bluuebunny/crossref_metadata_2025 huggingface dataset:
APPLICATION OF PHOSPHODIESTERASE TYPE 5 INHIBITORS SILDENAFIL IN PATIENTS WITH PULMONARY HYPERTENSION
Authors: Martynyuk T. V. , Dadacheva Z. H. , Paramonov V. M. , Arkhipova O. A. , Nakonechnikov S. N. , Chazova I. Ye.
Published: August 2022

The key component of the pathogenesis of pulmonary hypertension (PH) is endothelial dysfunction with imbalance between vasodilators and vasoconstrictors and activation of the blood coagulation system. Randomized trials showed a beneficial effect of phosphodiesterase type 5 (PDE-5) inhibitors on vascular remodelling and vasodilatation in pulmonary arterial hypertension (PAH). Sildenafil is the only PDE-5 inhibitor that is officially approved by Pharmacological Commitee in our country. PDE-5 inhibitors by blocking the breakdown of cyclic guanosinemonophosphate (cGMP) resulted in prolongation of the action of vasoactive mediators including nitric oxide (NO) that cause vasodilation and antiproliferation in the lung. Sildenafil demonstrated the efficacy in uncontrolled clinical studies in pts with idiopathic pulmonary hypertension, PAH due to systemic connective tissue disease, congenital heart defects, with pulmonary embolism. 25-75mg at doses 2-3 times a day in patients with improved pulmonary hemodynamics, exercise tolerance. Basis for the authorization of this drug in the setting of PAH was a large randomized, placebo-controlled trial in which different doses of sildenafil were assessed in 278 patients presenting with idiopathic PAH, PAH related to connective tissue disease or congenital systemic to pulmonary shunts surgically corrected. After three months of treatment significant hemodynamic and functional class improvements were noted in every sildenafil group as compared to placebo. An approved dose is 20 mg three times a day, but in clinical practice often higher doses of 40-80 mg to 3 times per day are in need. Stable long-term efficacy of Sildenafil was observed with the dose of 80 mg 3 times a day in SUPER-2 trial. PACES trial demonstrated the efficacy of sildenafil in combination with intravenous epoprostenol.
CARDIAC REHABILITATION IN BELARUS: CURRENT STATUS OF THE PROBLEM
Authors: Sujayeva V. A. , Sudzhayeva S. R.
Published: August 2022

Authors brought historical way of cardiac rehabilitation as sciences. There was described evolution terms and intensity of physical rehabilitation since XVIII century and so far. The separate attention was paid on social importance of cardiac rehabilitation and on its influence on resistant and temporary disability. There was provided not only historical review of cardiac rehabilitation status in countries of Western Europe and the USA but also data about cardiac rehabilitation in the USSR. In USSR in the 90th years of the XX century scientifically based program of physical rehabilitation and after myocardial infarction was created. Separate attention was paid on formation of cardiac rehabilitation in Republic of Belarus taking into account changes of organizational model rehabilitation help and also new medical, diagnostic and cardiosurgical technologies have been developed. Scientific researches in the field of cardiac rehabilitation have started in Republic of Belarus since 80th years of the XX century. Authors described newly created rehabilitation classification of patients after myocardial infarction and percutaneous coronary intervention. They studied the influence of thrombolytic therapy, percutaneous coronary intervention and developed rehabilitation programs on outcomes in patients after myocardial infarction. Significant effect of developed program of cardiac rehabilitation revealed by authors dictate the necessity of development and widespread similar rehabilitation programs for all categories of cardiac patients.
The GAPS Programme at TNG XXXIX. Multiple Molecular Species in the Atmosphere of the Warm Giant Planet WASP-80 b Unveiled at High Resolution with GIANO-B
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Authors: Carleo Ilaria , Giacobbe Paolo , Guilluy Gloria , Cubillos Patricio E. , Bonomo Aldo S. , Sozzetti Alessandro , Brogi Matteo , Gandhi Siddharth , Fossati Luca , Turrini Diego , Biazzo Katia , Borsa Francesco , Lanza Antonino F. , Malavolta Luca , Maggio Antonio , Mancini Luigi , Micela Giusi , Pino Lorenzo , Poretti Ennio , Rainer Monica , Scandariato Gaetano , Schisano Eugenio , Andreuzzi Gloria , Bignamini Andrea , Cosentino Rosario , Fiorenzano Aldo , Harutyunyan Avet , Molinari Emilio , Pedani Marco , Redfield Seth , Stoev Hristo
Published: August 2022

Detections of molecules in the atmosphere of gas giant exoplanets allow us to investigate the physico-chemical properties of the atmospheres. Their inferred chemical composition is used as tracer of planet formation and evolution mechanisms. Currently, an increasing number of detections is showing a possible rich chemistry of the hotter gaseous planets, but whether this extends to cooler giants is still unknown. We observed four transits of WASP-80 b, a warm transiting giant planet orbiting a late-K dwarf star with the near-infrared GIANO-B spectrograph installed at the Telescopio Nazionale Galileo and performed high-resolution transmission spectroscopy analysis. We report the detection of several molecular species in its atmosphere. Combining the four nights and comparing our transmission spectrum to planetary atmosphere models containing the signature of individual molecules within the cross-correlation framework, we find the presence of H2O, CH4, NH3, and HCN with high significance, tentative detection of CO2, and inconclusive results for C2H2 and CO. A qualitative interpretation of these results, using physically motivated models, suggests an atmosphere consistent with solar composition and the presence of disequilibrium chemistry and we therefore recommend the inclusion of the latter in future modeling of sub-1000 K planets.
Reconfiguration and Eruption of a Solar Filament by Magnetic Reconnection with an Emerging Magnetic Field
Authors: Li Leping , Peter Hardi , Pradeep Chitta Lakshmi , Song Hongqiang , Xu Zhe , Xiang Yongyuan
Published: August 2022

