bluuebunny/crossref_metadata_2025 huggingface dataset:
Phosphatidylserine-Targeting Monoclonal Antibodies Exhibit Distinct Biochemical and Cellular Effects on Anti-CD3/CD28–Stimulated T Cell IFN-γ and TNF-α Production
Authors: Calianese David , Kreiss Tamara , Kasikara Canan , Davra Viralkumar , Lahey Kevin C , Gadiyar Varsha , Geng Ke , Singh Sukhwinder , Honnen William , Jaijyan Dabbu Kumar , Reichman Charles , Siekierka John , Gennaro Maria Laura , Kotenko Sergei V , Ucker David S , Brekken Rolf A , Pinter Abraham , Birge Raymond B , Choudhary Alok
Published: July 2021

Phosphatidylserine (PS)-targeting monoclonal Abs (mAbs) that directly target PS and target PS via β2-gp1 (β2GP1) have been in preclinical and clinical development for over 10 y for the treatment of infectious diseases and cancer. Although the intended targets of PS-binding mAbs have traditionally included pathogens as well as stressed tumor cells and its associated vasculature in oncology, the effects of PS-targeting mAbs on activated immune cells, notably T cells, which externalize PS upon Ag stimulation, is not well understood. Using human T cells from healthy donor PBMCs activated with an anti-CD3 + anti-CD28 Ab mixture (anti-CD3/CD28) as a model for TCR-mediated PS externalization and T cell stimulation, we investigated effects of two different PS-targeting mAbs, 11.31 and bavituximab (Bavi), on TCR activation and TCR-mediated cytokine production in an ex vivo paradigm. Although 11.31 and Bavi bind selectivity to anti-CD3/28 activated T cells in a PS-dependent manner, surprisingly, they display distinct functional activities in their effect on IFN-γ and TNF-ɑ production, whereby 11.31, but not Bavi, suppressed cytokine production. This inhibitory effect on anti-CD3/28 activated T cells was observed on both CD4+ and CD8+ cells and independently of monocytes, suggesting the effects of 11.31 were directly mediated by binding to externalized PS on activated T cells. Imaging showed 11.31 and Bavi bind at distinct focal depots on the cell membrane. Collectively, our findings indicate that PS-targeting mAb 11.31 suppresses cytokine production by anti-CD3/28 activated T cells.
Soluble FAS Ligand Enhances Suboptimal CD40L/IL-21–Mediated Human Memory B Cell Differentiation into Antibody-Secreting Cells
Authors: van Asten Saskia D , Unger Peter-Paul , Marsman Casper , Bliss Sophie , Jorritsma Tineke , Thielens Nicole M , van Ham S Marieke , Spaapen Robbert M
Published: July 2021

Differentiation of Ag-specific B cells into class-switched, high-affinity, Ab-secreting cells provides protection against invading pathogens but is undesired when Abs target self-tissues in autoimmunity, beneficial non–self-blood transfusion products, or therapeutic proteins. Essential T cell factors have been uncovered that regulate T cell–dependent B cell differentiation. We performed a screen using a secreted protein library to identify novel factors that promote this process and may be used to combat undesired Ab formation. We tested the differentiating capacity of 756 secreted proteins on human naive or memory B cell differentiation in a setting with suboptimal T cell help in vitro (suboptimal CD40L and IL-21). High-throughput flow cytometry screening and validation revealed that type I IFNs and soluble FAS ligand (sFASL) induce plasmablast differentiation in memory B cells. Furthermore, sFASL induces robust secretion of IgG1 and IgG4 Abs, indicative of functional plasma cell differentiation. Our data suggest a mechanistic connection between elevated sFASL levels and the induction of autoreactive Abs, providing a potential therapeutic target in autoimmunity. Indeed, the modulators identified in this secretome screen are associated with systemic lupus erythematosus and may also be relevant in other autoimmune diseases and allergy.
T Cells Retain Pivotal Antitumoral Functions under Tumor-Treating Electric Fields
Authors: Diamant Gil , Simchony Goldman Hadar , Gasri Plotnitsky Lital , Roitman Marina , Shiloach Tamar , Globerson-Levin Anat , Eshhar Zelig , Haim Oz , Pencovich Niv , Grossman Rachel , Ram Zvi , Volovitz Ilan
Published: July 2021

