bluuebunny/crossref_metadata_2025 huggingface dataset:
Serendipitous Discovery of T Cell–Produced KLK1b22 as a Regulator of Systemic Metabolism
Authors: Arwood Matthew L , Sun Im-Hong , Patel Chirag H , Sun Im-Meng , Oh Min-Hee , Bettencourt Ian A , Claiborne Michael D , Chan-Li Yee , Zhao Liang , Waickman Adam T , Mavrothalassitis Orestes , Wen Jiayu , Aja Susan , Powell Jonathan D
Published: June 2023

In order to study mechanistic/mammalian target of rapamycin’s role in T cell differentiation, we generated mice in which Rheb is selectively deleted in T cells (T-Rheb−/− C57BL/6J background). During these studies, we noted that T-Rheb−/− mice were consistently heavier but had improved glucose tolerance and insulin sensitivity as well as a marked increase in beige fat. Microarray analysis of Rheb−/− T cells revealed a marked increase in expression of kallikrein 1–related peptidase b22 (Klk1b22). Overexpression of KLK1b22 in vitro enhanced insulin receptor signaling, and systemic overexpression of KLK1b22 in C57BL/6J mice also enhances glucose tolerance. Although KLK1B22 expression was markedly elevated in the T-Rheb−/− T cells, we never observed any expression in wild-type T cells. Interestingly, in querying the mouse Immunologic Genome Project, we found that Klk1b22 expression was also increased in wild-type 129S1/SVLMJ and C3HEJ mice. Indeed, both strains of mice demonstrate exceptionally improved glucose tolerance. This prompted us to employ CRISPR-mediated knockout of KLK1b22 in 129S1/SVLMJ mice, which in fact led to reduced glucose tolerance. Overall, our studies reveal (to our knowledge) a novel role for KLK1b22 in regulating systemic metabolism and demonstrate the ability of T cell–derived KLK1b22 to regulate systemic metabolism. Notably, however, further studies have revealed that this is a serendipitous finding unrelated to Rheb.
The NF-κB/Relish Activates miR-308 to Negatively Regulate Imd Pathway Immune Signaling in Drosophila
Authors: Yao Xiaolong , Ni Jiajia , Lin Lu , Jin Ping , Ma Fei
Published: June 2023

The strength and duration of the NF-κB signaling response must be tightly modulated to avoid an inadequate or excessive immune response. Relish, a core NF-κB transcription factor of the Drosophila Imd pathway, can control the expression of antimicrobial peptides, including Dpt and AttA, to defend against Gram-negative bacterial infections, but whether Relish may regulate miRNA expression to participate in the immune response remains unclear. In this study, taking advantage of Drosophila S2 cells and different overexpression/knockout/knockdown flies, we first found that Relish could directly activate the expression of miR-308 to negatively regulate the immune response and promote the survival of Drosophila during Enterobacter cloacae infection. Second, our results demonstrated that Relish-mediated expression of miR-308 could suppress target gene Tab2 to attenuate the Drosophila Imd pathway signal during the middle and late stages of the immune response. Third, we detected the dynamic expression patterns of Dpt, AttA, Relish, miR-308, and Tab2 in wild-type flies after E. coli infection, which further revealed that the feedback regulatory loop of Relish–miR-308–Tab2 plays a crucial role in the immune response and homeostasis maintenance of the Drosophila Imd pathway. Overall, our present study not only illustrates an important mechanism by which this Relish–miR-308–Tab2 regulatory axis can negatively control the Drosophila immune response and participate in homeostasis maintenance but also provides new insights into the dynamic regulation of the NF-κB/miRNA expression network of animal innate immunity.
Towards an Evaluation Process for Regime Recognition Approaches: Addressing Variability in Labeling Training Data
Authors:   National Research Council Canada, Cheung Catherine , Seabrook Emma
Published: June 2023

Regime recognition is an important tool for monitoring aircraft usage. Algorithms for this task are normally trained and tested on flight load survey data. In many instances, significant portions of the flight data are not used because of labeling uncertainties. Flight test data is expensive to generate, but machine learning-based solutions rely on copious amounts of training data, so the idea of discarding data is unappealing. This paper presents a process to consistently and systematically label flight data with common helicopter regimes that would reduce the amount of unlabeled flight test data. The approach makes use of regime descriptions and parameter time histories to assign labels, which are then verified using flight path and flight test card information. Although the implementation of the approach is challenging, the initial results from Bell 206 test flights demonstrate that this approach can significantly reduce the amount of unlabeled flight data, enabling much more usable data for training algorithms.
Automated Fiber Placement Double in-Situ Manufacturing Technology of Thermoplastic Composites Components
Authors:   PZL Mielec a Lockheed Martin Company, Glodzik Marcin ,   Lukasiewicz Research Network, Krauze Wojciech , Wojtuszewski Radoslaw , Banas Aleksander , Farbaniec Konard , Sienicki Jaroslaw , Galaczynski Tomasz
Published: June 2023