Both observations and simulations suggest that the solar filament eruption is closely related to magnetic flux emergence. It is thought that the eruption is triggered by magnetic reconnection between the filament and the emerging flux. However, the details of such a reconnection are rarely presented. In this study, we report the detailed reconnection between a filament and its nearby emerging fields, which led to the reconfiguration and subsequent partial eruption of the filament located over the polarity inversion line of active region 12816. Before the reconnection, we observed repeated brightenings in the filament at a location that overlies a site of magnetic flux cancellation. Plasmoids form at this brightening region, and propagate bidirectionally along the filament. These indicate the tether-cutting reconnection that results in the formation and eruption of a flux rope. To the northwest of the filament, magnetic fields emerge, and reconnect with the context ones, resulting in repeated jets. Afterwards, other magnetic fields emerge near the northwestern filament endpoints, and reconnect with the filament, forming the newly reconnected filament and loops. A current sheet repeatedly occurs at the interface, with the mean temperature and emission measure of 1.7 MK and 1.1×1028 cm−5. Plasmoids form in the current sheet, and propagate along it and further along the newly reconnected filament and loops. The newly reconnected filament then erupts, while the unreconnected filament remains stable. We propose that besides the orientation of emerging fields, some other parameters, such as the position, distance, strength, and area, are also crucial for triggering the filament eruption.
Spectral Lag Transition of 32 Fermi Gamma-Ray Bursts and Their Application on Constraining Lorentz Invariance Violation
Authors: Liu Zi-Ke , Zhang Bin-Bin , Meng Yan-Zhi
Published: August 2022

The positive-to-negative transition of spectral lag is an uncommon feature reported in a small number of gamma-ray bursts (GRBs). An application of such a feature has been made to constrain the critical quantum gravity energy (E
QG) of the light photons under the hypothesis that the Lorentz invariance might be violated. Motivated by previous case studies, this paper systematically examined the up-to-date GRB sample observed by Fermi Gamma-ray Burst Monitor for the lag transition feature to establish a comprehensive physical limit on the Lorentz invariance violation (LIV). This search resulted in 32 GRBs with redshift available, which exhibit the lag transition phenomenon. We first fit each of the lag–E relations of the 32 GRBs with an empirical smoothly broken power-law function, and found that the lag transition occurs typically at about 400 keV. We then implemented the LIV effect into the fit, which enabled us to constrain the lower limit of the linear and quadratic values of E
QG, which are typically distributed at 1.5 × 1014 and 8 × 105 GeV, respectively.
A Current Concepts Update in Pilon Fracture Management
Authors: Utomo Pamudji , Idulhaq Mujaddid , Abdulhamid Muhammad
Published: August 2022

A review of the existing literature, related to treatment options and management principles of pilon fractures, was performed, and its results are presented. Pilon fractures have a very diverse pattern, but there are general characteristics to help diagnose and plan therapy. The choice of therapy is highly dependent on the surrounding soft-tissue environment. Different methods of treatment, lack of standard management protocols, and the high risk of complications make this injury one of the biggest challenges that an orthopedic surgeon can face. This review focuses on the general aspects of the pilon fracture management as well as its complications and possible solutions.
Food Security and Stunting Incidences in the Coastal Areas of Indonesia
Authors: Yuliantini Emy , Sukiyono Ketut , Yuliarso M. Zulkarnain , Sulistyo Bambang
Published: August 2022

BACKGROUND: Food insecurity is a condition determined by limited or uncertain access to nutritious food for active, healthy, disproportionate people or community of people who are not prepared to anticipate. Stunting in coastal areas such as Indonesia is still severe at 30.8%, higher than the global data at 22.2%. Stunting in sub-Saharan Africa is 34.5%, Ethiopia is 52.4%, and Congo is 40%. The World Health Organization has determined that nutritional problems in a country should be <20% since it leads to impaired growth, development, and degenerative diseases in later adulthood.

AIM: This study aimed to identify the risk factors of the determinant of food security and stunting in the Indonesian Coastal regions.

METHODS: This review was conducted by collecting literature from various publications or articles in English and Indonesian, using the online database of PubMed, ScienceDirect, ProQuest, and manual searching using Google Scholar in reputable journals since the 2000s regarding factors related to or influencing factors can determine food security and the occurrence of stunting in the Indonesian Coastal regions.

RESULTS: Several studies pointed out that one of the causes of stunting in children is the lack of good nutrition for an extended period and often not realized by the parents until their children reach over 2 years old and look stunted. Based on the results of the literature review, it shows that the risk factors for stunting in coastal areas of Indonesia include birth length at risk of 16.43 times, low maternal education at risk of 3.27 times, children living in villages at risk of 2.45 times, LBW at risk 4.5 times, no ANC at risk of 3.4 times, no immunization at risk of 6.38 times, and not exclusively breastfeed at risk of 4.0 times.

