bluuebunny/crossref_metadata_2025 huggingface dataset:
Defining Parameters That Modulate Susceptibility and Protection to Respiratory Murine Coronavirus MHV1 Infection
Authors: Silva Elvia E , Moioffer Steven J , Hassert Mariah , Berton Roger R , Smith Matthew G , van de Wall Stephanie , Meyerholz David K , Griffith Thomas S , Harty John T , Badovinac Vladimir P
Published: December 2023

Patients infected with SARS-CoV-2 experience variable disease susceptibility, and patients with comorbidities such as sepsis are often hospitalized for COVID-19 complications. However, the extent to which initial infectious inoculum dose determines disease outcomes and whether this can be used for immunological priming in a genetically susceptible host has not been completely defined. We used an established SARS-like murine model in which responses to primary and/or secondary challenges with murine hepatitis virus type 1 (MHV-1) were analyzed. We compared the response to infection in genetically susceptible C3H/HeJ mice, genetically resistant C57BL/6J mice, and genetically diverse, variably susceptible outbred Swiss Webster mice. Although defined as genetically susceptible to MHV-1, C3H/HeJ mice displayed decreasing dose-dependent pathological changes in disease severity and lung infiltrate/edema, as well as lymphopenia. Importantly, an asymptomatic dose (500 PFU) was identified that yielded no measurable morbidity/mortality postinfection in C3H/HeJ mice. Polymicrobial sepsis induced via cecal ligation and puncture converted asymptomatic infections in C3H/HeJ and C57BL/6J mice to more pronounced disease, modeling the impact of sepsis as a comorbidity to β-coronavirus infection. We then used low-dose infection as an immunological priming event in C3H/HeJ mice, which provided neutralizing Ab-dependent, but not circulating CD4/CD8 T cell–dependent, protection against a high-dose MHV-1 early rechallenge. Together, these data define how infection dose, immunological status, and comorbidities modulate outcomes of primary and secondary β-coronavirus infections in hosts with variable susceptibility.
Effector-Phase IL-2 Signals Drive Th1 Effector and Memory Responses Dependently and Independently of TCF-1
Authors: Charley Krystal R , Ramstead Andrew G , Matous Joseph G , Kumaki Yohichi , Sircy Linda M , Hale J Scott , Williams Matthew A
Published: December 2023

Following viral infection, CD4+ T cell differentiation is tightly regulated by cytokines and TCR signals. Although most activated CD4+ T cells express IL-2Rα after lymphocytic choriomeningtis virus infection, by day 3 postinfection, only half of activated T cells maintain expression. IL-2Rα at this time point distinguishes precursors for terminally differentiated Th1 cells (IL-2Rαhi) from precursors for Tfh cells and memory T cells (IL-2Rαlo) and is linked to strong TCR signals. In this study, we test whether TCR-dependent IL-2 links the TCR to CD4+ T cell differentiation. We employ a mixture of anti–IL-2 Abs to neutralize IL-2 throughout the primary CD4+ T cell response to lymphocytic choriomeningitis virus infection in mice or only after the establishment of lineage-committed effector cells (day 3 postinfection). We report that IL-2 signals drive the formation of Th1 precursor cells in the early stages of the immune response and sustain Th1 responses during its later stages (after day 3). Effector-stage IL-2 also shapes the composition and function of resulting CD4+ memory T cells. Although IL-2 has been shown previously to drive Th1 differentiation by reducing the activity of the transcriptional repressor TCF-1, we found that sustained IL-2 signals were still required to drive optimal Th1 differentiation even in the absence of TCF-1. Therefore, we concluded that IL-2 plays a central role throughout the effector phase in regulating the balance between Th1 and Tfh effector and memory cells via mechanisms that are both dependent and independent of its role in modulating TCF-1 activity.
Inhibition of the C1s Protease and the Classical Complement Pathway by 6-(4-Phenylpiperazin-1-yl)Pyridine-3-Carboximidamide and Chemical Analogs
Authors: Xu Xin , Herdendorf Timothy J , Duan Huiquan , Rohlik Denise L , Roy Sourav , Zhou Hinman , Alkhateeb Haya , Khandelwal Sanjay , Zhou Qilong , Li Ping , Arepally Gowthami M , Walker John K , Garcia Brandon L , Geisbrecht Brian V
Published: December 2023

The classical pathway (CP) is a potent mechanism for initiating complement activity and is a driver of pathology in many complement-mediated diseases. The CP is initiated via activation of complement component C1, which consists of the pattern recognition molecule C1q bound to a tetrameric assembly of proteases C1r and C1s. Enzymatically active C1s provides the catalytic basis for cleavage of the downstream CP components, C4 and C2, and is therefore an attractive target for therapeutic intervention in CP-driven diseases. Although an anti-C1s mAb has been Food and Drug Administration approved, identifying small-molecule C1s inhibitors remains a priority. In this study, we describe 6-(4-phenylpiperazin-1-yl)pyridine-3-carboximidamide (A1) as a selective, competitive inhibitor of C1s. A1 was identified through a virtual screen for small molecules that interact with the C1s substrate recognition site. Subsequent functional studies revealed that A1 dose-dependently inhibits CP activation by heparin-induced immune complexes, CP-driven lysis of Ab-sensitized sheep erythrocytes, CP activation in a pathway-specific ELISA, and cleavage of C2 by C1s. Biochemical experiments demonstrated that A1 binds directly to C1s with a K  d of ∼9.8 μM and competitively inhibits its activity with an inhibition constant (K  i) of ∼5.8 μM. A 1.8-Å-resolution crystal structure revealed the physical basis for C1s inhibition by A1 and provided information on the structure–activity relationship of the A1 scaffold, which was supported by evaluating a panel of A1 analogs. Taken together, our work identifies A1 as a new class of small-molecule C1s inhibitor and lays the foundation for development of increasingly potent and selective A1 analogs for both research and therapeutic purposes.
Prevalence of pulmonary histoplasmosis infection among Human Immunodeficiency Virus/Tuberculosis patients attending infectious diseases hospital, Kano, northwestern Nigeria
Authors: Ibrahim Sumayya Shuaibu , Abubakar Aliyu Isah , Ramadan Taysir , Usman Umar , Sabo Yusuf Mohammad , Abubakar Firdausi , Kabir Umar Maryam , Yusuf Mustapha Ahmed
Published: December 2023