Tumor-treating fields (TTFields) are a localized, antitumoral therapy using alternating electric fields, which impair cell proliferation. Combining TTFields with tumor immunotherapy constitutes a rational approach; however, it is currently unknown whether TTFields’ locoregional effects are compatible with T cell functionality. Healthy donor PBMCs and viably dissociated human glioblastoma samples were cultured under either standard or TTFields conditions. Select pivotal T cell functions were measured by multiparametric flow cytometry. Cytotoxicity was evaluated using a chimeric Ag receptor (CAR)–T–based assay. Glioblastoma patient samples were acquired before and after standard chemoradiation or standard chemoradiation + TTFields treatment and examined by immunohistochemistry and by RNA sequencing. TTFields reduced the viability of proliferating T cells, but had little or no effect on the viability of nonproliferating T cells. The functionality of T cells cultured under TTFields was retained: they exhibited similar IFN-γ secretion, cytotoxic degranulation, and PD1 upregulation as controls with similar polyfunctional patterns. Glioblastoma Ag–specific T cells exhibited unaltered viability and functionality under TTFields. CAR-T cells cultured under TTFields exhibited similar cytotoxicity as controls toward their CAR target. Transcriptomic analysis of patients’ glioblastoma samples revealed a significant shift in the TTFields-treated versus the standard-treated samples, from a protumoral to an antitumoral immune signature. Immunohistochemistry of samples before and after TTFields treatment showed no reduction in T cell infiltration. T cells were found to retain key antitumoral functions under TTFields settings. Our data provide a mechanistic insight and a rationale for ongoing and future clinical trials that combine TTFields with immunotherapy.
Evaluation of Screening Tests for Pre-Transplant Compatibility Testing in Live-Related Kidney Transplants
Authors: Chauhan Rajni , Tiwari Aseem Kumar , Rajvanshi Chhavi , Mehra Simmi , Aggarwal Geet , Bansal Shyam Bihari , Kher Vijay
Published: July 2021

Introduction:

Pre-transplant compatibility testing involves the use of different methodologies (cell-based and solid phase based) for the determination of anti-human-leukocyte antigen (HLA) antibodies. Implementation of these donor-recipient methods in the screening of patients awaiting transplantation increased their chance of successful graft and patient outcomes.

Materials and Methods:

A total of 1054 patients visiting tertiary care hospitals for pretransplant compatibility testing were screened with cell-based tests; complement-dependent cytotoxicity crossmatch (CDC-XM) and flow cytometric crossmatch (FC-XM). The patients positive for either or both screening tests were suspected to have anti-HLA antibodies. Luminex single-antigen bead (SAB) tests were performed in such patients to determine and identify antibody specificity and establish donor-specific antibody (DSA).

Results:

The study showed a significantly higher sensitivity of the FCXM (94.6%) method when compared with CDC-XM (35.7%), considering the SAB assay as the gold standard technique. The specificity of CDC-XM (100%) was slightly higher than the FC-XM (76.3%). Combination of FC-XM with CDC-XM (17 cases) was 100% sensitive and specific to identify DSA (s). The graft-survival was 94.77% using the proposed algorithm.

Conclusions:

The combination of CDC-XM and FC-XM, along with SAB assay, could be used as a screening algorithm as it is a useful technique in identifying the specificities of alloantibodies, assessment of DSAs. Hence, the presented algorithm can become a new standard for the identification of potential recipients awaiting kidney transplantation in India.
Raoultella terrigena Infections in Hematopoietic Stem Cell Transplant Recipients
Authors: Mellouli Ameni , Chebbi Yosra , Raddaoui Anis , El Fatmi Rym , Ladeb Saloua , Othmen Tarek Ben , Achour Wafa
Published: July 2021

Background:

Raoultella terrigena is a Gram-negative bacterium mainly reported as aquatic and soil organism. It is rarely involved in human infections. This study investigated the epidemiology of R. terrigena infections in the National Bone Marrow Transplant Center of Tunis (NBMTC) between January 2010 and March 2018, their associated antibiotics resistance patterns, and the molecular features of extended-spectrum β-lactamase (ESBL) producing strains.