CONCLUSION: The results of this synthesis that consistently become risk factors for stunting in children in coastal areas are family socio-economic status (family income), mother’s education, low birth weight, premature birth, non-exclusive breastfeeding, length of birth, and macronutrient and micronutrient deficiencies. Those are given the complex risk factors for stunting.
Stereotypen des Südens und des Nordens in Goethes Römischen Elegien
Authors: Hillenbrand Rainer
Published: August 2022

Le moi élégiaque du Goethe des Élégies romaines utilise les stéréotypes de la joie de vivre sensuelle du Sud et du conventionalisme intellectuel du Nord d’une manière si contradictoire et si exagéré que l’idéal amoureux « romain » se révèle être illusion pseudo-religieuse d’un visiteur « nordique » qui cherche à construire un monde de substitution à son lieu d’origine. Goethe ne représente pas lui-même ces stéréotypes, mais il montre l’instrumentalisation rhétorique qu’en fait un héros conduit par l’intérêt. C’est l’échec manifeste de l’exigence d’un monopole érotique et la mise en place d’une distance esthétique qui permettent à la création littéraire d’apparaître comme classique, comme « équilibre de forces contraires », la sensualité ‘méridionale’ conservant sa valeur complémentaire face à la réflexivité ‘nordique’.
Innovations for microbiome targeting interventions – a patent landscape analysis indicating overall patenting activity decline and promising target disease areas
Authors: Timmis J.K. , Roussilhon D. Flaherty , van de Burgwal L.H.M.
Published: August 2022

The human microbiota have been implicated in the aetiology and remedy of a host of disorders. However, due to the pervasive uncertainty inherent in the field of microbiota-targeting interventions and associated issues with establishing rigorous safety and efficacy profiles, regulatory oversight is suboptimal. This can dissuade innovators from further exploring novel and much needed health interventions. Modification of regulatory protocols and practices requires focussed efforts and funding to build the evidence base around future regulatory needs. Such modification can be critically informed by identification of changes and trends in technology fields to facilitate identification of regulatory gaps. To this purpose, this study rigorously collected and analysed patent data from Espacenet – covering the years 2013-2018 – and created a patent landscape analysis of microbiome targeting interventions with a focus on medicinal products. Pertinent patenting activity has declined overall. While, in absolute terms, patents most frequently claimed inventions targeting disorders of the gut and alimentary tract, relative year-on-year interest increases have been substantial for cancer, and disorders of the (neuro-)muscular and respiratory systems – driven by the private sector. Academic stakeholders showed top interest in disorders of the metabolism, anti-infectives, and skeletal and dermatological diseases. Although medicinal preparation claims dominated our dataset, a third of patents claimed food preparations, while only 1% claimed application as a diagnostic. Finally, China is, by an inordinate margin, a market of particular interest for both domestic and foreign innovators, indicating that microbiome targeting intervention innovation for EU and US markets might be frustrated. This study is the first to empirically demonstrate that live biotherapeutic product innovation is decelerating and potentially frustrated, supporting the urgent need for improved regulatory standards. Our results indicate which disease areas deserve particular attention for research funding to facilitate proper regulatory appraisal in the near- to mid-term future.
Fuzzy optimal harvesting of a prey-predator model in the presence of toxicity with prey refuge under imprecise parameters
Authors: Zhai Shuqi , Wang Qinglong , Yu Ting
Published: August 2022

The objective of this paper is to investigate the dynamic behaviors of a prey-predator model incorporating the effect of toxic substances with prey refuge under imprecise parameters. We handle these biological parameters in model by using interval numbers. The existence together with stability of biological equilibria are obtained. We also analyze the existence conditions of the bionomic equilibria. The optimal harvesting strategy is explored by taking into account instantaneous annual discount rate under fuzzy conditions. Three numeric examples are performed to illustrate our analytical findings.
Les signes de la douleur chez Cureau de La Chambre : (dé)raisons d’une hyperbole
Authors: Andrault Raphaële
Published: August 2022

Cet article s’attache à l’expression de la douleur dans l’une des rares monographies consacrées à cette question à l’époque moderne : les Caractères de la douleur, quatrième volume des monumentaux Caractères des passions publiés par le médecin Marin Cureau de La Chambre entre 1640 et 1662. En conjuguant les apports de la rhétorique à ceux de la philosophie scolastique et de la médecine, Cureau est conduit à donner une ampleur inédite à la description des signes de la douleur – qu’il s’agisse des mimiques, comportements, changements physiologiques ou des « façons de parler ». Il accorde à ces dernières une place de premier plan et les comprend comme des « hyperboles ». Le terme ne vise cependant pas à disqualifier la plainte, comme nous le montrons ici. Cureau justifie l’hyperbole par l’effet qu’elle cherche à produire chez autrui : compenser la sous-estimation habituelle de la douleur de l’autre afin de susciter un sentiment de compassion et un comportement d’entraide à la hauteur de la douleur ressentie.
Souffrant d’« insouffrables » souffrances : espaces et représentations de la douleur dans la dernière maladie de Philippe II (été 1598)
Authors: Andretta Elisa
Published: August 2022