Presented idea describes the manufacturing approach to low-cost production and assembly of a composite part in one operation with the use of AFP (Automated Fiber Placement) technology. The proposal illustrates production of the floor panel dedicated to helicopters and airplanes. Traditionally, stiffeners are joined to the composite skin after it has been manufactured, most often in a different fixture, position, and other process. The present idea takes full advantage of the AFP method, which makes it possible these separate processes to be combined in one operation, allowing the hybridization of the fiber placement skins with the joining of the stiffeners. The article presents then design, tooling and manufacturing principals of a such innovative hybrid approach in a building of complex aircraft composite components.
Field Repair of Advanced Multifunctional Composite Structure
Authors:   The Boeing Company, Chiu Lisa ,   US Army CCDC AvMC, Robeson Mark , McCarthy Dennis , Urcia Manny , Lee Andy
Published: June 2023

Rotorcraft structures fabricated from composites enable lightweight multifunctional design solutions that provide enhanced structural performance, enable transparent conformal apertures, and improve durability and damage tolerance. The designs are enabled by utilizing the unique properties of X-Cor™ fiber-reinforced, heat-formed core sandwich panels. The development and demonstration of suitable repairs is a critical aspect of fielding composite rotorcraft structure. Contained herein is a discussion of the methodology, analysis, and execution of the repair of composite rotorcraft structures that utilize the X-Cor™ material system. The discussion includes two case studies: 1- the repair of a prototype composite tailboom for restoration of structural capability, as well as 2- the repair of a multifunctional structural aperture for embedded antenna, where both structural and electrical performance are restored. Results, challenges, and lessons learned will be discussed.
Estimation of Probability of Exceeding SC-VTOL Performance Requirements During Automatic Landing Using Subset Simulation
Authors:   Technical University of Munich, Krammer Christoph , Holzapfel Florian
Published: June 2023

With the rising interest in urban air mobility, new regulations are released to enable the certification of electric Vertical Take-off and Landing (eVTOL) vehicles. These novel performance requirements pose both technical challenges and opportunities for new design approaches. In this paper, we apply a Markov chain Monte Carlo method called subset simulation to the flight dynamic model of a prototype eVTOL vehicle to estimate the probability of violating performance and operational criteria. These requirements are derived from the means of compliance for the EASA 'Special Condition for small-category VTOL aircraft'; and 'Prototype Technical Design Specifications for Vertiports,' with additional aspects from the EASA 'Certification Specifications for All Weather Operations' transferred to eVTOL aircraft. The simulations are conducted with a closed-loop experimental flight guidance and control system for automatic landing in combination with varying parameters in the environmental and aircraft models. The computation time to estimate the failure probabilities is reduced compared to pure Monte Carlo methods by utilizing a subset simulation framework. Initial results show the sensitivity of exceeding limit thresholds to the parameters varied in the flight dynamic model.
Watching Weight: Autorotation Insights for a winged Single Main Rotor (wSMR)
Authors:   US Army CCDC AvMC, Lopez Mark ,   San Jose State University, Padthe Ashwani , Berger Tom , Glover Emily
Published: June 2023

A single main rotor helicopter with a wing is one proposed design for the U.S. Army Future Vertical Lift (FVL) Capability Set 1 (CS-1). The wing is intended to share lift and offload the main rotor, increasing the achievable speeds; however those features come with tradeoffs particularly in autorotation. This work studies single main rotor configurations in autorotation conditions using a range of approaches: simple analytical models, more complex medium-fidelity physics-based flight dynamics modeling, and also examination of flight test data. The analyses are then leveraged to examine the effects of adding a wing to a single main rotor configuration and the tradeoffs for autorotation versus nominal operating conditions. Overall the results show that adding a wing tends to increase the rate of descent for autorotation.
Employment of Simulation for the Flight Certification of Rotorcraft
Authors:   Politecnico di Milano, Quaranta Giuseppe ,   Royal Netherlands Aerospace Center - NLR, Hoff Stefan ,   Cranfield University, Lu Linghai ,   University of Liverpool, Padfield Gareth ,   German Aerospace Center - DLR, Podzus Philipp , White Mark
Published: June 2023

The aim of this paper is to provide guidance on the employment of flight simulation to demonstrate, either directly or indirectly, compliance with the flight-related requirements within the certification standards for small or large rotorcraft. Herein are presented the approaches that are suggested in the guidelines for rotorcraft certification by simulation developed by the RoCS project to tackle the topic of the credibility of simulation.
Modeling Turboshaft Engines for the Revolutionary Vertical Lift Technology Project, Expanded
Authors:   NASA Glenn Research Center, Chapman Jeffryes ,   US Army DEVCOM AvMC, Vegh Michael , Snyder Christopher , Nunez Gerardo
Published: June 2023

Turboshaft engine performance and weight models were developed to support conceptual propulsion and vehicle mission design and performance under the Revolutionary Vertical Lift Technology (RVLT) Project in 2019 by Snyder.T hese models were developed using open data sources, assuming present and future technology levels, and range from 650 to 5,000 output shaft horsepower (485 to 3,730 kW). This paper expands on the previous research, extending the power ranges from 200 to 15000 output shaft horsepower (150 to 11,200 kW) Documenting the methodology, assumptions, and resulting performance realizes important benefits for NASA and the aviation community.
Implications of Sustainable Aviation Fuel for the Rotorcraft Industry
Authors:   Sikorsky a Lockheed Martin Company, Andrejczyk Robert
Published: June 2023

