bluuebunny/crossref_metadata_2025 huggingface dataset:
Relating Visual Production and Recognition of Objects in Human Visual Cortex
Authors: Fan Judith E. , Wammes Jeffrey D. , Gunn Jordan B. , Yamins Daniel L.K. , Norman Kenneth A. , Turk-Browne Nicholas B.
Published: December 2019

Drawing is a powerful tool that can be used to convey rich perceptual information about objects in the world. What are the neural mechanisms that enable us to produce a recognizable drawing of an object, and how does this visual production experience influence how this object is represented in the brain? Here we evaluate the hypothesis that producing and recognizing an object recruit a shared neural representation, such that repeatedly drawing the object can enhance its perceptual discriminability in the brain. We scanned human participants (N= 31; 11 male) using fMRI across three phases of a training study: during training, participants repeatedly drew two objects in an alternating sequence on an MR-compatible tablet; before and after training, they viewed these and two other control objects, allowing us to measure the neural representation of each object in visual cortex. We found that: (1) stimulus-evoked representations of objects in visual cortex are recruited during visually cued production of drawings of these objects, even throughout the period when the object cue is no longer present; (2) the object currently being drawn is prioritized in visual cortex during drawing production, while other repeatedly drawn objects are suppressed; and (3) patterns of connectivity between regions in occipital and parietal cortex supported enhanced decoding of the currently drawn object across the training phase, suggesting a potential neural substrate for learning how to transform perceptual representations into representational actions. Together, our study provides novel insight into the functional relationship between visual production and recognition in the brain.

SIGNIFICANCE STATEMENTHumans can produce simple line drawings that capture rich information about their perceptual experiences. However, the mechanisms that support this behavior are not well understood. Here we investigate how regions in visual cortex participate in the recognition of an object and the production of a drawing of it. We find that these regions carry diagnostic information about an object in a similar format both during recognition and production, and that practice drawing an object enhances transmission of information about it to downstream regions. Together, our study provides novel insight into the functional relationship between visual production and recognition in the brain.
THE INTRODUCTION OF INNOVATIVE CONCEPTS IN THE MANAGEMENT SYSTEM OF THE SANATORIUM-RESORT ENTERPRISE IN THE CONTEXT OF ENSURING SOCIO-ECONOMIC SECURITY
Authors: BURYK ZORIANA
Published: December 2019

.  Goal. Coverage of introduction of innovative concepts in the system of management of activity of sanatorium and resort enterprises. Research methodology. The following methods were used: analysis (theoretical review of scientific literature on the problem of research); a synthesis that made it possible to integrate individual parts of the facility into a single unit (development of a Balanced Scorecard for health resort enterprises in terms of socio-economic security); benchmarking that allowed us to map concepts (spa marketing, business performance management, and balanced scorecard). Results. The peculiarities of the management system of the sanatorium and resort enterprises in the conditions of social and economic security are considered. It is stated that the concept of management in terms of ensuring the socio-economic security of any enterprise of the sanatorium and resort complex is based on clearly formed systems of organization of management of socio-economic development. The basic methods of implementation, organization and management of social and economic security at the enterprise are distinguished. It is noted that spa marketing is a concept of management of the spa enterprise, which provides a comprehensive study of the needs of clients in the spa treatment and recreation for their fullest satisfaction through complex efforts to produce, sell and promote the spa product in a competitive market with the aim ensuring socio-economic security and profit. The basic processes covered by the concept of Business Performance Management for spa companies are presented. The Balanced Scorecard Balance Scorecard system has been developed for sanatorium and resort enterprises in terms of social and economic security. Scientific novelty. The basic innovative concepts (spa marketing, Business Performance Management and Balanced Scorecard) are proposed, which introduction into the enterprise management system will ensure effective management decisions, achievement of strategic goals, increase of profit and social and economic security in general. Practical importance. The introduction of our proposed concepts into the management system of sanatorium and resort enterprises will provide such an institution with a complete and effective implementation of processes for managing its activities, providing customer service and optimizing the functions and management procedures performed.
INNOVATIVE TEXTILES INDUSTRY AND ITS FUTURE WITHIN THE CONCEPT OF CIRCULAR ECONOMY – FROM THE GLOBAL TO REGIONAL PERSPECTIVE
Authors: WYSOKIŃSKA ZOFIA
Published: December 2019

The paper deals with the complex analyses of production, export and import of products in the textile industry in different countries of the world. The largest manufacturers and exporters of textile products are identified. Trends in production capacity changes in the industry over the past years are analysed. The place and role of textile industry development in the context of the implementation of the circular economy principle in line with the EU priorities are substantiated. The main directions of perspective development of the textile industry are identified. Two main national documents that have been developed in Poland which set out the current development directions of the country in the field of sustainable development and environmental protection: Strategy for Responsible Development until the year 2020 (with the perspective until the year 2030) and National Waste Management Plan elaborated in the year 2014. The article provides a detailed analysis of the development of regional industry, including the textile industry based on the city of Lodz (Poland). The identified areas of smart specialisations of the Region of Lodz include the following sectors of economic activity: modern textile and fashion industry; advanced building materials; medicine, pharmacy, and cosmetic industry; power generation (including Renewable Energy Sources); innovative agriculture and agricultural and food processing; computer science and telecommunication. The paper proposes the main directions of the textile industry development in the example of Poland: 1) generation of minimal waste in the production process (1R - with application of the most innovative technology), 2) its maximum re-use (2R), 3) application of the third method within the three R formula (reduce, reuse, recycle) which is recycling (3R), the awareness of the importance of which among producers and citizens in many countries is systematically growing.
DEVELOPMENT OF RENEWABLE ENERGY SOURCES IN THE CONTEXT OF ENERGY MANAGEMENT
Authors: YAKUBIV VALENTYNA , MAKSYMIV YULIIA , HRYHORUK IRYNA , POPADYNETS NAZARIY , PIATNYCHUK IRYNA
Published: December 2019