Histoplasmosis is a disease with a global distribution and hyperendemic zones. The severity of the sickness is determined by the number of conidia inhaled and the host’s cellular immune system’s performance. This study aimed to determine the prevalence of pulmonary histoplasmosis infection among Human Immunodeficiency Virus (HIV) / Tuberculosis (TB) patients attending an infectious diseases hospital in Kano, Nigeria. The study is a cross-sectional hospital study, in which 203 intervieweradministered questionnaires were distributed, sputum samples were collected, and fungal culture was carried out. Identification and antifungal susceptibility for the test isolates were done using microscopic examination and agar disc diffusion. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 22.0. The prevalence of histoplasmosis was 5.4%. Of the 67 (33.0%) samples collected from TB patients, only 5 (2.5%) were positive for Histoplasma capsulatum, and of the 75 (37.0%) samples collected from HIV patients, only 4 (2.0%) were positive. The findings highlight the need for developing better diagnostic tools that will promptly make the diagnosis of the infection, especially in developing countries. Histoplasmosis can present with symptoms similar to other respiratory diseases, which may lead to delays in treatment, and increase the financial burden of managing the infection on the patients.
Dose–Effect Relationship of Motor Nerve Inexcitability on Outcome in Guillain–Barré Syndrome: A Prospective Cohort Study
Authors: Kumar Mritunjai , Tiwari Ashutosh , Kumar Shakti , Singh Rajni
Published: December 2023

Objective:

One or more inexcitable motor (IM) nerves are common during electrodiagnostic (EDx) study in Guillain–Barré syndrome (GBS). This study assessed the dose–effect relationship of IM nerves on outcome in patients with acute inflammatory demyelinating polyneuropathy (AIDP) and acute motor and/or sensory axonal neuropathy (AMAN and AMSAN).

Materials and Methods:

Eighty-eight GBS patients admitted during May 2018–June 2023 underwent detailed clinical evaluation and EDx study. Admission and follow-up disability were assessed on a 0–10 Clinical Grading Scale (CGS). Outcome was recovery at 6 months, defined as good (CGS <3) and poor (CGS ≥3). Binary multivariate logistic regression with backward elimination was used to calculate independent predictors of outcome.

Results:

Proportion of patients with complete recovery decreased significantly with increasing numbers of IM nerves (P < 0.01). Seventy-six patients were followed for 6 months. Among patients with IM nerves (n = 28), complete recovery was similar between AIDP and axonal GBS (70% vs. 50%, respectively; P = 0.40). However, in patients with recordable compound muscle action potentials (CMAPs) in all the motor nerves (n = 26), axonal GBS had significantly poor recovery compared to AIDP (75% vs. 9.1%; P = 0.01). Among patients receiving intravenous immunoglobulin (IVIg; n = 42), poor recovery was seen in 53.6% with IM nerves compared to 35.7% without (P = 0.28), while it was 37.5% versus 5.6% (P = 0.04), respectively, in those who did not receive IVIg (n = 34). However, only admission disability (odds ratio [OR] 0.88, 95% confidence interval [CI] 0.81–0.97; P = 0.007) was found to be an independent predictor of outcome.

Conclusion:

Although increasing numbers of IM nerves were associated with poor outcome on univariate analysis, they did not predict 6 months’ outcome independently. Outcome did not differ between axonal GBS and AIDP among those with IM nerves. IVIg improved outcome in patients with IM nerves.
The impact of the COVID pandemic on publication disciplines among major general medical journals: A bibliometric analysis using natural language processing and traditional statistics
Authors: Sellers Austin R. , Fierstein Jamie L. , Gray Geoffrey M. , Miller Alexandra M. , Caberto A. J. , Ahumada Luis M. , Jallo George , Ford Daniel E. , Goldenberg Neil A.
Published: December 2023

Introduction:

The COVID-19 pandemic has altered the design, conduct, and dissemination of medical and scientific research; yet, little is known regarding the changes in publication trends as a result of the pandemic. The principal objective of this study was to evaluate the changes associated with the COVID-19 pandemic regarding the representation of medical disciplines among top-ranking journals.

Materials and Methods:

PubMed was queried from January 1, 2019, to December 31, 2021, to identify the articles published in five high-impact factor general medical journals. Extracted data included publication type, publication date, and major MeSH terms. Journal Descriptor Indexing software produced a “discipline” per article for the analysis. Time periods of 01/2019–12/2019 (pre-COVID-19), 04/2020–12/2020 (early intra-COVID-19), and 1/2021–12/2021(late intra-COVID-19) were used to compare publication frequencies, by discipline (e.g., virology) and by article type (e.g., regular article, commentary, and letter).