International governments and the airline industry have set goals to progressively replace aviation fossil fuels with sustainable aviation fuel (SAF). SAF is presently less than 0.1 % of the global aviation fuel supply but projected to be greater than 50% by 2050. SAF is kerosene synthetically produced from sustainable agriculture and recycled waste. SAF has lower contrail-forming particulates and has substantial benefit of lifecycle CO2 reduction from using sustainable feedstocks rather than petroleum. The rotorcraft industry consumes less than 1% of the global aviation fuel supply and is not driving the transition to SAF but will need to have compatibility with SAF. The American Society of Testing and Materials (ASTM) has developed a process in conjunction with the FAA and original equipment manufacturers (OEMs) whereby SAF blends are approved as drop-in equivalent to ASTM D1655 Jet A/A1 fuel and can then be seamlessly distributed and utilized under existing aircraft approvals for Jet A/A1. SAF candidates are comprehensively evaluated by an OEM task group. Global aviation industry, certification agencies, and military are harmonizing around this approach. The FAA has encouraged rotorcraft manufacturers to monitor OEM task group proceedings and provide input for concerns to rotorcraft. A unique rotorcraft concern regarding suction lift fuel systems is explained as an example.
THE ITALIAN FUND FOR THE VICTIMS OF THE THIRD REICH: CRITICAL REFLECTIONS AND A PROPOSAL FOR FUTURE REPARATION INITIATIVES
Authors: Facchinetti Anna
Published: June 2023

Building on the dispute between Germany and Italy over states' jurisdictional immunities, the contribution shows how Italy's recent establishment of the Restorative Trust Fund for victims of the Third Reich is not sufficient to resolve the dispute between the two states. Taking a cue from restorative models adopted domestically by various states, particularly with reference to transitional justice, the contribution outlines a model of a trust fund in favor of victims that can combine the right of access to justice with respect for immunity from the jurisdiction of the foreign state, useful for future restorative initiatives in Italy or abroad. To avoid violations of immunity, the forum state wishing to take over from the responsible foreign state for the purpose of reparation should create a grievance commission with exclusive jurisdiction over applications for access to the reparation fund, so that the proceedings are not brought by the victim against the foreign state, but directly with respect to the reparation fund. The contribution explains why this procedure is not contrary to foreign state immunity with reference to the concept of indirect impleading in Article 6(2)(b) of the UN Convention on Jurisdictional Immunities of States and their Property. The decisions of a grievance commission would not bring into play the immunity from the jurisdiction of the foreign state as long as they do not affect the property, rights and interests of the latter in the domestic system of the forum state. To this end, the commission's decisions-executable on the ground, subject, therefore, to the property of the foreign state-should be drafted in the form of a finding of victim status, not a finding of responsibility of the foreign state. In order to provide victims with full access to justice, on the other hand, it is necessary for the decisions of the grievance commission to be appealable to ordinary courts.
EVENTI DI DIPARTIMENTO 2022
Authors: 2022 Gli Eventi
Published: June 2023

Non disponibile.
Uguaglianza di opportunità. Sì, ma quale?
Authors: Granaglia Elena
Published: June 2023

Non disponibile.
A study of subcutaneous emphysema, factors contributing to its development, resolution and management with different modalities
Authors: Goyal Mukesh , Jimmy Jose K. , Dixit Ramakant , Garg Deepak Kumar
Published: June 2023

Subcutaneous emphysema is defined as an escape of air in subcutaneous tissue. It is one of the most common complications after inter-costal chest tube drainage. Subcutaneous emphysema is usually benign requiring no specific treatment, but extensive subcutaneous emphysema can be uncomfortable and alarming for the patient. It can rarely lead to airway compromise, respiratory failure and death. Factors leading to its development, following chest tube insertion and methods of management, have not been extensively studied and published. This was an analytical study done over a period of two years, on indoor patients who developed subcutaneous emphysema. These cases were managed using four different modalities and were analyzed for various factors contributing to the development, severity, and resolution of subcutaneous emphysema. Results of this study highlight that the cases of hydropneumothorax and secondary pneumothorax were significantly more predisposed to the development of severe subcutaneous emphysema (following intercostal chest tube insertion) and large air leak as compared to others. Larger air leak develops higher grades of subcutaneous emphysema. The average time for resolution of subcutaneous emphysema was similar among the different modalities of management compared in the study.
Implementing Interprofessional Education Into Clinical Experiences: Athletic Training Faculty Perceptions
Authors: Hankemeier Dorice A. , Feld Sharon D. , Manspeaker Sarah A. , Kirby Jessica L.
Published: June 2023

Context

Health care students must be prepared to engage in collaborative practice with one another. Because athletic training programs are preparing students to enter this collaborative world, interprofessional education (IPE) must be integrated into the curriculum. One aspect for consideration is clinical experiences, but little is known about how athletic training programs are implementing IPE during clinical education experiences.

Objective

To explore how professional, postbaccalaureate athletic training programs are integrating IPE from a clinical education perspective.

Design

Consensual qualitative research.

Setting

Phone interviews.

Patients or Other Participants

Coordinators of clinical education and program faculty who have a role in IPE implementation. A total of 17 faculty engaged in an interview regarding implementing IPE in their respective athletic training programs.

Data Collection and Analysis

Participants engaged in 30- to 45-minute phone interviews that were audio recorded for accuracy and transcribed verbatim. We used a consensual qualitative research approach to data analysis and developed a codebook collaboratively and continued to code using updated codebooks to ensure codes were accurate. We used member checking, internal auditing, and external auditing to ensure trustworthiness.