The paper deals with global trends in energy consumption and renewable energy generation. Worldwide practices in financing of renewable energy production are analysed according to the following dimensions: sources of financing, types of used policy instruments, types of recipients (public or private) and types of financed technologies. The key factors that influence the investment attractiveness of renewable energy sources in the world are presented. Main obstacles impeding the utilisation of potential of renewable energy generation in Ukraine are pointed out from the standpoint of the global development trends, as the experience of economically developed countries are advised to be used for Ukraine. Conditions for investment activity in this field should be created (involving both domestic and foreign investments), stimulating state policy should be implemented, and an energy management based on the international experience should be developed. The problems of renewable energy sources in Ukraine are described, in particular, the presence of investment risk in terms of its components as general economic, legal and financial. In the most developed countries in terms of RES consumption direct public investment is a small proportion of total renewable energy financing, whereas private investment has the major share. A significant obstacle to the possibility of realizing such experience in Ukraine is the presence of investment risk, mainly caused by unstable political conditions (both internal and external). Energy management and monitoring activities of enterprises of various forms of ownership and branch affiliation should be introduced along with the necessity of attracting investments in renewable energy. It is expected that the results presented in this article may be useful for improving the renewable energy development policy both at the country level and at the level of a particular economic entity.
TAX PLANNING IN THE ENTERPRISE MANAGEMENT SYSTEM
Authors: ZHUK OLHA , TOMASHEVSKA ANTONINA
Published: December 2019

The differences between the concepts of “tax planning”, “tax minimization” and “tax optimization” are investigated and it is established that tax minimization is the maximum reduction of all taxes, tax optimization is the achievement of a proportion between all aspects of an entity's activity; tax planning The system of measures of the enterprise is directed to the maximum use of the current legislation for the purpose of legal optimization of payments. It has been determined that the ways to reduce the tax burden include tax benefits, preferential taxation and the possibility of choosing a simplified system of taxation by small business entities. The levels and requirements to be followed in tax planning are identified and substantiated: organization of accounting and tax accounting, examine tax law, determine the list of benefits, correct accrual and timely payment, using legal methods to reduce the tax burden.

The methods which are applied in tax planning are substantiated: current internal control, preliminary tax examination, comparative analysis.

It is determined that tax planning is influenced by certain factors: the sphere of the activity in which the entity operates, the types of activity  it is engaged in; status of belonging to a legal or natural person;  the purpose of tax planning and the possibility of applying tax benefits. The tax planning system should be formed in accordance with principles: compliance with tax law; justification of the feasibility of applying the tax system; prompt response to changes in tax law; use of tax planning methods; use favorable tax regimes. Tax planning spends efforts on the following functions: analytical, accumulation, distribution, control.

It is established that the assessment of the effectiveness of the enterprise tax policy should be made through a system of indicators: the level of tax burden on the enterprise; the level of influence of tax planning on the magnitude of the enterprise's tax liabilities and the effectiveness of the enterprise's tax planning and tax policy in general. Effectively organized tax policy at the enterprise will help improve the results of the enterprise. Tax planning should be an integral part of the overall planning of the enterprise.
Tolkien’s Allegory: Using Peter Jackson’s Vision of Fellowship to
Illuminate Male Adolescent Catholic Education
Authors: Zoeller Adam , Malewitz Thomas
Published: December 2019

With many of the Catholic student population disengaged from regular
ritual experiences their working vocabulary of the prayers and knowledge of
the Church is limited. A beneficial bridge for many of these disconnected
students, specifically male adolescents has been the use of storytelling in
connection to Catholic themes to lay the foundations of ritual and deeper
concepts through a more familiar setting. Through media literary,
multi-modal instruction and Scripture exegesis adolescents can begin to
recognize, understand, and feel a connection with the severity of the
sacrifice of the Apostles in following Jesus of Nazareth. This article will
offer some insights that have proven to be beneficial to help male
adolescents to engage the complicated and foreign concepts and topics of the
new curriculum framework, in association with Peter Jackson’s vision of
Tolkien’s Fellowship of the Ring.
Functional capacity and sociodemographic conditions of elderly people at the Eliza Queiroz Maciel Living Center of Manacapuru, Amazonas, Brazil
Authors: Ana Felisa Hurtado-Guerrero , Gomes Lope Elizama Andre , Hurtado-Guerrero José Camilo
Published: December 2019