Results:

8706 articles were identified in the pre-COVID-19 period and 6611 and 8094 were identified in the early- and late-intra-COVID-19 period, respectively. During the periods of interest, 5203, 4248, and 4960 publications produced an indexed discipline. The distribution of publications by discipline differed significantly overtime, with “virology” increasing in rank from 18th to 1st (71 vs. 1364) pre versus early intra-pandemic, and remaining first late intra-pandemic (436 articles).

Conclusions:

These analyses provide a framework to quantify the shift in publishing practices toward virology-related articles during the pandemic. Virology was the most common topic in the early- and late-intra-pandemic periods. Future study should evaluate specialty-specific journals, as well as the examination of the broader impact of decreased non-pandemic specific articles during times of pandemic.

The following core competencies are addressed in this article:

Medical knowledge.
A case of vitamin-D dependent type-1A rickets
Authors: Gupta Ashish , Mukherjee Soham , Bhadada Sanjay Kumar
Published: December 2023

Rickets is a disease of growing bones characterized by softening of bones as a result of defective mineralization of cartilage in the epiphyseal growth plate. The predominant cause is a deficiency or impaired metabolism of vitamin D. Some forms of rickets do not respond to regular doses of cholecalciferol, which leads to suspicion of vitamin D-dependent rickets (VDDR). VDDR is of two types: type I is due to defective renal tubular 25-hydroxyvitamin D 1-α hydroxylase, and type II is due to end-organ resistance to the active metabolite of vitamin D. Here, we describe a child with seizures and calcipenic rickets with biochemical profile suggestive of VDDR type 1 worsened by phenytoin which responded completely to calcium and calcitriol supplementation. Whole exome sequencing revealed a heterozygous missense mutation in exon 7 of the TRPV4 gene (chromosome 12,c.1292C>A), whereas no mutations in CYP2R1, CYP27B1, VDR, and CYP3A4 were detected.
Macroprolactinoma and empty sella: Swinging pendulum and lessons for dopamine agonists therapy
Authors: Rastogi Ashu
Published: December 2023

Prolactinomas account for nearly 40% of all pituitary tumors with a remarkable response to dopamine agonist (DA) therapy, rendering surgical intervention unnecessary in most cases. Clinical guidelines recommend discontinuing DA therapy two years after achieving normalized prolactin levels and without tumor visibility on MRI. We report a middle-aged man with a macroprolactinoma who presented with apoplexy and panhypopituitarism. The patient responded remarkably to cabergoline with normalization of prolactin and complete tumor disappearance with radiological empty sella within 18 months, and subsequently, he discontinued cabergoline. The patient presented lately (after 10 years) with a recurrence of macroprolactinoma, for which he was reinitiated on cabergoline therapy. Patients with an empty sella remain susceptible to tumor recurrence, as pituitary adenomas may arise from residual pituitary tissue or microscopic tumor remnants may persist, which is not discernible radiologically. This case is a poignant reminder of the importance of diligent and long-term clinical and biochemical monitoring in patients with prolactinomas.
Histopathological Spectrum of Leiomyoma of the Uterus with an Emphasis on Pathological Technique to Avoid the Misdiagnosis: A Single Tertiary Centre Experience
Authors: Kumari Suman , Yadav Gajendra Kumar , Kaushik Bhoomika , Kumar Arvind , Phulware Ravi Hari , Singh Ashok , Durgapal Prashant , Mundhra Rajlaxmi , Kishore Sanjeev
Published: December 2023

Background:

The most typical uterine tumour that develops from smooth muscle is a leiomyoma. It might be challenging to provide an accurate diagnosis when it exhibits abnormal gross features or artefacts. The fixation, grossing, taking sections, tissue processing, sectioning and staining are all aspects that might alter the histological spectrum, which varies from benign to malignant. Therefore, careful consideration must be given to all advantages and disadvantages in specimen handling, processing, evaluating gross examination and obtaining sections to arrive at a definitive diagnosis.

Aims:

To identify the pathological factors that affect the diagnostic accuracy in resection specimen of uterine mass, clinico-radiologically suggestive leiomyoma.

Patients:

All female patients (352) who underwent surgery for clinically suggestive uterine leiomyoma in a period of two years were included in the study.

Materials and Methods:

It was a retrospective observational study in a tertiary care centre that spanned 2 years, from January 2019 to January 2021. All patients who had undergone surgery for leiomyoma in this duration were included. All big specimens underwent customised pathology techniques.

Results:

A total of 352 cases, including 348 leiomyomas, three uterine smooth-muscle tumours of uncertain malignant potential (STUMP) and one case of leiomyosarcoma, were studied. A majority of patients were in the age group of 36–45 years (49.04%). Total hysterectomy was the most common type of surgery performed for leiomyoma (62.06% cases). The most common site of occurrence is intramural. The average size of leiomyoma was 4.72 cm. A majority (88.21%) of leiomyomas were of typical type without any degeneration or variation in histology. Hyalinised collagen (5.75%) is the most frequent finding encountered as a histopathological variant, followed by myxoid change (1.43%). Associated pathology with leiomyoma was adenomyoma (10.91%), followed by uterine malignancy. Adopting the pathology techniques, three cases of uterine smooth-muscle tumours of uncertain malignant potential (STUMP) and one case of leiomyosarcoma could be identified.