Results

Two main themes emerged from the data, with resulting subthemes for each. The theme of clinical experiences comprised four subthemes including intentional placement, assessment, linking to courses, and organic IPE. The theme of preceptor involvement includes the need for preceptor development, clear objectives, and active facilitation. We also used a frequency count to determine how many faculty indicated that IPE was currently occurring during clinical education in their programs.

Conclusions

As IPE continues to grow in necessity, athletic training educators should seek opportunities to allow athletic training students to learn about, from, and with other professions. Faculty will need to be intentional about these opportunities and will need to ensure preceptors are trained to integrate IPE and have clear objectives for IPE.
Knowledge, attitudes, and practices of dentists after the COVID-19 pandemic: A cross-sectional study
Authors: Varghese Eby , Krishnan Ramesh , Muddebihal Farahnaz , Dawood Tazeen , Gowrish S. , Lavanya T. , Babu J. Suresh , Swarnalatha C. , Nayyar Abhishek Singh
Published: June 2023

Background:

Dentists are at an increased risk of encountering cross-infections because of working in close proximity with oral mucosa and saliva making use of high-speed rotary instruments during treatment generating large amount of aerosols and splatter which in turn increases the probability of nosocomial spread of infections. The present study aimed to evaluate the knowledge, attitudes, and practices of dentists after the COVID-19 pandemic.

Materials and Methods:

The present cross-sectional study was conducted using Google Forms wherein a well-structured questionnaire composed of a total of 25 closed-ended questions was distributed among practicing dentists through online mode. Step-wise linear regression analysis was done to determine the influence of independent variables on the knowledge, attitude, and practice scores of the participants. P < 0.05 was considered statistically significant.

Results:

On analyzing the results, multiple linear regression analysis revealed no significant difference in the knowledge scores among the participants, while good attitude and practice scores were significantly associated with higher qualification of the participants. Another noteworthy finding in the study was the significant correlation observed between the various components of the knowledge, attitude, and practice scores among the participants (P < 0.05).

Conclusion:

It could be concluded from the findings of the present survey that dentists were found to have good knowledge scores about the COVID-19 pandemic. They should, however, pay more emphasis on practicing tele-triaging and proper screening and should follow various guidelines and advisories issued from time to time by the competent authorities.
Comparison of diagnostic effects of infrared imaging, visual inspection, and bitewing radiography in primary occlusal caries of permanent teeth
Authors: Saffarpour Aida , Tonkaboni Arghavan , Pareshkooh Mahdi Karimipour , Nazari Sadaf Ostad Agha , Manafi Saba , Kharazifard Mohammad Javad
Published: June 2023

Background:

This study compared the diagnostic efficacy of VistaCam iX infrared camera, visual inspection, and bitewing-radiographs for the detection of primary occlusal caries of permanent teeth.

Materials and Methods:

In this in vitro experimental study, 80 extracted human premolars were evaluated. The occlusal surfaces of these teeth were demineralized by immersion in a demineralizing agent. Then, the International Caries Detection and Assessment System (ICDAS II), bitewing-radiography, and Proxi head of VistaCam iX were used to inspect them. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each diagnostic modality. Data were analyzed using SPSS. Twenty-five at P < 0.05 level of significance with one-way analysis of variance and Games–Howell test.

Results:

Bitewing-radiography had significantly lower sensitivity than ICDAS II and VistaCam (P < 0.05). ICDAS II was comparable to VistaCam, with no significant difference in sensitivity (P > 0.05). ICDAS II had a significantly higher PPV than bitewing-radiography and VistaCam (P < 0.05). The sensitivity of bitewing radiography was significantly lower than that of ICDAS II and VistaCam (P < 0.05). ICDAS II was comparable to that of VistaCam with no significant differences in sensitivity (P > 0.05). ICDAS II had a considerably higher PPV than bitewing-radiography and VistaCam (P < 0.05). The NPV of ICDAS II visual inspection was significantly higher than that of bitewing-radiography and VistaCam (P < 0.05). The ICDASS II and VistaCam had a repeatability coefficient of 47.4%. For bitewing-radiography and VistaCam, this value was 44.2% and 83.4% for ICDAS II and bitewing-radiography.

Conclusion:

Visual inspection seems to be superior to bitewing-radiography and VistaCam in detecting primary occlusal caries of permanent teeth.
Periodic acid–Schiff staining in oral exfoliative cytology of diabetic patients: The odyssey for noninvasive screening – A systematic review and meta-analysis
Authors: Aniyan K. Yesoda , Lakshmi Krithika Chandrasekar , Ganesan Anuradha
Published: June 2023

Background:

Diabetes mellitus is a dominant metabolic disorder in the current fast paced culture; its prevalence is escalating worldwide and among all age groups. Guidelines recommend universal screening for diabetes; however, the uptake of these tests in individuals suggests challenges owing to invasive nature of blood collection. Thus, there arises the need for a noninvasive investigation for diabetes screening with a minimum paraphilia and for all medical settings.

Materials and Methods:

We have thus conducted a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, to quantify the association between diabetes and effectiveness of periodic acid–Schiff staining of exfoliative cytology as a screening method. MEDLINE, EMBASE, Cochrane, Scopus, Web of science, CINAHL, and Google Scholar were searched systematically for publications dated till July 20, 2022. Six studies (case–control cross-sectional) were selected and evaluated in depth. The statistical evaluation was done with a forest plot with odds ratio and weightage examined.