Goals: To evaluate the functional capacity and sociodemographic conditions of the elderly people who were attended in the Eliza Queiroz Maciel elderly living center in the city of Manacapuru, Amazonas, Brazil with emphasis on functional capacity. Methods: Cross-sectional quantitative approach. Results: Among the 78 elderly participants, women (83.3%), widows (41.0%), and between 65-69 years old (37.2%), brown (46.1%), Catholic (76.9%), incomplete elementary school (35.9%), 4 to 6 children (30.8%), retired (78.2%), monthly income 1 to 3 minimum wages (73.1%), home of masonry (75.6%) and own home (88.5%), with electricity, piped water, garbage collection and sewage services (48.7%). They had, in average, dependence in the Katz ADL (5.1%) and in the Lawton and Brody IADL (16.7%). Conclusions: It is concluded that this study constitutes an important tool for the manager of the Eliza Queiroz Maciel elderly living center, in the work of prevention of aggravations to the health of the elderly who participate in these activities aiming at improving the quality of life.
The gambler’s fallacy in problem and non-problem gamblers
Authors: Matarazzo Olimpia , Carpentieri Michele , Greco Claudia , Pizzini Barbara
Published: December 2019

Background and aims

Although numerous correlational studies have shown an association between cognitive distortions and problem gambling, only a few behavioral studies have investigated this topic by comparing problem (PGs) and non-problem gamblers (N-PGs). This quasi-experiment investigated the occurrence in both groups of a widespread cognitive distortion, the gambler’s fallacy (GF), using a fictitious roulette game. Moreover, it investigated whether the GF increased the bet amount and whether impulsivity and sensation seeking were associated with the GF.

Methods

Two indices of the GF were used: a cognitive index, the probability estimate of each outcome (black/red) after manipulating the final run length (the same outcome occurring four times/once), and a behavioral index, the choice of the outcome on which to bet. A total of 320 (160 PGs and 160 N-PGs) unpaid male volunteers, aged between 18 and 68, participated in this study.

Hypotheses

Erroneous probability estimates should mediate the effect of longer runs on the alternation choice (i.e., the choice of an outcome different from the previous one) to support the occurrence of GF. The GF should increase betting. PGs should be more prone than N-PGs to GF.

Results

The choice of the outcome depended on both cognitive (erroneous probability estimates) and affective (preference for red) factors. PGs bet more than N-PGs but they were not more prone than N-PGs to incurring GF. Although impulsivity and sensation seeking were more intense in PGs than in N-PGs, they scarcely affected GF.

Discussion and conclusions

Overall, our results corroborate the tested model of the GF that links mistaken probability estimates, choice of the outcome on which to bet, and bet amount. However, they are similar to PGs and N-PGs and fail to corroborate the hypothesis that the GF is more evident in PGs.
Collection of selected articles 2019
Authors: Editorial Article
Published: December 2019

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Extracorporeal membrane oxygenation meta-analysis of time-to-event data in respiratory failure in adults v1
Authors: Frank Roh Hyunsuk , Kim Chang-Guk , Chon Soon-Ho , Mogg Kim Jung
Published: December 2019

Purpose:Time-to-event data of hazard ratios were used to generate a forest plot of mortality on extracorporeal membrane oxygenation (ECMO) in respiratory failure in adults. Materials and Methods:A systemic search was conducted in PubMed from 1975 to 2018. Among 4,121 articles, a total of 5 clinical reports comprising 1,014patients (333 of the patients who underwent ECMO and 681 of the patients who did not undergo ECMO) met the inclusion criteria. Results:The pooled hazard ratio of 0.64 (95% confidence interval (CI): 0.54, 0.76) suggests that the ECMO group comprising both veno-arterial (VA) type and a majority of veno-venous (VV) type was significantly associated with a reduction in mortality compared with the non-ECMO group in respiratory failure. The results of VV-ECMO alone also showed significantly improved patient survival of respiratory failure with a CI of 0.67 (0.56, 0.81). Conclusions:The results of the ECMO group with VV and VA types, or the VV type alone revealed a reduction in mortality for patients with respiratory failure based on time-to-event data.Future investigation of the efficacy of VA-ECMO alone in respiratory failure may be more enlightening.
Thinking about artificial intelligence: what can we expect?
Authors: Likhterman L. B.
Published: December 2019

This article is devoted to philosophical assessment of the outlooks of artificial intelligence, issues of artificial intelligence and faith, limits of progress, possibilities and limitations of artificial intelligence, and the value of humanism in the nearest future.
Interlaminar decompression for patients with degenerative lumbar stenosis. Literature review and results of a prospective study
Authors: Grin A. A. , Nikitin A. S. , Kalandari A. A. , Asratyan S. A. , Yusupov S.‑E. R.
Published: December 2019

The study objective is to assess the effectiveness of interlaminar decompression in patients with degenerative lumbar stenosis.

Materials and methods. A prospective study was conducted among 100 patients with degenerative lumbar stenosis. All patients were operated, interlaminar decompression of the symptomatic side was made. Outcomes were assessed by using a visual analogue scale and Oswestry questionnaire 1 and 2 years after surgery. Among patients with an unsatisfactory result, the cause of the unsatisfactory outcome was studied.