La dernière maladie de Philippe II (été 1598) constitue un observatoire privilégié pour réfléchir, dans une perspective historique et située, à la douleur suscitée par la peine d’autrui au xvie siècle. À partir de l’analyse de sources produites par différents témoins de l’événement, l’article s’interroge tout d’abord sur la place que la douleur occupe dans les récits des derniers mois du roi. Il vise ensuite à déconstruire les représentations édifiantes qui présentent un roi stoïque et pieux acceptant en bon martyr des peines qui lui seraient envoyées du ciel et à montrer comment se définit autour de la douleur un espace de négociations entre Philippe II et ses médecins et chirurgiens. Une attention particulière est accordée à la façon dont ces acteurs sanitaires, directement impliqués dans la gestion d’une situation délicate, perçoivent la douleur du roi et cherchent à y faire face, tout en étant soumis aux pressions que leur impose la prise en charge de cet illustre patient.
« Se condouloir » à distance
Authors: Brancher Dominique
Published: August 2022

À partir du xive siècle, la notion de compassio est réinterprétée, voire réinventée, dans le cadre de la médecine et de la philosophie naturelle, notamment à travers les commentaires à la section 7 des Problemata physica attribués à Aristote. L’Expositio de Pietro d’Abano, commentaire de référence jusqu’au xvie, forge le néologisme condolor tout en introduisant le critère de ressemblance (similitudo) : la compassion diminue à mesure que la proximité (ontologique, géographique, familiale) s’amenuise.Héritier critique de cette tradition, Montaigne aborde de manière lucide et inédite le problème de la compassion : d’une part, il remet en cause le principe d’une compassion plus ou moins forte selon la ressemblance des êtres et rompt avec les réflexes compassionnels de deux groupes socioculturels bien distincts (le vulgaire pour le spectacle des exécutions publiques, la gentilhommerie pour la chasse) ; d’autre part, il s’intéresse très explicitement à l’ambiguïté de ses ressorts.
La gestion des épizooties de peste bovine dans les villes de l’espace belge au xviiie siècle
Authors: Riguelle William
Published: August 2022

S’appuyant principalement sur la réglementation des instances de pouvoir central, provincial et local, ainsi que sur quelques mémoires, essais et rapports médicaux, cette contribution propose d’aborder la gestion de la peste bovine dans les villes des Pays-Bas et de la principauté de Liège au xviiie siècle. Il s’agit de montrer comment le corps animal devient un enjeu à la fois administratif et sanitaire dans ce contexte de crise, et d’observer la manière dont il influence l’organisation et l’approvisionnement de l’espace urbain, territoire moins souvent traité dans les études consacrées à cette thématique. En s’intéressant à l’instauration d’un cordon sanitaire et au renforcement de la politique de surveillance alimentaire, cette étude montre la capacité de la ville à s’organiser en période d’épizootie pour assurer à la fois la préservation de la santé publique et le bon fonctionnement de l’économie. L’attention que suscite la maladie au sein de la société est d’ailleurs considérable, en témoignent l’évolution de la médecine vétérinaire, les écrits de plusieurs médecins européens sur le sujet ainsi que la création d’une jointe dans certaines provinces des Pays-Bas.
Application of Blockchain Technology in Fresh Food Supply Chain Under COVID-19 Environment in China
Authors: Feng Tianzhong , Li Heng , Sun Zhisheng
Published: August 2022

Food safety is a vital issue of public and social concern. Since the outbreak of the COVID-19, frozen fresh food has become the hardest hit area for the spread of the COVID-19. In response to the opaque information, lack of trust, and difficulty in traceability in the fresh food supply chain, the article proposes blockchain technology to address the problem. This paper defines a blockchain technology use case and a quick reference guide to design a blockchain network for the food industry. It improves transparency throughout the supply chain and helps reconcile the documentation and required data with legislation authorities to import cold chain products to certify the quality of the final product. The fresh food supply chain framework can ensure integrity, authenticity, and supply chain information. This design is of great significance to ensure the traceability of the fresh food supply chain.
Health management and patient care
Authors: Sathiadas M. G.
Published: August 2022

No abstract available
A comparison of outcomes of management of Dengue Haemorrhagic Fever using minimal intervention and the standard management protocol in paediatric units of a Sri Lankan tertiary care facility; A retrospective comparative cross-sectional study
Authors: Liyanarachchi Nayana , Pussegoda Kaushalya , Wimalasena Githma , Lakpriya Sudheera , Wijesinghe Champa
Published: August 2022

Dengue is a mosquito-borne viral infection found in tropical and sub-tropical climates worldwide. Dengue Fever is a significant health concern in Sri Lanka. Dengue Hemorrhagic Fever is managed following a standard protocol laid down by the Ministry of Health Sri Lanka. During the recent epidemic of dengue a deviation from standard protocol was observed with minimal intervention (i.e. without intravenous fluids and urinary catheterisation).This study aimed to compare minimal intervention vs. standard protocol with regard to the development of complications and outcomes of children with Dengue Haemorrhagic Fever.A comparative cross-sectional study was conducted retrospectively using secondary data.The clinical records of paediatric patients with Dengue Haemorrhagic Fever (n=151) admitted to Teaching Hospital, Karapitiya, Galle, Sri Lanka during 2019. The study subjects were categorised into two groups as standard protocol and minimal intervention based on the type of management received.Of 151 patients , 98 (65%) were managed following standard protocol and 53 (35%) following minimal intervention. No significant differences were observed in the two groups in age (p=0.57), sex (p=0.72), day of fever on admission (p=0.65), and haematological parameters on admission (p>0.05). There was no difference in the recovery and duration of hospital stay in the two groups. However, infections (p=0.04) and fluid overload (p=0.004) were significantly more common in the standard protocol group compared to the minimal intervention group.Minimal intervention reduces complications of the management of DHF and reduces the burden to the health care system and patients.
Demographic factors, patterns, and trends of deaths following road traffic accidents in the northern Sri Lanka
Authors: Mayorathan U. , Malmarugan R.
Published: August 2022