Results:

It was proved that exfoliative cytology with periodic acid–Schiff (PAS) staining can be used as a screening test for diabetic status evaluation. The findings suggest that the aforesaid noninvasive test is a conclusive screening practice for diabetics.

Conclusion:

This systematic review and meta-analysis suggest that PAS staining in exfoliative cytology can be used as a noninvasive screening in diabetic individuals to assess the current level of blood glucose. Given the increased risk of diabetes worldwide, higher quality prospective evidence is suggested in larger sample sizes with other metabolic disorders, ethnicity, and oral disorders to further evaluate the plausibility of the results.
Effect of bleaching with 15% carbamide peroxide on color stability of microhybrid, nanohybrid, and nanofilled resin composites, each in 3 staining solutions (coffee, cola, red grape juice): A 3-phase study
Authors: Ghaemi Azadeh , Sharifishoshtari Sanaz , Shahmoradi Mohsen , Akbari Hossein , Boostanifard Parisa , Bagheri Sepideh , Shokuhifar Mohammadreza , Ashoori Negin , Rakhshan Vahid
Published: June 2023

Background:

The literature on the effect of bleaching on stainability and color stability of any composites is scarce and controversial. In the case of some composites and/or bleaching agents or staining solutions, there is no previous study. Therefore, this rather large study was conducted for the first time to examine simultaneously the effects of bleaching and 3 staining solutions on 3 composite types.

Materials and Methods:

This 3-phase experimental in vitro study was performed on 18 groups of 5 specimens each: 90 composite discs with 10 mm diameter and 1 mm thickness were fabricated from 3 resin composites (microhybrid, nanohybrid, and nanofilled). Forty-five discs underwent bleaching with 15% carbamide peroxide, and the remaining 45 were immersed in distilled water at room temperature. The color assessment was performed before and after this step, and Δa, Δb, and ΔL color parameters were calculated for each specimen. The specimens were then immersed in coffee, cola, and red grape juice for 2 weeks, and underwent colorimetry again. The simultaneous effects of bleaching and staining agents and composite types on ΔE (color changes) of composite specimens were analyzed using an independent-samples t-test, a Mann–Whitney U-test, and two-way and one-way analysis of variances followed by a Tukey and a Dunnett's T3 tests (α = 0.05).

Results:

Bleaching had no significant effect on color changes of microhybrid, nanohybrid, or nanofilled composites (P > 0.05). The stainability of composites did not increase after bleaching (P > 0.05). Regardless of the composite type and the presence of bleaching, coffee had the worst effect on color of composite specimens, while cola had the smallest staining effect (P < 0.05).

Conclusion:

Stainability of microhybrid/nanohybrid/nanofilled composites did not increase after bleaching with 15% carbamide peroxide. Coffee should be consumed with care, as far as composite coloring is a concern, regardless of the type of composite in use or its bleaching history. Cola was the weakest stainer. Coffee always caused perceptible staining (ΔE >3.7), regardless of the composite in use or its bleaching history. Red grape juice caused such perceptible colorations in most cases. Cola did not cause any perceptible discoloration in most cases.
Ex vivo evaluation of the efficacy of depotphoresis method in root canal disinfection
Authors: Moradi Saeed , Moushekhian Siavash , Karazhyan Reza , Ebrahimi Amir
Published: June 2023

Background:

Electrochemical disinfection of the root canal system (RCS) is introduced as an alternative to conventional irrigation. The aim of this study was to assess the efficacy of depotphoresis method in the disinfection of accessible and inaccessible RCSs.

Materials and Methods:

In this comparative in vitro study disinfection of Enterococcus faecalis-infected RCS using two methods, (1) depotphoresis and (2) sodium hypochlorite (NaOCl) irrigation plus passive ultrasonic agitation (PUA) took place on 40 extracted maxillary anterior teeth. Decoronation was done with a diamond disc, and the canals were instrumented. The roots were divided into two phases: the specimens with canal obstruction and the specimens without canal obstruction. The smear layer was removed, and the specimens were infected for 21 days with E. faecalis. After disinfection procedures, bacterial samples were taken using two sterile #35 paper points, and colony-forming units (CFU) were counted. Data were analyzed statistically using the Kruskal–Wallis test, with a significance level at P < 0.05, to indicate differences between depotphoresis and NaOCl plus PUA groups.

Results:

In both phases, Log CFU after depotphoresis treatment was significantly lower than NaOCl irrigation plus PUA treatment (P < 0.05).

Conclusion:

Treatment with depotphoresis was significantly more effective than NaOCl irrigation plus PUA treatment.
A Study of Thyroid-Stimulating Hormone in Patients with Type 2 Diabetes Mellitus
Authors: Rahman Sofiur , Dhanowar Rajesh Kumar , Saha Aritra , Das Dipankar , Ozah Jinku
Published: June 2023

Background:

Diabetes and thyroid dysfunctions are closely related to endocrine disorders. Research has shown that there is a clear connection between hyperinsulinemia, insulin resistance, increased glycated haemoglobin (HbA1c) levels, and abnormal thyroid function. Hypothyroidism is relatively common in diabetic patients, particularly in those with suboptimal glycemic control. As a result, screening for thyroid dysfunction in diabetic patients can aid in the early identification and treatment of hypothyroidism, potentially reducing the risk of complications associated with the condition.

Objectives:

Correlation of TSH and HbA1c in diabetic patients.