Conclusion:

A pathologist needs to be skilled in troubleshooting lacunae, whether they are caused by fixing the gross or by cutting sections and staining tissue processing. These variables affect the accuracy of the diagnostic process.
The Effect of Auditory Stimulation on the Nonlinear Dynamics of Heart Rate
Authors: Dimitriev Dmitri , Indeykina Olga , Dimitriev Aleksey
Published: December 2023

Background:

Although it is known that sound exposure evokes changes in autonomic activity, the effects of noise and music on the nonlinear behavior of heart rate fluctuations remain poorly understood and controversial. This study aims to assess the influence of sound subjective emotional valence and arousal on the nonlinear characteristics of the autonomic nervous system during passive listening.

Methods:

In this study, 42 subjects listened to four sounds: (1) white noise, (2) road traffic noise, (3) excitatory music, and (4) a lullaby. The experiment consisted of two consecutive sessions: 5 minutes of rest, followed by 5 minutes of listening. RR intervals were recorded during both sessions. The following linear and nonlinear heart rate variability (HRV) indices were computed: Standard deviation of NN (SDNN), The root mean square of successive differences between normal heartbeats (RMSSD), F, high frequency (HF), approximate entropy (ApEn) and sample entropy (SampEn), correlation dimension (D2), Poincaré plot indices (SD1, SD2), fractal scaling exponents (alpha1, alpha2), and recurrence plot indices (mean line length [Lmean], maximum line length [Lmax], determinism [DET], laminarity [LAM], maximal vertical length [Vmax], trapping time [TT], Shannon entropy of line length distribution [ShanEn]).

Results:

Excitatory music was associated with a significant decrease in SDNN (from 47.3 ± 3.59 to 38.31 ± 3.16, P < 0.01), RMSSD (from 51.07 ± 4.75 to 42.53 ± 3.9, P < 0.05), HF (from 1516.26 ± 245.74 to 884.07 ± 183.44, P < 0.001), and low frequency (LF; from 973.33 ± 176.09 to 760.28 ± 150.35, P < 0.05). Excitatory music exposure induced significant increases in DET (P < 0.01), SD1 (P < 0.05), and SD2 (P < 0.05), but changes in detrended fluctuation analysis (DFA), SampEn, and D2 were nonsignificant. Traffic noise, white noise, and the lullaby did not cause significant changes in the measures of HRV.

Conclusion:

Presentation of excitatory music that evokes strong negative emotions elicits a prominent decrease in respiratory sinus arrhythmia. Poincaré plot and recurrence plot measures possess high sensitivity to excitatory music. Contrary to previous studies, we did not find the effects of relaxing music on HRV.
Clinical and epidemiological profile of patients with eyelid malignancies in a Colombian population
Authors: Ossa Andrés Felipe Ramírez , Trivino Yuli Jessica Hoyos , Ramirez Marcela Arango , Villada Ochoa Oscar Alonso
Published: December 2023

Purpose:

To establish the demographic, clinical characteristics, and factors related to the development of eyelid tumors in two ophthalmology services in a Colombian population.

Methodology:

Retrospective, cross-sectional study of secondary cut, evaluating clinical histories of ophthalmological consultation in two ophthalmological centers in the period of years 2015–2021 with confirmed diagnosis by biopsy of malignant neoplasm of the eyelid, clinical, and demographic variables was identified. Statistical analyses were performed using the SPSS version 20 program.

Results:

In a 7-year period, a total of 1802 ophthalmology medical records were reviewed, with a prevalence of 6.7 × 1000 population evaluated, an average age of 64.5 years. It was found a greater affectation in the female gender (61.2%). The main consultation symptom was the appearance of an eyelid lesion (83.6%), and the most common histological subtype was basal cell carcinoma (BCC) (66.4%), mainly affecting the right lower eyelid (40.8%). And extending to areas adjacent to the eyelid only in 28.9% of cases, receiving especially surgical management (87.4%).

Conclusions:

The data found is consistent with other epidemiological studies carried out worldwide on clinical and demographic data of patients affected by malignant eyelid tumors. It mainly affects older populations, being the basal cell histological subtype the most common within our population. Future studies can be carried out on this basis to broaden the knowledge and applicability.
A cosmetic blemish: Cilium incarnatum externum
Authors: Beri Nitika , Bhatia Rahul , Sahu Pramod Kumar , Das Gopal Krushna , Kumar Nitish
Published: December 2023

A 34-year-old female presented with unilateral, localized, linear, and brown lesion over the left upper eyelid causing cosmetic blemish. On clinical examination, upturning of the eyelash under the involved skin was seen and diagnosed as a case of cilium incarnatum externum. A simple excision followed by electrolysis for this unusual abnormality provides satisfactory results for both patient and the treating physician. Only 9 cases have been reported till date in world literature.
An Algorithmic Approach to Diagnosis in Patients with Ocular Surface Discomfort
Authors: Ambati Divya , Rao Srinivas K.
Published: December 2023