This study aimed to understand the prevalence of road traffic accident (RTA)-related death in the northern province of Sri Lanka, exploring the demography, vehicle involved, and hospital admission.A Hospital-based cross-sectional descriptive study done and data were collected retrospectively from 210 autopsies and case notes at Teaching hospital Jaffna.Motorbike riders were more vulnerable, with an incidence of 55.2%. Age above 61 years contributed significantly to death after hospitalization with a P-value of < 0.005. The influence of alcohol at the time of the incident markedly contributed to the loss of life before hospital admission.In conclusion the motorcycles were deemed to contribute to the mortality and alcohol influence and age contributing to the pre-and post-hospitalization deaths, respectively.
Post Infectious Glomerular Nephritis (PIGN) leading to Posterior Reversible Encephalopathy Syndrome (PRES); an uncommon presentation
Authors: Sharmika S. , Rushanthini S. , Brammah T. , Jeevagan V. , Peranantharajah T.
Published: August 2022

Posterior Reversible Encephalopathy Syndrome (PRES) is an acute encephalopathy characterized by headache, altered consciousness, visual symptoms and convulsions. Diagnosis is supported by Magnetic resonance imaging (MRI) of the Brain. Here we report a case of PRES in a 24-year-old-male who showed complete recovery with the control of blood pressure. Finally Post Infectious Glomerular Nephritis (PIGN) was found to be the underlying etiology of hypertension to develop PRES.
The underutilized resources in the lowland wet zone forests of Sri Lanka and untapped Indigenous knowledge of peripheral households
Authors: Ranawake A. L.
Published: August 2022

Biological diversity and cultural diversity have been identified as interdependent factors by UNESCO “Culture for the 2030 Agenda”.  Biological diversity determines the livelihood of the inhabitants. The contribution of inhabitants to conserve or manage the habitat sustainably is highly recognized by the world heritage convention.  Minimizing waste, avoiding chemicals, selecting natural and healthier products, and recyclability are the five sustainability goals in trend. Ecological sustainability is the key feature of the communities living in their natural habitats. Indigenous knowledge of the people who lived in a specific area for generations is an underutilized resource for the sustainable management of the ecological system. Data centrism, carbon offsetting, and going for green products are new concepts of the century. These concepts were often applied by the local people who lived closer to lowland tropical forests in Sri Lanka. Gathering information on indigenous knowledge and identifying the diverse materials used by the indigenous people will be a reference library for future sustainable utilization, management, and conservation of lowland tropical forests. The present work describes indigenous knowledge as revealed by the local people who live closer to lowland tropical forests. The information is mainly focused on agriculture-related themes, namely food (mushrooms, aquatic and terrestrial leaves, wild fruits, aquatic molluscs), wood, vines, and leaves for production purposes (materials for housing, wood for specific purposes, leaves for weaving), natural substances (oils, wax, resins, dies, and toxic substance gathered from the forests, their sources, and usage) and honey collection and animal rearing. This invites the scientific community to explore the untouched areas in the nutraceutical, pharmaceutical, ethnobotanical, phytochemical, and architectural fields within new trending concepts such as ecological sustainability, eco-friendly, low-waste food, functional food, carbon footprint offset, green building, eco-tourism, and tightening supply chain concepts.
Computational Characterization of Unsteadiness and Turbulence in Rotor Hub Wakes
Authors: Mobley Forrest J. , Wall Tristan D. , Coder James G.
Published: August 2022

Reynolds stresses and turbulent kinetic energy are studied in the wakes of several helicopter rotor hub geometries in forward flight. Computational fluid dynamics simulations are performed using NASA's OVERFLOW 2.2n Reynoldsaveraged Navier–Stokes solver. The simulations impose
flow conditions based on previous and current experimental and numerical studies. Discrete Fourier transforms are used to examine velocity harmonics for several frequencies and compared against available experimental results. Components of the Reynolds stress tensor are computed and examined.
Production and transport of the turbulent kinetic energy are examined through the rotor hub wakes at six streamwise coordinates. It was found that the scissor arms, previously found to have a significant effect on rotor hub force harmonics, also had a significant effect on the magnitudes of
Reynolds stresses and turbulent kinetic energy. Integrated values of turbulent kinetic energy flux indicate that drag-reducing designs have a direct effect on turbulent kinetic energy levels in the wake.
Assessment of colistin resistance in Gram negative bacteria from clinical samples in resource-limited settings
Authors: Chauhan Shubham , Kaur Narinder , Saini Adesh K. , Chauhan Jyoti , Kumar Harit
Published: August 2022

Objective:

To find a proper method to assess colistin resistance in multidrug resistant Gram negative bacteria (MDR-GNB) on a routine basis in resource limited settings.

Methods:

Clinical samples were processed. MDR-GNB were identified and were examined for colistin resistance by colistin broth elution method, colistin agar method, and colistin disk elution screening method. Broth microdilution method was used the gold standard.

Results:

A total of 10 235 clinical samples were processed, in which 857 (8.4%) MDR-GNB were identified. The very significant errors, categorical agreement, major errors, positive predictive values, negative predictive values, specificity and sensitivity of all the phenotypic methods were 5.5%, 0%, 94.4%, 100%, 99.6%, 100% and 94.4%, respectively for the detection of colistin resistance. The colistin elution screening method was cheap and easy to perform with similar results to broth microdilution method.

