochemical parameters and expression of enzymes were comparable. Majority of the parameters were raised or altered in diabetic cataract compared to senile cataract.
Validation of three weight gain-based algorithms as a screening tool to detect retinopathy of prematurity: A multicenter study
Authors: Raffa Lina , Alamri Aliaa , Alosaimi Amal , Alessa Sarah , Alharbi Suzan , Ahmedhussain Huda , Almarzouki Hashem , AlQurashi Mansour
Published: June 2023

Purpose:

Screening guidelines for retinopathy of prematurity (ROP) are updated frequently to help clinicians identify infants at risk of type 1 ROP. This study aims to evaluate the accuracy of three different predictive algorithms—WINROP, ROPScore, and CO-ROP—in detecting ROP in preterm infants in a developing country.

Methods:

This retrospective study was conducted on 386 preterm infants from two centers between 2015 and 2021. Neonates with gestational age ≤30 weeks and/or birth weight ≤1500 g who underwent ROP screening were included.

Results:

One hundred twenty-three neonates (31.9%) developed ROP. The sensitivity to identify type 1 ROP was as follows: WINROP, 100%; ROPScore, 100%; and CO-ROP, 92.3%. The specificity was 28% for WINROP, 1.4% for ROPScore, and 19.3% for CO-ROP. CO-ROP missed two neonates with type 1 ROP. WINROP provided the best performance for type 1 ROP with an area under the curve score at 0.61.

Conclusion:

The sensitivity was at 100% for WINROP and ROPScore for type 1 ROP; however, specificity was quite low for both algorithms. Highly specific algorithms tailored to our population may serve as a useful adjunctive tool to detect preterm infants at risk of sight-threatening ROP.