Patients often present with symptoms of ocular surface discomfort. Although a significant proportion of these changes are related to problems of the tear film, other causes exist. Unfortunately, the nature of the symptoms expressed by the patient is nonspecific and does not have a diagnostic significance. In many instances, there is also a significant disconnect between patient-reported symptoms and physician-determined signs of disease. Hence, a methodical approach is required to properly diagnose and manage the problems in such patients. This includes an understanding of normal interrelationships between the various components that constitute the ocular surface, conditions that can impact these, and the resulting changes that can occur. The importance of recognising the other conditions that may coexist with and exacerbate tear film abnormalities, the history-taking process to determine these, and the examination of the eye and other systems is highlighted. Finally, an algorithmic approach that puts together all of the information from the above is discussed. Following this process can help arrive at the proper diagnosis in patients with ocular surface discomfort and help manage their condition appropriately.
Herpes Zoster Dermatitis after Corneal Collagen Cross-Linking with Riboflavin: A Case Report
Authors: Koya Sree Divya , Potti Sudhakar , Shah Kruti K.
Published: December 2023

A middle-aged female presented with complaints of decreased vision in both eyes OD (right eye) > OS (left eye), since 6 months, and eye rubbing. Due to steep keratometry readings on an automated keratometer, pentacam was done, and the findings were suggestive of keratoconus in OD and formefruste keratoconus in OS. As best corrected visual acuity (BCVA) decreased only since 6 months and pentacam readings were suggestive of keratoconus, the patient was treated with corneal collagen cross-linking with riboflavin (C3R) in OD, to halt the progression. On post-op day 5, the patient presented with erythema, small papulovesicular lesions over the right half of the face and forehead, suggestive of herpetic skin lesions. She was prescribed topical eye drops for post-C3R haze and oral acyclovir for skin lesions, which were regressed within 1 week. Early diagnosis and appropriate treatment of herpes zoster dermatitis prevent worsening of signs and decrease further risk of herpetic keratitis and associated complications. Thus in this case, ultraviolet (UV)-A irradiation acted as a trigger for herpes zoster virus reactivation.
A Clinical Study on Orbital Tumours in a Tertiary Care Centre in South India
Authors: Rani Rita Hepsi , Velmurugan Thendral , Anandhi J
Published: December 2023

Introduction:

Space-occupying lesions of the orbit, both benign and malignant, cause significant functional and anatomical problems. A systematic and comprehensive approach is needed for prompt diagnosis and appropriate management of orbital space-occupying lesions.

Methods:

A total of 50 patients with orbital tumours were enrolled in the study. And it is a cross-sectional study conducted in the Department of Ophthalmology in Tirunelveli Medical College Hospital, Tamilnadu, India, for a time frame of 36 months from January 2018 to January 2021 and a follow up period of 12 months.

Results:

A total of 50 patients were included in the study. The most common age group involved was 40-60 years, and the mean age was 38 ± 5 years. Females were 40% and males were 60%. In 96% there was unilateral involvement and 4% had bilateral involvement. In the age group under 60 years, 23 eyes had a benign tumour and 11 eyes had a malignant tumour. In the age group of more than 60 years, 14 eyes had a malignant tumour and 2 had a benign tumour. Eccentric proptosis was reported in 85%, and axial proptosis was reported in 15%. In the total study population, 51% of the patients had benign lesions and 49% had malignant lesions. The majority of the cases are treated by chemotherapy alone (39%). The average survival rate is 81% in one year.

Discussion:

A multimodal systematic approach aids proper diagnosis and also prevents the quandary before commencing treatment. The tumour board discussion in treating every case of a space-occupying lesion plays a vital role in channelizing the case approach. The percentage of malignant tumours increased with age, due to the higher incidence of metastasis in the elderly. Old age tumours should be more suspected of malignancy which can be lifesaving.
The Role of Retrobulbar Injection of Amphotericin B in the Management of Orbital Mucormycosis in a Tertiary Care Centre—Prospective Analytical Study
Authors: Yogeswari A , Sujatha R , Kavithanjali M , Shobana K
Published: December 2023

Aim:

To study the role of retrobulbar (intraorbital) injection of amphotericin-B in the management of orbital mucormycosis.

Materials and Methods:

Patients with nasal diagnostic endoscopy or imaging confirmed, orbital mucormycosis were given 3 doses of 3.5 mg/ml of retrobulbar injection amphotericin-B for 3 alternate days and followed up for 72 hours for progression of symptoms.

Results:

Out of total 696 in-patients, 464 were males (66%) and 232 were females (34%), 612 were diabetic (88%), 490 were covid positive (71%), 308 patients have taken steroid (45%), 205 patients were given oxygen (30%). Out of 696 in-patients, 312 (45%) were started on retrobulbar injection of amphotericin. Dose wise-out of 312 retrobulbar injections, less than 3 doses is given for 69 patients (22%), 3 doses completed for 243 patients (78%). Outcomes-out of 243 three dose completed patients,49 (20%) patients has shown improvement in terms of vision and symptoms, 172 (71%) patients were stable without progression, 64 (26%) patients have shown deterioration out of which 35 patients progressed rapidly and undergone exenteration and remaining 29 are under observation.