Materials and Methods:

This hospital-based cross-sectional study was conducted in the Department of Medicine, Assam Medical College, Dibrugarh, between February 2022 and February 2023. A total of 120 patients with diabetes attending the department without any prior history of thyroid disease or any factor that may affect thyroid function were included in this study. Thyroid-stimulating hormone (TSH) and HbA1c were done in all subjects.

Results:

The result showed that the mean age was 57.68 years with female preponderance (58.33%) and increased mean levels of HbA1c (7.8850%) and TSH (13.566 micro IU/mL). In our study, the mean serum TSH level was significantly higher in uncontrolled diabetes than that in controlled diabetes patients. HbA1c also showed a positive correlation (r = 0.574; P < 0.001) with thyroid abnormality.

Conclusions:

Conducting thyroid function screenings on diabetic patients can aid in the identification of asymptomatic hypothyroid patients. Early detection of underlying thyroid dysfunction facilitates timely treatment, which may enhance glycemic control and ultimately improve the quality of life for diabetic patients.
A Study of Malaria in West Bengal
Authors: Nath Arvind
Published: June 2023

Background:

Malaria still occurs in West Bengal which is one of the states in the eastern part of India.

Materials and Methods:

The study design included an analysis of the 2017 and 2018 annual reports of the National Centre for Vector Borne Disease Control (NCVBDC).

Results:

The district of Kolkata had a high Annual Parasite Incidence (API) of Malaria of 3.72 during 2017 which decreased to 3.12 in 2018.

Conclusion:

If interventions such as the treatment of asymptomatic carriers take place, it is expected that the API will come down sooner in Kolkata district and in the rest of the state too.
A Case of Granulomatosis with Polyangiitis Presenting as Necrotizing Pneumonia
Authors: Mallik Sonali , Kaur Amanpreet , Suna Sarada Priyadarshini
Published: June 2023

Systemic vascular diseases frequently involve the respiratory system leading to inflammation of varying-sized vessels in the lungs by various immunological mechanisms. Granulomatosis with polyangiitis (Wegner’s granulomatosis) is one of the rare vascular diseases involving medium and small vessels in various organs. In typical cases, the upper and lower respiratory tract and kidneys are involved producing granulomatous inflammation of small arteries leading to necrotizing vasculitis usually associated with antineutrophil cytoplasmic antibodies (ANCA). Abnormal chest X-rays are seen in almost 70% of the patients during the course of the disease which includes nodules, infiltrate, and necrosis with subsequent cavitation. In rare cases, it may mimic the radiological features of pneumonia thus making the diagnosis difficult. So, here we present a case of a 53-year-old male who presented with necrotizing pneumonia with parapneumonic effusion later found out to be a case of C ANCA positive granulomatosis with polyangiitis.
A Cross-Sectional Study of Association between Serum Uric Acid Levels and Smoking in Chronic Smokers in a Tertiary Care Hospital
Authors: Mohamed Shebin Bedardeen , Nagarajan Kinathankaraiyan , Sindhukumar Sindhya KumaraswamyNadar
Published: June 2023

Background:

Smoking is harmful and causes various diseases due to the accumulation of free radicals causing oxidative damage. Antioxidants help in resisting damage from oxidative stress resulting from cigarette smoking. The presence of the double bonds in the uric acid makes it a powerful antioxidant. Uric acid measurement is cheap, and hence, it can be used as a periodical screening tool for ensuring the adequate antioxidant activity.

Objectives:

To study the relationship between serum uric acid level and smoking in chronic smokers.

Materials and Methods:

This is a cross-sectional study among 110 smokers of age group between 28 and 60 years. A complete detailed history was obtained from subjects including age, sex, average number of daily cigarettes smoked, duration of smoking, and dietary habit. After examination, the attained subjects’ serum uric acid level were assessed.

Results:

Average number of cigarettes smoked (cigarettes/day) and Pack years of smoking have a significantly negative correlation with serum uric acid (mg/dL) and are not correlated with the duration of the smoking. The correlation of serum uric acid with the Pack years of smoking was significant within the age groups and with different dietary patterns, and not with the gender. Linear regression model predicts that serum uric acid (mg/dL) decreases −0.09 times for each unit increase in Pack years of smoking and is statistically significant.

Conclusion:

Cessation of smoking can be recommended among the smokers, to maintain the normal serum uric acid, as uric acid is responsible for the major antioxidant activity in the body, to prevent cancers.
Therapy with Erythropoietin-alpha and Erythropoietin-beta for Anemia of Chronic Kidney Disease in Children on Maintenance Hemodialysis
Authors: Mateo Diño-Santos Phoebe Anne , Dela Cruz Rachelle C. , Santos Caridad M. , B. Catacutan Angelo Martin
Published: June 2023

Background and Aims:

Anemia is a common complication of chronic kidney disease which can be treated with erythropoietin (EPO). We compared the outcomes of EPO-alpha and EPO-beta in children on maintenance hemodialysis.

Settings and Design:

This was a retrospective cohort study.

Methods:

Hemodialysis patients aged 12 to <19 years with hemoglobin ≥8 to <11 g/dL were grouped according to the type of EPO they received. Successful treatment was defined as achievement of hemoglobin ≥11g/dL within 3 months of treatment and successful maintenance as hemoglobin ≥11g/dL for ≥3 months after successful treatment. The effectiveness and treatment cost using EPO-A and EPO-B were compared. Standard statistical tests were used, including Chi-square, Fisher's exact, Student's t-test, Mann–Whitney U-test, and multiple regression.