Results. One year after surgery a satisfactory result was noted in 71 patients, and 2 years after surgery a satisfactory result was noted in 67 patients. The following causes of unsatisfactory outcome were found in 33 patients: 9 – spinal canal restenosis, 2 – herniated disc at the operation level, 4 – the facet syndrome, 4 – development of clinical instability, 3 – pain in the opposite leg (there was no pain before the operation), 2 – development of delayed radiculopathy, 9 – decompensation of concomitant diseases (4 – coxarthrosis, 3 – gonarthrosis, 2 – chronic ischemia of the lower extremities). Among the risk factors for restenosis, statistically significant relationship was found only with the presence of spondylolisthesis.

Conclusion. Interlaminar decompression is an effective surgical option in patients with degenerative lumbar stenosis. The presence of spondylolisthesis is a risk factor for the inefficiency of this operation.

Conflict of interest. The authors declare no conflict of interest.

Informed consent. All patients gave written informed consent to participate in the study
Intraneural ganglion of the peroneal nerve: a report of 3 cases and literature review
Authors: Evzikov G. Yu. , Bashlachev M. G. , Farafontov A. V. , Nikitin S. S. , Grebenev F. V.
Published: December 2019

The objective is to report 3 cases of intraneural cyst (ganglion) of the peroneal nerve and compare our own findings with the data from scientific literature.

Case reports. Three patients with intraneural ganglions of the common peroneal nerve were treated in the Department of Neurosurgery, A.Ya. Kozhevnikov Clinic of Nervous Diseases, I.M. Sechenov First Moscow State Medical University between 2013 and 2019. All patients underwent extensive dissection of the cyst wall, evacuation of secretion; 2 of them had ligation of the articular nerve branch, while in one patient, the articular branch was not revealed. Complete nerve recovery was registered in all cases.

Conclusion. We believe that ganglion dissection using microsurgical techniques with surgical microscope is a safe and noncomplex procedure; therefore, the avoidance of this manipulation seems unjustified.

Conflict of interest. The authors declare no conflict of interest.

Informed consent. All patients gave written informed consent to the publication of their data.
Adaptive Backstepping Controller of PMLSM
Authors: Yahiaoui Maamar , Bousserhane I. Kh. , Saidi Y. , Serraoui M.
Published: December 2019

In this paper, a nonlinear adaptive speed controller for permanent magnet linear synchronous motors based on a newly developed adaptive recursive Backstepping control approach for a permanent magnet synchronous motor drive is discussed and analyzed. The Backstepping technique provides a systematic method to address this type of problem. It combines the notion of Lyapunov function and a controller procedure recursively.  The adaptive Backstepping control approach is utilized to obtain the robustness for mismatched parameter uncertainties. The overall stability of the system is shown using Lyapunov stability theorem. The simulation results clearly show that the proposed scheme can track the speed reference.
System Identification and Model Validation of Recursive Least Squares Algorithm for Box–Jenkins Systems
Authors: Aldian Ambark Shashoa Nasar , S. Elmezughi Abdurrezag , N. Jleta Ibrahim , B. Ekreem Nasser
Published: December 2019

In this paper, a new-type recursive least squares algorithm is proposed for identifying the system model parameters and the noise model parameters of Box–Jenkins Systems. The basic idea is based on replacing the unmeasurable variables in the information vectors with their estimates. The proposed algorithm has high computational efficiency because the dimensions of the involved covariance matrices in each subsystem become small. Validation of the model is evaluated using some statistical methods, Which, best-fit criterion and Histogram. Simulation results are presented to illustrate the effectiveness of the proposed algorithm.
Gépjárművédelmi megoldások a modern lopási módszerek ellen
Authors: Szayer Géza , Kovács Bence
Published: December 2019

A cikk bemutatja a modern gépjármű lopási eszközöket és módszereket, illetve a Gorilla gépjárművédelmi rendszer fejlesztésből műszaki részleteket, mely a jelenleg alkalmazott módszerek ellen hatásos védelmet jelent. A cikk taglalja a gépjárművekbe utólagosan integrált eszközök rádiós megoldásainak műszaki és biztonságtechnikai nehézségeit is.
THE SUBSTANTIATION OF THE PERIODIC PSYCHOPHYSIOLOGICAL RESEARCH SYSTEM WITH USE OF POLYGRAPH IN PERSONNEL WORKING PROCESS IN THE MINISTRY OF DEFENSE OF UKRAINE AND THE ARMED FORCES OF UKRAINE
Authors: Hryshyn S. , Kuzmenko M. , Khalimanenko S.
Published: December 2019

In accordance with the levels of corruption and other risks, potential areas of abuse in the areas of activity in the military sphere, with the purpose of exercising preventive influence on the personnel of the Ministry of Defense of Ukraine and the Armed Forces of Ukraine, as well as real prevention of offenses that could be committed, a survey of personnel using a polygraph in the Ministry of Defense and the Armed Forces of Ukraine. This system is a collection of individual elements, the combination of which creates a new property – the existence of constantly operating psychophysiological studies using a polygraph, conducted for certain categories of personnel for a predetermined time and agreed questions. This, in turn, will help to increase the effectiveness of using the polygraph in solving the problems of personnel security and the prevention of various kinds of offenses by the personnel of the Ministry of Defense of Ukraine and the Armed Forces of Ukraine. Key words: psychophysiological research of personnel using polygraph, preparation and adoption of personnel decisions, system of periodic inspections using polygraph, risks, potential areas of abuse, timing.
Neural Network Classification of Brainwave Alpha Signals in Cognitive Activities
Authors: Azhari Ahmad , Susanto Adhi , Pranolo Andri , Mao Yingchi
Published: December 2019