Conclusion:

Retrobulbar injection of amphotericin-B along with iv amphotericin and sinus debridement through FESS have shown improvement and also halted the progression. Patients in stage 3a and 3b have shown better outcome with retrobulbar injection of amphotericin-b than in stage 3c and 3d.
Multi-linear forms, graphs, and
$L^p$
-improving measures in
${\Bbb F}_q^d$
Authors: Bhowmik Pablo , Iosevich Alex , Koh Doowon , Pham Thang
Published: December 2023

The purpose of this paper is to introduce and study the following graph-theoretic paradigm. Let
$$ \begin{align*}T_Kf(x)=\int K(x,y) f(y) d\mu(y),\end{align*} $$
where
$f: X \to {\Bbb R}$
, X a set, finite or infinite, and K and
$\mu $
denote a suitable kernel and a measure, respectively. Given a connected ordered graph G on n vertices, consider the multi-linear form
$$ \begin{align*}\Lambda_G(f_1,f_2, \dots, f_n)=\int_{x^1, \dots, x^n \in X} \ \prod_{(i,j) \in {\mathcal E}(G)} K(x^i,x^j) \prod_{l=1}^n f_l(x^l) d\mu(x^l),\end{align*} $$
where
${\mathcal E}(G)$
is the edge set of G. Define
$\Lambda _G(p_1, \ldots , p_n)$
as the smallest constant
$C>0$
such that the inequality (0.1)
$$ \begin{align} \Lambda_G(f_1, \dots, f_n) \leq C \prod_{i=1}^n {||f_i||}_{L^{p_i}(X, \mu)} \end{align} $$
holds for all nonnegative real-valued functions
$f_i$
,
$1\le i\le n$
, on X. The basic question is, how does the structure of G and the mapping properties of the operator
$T_K$
influence the sharp exponents in (0.1). In this paper, this question is investigated mainly in the case
$X={\Bbb F}_q^d$
, the d-dimensional vector space over the field with q elements,
$K(x^i,x^j)$
is the indicator function of the sphere evaluated at
$x^i-x^j$
, and connected graphs G with at most four vertices.
Presentations for tensor categories
Authors: East James
Published: December 2023

We introduce new techniques for working with presentations for a large class of (strict) tensor categories. We then apply the general theory to obtain presentations for partition, Brauer and Temperley–Lieb categories, as well as several categories of (partial) braids, vines, and mappings.
Regional disparities in the availability of cancer clinical trials in Korea
Authors: Jang Jieun , Choi Wonyoung , Sim Sung Hoon , Kang Sokbom
Published: December 2023

OBJECTIVES: Unequal access to cancer clinical trials is an important issue, given the potential benefits of participation for cancer patients. We evaluated regional disparities in access to cancer clinical trials in Korea.METHODS: From the Ministry of Food and Drug Safety database, we extracted 2,465 records of all cancer clinical trials approved between January 2012 and April 2023. To measure disparities in cancer clinical trial access, we calculated the ratio of clinical trials open to non-capital areas relative to those open to capital areas. We then analyzed temporal trends in this ratio, which we termed the trial geographical equity index (TGEI).RESULTS: Disparities in access to cancer clinical trials, as indicated by the TGEI, did not significantly improve during the study period (regression coefficient, 0.002; p=0.59). However, for phase II/III trials sponsored by global pharmaceutical companies, the TGEI improved significantly (regression coefficient, 0.021; p<0.01). In contrast, the TGEI deteriorated for trials initiated by investigators or those testing domestically developed therapeutics (regression coefficient, -0.015; p=0.05). Furthermore, the increasing trend of TGEI for phase II/III trials sponsored by global companies began to reverse after 2019, coinciding with the outbreak of coronavirus disease 2019 (COVID-19).CONCLUSIONS: Over the past decade, access to cancer clinical trials has improved in Korea, particularly for phase II/III trials evaluating therapeutics from global companies. However, this increase in accessibility has not extended to trials initiated by investigators or those assessing domestically developed therapeutics. Additionally, the impact of COVID-19 on disparities in clinical trial access should be closely monitored.
The association between migraine and Parkinson’s disease: a nationwide cohort study in Korea
Authors: Ha Woo-Seok , Kim Jaeho , Hwang Hee Won , Lee Sue Hyun , Kim Ji In , Hong Jin Yong , Park Sang Hyun , Han Kyung Do , Baek Min Seok
Published: December 2023

OBJECTIVES: Clinical studies have suggested an association between migraine and the occurrence of Parkinson’s disease (PD). However, it is unknown whether migraine affects PD risk. We aimed to investigate the incidence of PD in patients with migraine and to determine the risk factors affecting the association between migraine and PD incidence.METHODS: Using the Korean National Health Insurance System database (2002-2019), we enrolled all Koreans aged ≥40 years who participated in the national health screening program in 2009. International Classification of Diseases (10th revision) diagnostic codes and Rare Incurable Diseases System diagnostic codes were used to define patients with migraine (within 12 months of enrollment) and newly diagnosed PD.RESULTS: We included 214,193 patients with migraine and 5,879,711 individuals without migraine. During 9.1 years of follow-up (55,435,626 person-years), 1,973 (0.92%) and 30,664 (0.52%) individuals with and without migraine, respectively, were newly diagnosed with PD. Following covariate adjustment, patients with migraine showed a 1.35-fold higher PD risk than individuals without migraine. The incidence of PD was not significantly different between patients with migraine with aura and those without aura. In males with migraine, underlying dyslipidemia increased the risk of PD (p=0.012). In contrast, among females with migraine, younger age (<65 years) increased the risk of PD (p=0.038).CONCLUSIONS: Patients with migraine were more likely to develop PD than individuals without migraine. Preventive management of underlying comorbidities and chronic migraine may affect the incidence of PD in these patients. Future prospective randomized clinical trials are warranted to clarify this association.
Bridging the Gap from Molecular Surveillance to Programmatic Decisions for Malaria Control and Elimination
Authors: Golumbeanu Monica , Edi Constant A. V. , Hetzel Manuel W. , Koepfli Cristian , Nsanzabana Christian
Published: December 2023