Results:

Thirty-two subjects were included with 16 patients in each group. Patients receiving EPO-B, compared to EPO-A, more often achieved successful treatment (75% vs. 31.2%, P = 0.03; EPO-A adjusted odds ratio, 0.07; 95% confidence interval, 0.01–0.71) and maintenance (50% vs. 40%, P = 0.99). EPO-B required lower doses than EPO-A for successful treatment (208 ± 151 vs. 393 ± 140 U/kg/week; P = 0.03) and maintenance (P = 0.99). The median increase of hemoglobin using EPO-B was higher (P = 0.002) beyond the first month. Hypertensive episodes were similar in both groups. Therapy costs were lower with EPO-B than EPO-A during treatment (P = 0.04) and maintenance (P = 0.32) phases.

Conclusions:

This is the first study that directly compares EPO-A and EPO-B in children on maintenance hemodialysis. EPO-B was more effective than EPO-A in the management of anemia in children on maintenance hemodialysis. Both agents had comparable safety profiles. Prospective large studies are required to confirm these findings.
Every Dark Urine is Not Hematuria – A Novel Mutation Associated with Alkaptonuria
Authors: Khan Mohammed Fahad , Babu Kishore , Siddini Vishwanath , Ballal H. Sudarshan
Published: June 2023

A 3-year-old boy came to our outpatient department with complaints of dark urine noticed by the mother since birth. On examination, the child had dysmorphic facies, synophrys, hypertelorism, micrognathia, prominent lashes, and difficulty in vision. The weight and height were below the third centile. Urinalysis showed glucosuria; tandem mass spectrometry and gas chromatography–mass spectrometry showed high levels of homogentisic acid and glycerol-3-phosphate. Exome sequencing revealed a missense homozygous variant in the gene encoding homogentisate 1,2-dioxygenase. A diagnosis of alkaptonuria was made and the patient was started on a low-protein diet and ascorbic acid.
Cystic Renal Dysplasia with Supernumerary Kidney
Authors: Joshi Anagha Rajeev , Muthe Mridula Manohar , Rai Pareekshith R.
Published: June 2023

The supernumerary kidney is a rare anomaly characterized by the presence of an extra kidney. Obstructive cystic dysplasia occurs secondary to outflow tract obstruction. We present the case of a 10-year-old girl with recurrent urinary tract infection in whom evaluation revealed obstructive cystic dysplasia of the left kidney with ipsilateral vesicoureteric reflux and right supernumerary kidney. The history was significant for surgery for Ladd bands and spontaneous closure of an atrial septal defect. While ultrasound showed an empty left renal fossa, dimercaptosuccinic acid scan showed solitary right kidney with focal photopenic areas in the lower pole suggesting pyelonephritis. Contrast-enhanced computed tomography revealed right fused supernumerary kidney with focal nephronia and shrunken left kidney. The left ureter inserted ectopically into the urinary bladder; micturating cystourethrography confirmed grade 2 vesicoureteric reflux. The child was managed conservatively with antibiotics. Cystic renal dysplasia and supernumerary kidneys are a rare association that requires clinical and radiological monitoring. Screening of the contralateral functioning kidney and surgical correction of any anomalies is imperative. This case highlights the need for systematic evaluation for coexisting anomalies in patients with abnormal renal ultrasonography.
Epidemiological and clinical profile of children reported with HFMD-like illness in the field practice area of an urban health training center of a teaching hospital in Thiruvananthapuram district, Kerala
Authors: Kanchana Bhagyalakshmi M , Jayaraman Vikram , Krishnan Jishnu , Rajendran Prathibha R M , Moideenkutty Adhila K , Chintha Sujatha , Kumari Anuja U , Kumari Archana P K S
Published: June 2023

Hand, foot, and mouth disease (HFMD) is an infectious disease mainly affecting children caused by Coxsackievirus A16, A4-7,9,10, B1-3, and enterovirus 71.

Objective:

The aim of this work was to study the epidemiological and clinical profile of children with HFMD-like illness in the field practice area of an urban health training center of a teaching hospital in Thiruvananthapuram district, Kerala during the period from March 2022 to June 2022.

Materials and Methods:

A cross-sectional study was conducted among 35 cases reported with papulovesicular skin lesions with or without oral lesions. The cases were retrospectively reviewed and data were collected.

Results:

Out of 35 cases, 22 (62.85%) were female and 13 (37.15%) were male children. The mean age (standard deviation [SD]) of the participants was 3.29 (1.43) years. Fever (85.71%) and rash (94.29%) were the most common presenting symptoms. The mean duration (SD) of illness was 8.94 (4.51) days. All cases recovered completely with supportive treatment. Recurrence of the disease was noted among 7 (20%) children within a median period (interquartile range) of 44 (30, 90) days.

Conclusion:

Children in the age group of 1–6 years were the most affected population, and all recovered completely without complications. The clinical and epidemiological characteristics described will be useful for early diagnosis and thus prevent further transmission of the disease.
Epidemiological trend and change in mortality of leptospirosis: An emerging public health threat post-flood in a tertiary care centre in North Kerala
Authors: Athira Thottathan , Chandran Priya , Bindu Vadakkayil
Published: June 2023

Introduction:

Leptospirosis is considered to be one of the most widespread and emerging zoonosis in the world. Climate change and global warming is affecting the rainfall and flood episodes which leads to the outbreak of disease. Analyzing the trend and change in the mortality pattern of disease is needed to make necessary public health interventions and strategies.