The signal produced by human brain waves is one unique feature. Signals carry information and are represented in electrical signals generated from the brain in a typical waveform. Human brain wave activity will always be active even when sleeping. Brain waves will produce different characteristics in different individuals. Physical and behavioral characteristics can be identified from patterns of brain wave activity. This study aims to distinguish signals from each individual based on the characteristics of alpha signals from brain waves produced. Brain wave signals are generated by giving several mental perception tasks measured using an Electroencephalogram (EEG). To get different features, EEG signals are extracted using first-order extraction and are classified using the Neural Network method. The results of this study are typical of the five first-order features used, namely average, standard deviation, skewness, kurtosis, and entropy. The results of pattern recognition training show that 171 successful iterations are carried out with a period of execution of 6 seconds. Performance tests are performed using the Mean Squared Error (MSE) function. The results of the performance tests that were successfully obtained in the pattern test are in the number 0.000994.
A study on knowledge and practices of antenatal care among pregnant women attending antenatal clinic at a tertiary care hospital, Gujarat, India
Authors: Jain Rohit , Upadhyay Chintan , Nayak Bipin
Published: December 2019

Background: Improving maternal health is one of the eight-millennium development goals (MDGs). Since 1990, maternal deaths worldwide have dropped by 47%. This study aimed to determine the level of knowledge, attitude, and practice on ANC among pregnant women attending the antenatal clinic at a tertiary care hospital in Gujarat and their association with various sociodemographic factors.Methods: A cross-sectional study was carried out among 384 pregnant women in their 3rd trimester attending the antenatal clinic in a tertiary care hospital of Gujarat during April 2018 to September 2018. Pretested questionnaire was used for collecting data by interview after obtaining informed consent. Statistical analysis was performed using SPSS version 20 and Epi Info software.Results: Study reveals that about 58% women had adequate knowledge regarding ANC. It was found that almost all the variables such as age, education, occupation, parity, type of family, and socioeconomic status (SES) had a significant association with awareness about ANC. 100% women were having a positive attitude toward ANC. Around 70%, women were practicing adequately, and variables such as education and SES had a significant association with practices about ANC.Conclusions: These findings can be used to plan a health intervention program aiming to improve the maternal health practices and eventually improve the health status of the women.
Obstetrical outcome of pregnancy complicated with first trimester bleeding and subchorionic hematoma
Authors: Agarwal Kiran , . Ritu , Singh Amrita , Singh Anjali , Mishra Amrita
Published: December 2019

Background: First trimester bleeding complicates around 20-27% of pregnancy. Objective of this study was to evaluate and compare the feto-maternal and pregnancy outcome in patients presenting with live pregnancy complicated with first trimester bleeding and subchorionic hematoma with those without subchorionic hematoma.Methods: In this prospective observational study, based on ultrasonography, live pregnancies were categorized into two groups, first group having first trimester bleeding with subchorionic hematoma and second with first trimester bleeding only without any hematoma. They were evaluated for the end outcome of pregnancy in terms of abortion and continuation. Continued pregnancies were evaluated for antenatal complications, delivery and intrapartum events along with fetal outcomes.Results: Outcome of pregnancies presenting with first trimester bleeding in terms of abortion was similar in both the groups, 22.8% and 21.5% with hematoma and without hematoma respectively. Incidence of preeclampsia was 11.4% and Fetal growth restriction was 7% in pregnancies with first trimester bleeding with hematoma and was significantly higher than those without hematoma which was 3.07% for preeclampsia and 3% for fetal growth restriction. Incidence of antepartum haemorrhage was higher in hematoma group but the result was not statistically significant. 20% pregnancies with first trimester bleeding with hematoma had preterm deliveries, while it was 7.7% in pregnancies without hematoma and the difference was statistically significant. Low birth weight had occurred in 20% of babies in first group of patients while 4.6% in second group, difference being statistically significant.Conclusions: We found that live pregnancies with first trimester bleeding and subchorionic hematoma were associated with similar risk of miscarriage and antepartum haemorrhage while increased risk of preeclampsia, fetal growth restrictions, preterm birth, non-reassuring fetal heart pattern, caesarean delivery and low birth weight baby when compared to patients with first trimester bleeding without subchorionic hematoma. There was no difference in 5 minutes Apgar score and the NICU admission in both the groups.
Risk assessment for type 2 diabetes mellitus in Muttanallur village, Bangalore, India
Authors: Dasaraju Suma , D. Sudeepa , Barik Debasish , Hiremath Lalitha D.
Published: December 2019