Conclusions:

All the evaluation methods for colistin resistance showed similar results. So the laboratories can choose any method for detection of colistin resistance. However, we recommend colistin disk elution screening method because, it is easy and cheap and can be performed in limited resources.
FOXA1 in prostate cancer
Authors: Dong Hui-Yu , Ding Lei , Zhou Tian-Ren , Yan Tao , Li Jie , Liang Chao
Published: August 2022

Most prostate cancers initially respond to androgen deprivation therapy (ADT). With the long-term application of ADT, localized prostate cancer will progress to castration-resistant prostate cancer (CRPC), metastatic CRPC (mCRPC), and neuroendocrine prostate cancer (NEPC), and the transcriptional network shifted. Forkhead box protein A1 (FOXA1) may play a key role in this process through multiple mechanisms. To better understand the role of FOXA1 in prostate cancer, we review the interplay among FOXA1-targeted genes, modulators of FOXA1, and FOXA1 with a particular emphasis on androgen receptor (AR) function. Furthermore, we discuss the distinct role of FOXA1 mutations in prostate cancer and clinical significance of FOXA1. We summarize possible regulation pathways of FOXA1 in different stages of prostate cancer. We focus on links between FOXA1 and AR, which may play different roles in various types of prostate cancer. Finally, we discuss FOXA1 mutation and its clinical significance in prostate cancer. FOXA1 regulates the development of prostate cancer through various pathways, and it could be a biomarker for mCRPC and NEPC. Future efforts need to focus on mechanisms underlying mutation of FOXA1 in advanced prostate cancer. We believe that FOXA1 would be a prognostic marker and therapeutic target in prostate cancer.
Transcatheter management of aorto-right ventricular tunnel
Authors: Kalyanasundaram Muthusamy , Kasha Abhishek , Gopalakrishnan Sai , Jothinath Kaushik
Published: August 2022

Herein, we report successful device closure of aorto-right ventricular tunnel (ARVT) in a 2 year-old-boy presenting with recurrent respiratory tract infection and poor weight gain. He was initially diagnosed with coronary arteriovenous fistula after the clinical examination and echocardiogram. However, his cardiac catheterization revealed ARVT. Although most of the aorto-ventricular tunnels are managed by surgical intervention, we successfully managed our case with transcatheter intervention.
Endovascular stent implantation as a primary method of treatment for blocked modified Blalock[FIGURE DASH]Taussig shunt
Authors: Lale Praneet , Aggarwal Neeraj , Agarwal Mridul , Joshi Reena Khantwal , Joshi Raja , Vivek B. S.
Published: August 2022

Modified Blalock[FIGURE DASH]Taussig shunt is a commonly performed palliative cardiac surgery. Complications like early or late occlusion have been reported in approximately 10% of patients. Thrombosis, stenosis, or kinking are possible mechanisms that lead to shunt obstruction which may be life-threatening and need urgent intervention in form of medical, surgical, or interventional catheterization. Traditionally, these patients are managed in the operating room with shunt revision but with advancing techniques, percutaneous interventions are being increasingly deployed to salvage these patients effectively. We describe our experience of two cases of blocked modified Blalock[FIGURE DASH]Taussig shunt, which was successfully managed by stenting the shunt.
Right ventricular outflow tract histology post-stenting and in-stent stenosis
Authors: Prabhu Sudesh , Mehra Siddhant , Kanaparthi Shravan , Maiya Shreesha Shankar , Rao Sruti
Published: August 2022

The right ventricular outflow tract (RVOT) stenting is used for the treatment of Fallot-type lesions when not amenable to complete correction or when surgical palliation carries a substantial risk. Despite the increasing clinical application, there is a lack of data that describe the RVOT morphology after stenting. This article elucidates post-RVOT stenting and in-stent stenosis, which is thought to be a zonal phenomenon, in this case, predominantly occurring proximally, in the portion of the stent apposing the RVOT infundibulum.
Application of Vessel Navigator™ fusion imaging software in a complex transcatheter palliation of Tetralogy of Fallot with pulmonary atresia
Authors: Sivakumar Kothandam , Mumtaz Zeeshan Ahmed , Sagar Pramod
Published: August 2022

Extreme pulmonary artery hypoplasia in cyanotic malformations precludes palliative surgeries. When aortopulmonary collaterals (APC) in such patients are also hypoplastic, their unifocalization to create a neopulmonary vasculature is also hampered. Stent angioplasty of the outflow or collateral arteries may reduce hypoxia but is challenging in tortuous and atretic tracts. Fusion imaging overlays anatomical data from computed tomography during adult structural interventions, but its use is not often reported in young children with complex cyanotic malformations. This report shows utility of fusion imaging in pulmonary atresia with extremely hypoplastic pulmonary arteries and stenotic APC to guide stenting of outflow tract and collaterals.
Transcatheter closure of congenital portosystemic shunts – A multicenter experience
Authors: Koneti Nageswara Rao , Bakhru Shweta , Jayranganath Mahimarangaiah , Kappanayil Mahesh , Bobhate Prashant , Srinivas Lakshmivenkateshiah , Kulkarni Snehal , Kodandarama Sastry Usha Mandikal , Kumar Raman Krishna
Published: August 2022

Background:

Congenital portosystemic shunts (CPSS) are rare and present variably with hepatic encephalopathy, pulmonary arteriovenous malformations (PAVMs), and pulmonary hypertension (PH).