Objective:

To study the epidemiological trend of leptospirosis cases reported to our institute over the last 5 years (2018–2022) and to identify the factors associated with the mortality of leptospirosis.

Materials and Methods:

Secondary data regarding all admitted cases of leptospirosis reported to the surveillance unit of our institution was used. Data were also collected from reports of death audits conducted at frequent intervals.

Results:

Total number of leptospirosis cases reported during the last 5 years was 3102, with 401 deaths (case fatality rate 12.9 %). A varying trend of cases was noted. A maximum number of cases was reported in 2018 after the flood. The mean age was 44.6 ± 16 years. Males were predominantly affected (77.2%). Occupational risk was reported by nearly half of the patients (46%), whereas a history of exposure to contaminated water was present among more than half of them (52%). Less than one-third of the total cases (28%) were confirmed by laboratory diagnosis. Hepatorenal syndrome (55.7%), Myocarditis (50%), and acute respiratory distress syndrome (30%) were the major causes of death.

Conclusion:

An increase in leptospirosis cases was reported post-flood in our institution. Early diagnosis and treatment are essential. Preventive measures should be strengthened and proper sanitation, health education, and intersectoral collaboration are essential to keep the disease under control.
Trends and profile of SARS-CoV-2 infection following COVID vaccination among health-care workers
Authors: John Susan , Hari Harsha , Orathel Sunny P , Nair Shiv K
Published: June 2023

Introduction:

Health-care workers (HCWs) across the country were administered Covishield (COVID vaccination) in a phased manner. This study aimed to explore the trends in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection postvaccination among HCWs, with a view of the demographic and clinical features among a subset of those affected.

Materials and Methods:

A cross-sectional study was performed at a tertiary care center among HCWs who were affected following vaccination during the period April 2021–October 2022. A Google Form was sent out to assess the disease profile and transmission dynamics of which a subset was returned.

Results:

A total of 1657 HCWs tested positive for coronavirus disease-2019 (COVID-19) during the period April 2021–October 2022. Of these, 77.42% were females and 92.67% were completely vaccinated. Nurses were the majority (46.30%) and the least-doctors (6.63%). The most common symptom presentation was cough (76.90%) and fever (73.50%), whereas anosmia, ageusia, and breathing difficulty were minimal. The mean duration between second dose and turning positive was between 165.54 ± 121.98 days. Among HCWs who turned positive, only 7.10% required hospital admission and only one person needed intensive care unit admission. Among those who reported positive, 54.60% mentioned that their close contacts subsequently turned positive. Of these, workplace and household contacts were 49.2% and 46.2%, respectively.

Conclusion:

The predominant symptoms in COVID-19 infection postvaccination are fever, cough, and myalgia. However, the severity of the infection was decreased, requiring mostly home isolation. Transmission of infection was mainly to household and workplace close contacts.
Occupational hazards under a warmer planet: A cross-sectional study on occupational dermatitis, musculoskeletal disorders, and heat strain score index among construction workers at Kottayam, Kerala
Authors: James Nimmi T , M V Sruthi , C R Saju , M P Jini
Published: June 2023

Background:

Global climate change has a major impact on occupational health. Construction workers are the most vulnerable group to work under a warmer planet. Potential health consequences to them include occupational skin diseases, musculoskeletal diseases, respiratory problems, cancers, mental health disorders, and infectious diseases. The incidence of occupational dermatitis and work-related musculoskeletal diseases is at its peak. This study aimed to bring out the burden of the above-mentioned occupational diseases among construction workers at Kottayam and also to calculate their heat strain score index as they are the most vulnerable group to work under a warmer planet.

Objectives:

To assess the prevalence of work related occupational dermatitis and musculoskeletal disorders among construction workers and also to calculate their heat strain score index.

Materials and Methods:

A cross-sectional study was conducted among 82 (n = 82) construction workers in Kottayam, Kerala. Purposive sampling was done. Validated, standard questionnaires were used to collect data by interview method, followed by clinical examination. Data were entered and analyzed in SPSS version 23.

Results:

Eighty-two construction workers participated in the present study. A total of 62% were migrants, and 38% were Keralites. Among 82 workers, nine (11%) of them reported having hand eczema and eight of them (9.8%) reported having wrist eczema. Neck pain (18.3%) and low back ache (18.3%) were the most common musculoskeletal symptoms. Heat strain score index of the workers was calculated. A total of 69.5% were in the green zone, 28% were in the yellow zone, and 2.5% were in the red zone.

Conclusion:

Construction workers are highly exposed to the risk of getting work-related occupational dermatitis and musculoskeletal disorders. The most common occupational skin complaint among these construction workers was itchy rash (12.2%). The overall prevalence of musculoskeletal symptoms was 51.2%. Neck pain and low backache were the most common musculoskeletal symptoms. On the calculation of heat strain score index, these workers were found to have a higher heat strain score index. A total of 28% in the yellow/alarm zone and 2.5% in the red/danger zone. Statistically significant association was established between the intensity of physical work (P = 0.0001) and the intensity of thirst (P = 0.001) with the total heat strain score.