Background: Diabetes is a major cause of morbidity and mortality worldwide. There are certain risk factors involved in the development of type 2 DM. Affordable, quick and easily available validated tools are required for assessment of risk factors for type 2 DM. Using one such questionnaire, Finnish Diabetes Risk Score [FINDRISK], we have conducted an observational study in a rural area to identify and assess the risks for the development of type 2 DM.Methods: This cross sectional, observational, community-based study was undertaken, in Muttanallur Village, Bangalore. After the application of inclusion and exclusion criteria, 487 subjects were included. According to the final score obtained with the FINDRISK questionnaire, the individuals were classified into mild, moderate, high and very high-risk groups.Results: After the analysis of the variables, 253 individuals (52%) came under moderate risk with a score of (7-14) and 6 (1.2%) were categorized as having very high risk. Females, subjects above the age group of 45 years, having BMI ≥30 kg/m2, waist circumference of ≥37 inches, not having 30 minutes of daily physical activity and consumption of vegetables and fruits, with history of hypertension, high blood glucose during pregnancy or in the past, were having higher moderate to high risk prevalence and had more chances of developing type 2 DM (p value <0.001).Conclusions: As per the results of this study authors concluded that there was a statistically significant association between certain clinical variables with the development of future type 2 DM.
Usual interstitial pneumonia - secondary vs idiopathic pulmonary fibrosis
Authors: Sharma Divyendu , Agrawal Rajesh , Agarwal Rajat , Kumar Amit , Gupta Utkarsh
Published: December 2019

Background: Interstitial Lung Diseases is a group of disorders where the pulmonary interstitium, alveolar structures and the small airways are affected. Identification of a specific pattern on HRCT, with a thorough clinical evaluation can help a physician in narrowing down the differential diagnosis for the underlying cause. Usual Interstitial Pneumonia (UIP) is a frequently identified pattern. Differentiating patients with definite UIP pattern, into IPF and non-IPF spectrums is important. Aim of this study is to compare UIP patients with a secondary cause vs Idiopathic Pulmonary Fibrosis.Methods: Statistically 33 patients having UIP pattern on HRCT were evaluated based on the history of extrapulmonary symptoms, environmental exposure, drugs and subsequent serology testing. Patients were divided into two groups - IPF and UIP with a secondary cause. Both groups were compared on various clinical parameters. Inferences were drawn from the same.Results: Total 66.6% patients were identified to have Idiopathic Pulmonary Fibrosis, 33.3% had UIP with a secondary cause. Majority of patients with a secondary cause had Connective Tissue Disorder (90.9%) and one patient of Chronic Hypersensitivity Pneumonitis (HP).Conclusions: Absence of extrapulmonary symptoms in UIP patients need no further investigations and can be diagnosed as a case of IPF. However, presence of extrapulmonary symptoms needs further evaluation to diagnose the underlying disease and start treatment for the same.
Correlation between personal hygiene and the incidence of leprosy in Central Jakarta area in 2017
Authors: Aisah Siti , Bubakar Ahmad Haykal Abdurahman , Setiasih Nenden Lilis
Published: December 2019

Background: Leprosy is a chronic infectious disease caused by Mycobacterium leprae (M. leprae) which mainly attacks the skin and peripheral nerves. Indonesia is the third country with the most leprosy sufferers with 17,202 cases. The Ministry of Health of the Republic of Indonesia reports that the cumulative number of leprosy cases in 2013 in Indonesia was 16,856 cases. Among them is multibacillary-type leprosy. Although Indonesia achieved national elimination of leprosy in June 2000, the number of leprosy sufferers in Indonesia is still quite high. The high number of multibacillary types shows epidemiological problems and serious clinical implications because patients with multibacillary-type leprosy are a source of leprosy transmission and have a higher risk of reaction and disability due to nerve damage. The spread of leprosy in Indonesia is caused by several factors, one of which is related to hygiene behavior related to skin hygiene, hand and nail hygiene, genital hygiene, clothing hygiene, towel hygiene, mattress and bed hygiene that do not meet health requirements.Methods: The objective of this study was to determine the correlation of personal hygiene and the level of transmission of leprosy in Central Jakarta. Primary data is quantitative data obtained directly from respondents through a questionnaire instrument. Presentation and analysis of data is performed through computer using the SPSS 22 for Windows program using statistical analysis. To find out the correlation between personal hygiene and the incidence of leprosy, Chi-Square analysis was used.Results: The analysis found that the p-value was 0.004< α=0.05 which means that H1 is accepted. It is concluded that there is a significant correlation between personal hygiene and the incidence of leprosy in the Central Jakarta area in 2017.Conclusions: The correlation is that someone who has leprosy has poor personal hygiene. Meanwhile, someone who has good personal hygiene does not suffer from leprosy.
The correlation between the preoperative measurement of estimated cerebral perfusion pressure and estimated intracranial pressure as obtained by trans cranial doppler with modified fisher grade as seen in computed tomography scan head in patients with acute sub arachnoid hemorrahage undergoing surgical clipping
Authors: Paul Shamik Kr , Kataria Ketan , Bloria Summit
Published: December 2019