Objective:

The objective of the study was to see the feasibility of transcatheter closure of CPSS and their outcome.

Materials and Methods:

We analyzed the data of 24 patients of CPSS who underwent transcatheter closure from five institutions (March 2013 to April 2019). Baseline evaluation included echocardiography with bubble contrast study, ultrasound examination of the abdomen, computed tomography angiogram, and cardiac catheterization with test balloon occlusion of the CPSS. The evaluation showed cyanosis due to PAVM in 12, PH in 8, and respiratory distress in 2. Two had both cyanosis and PH. Criteria for eligibility for complete catheter closure of CPSS included demonstration of intrahepatic portal vein (PV) radicals together with a PV pressure of ≤18 mmHg on occlusion.

Results:

The median age and weight were 8 years (0.5–21) and 19.5 kg (4.2–73), respectively. Transcatheter closure was performed in 21 patients (22 procedures) using a variety of occlusive devices and stent-graft exclusion was done in one patient. Closure was not done in 3 in view of high portal venous pressures and hypoplastic PVs. During the follow-up (median: 42 months and range: 61 days–4.8 years), saturation normalized in 14 patients with PAVM. PH declined in all eight patients who underwent the procedure. Respiratory distress improved in two patients.

Conclusions:

Early and short-term follow-up results of catheter closure of CPSS appear promising. However, further, follow-up is needed to demonstrate long-term effectiveness.
Unique challenges posed by a dysfunctional native right ventricular outflow tract for percutaneous pulmonary valve implantation using SAPIEN-S3 valve
Authors: Sivakumar Kothandam , Chandrasekaran Ramyashri , Hijazi Ziyad M.
Published: August 2022

Dysfunctional right ventricular outflow tracts after a repair for tetralogy of Fallot using a transannular patch offer limited nonsurgical opportunities due to their large dimensions. A discrete subannular narrowing between a dilated right ventricle and the enlarged pulmonary trunk was a potential anatomical target for the creation of a landing zone using a prestent in a young male with severe pulmonary regurgitation and moderate stenosis. Asymmetric expansion of the prestent in the angulated outflow tract led to distal stent embolization that was stabilized by another telescoping stent before successful valve implantation. This manuscript details the unique challenges posed by a dilated regurgitant outflow tract for implanting a pulmonary valve.
Pragmatic issues and prescribing patterns in bipolar disorder
Authors: Garg Shobit , Goyal Nishant , Tikka Sai Krishna , Mishra Preeti
Published: August 2022

Background:

There is substantial treatment gap between the suggested guidelines and pragmatic clinical practice for psychotropic usage in bipolar disorder (BD) due to the lack of naturalistic studies and not taking into account the transcultural differences and diverse background. We intend to study this treatment gap and elucidate the preference of psychotropics and prescription patterns, critical clinical issues faced and related pragmatics in BD by conducting the mental health professionals survey.

Methodology:

After focused discussions, Canadian Network for Mood and Anxiety Treatments guidelines being the primary anchor, a 46-item online survey questionnaire was prepared. With 25.4% response rate, 127 psychiatrists were evaluated using Survey Monkey® electronic platform on the demographics, predominant polarity; usage of antipsychotics, antidepressants, and electroconvulsive therapy, psychotropic's preference (monotherapy vs. polytherapy) in the acute and maintenance phase of BD.

Results:

Majority of the participants were males (70.9%) and placed in government institute or medical colleges. Majority agreed that child and adolescent and old age bipolar probands are not routinely seen but subthreshold BD cases are frequent; did not prefer mood stabilizer in pregnancy (61.4%) and antidepressants, preferred polytherapy in acute but monotherapy in maintenance phase (after 3rd episode), seldom preferred ECT as an option (more in suicidality), agreed to a subset of BD being refractory and neuroprogressive.

Conclusion:

This study elucidates the importance of treatment preferences, prescribing patterns and pragmatic issues faced by the clinicians. These patterns if studied longitudinally in a systematic manner would help in modifying the potential treatment strategies and reduce treatment gap.
Prevalence of adult ADHD in patients with substance use disorder in North East India
Authors: Samal Biswajeet , Senjam Gojendra , Ravan Jayaprakash Russell , Ningombam Heramani Singh , Das Rama Chandra , Das Sudipta Kumar
Published: August 2022

Background:

Attention deficit and hyperactive disorder (ADHD) often co-exist with substance use disorders (SUD) both in adolescents and adults. Untreated ADHD can lead to multiple relapses, sociooccupational dysfunction and may worsen the outcome of SUD. ADHD is often underdiagnosed in the adult population. Therefore, the present study was intended to determine the types, patterns, and factors related to drug dependence among different age groups and to estimate the prevalence of adult ADHD in SUD patients in North East India.

Materials and Methods:

This is a cross-sectional hospital-based study carried out in patients diagnosed with SUD as per the Diagnostic and Statistical Manual Disorders, 5th Edition. Adult ADHD Self-Report Scale (v1.1) Symptom Checklist was applied to screen for symptoms of adult ADHD in the patients.

Results:

In the age group of 18–29 years, 82.7% of patients were diagnosed with opioid use disorder (OUD), while 63.9% of the subjects in the age group of 30–49 years patients suffered from Alcohol Use Disorder (AUD). All patients of age 50 years and above were AUD. Our study showed that 24.3% of the total study population had the presence of adult ADHD. Symptoms of Adult ADHD were found in a higher proportion among OUD (28.7%) in comparison to OUD (11.5%).