An increasing number of molecular and genomic assays are available to study malaria parasite populations. However, so far they have played a marginal role in informing policy and programmatic decision-making. Currently, molecular data are mainly used for monitoring drug efficacy against Plasmodium falciparum; assessing molecular markers of drug and insecticide resistance; and assessing P. falciparum histidine-rich protein 2 and 3 genes (Pfhrp2/3) deletion. We argue that additional use cases for molecular routine surveillance could be implemented in the near future, especially in transmission settings approaching elimination. These would include using quantitative polymerase chain reaction to monitor the prevalence of sub-patent infections in asymptomatic carriers, monitoring parasite genetic diversity as transmission intensity is changing, using genomic data to determine the origin of imported infections and characterize transmission chains in settings with very low malaria transmission, and using serology to monitor recent and past exposures in low-transmission settings. Molecular surveillance could inform control programs on adapting novel strategies, such as reactive case detection or focal mass drug administration, and help evaluate the impact of interventions currently in place. To better integrate molecular and genomic data into control program decision-making, engagement of national malaria control experts is crucial. Local laboratory capacity needs to be strengthened, shortening the time from sample collection to data availability. Here, we discuss opportunities and challenges of the use of molecular and genomic data for supporting malaria control and elimination efforts, as well as the avenues to link molecular and genomic data with gold standard epidemiological measurements through mathematical modeling.
Implementation and Evaluation of a Training Program for Traditional Healers to Improve Knowledge of Noma (Cancrum Oris) in Burkina Faso
Authors: Baratti-Mayer Denise , Jeannot Emilien , Dupuis Marc
Published: December 2023

Noma (cancrum oris) is an orofacial gangrene affecting young children living in extreme poverty. The acute morbidity is high, and survivors suffer from physical and social sequelae. When diagnosed early, noma can be cured. Noma is especially prevalent in sub-Saharan Africa, where traditional medicine is the norm. The aim of this work was to provide 1-day training to traditional healers in Burkina Faso and to evaluate change in knowledge of noma across time. A sample of 78 healers who attended the training were asked to complete the same questionnaire before, immediately after, and 8 months after the training. A total of 66 healers completed the entire study. Before training, more than 40% of the participants did not know any of its key messages. Most of the key messages were acquired and still present after 8 months by a large proportion of the participants. Systematic intraoral examination was practiced by 7 (9.0%) of the traditional healers before training, and 43 (65.2%) reported doing so 8 months after training. The key messages aiming to improve early diagnosis as well as rapid and adequate treatment (the recognition of facilitating factors and the need to perform a systematic oral examination and to advise hospital transfer) have been well integrated. The study suggests that organizing a self-managed training program is feasible when done within an association, as was the case here, and owing to the willingness to collaborate shown by the traditional healers who participated in our study.
Guessing from Textones. Distributed Translation as Exemplified by Sea and Spar Between (2010) by Stephanie Strickland and Nick Montfort
Authors: Górska-Olesińska Monika , Pisarski Mariusz
Published: December 2023

This article discusses the challenges of translating poetry generators in multi-authorial, creative collaborations and within the context of understanding text as a process. Stephanie Strickland’s and Nick Montfort’s Sea and Spar Between is in many respects a translational challenge that in some languages might be considered an impossible task. Polish, our target language, imposes some serious constraints: one-syllable words become disyllabic or multisyllabic, kennings have different morphological, lexical, and grammatical arrangements, and most of the generative rhetoric of the original (like anaphors) must take into consideration the grammatical gender of Polish words. As a result, the JavaScript code, instructions that accompany the JavaScript file, and arrays of words that this poetry generator draws from, needed to be expanded and rewritten. Moreover, in several crucial points of this rule-driven work, natural language forced us to modify the code.

In translating Sea and Spar Between, the process of negotiation between the source language and the target language involves more factors than in the case of traditional translation. Strickland and Montfort read Dickinson and Melville and parse their readings into a computer program (in itself a translation, or port, from Python to JavaScript), which combines them in almost countless ways. Such a collision of cultures, languages, and tools becomes amplified when transposed into a different language. This transposition involves the original authors of Sea and Spar Between, the four original translators of Dickinson and Melville into Polish, and ourselves, turning into a multilayered translational challenge, something we propose to call a distributed translation. While testing the language and the potential of poetry translation in the digital age, the experiment – we hope – has produced some fascinating and thought-provoking poetry.
taH pagh taHbe: Shakespearean Experiment in Translation
Authors: Kowalcze-Pawlik Anna
Published: December 2023

This article discusses experimental translation on the example of intralingual translation in the Play On! Translation project accompanying the Oregon Shakespeare Festival, and intersemotic/intermedial translation in the OMGShakespeare series and Star Trek-related texts. These are approached as exercises in post-translation as defined by Edwin Gentzler in his volume on the subject.
Upper Jurassic Source Rock Evaluation and Thermal Maturity Evolution of the NW Sab’Atayn Basin, Yemen
Authors: Al-Azazi Nabeel A. S. , Alsrory A. S. A. E. , Albaroot Mohammed
Published: December 2023