Background: In Aneurysmal Sub Arachnoid haemorrhage, precise Cerebral Perfusion Pressure (CPP) and Intracranial Pressure (ICP) measurement can only be achieved by an invasive monitoring device. The study aimed at non-invasively estimating the preoperative values of CPP and ICP by use of validated formulae. These estimated flow velocities (estimated CPP or eCPP and estimated ICP or eICP) of the Middle Cerebral Artery were obtained by Trans Cranial Doppler ultrasound and comparing it with the preoperative CT Head Fisher Scale. In the Institute Rimed Digi-Lite Trans Cranial Doppler machine was used for research and Siemens (Somatom) 64 CT Scanner from GE (Signa) was used to perform CT scan of patients.Methods: It is a prospective, observational study which was studied between July 2017 and December 2018 in Post Graduate Institute of Medical Education and Research, Chandigarh, India. This study is a secondary analysis of a prospective observational study which was primarily designed to evaluate the neurological outcome related to the effect of estimated Intracranial Pressure and estimated Cerebral Perfusion Pressure as measured by Trans Cranial Doppler in patients with a SAH. A total of 100 patients were recruited in this study.Results: There was significant correlation between estimated CPP and Fisher Grading. There was no strong correlation between the modified Fisher Grade and estimated ICP.Conclusions: This study was able to give a statistically significant correlation between eCPP and Fisher Grading (p value- 0.047), as the Modified Fisher grading increased, so did the eCPP, this observation was unique, and it went against the hypothesis. However, no statistically significant co-relation was seen during comparison of eICP and Fisher Grading (p value- 0.069).
A study of serum thyroid stimulating hormone levels, and its correlation with clinical features and delayed diagnosis of hypothyroidism in central India
Authors: Jhavar Dharmendra , Chandra Umesh Kumar , Badole Shivshankar , Rahekar Anurag , Vishwakarma Sumit
Published: December 2019

Background: The clinical manifestations of hypothyroidism are variable, depending upon its cause, duration and severity. The spectrum extends from subclinical to overt hypothyroidism to myxedema coma. A high degree of suspicion is thus required in order to appreciate the clinical manifestation of the disorder to reach a diagnosis. Purpose of this study was to correlate serum TSH level with severity of clinical manifestations and evaluate possible cause of delay in the diagnosis.Methods: A cross section observational and descriptive study for the assessment of severity of primary hypothyroidism at presentation and evaluation of the causes of delay in diagnosis in 86 patients was done from December 2012 to November 2013 in the Department of Medicine, MGM Medical College, Indore, MP, India.Results: Illiterate patients had significantly (p value 0.002) higher TSH values at presentation. 34.8% of patients presented as severe hypothyroidism with TSH value >100 mIU/L. Delay of as much as 7 years was noted. Majority of patients had a delay of around 1 to 3 years in diagnosis. Only 4.6% patients were diagnosed without any delay due to high level of suspicion at presentation.Conclusions: Due to non-specific symptomatology of hypothyroidism diagnosis is often delayed. Therefore, high index of suspicion is required at the physician’s level and test of thyroid function is available at subsided cost therefore it should be offered to all such patients.
Role of topical intranasal steroids in pediatric hearing loss due to otitis media with effusion: the experiences
Authors: Swain Santosh Kumar , Behera Ishwar Chandra , Agrawala Rohit , Shajahan Nibi
Published: December 2019

Background: Otitis media with effusion (OME) is one of the commonest diseases causing hearing impairment in children. Hearing loss in early childhood may lead to risk of speech and language problems and psychosocial abnormalities. Aim of this study is to evaluate the role of topical intranasal steroids (Mometasone furoate) in pediatric hearing loss due to otitis media with adenoid hypertrophy.

Methods: A prospective study carried out at a tertiary care teaching hospital of eastern India where 104 children participated with diagnosis of otitis media with effusion and hearing loss between 2017 to 2019. These participants were divided into study group and control group. The age group of the children was between 5 to 10 years. Detail otoscopic examination, pure tone audiometry, tympanometry and nasopharyngeal endoscopy were done for assessing the hearing loss, fluid in the middle ear and adenoid hypertrophy.  

Results: There is improvement of hearing in the study group as compared to control group. A significant improvement in hearing was seen in the study group (p=0.0001). In the study group, 37 (77.08%) out of the 48 children OME resolved over a period of 12 weeks after treatment in comparison to 18 (37.50%) in the control group (p=0.0004).

Conclusions: Intranasal topical steroids can be a treatment option alternative to surgery in OME. As it is short term follow up in this study, long term follow up is required. Intranasal mometasone furoate treatment can be considered as a good treatment option for OME.
Prophylactic use of antibiotics as per SIGN 104 guidelines versus routine antibiotic prophylaxis for prevention of surgical site infection in clean and clean contaminated ENT surgical procedures: a comparative study
Authors: Bharath M. , Galagali J. R. , Mishra Awadhesh Kumar , Mallick Ajay , Nikhilesh E.
Published: December 2019

Background: Many clinicians continue to use antibiotic prophylaxis routinely in all surgical procedures, ignoring the guidelines issued by policy makers. In this prospective study we compared the rate of surgical site infection (SSI) in patients who received prophylactic antibiotics as a routine; with the rate of SSI in patients getting antibiotics strictly as per SIGN 104 Guidelines, for clean and clean contaminated procedures.