Conclusion:

The association of adult ADHD with OUD has been around three times than the AUD group. Hence young people (18–29 years) diagnosed with OUD need to be screened for adult ADHD and should be treated for the same for better abstinence and to prevent complications.
Assessment of lethality and its clinical correlates in suicide attempters with mood disorders
Authors: Chawla Nishtha , Deep Raman , Gupta Snehil , Vishwakarma Anuranjan , Sen Mahadev S.
Published: August 2022

Background:

Relatively limited literature is available on lethality assessment for suicide attempts in affective disorders from the Indian subcontinent.

Aims:

To assess the lethality and its clinical correlates in lifetime suicide attempters with mood disorders.

Methods:

A total of 100 lifetime suicide attempters, aged ≥18 years, with a DSM-5 diagnosis of bipolar disorder (BD) or major depressive disorder—recurrent (MDD-R) were recruited. Current euthymia was ascertained (Hamilton Depression Rating Scale (HAM-D) ≤7; Young Mania Rating Scale (YMRS) ≤4). Assessments were conducted using clinical pro forma, Risk–Rescue Rating Scale (RRRS), Columbia Suicide Severity Rating Scale (C-SSRS) and Barratt's Impulsiveness Scale (BIS).

Results:

Average age of the sample was 36.32 ± 11.76 years (48% males, 52% females). The mean duration of affective illness was 10.59 ± 8.32 years. Risk–rescue scores for lethality were significantly higher in males (vs females), bipolar disorder (vs unipolar), multiple attempters (vs single) and planned (vs unplanned) attempters. Risk–rescue score also showed a significant positive correlation with lifetime total and depressive episodes, and intensity of ideations, and a significant negative correlation with BIS—attention impulsiveness. Regression analysis [F (3,96) = 12.196, P < 0.001, adjusted R2 = 0.253] found that lifetime lithium prescription, intensity of suicidal ideations and attention impulsiveness explained 25.3% variance in lethality.

Conclusion:

Absence of lifetime lithium, higher intensity of suicidal ideations and lower attentional impulsiveness predicted higher lethality of suicide attempts. Lethality of suicide attempts was found to be associated with a multitude of clinical factors, notably male gender, bipolarity, multiple attempts, planned attempts and number of total and depressive episodes. Assessment of lethality and its correlates can help to plan strategies towards risk prevention in mood disorders.
Prevalence and effect of cyberchondria on academic performance among undergraduate dental students
Authors: Patanapu Siva Kumar , Sreeja Chilukuri Sai , Veeraboina Nagarani , Reddy Kandadi Vasavi , Voruganti Sreenivas , Anusha Patlola
Published: August 2022

Background:

Cyberchondria has been used to describe an increase in anxiety about one's health status as a result of excessive online searches. These online health research studies were associated with a small but reliable increase in depression and anxiety which may decrease concentration of a student on academics.

Methods:

The questionnaire was distributed among 302 undergraduate dental students (second year, third year, fourth year, and interns) of Kamineni Institute of Dental Sciences and Hospital. The survey tool comprised Cyberchondria Severity Scale–Short form (CSS-15) questionnaire and percentage of marks obtained in the previous University examination. Statistically significance was set at P < 0.05.

Results:

A significant difference was observed for subscale Compulsion (p = 0.05*), Distress (p = 0.001*) with a higher mean score among 24-26 years old dental students. Females had significant higher mean score subscales Distress (4.63 ± 2.93; P = 0.02*) and Reassurance (5.99 ± 2.90; P = 0.001*) than males. Regarding overall CSS, significant higher mean scores were observed among the students who scored less than 65% (7.90 ± 2.01) in their last year university academic examination (0.000*).

Conclusion:

Scheduling educational programs and strengthening easily accessible health services for the students has a particular importance in solving the health problems of young people.
Dapsone-induced Methemoglobinemia Case Report
Authors: Islami Maha Majdi
Published: August 2022

Methemoglobinemia is a rare disorder associated with an elevated methemoglobin level that occurs when hemoglobin is in the oxidized ferric ion form rather than reduced ferrous form. In patients with methemoglobinemia, the hemoglobin with oxidized ferric form cannot release oxygen to the tissues which leads to hypoxemia. Methemoglobinemia can be acquired or inherited. The acquired methemoglobinemia happens in patients after they take certain oxidizing drugs. This disorder is mostly treated with 2 mg/kg methylene. This disorder is mostly treated with 2 mg/kg methylene blue. However, administrating ascorbic acid as an antioxidant may also helpful, especially if a patient has taken two doses of methylene blue or if the use of methylene blue is contraindicated. Methemoglobinemia may not cure or may rebound after response to treatment, especially with long half-life drugs such as dapsone. As it states in the leaflet for methylene blue, if methemoglobinemia does not resolve after two doses, one should initiate another alternative. Ascorbic acid is a good alternative because it is an antioxidant to keep tissue from harm of free radicals and also has a role in reducing methemoglobin via co-factor nicotinamide adenine dinucleotide phosphate reeducates needed for glutathione metabolism. We discuss a case of methemoglobinemia treated successfully with oral ascorbic acid after using two doses of methylene blue. Oral ascorbic acid could be beneficial, especially when the patient was taken two doses of methylene blue.