Of Yemen’s Mesozoic basins, the Sab’atayn Basin offers the most significant potential for oil and gas exploration. The key consideration in the evaluation of source rocks to hydrocarbon exploration is the quantity and nature of the organic materials in sedimentations. Using organic geochemistry and total organic carbon content, organic-rich sediments from the Meem (Lower) and Lam (Upper) members from four wells in the NW Sab’atayn Basin were evaluated. The information gained reveals that the Meem source rocks have a total organic carbon content (TOC) value between 0.2–1.68 wt%, therefore suggests fair to very good source rocks. Only two samples in the Kamaran-01 well had values greater than 3 wt%, compared to the Lam source rocks’ values, which range from 0.2 to 3.81 wt%, which suggest excellent source rocks. The majority of the samples are made up of reworked organic debris, with no possibility for interesting source rocks, according to the Rock-Eval pyrolysis data. The majority of the Meem and Lam source rocks samples under study have Tmax values below 440 °C, placing them in the immature to marginally mature and on the main periphery of main phases of hydrocarbon formation. Based on the results of the Meem source rocks’ generative potential (GP), it may be inferred that non-generative rocks status of Meem source rocks due to GP values less than 2 mg HC/gm rock. Additionally, if the burial depth is sufficient to generate the necessary temperature and pressure, source rocks with extraordinarily high GP values of more than 10 mg Hc/g rock may serve as an efficient source rock for the Dahamr Ali-01 well. On the other hand Lam source rock is classified as moderate source rocks. Non-generative potential has been reported from Lam source rock in Himyar-01 well where the GP is less than 1 mg HC/g rock. The cross-plots of pyrolysis characteristics, such as HI versus Tmax (modified van Krevelen diagram) and TOC vs S2, which are most likely the result of deposition of more terrigenous type III organic materials derived from terrestrial in the study area, can be used to determine the kerogen type for Lam and Meem source units. The analysis of Meem source rocks demonstrated that they are typically plotted in the mature zone; however samples of Lam source rocks proved that they have been still immature, merely marginally mature in the Dahamr Ali-01 and Saba-01 wells.
Petrophysical and Geomechanical Analysis to Delineating Reservoirs in the Miocene Niger Delta Region of Nigeria
Authors: Ojo Odunayo Tope
Published: December 2023

The application of various petrophysical and elastic metrics has advanced reservoir characterization and provided critical geological formation information. Porosity declines with depth, according to sonic, neutron, and density logs. Lithology, pressure, and hydrocarbons all contribute to this. Formation resistivity and fluid saturation are used to identify hydrocarbon-bearing zones. Because oil and gas are non-conductive, hydrocarbon-containing rocks are more resistant than water. In lithological categorization, gamma logs and the Vp/Vs ratio have helped classify reservoirs as Agbada Formation sand-shale reservoirs. Reservoir elastic characteristics, specifically sandstones, have been studied at various depths. These discoveries have an impact on their brittleness, strength, and failure risk in a variety of scenarios. Hydrocarbon accumulation has been influenced by diagenetic compaction equilibrium in pressure-exposed shale source beds. The research advances our understanding of the geological formations of the Niger Delta and gives practical insights for exploration and production. Decisions on oil and gas are based on hydrocarbon reservoir assessments at various depths, including porosity, fluid saturation, and lithology. Well logs from Wells B001, B002, and B003 revealed the diverse properties of several Niger Delta reservoirs. These discoveries have benefited hydrocarbon exploration and production decision-making significantly.
Anomalie littéraire: la plume comique d’Hélène du Taillis
Authors: Gauthier Vicky
Published: December 2023

Literary anomaly: The comedic style of Hélène du Taillis

When we think of classic comedic novels, the names of male authors such as Rabelais, Cervantes, or Scarron often come to mind. However, the contributions of women writers to this genre have been overlooked as literary anomalies. Hélène du Taillis (1873-1961), a French journalist and writer, is a literary anomaly in the history of early 20th-century French literature. She wrote not one but two successful and critically acclaimed comedic novels, "Enterrons l’adultère" (1923) and "La Nouvelle Bovary" (1927), at a time when this genre was largely dominated by male writers and considered marginal literature (and still is today). This article aims to examine Taillis's two novels from the perspectives of Hamon and Saint-Gelais on irony and transfictionality. By doing so, highlighting the unique aspects of Taillis's comedic writing, demonstrating that a comical heritage also exists among women writers.
Survivre à la fin du monde : anomalie et ruine dans Oscar de profundis de Catherine Mavrikakis
Authors: Bernier-Wong Nicolas
Published: December 2023

Surviving the End of the World : Anomaly and Ruins in Oscar de profundis by Catherine Mavrikakis

The present study analyzes the representation of the anomaly in Oscar de profundis by Catherine Mavrikakis. This inexplicable event is paradoxically ever-present and completely absent in end of world literature. In particular, we will examine the role of ruins in the portrayal of the post-catastrophe scenario. This paper argues that the anomaly invites the reader to investigate further. However, they will only find ruins which are a constant reminder of what was lost and not an explanation of how these memories were erased from the collective conscience. The concept of depicting the anomaly through ruins will allow us to better understand how end of world literature may propose a critique of contemporary society.
Écarts par rapport à la norme dans Ce qui manque à un clochard de Nicolas Diat
Authors: Bouftouh Ahmed
Published: December 2023

Deviations from the norm in Ce qui manque à un clochard by Nicolas Diat This article looks at the representation of anomaly in Nicolas Diat's Ce qui manque à un clochard. We examine the character of Marcel Bascoulard, a marginal figure inspired by a real person with the same name. More specifically, we highlight his anomaly and the stances he takes towards those around him. Our work leads us to the idea that anomaly and literary and artistic creation go hand in hand in Bascoulard's case.