Methods: The study population comprised 235 patients. Group A consisted of 119 patients having 77 (65%) males and 42 (35%) females while Group B had 116 patients - 71 (61%) males and 45 (39%) females. Group A received routine antibiotic prophylaxis in all cases, while Group B received antibiotic prophylaxis as per SIGN 104 guidelines only. Both the groups were followed up for one month post-operatively for SSI and complications.

Results: SSI occurred in 2 patients (1.68%) in Group A and in 3 (2.59%) patients in Group B. There was no significant difference in the rate of SSI between the two groups (p=0.68). Procedure wise maximum SSI occurred in tympanoplasty and laryngectomy. Due to infection one case of tympanoplasty had graft failure and one case of laryngectomy had delayed wound healing. No major complications related to infection or antibiotic use occurred in either group.

Conclusions: Selective use of antibiotic prophylaxis as per SIGN 104 Guidelines does not lead to increase in SSI in clean and clean contaminated ENT procedures.
Quality of life and thigh girth following anterior cruciate ligament reconstruction using hamstring autograft
Authors: Baig Mirza A.
Published: December 2019

Background: Arthroscopic anterior cruciate ligament reconstruction is commonly performed with intent to return earlier to normal activities, so graft selection becomes more important. The use of hamstring tendon autograft is supposed to have less postoperative morbidities. In this prospective study we assess the early post-operative complications.

Methods: 25 patients were operated in Shadan Institute of Medical Sciences and Research Centre, Hyderabad, India, by the same surgeon and were assessed preoperatively, and 3 and 6 months after surgery. The hamstring and quadriceps strength were measured with PRIMUS RS machine. The patients were also assessed for their subjective complaints using International Knee Documentation Committee (IKDC) knee scoring system.

Results: The peak power of flexion and extension of the knee joint significantly improved following the surgery which is essential for any athletic activities. Quadriceps and hamstring strengths were restored to 90%, which suggests that the grafting has been successful in restoring isometric strength. This is necessary to return to sporting activities. Power of hamstrings and quadriceps significantly improved following surgery. Quadriceps and hamstring endurance recovered and improved at the end of 6 months following surgery. Using IKDC scoring, nearly normal were 14, normal were 10 and abnormal 1. 3 patients (12%) presented with anterior knee pain. Sensory loss was noted in 6 patients (24%) at the end of 6 months following surgery. Swelling was noted in 5 patients (25%).

Conclusions: Most morbidities are temporary in nature and do not significantly affect the patient’s activities.
Clinico-mycological study of onychomycosis
Authors: Ballal Sumedha , Bhat P. Ishwara , Abraham Anil , Savio Jayanthi
Published: December 2019

Background: Onychomycosis is the most common infective nail disorder accounting for 30% of cutaneous mycoses. Though predominantly caused by dermatophytes, yeast and non-dermatophyte moulds have also been implicated. Aim of this study was to describe and analyse clinical and mycological pattern of onychomycosis.

Methods: One hundred patients with onychomycosis diagnosed by direct potassium hydroxide microscopy and culture were included. Nail specimens were collected for fungal culture as per standard procedure. An analysis of demographic data, clinical features and mycological results was made.

Results: Majority of the affected cases were between 19 to 85 years of age. Fingernail onychomycosis was seen in 41 patients, toenail was seen in 46 patients, concurrent involvement was seen in 13 patients. The predominant clinical pattern seen was distal lateral subungual type (70%). Culture was positive among 49% patients. Among these patients non dermatophyte growth was predominant (72%) showing. Aspergillus species (31%) and Fusarium species (31%), Cladosporium species (4%) and Scytalidium species (2%). Trichophyton species (16%) and Candida species (16%) were also isolated. The clinico-etiological correlation revealed that a single pathogen could give rise to more than one clinical type of onychomycosis. Non-Dermatophyte moulds were the most common isolate followed by yeasts and dermatophytes. This is in contrast to earlier studies from a similar geographical region where dermatophytes were the commonest pathogen.

Conclusions: Non-dermatophyte moulds are emerging as the predominant isolate in onychomycosis. The clinical pattern of nail involvement showed no correlation with the fungal isolate.
Evaluation of vitamin D status, selenium and C-reactive protein level in psoriasis
Authors: Sumathi S. , Babu S. Vinod , Karthikeyan K.
Published: December 2019

Background: Psoriasis is an inflammatory skin disease associated with a variety of clinical conditions. Study aim to evaluate the association of vitamin D, selenium and C-reactive protein (CRP) levels in psoriasis.

Methods: This hospital-based case-control study involved 50 psoriasis cases and 47 healthy individuals. Serum vitamin D, selenium and CRP levels were measured, and the general demographic values were also recorded.

Results: Statistical analysis revealed that vitamin D levels are significantly lower in psoriasis (p<0.005). Among the demographic parameters, obesity was found more common among psoriasis cases than controls. Serum selenium and CRP levels were not significantly different between the two groups.

Conclusions: Vitamin D deficiency is strongly associated with psoriasis. Vitamin D supplementation can be useful in psoriasis management and also in the reduction of obesity. Serum selenium and CRP levels aren’t significant markers to demonstrate psoriasis.