Materials and Methods:

Our retrospective study concerned hematopoietic stem cell transplant (HSCT) adult recipients hospitalized at the NBMTC and infected with R. terrigena. The search of the ESBL and carbapenemases genes for multidrug-resistant strains was performed by PCR amplification.

Results:

Twelve strains of R. terrigena were responsible for infections in 10 hematopoietic stem cell transplant recipients (1.2% of total HSCT recipients). They were responsible for skin (n = 4) and urinary tract infections (n = 4). The first-line antibiotherapy was based on a monotherapy in one case and a dual therapy in eleven cases. Imipenem was the most prescribed antibiotic (n = 7/12). Mortality was attributable to R. terrigena infection in two over ten patients. Nine strains were producing ESBL. Five strains were resistant to ertapenem, two to imipenem, ten to ciprofloxacin, and five to amikacin. BlaCTX-M1
, blaOXA-48,
and bla
KPC were found in seven, four, and one strains, respectively.

Conclusion:

Low prevalence of R. terrigena infections in HSCT recipients but high rates of attributable mortality and multidrug-resistant strains.
Postexposure psychological sequelae in frontline health workers to COVID-19 in Andhra Pradesh, India
Authors: Das Keya , Ryali V. S. S. R. , Bhavyasree R. , Sekhar C. Madhu
Published: July 2021

Introduction:

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 has engulfed the globe since December 2019. Healthcare workers remain at the forefront of this battle, and like prior pandemics face mental health challenges along with physical risks. We aimed to study the perceived stress and possible posttraumatic stress in the frontline workers exposed to active COVID-19 duties in the state of Andhra Pradesh, India.

Methodology:

A special voluntary, anonymous, survey-based Google questionnaire was designed with mandatory consent form and queries to clarify inclusion exclusion criteria. Tools included valid, reliable self-administered scales, namely General Health Questionnaire 12, Perceived Stress Scale and Impact of Events Scales-Revised. A purposive sampling method was adopted, by posting the survey questionnaire on WhatsApp groups of doctors, interns, and nurses working on active COVID-19 duty in Andhra Pradesh.

Results:

About 69.7% of the frontline workers recorded higher perceived stress and definitive posttraumatic stress disorder (PTSD) was found in 34.8%, with psychological distress recorded in 53%.

Conclusion:

The higher levels of perceived stress discovered in the vast majority with definitive PTSD features in a third of the sample indicates the need for provision of mental health support proactively among frontline workers on active COVID-19 duty.
Impact of mindfulness-based therapy on psychological characteristics of juveniles in conflict with law in India
Authors: Madiha Maria , Akhouri Deoshree
Published: July 2021

Background:

According to National Crime Records Bureau, India, there has been a significant increase in criminal activities among juvenile over the past 3 years, especially in Uttar Pradesh in comparison to other Northern States. Various management strategies have been undertaken for such adolescents. However, there is a lack of management strategies in the Indian context for juvenile in conflict with law. Thus, this research work aims to see the effect of mindfulness-based therapy (MBT) on juveniles in conflict with law and not in conflict with law.

Aim:

The aim of the study was to see the effect of MBT on juveniles in conflict with law and not in conflict with law; to assess and compare the effect of MBT on their temperament, aggression, emotional quotient, and social quotient; and to see the effect of MBT on their level of mindfulness.

Methodology:

A total 25 adolescents of 13–19 years of age, both genders, literate and illiterate belonging from rural and urban population were included for the study. Among these, 17 juveniles in conflict with law were taken from District Child Protection Unit and eight juveniles not in conflict with law were taken from general adolescent population. After explaining the purpose of the study and attaining the consent from guardians, assessment was done using different psychological tools. MBT was used for the management. The pre-postresearch design was used.

Results and Conclusion:

Results obtained in this study are suggestive of that MBT is a fruitful management technique for juveniles in conflict with law serving in observation homes as well as for juveniles not in conflict with law.
Multiple cross-sectional assessments of empathy in medical undergraduate students
Authors: Shashikumar Ramadugu , Agarwal Kruti , Mohammad Aiman , Kaushik Chatterjee
Published: July 2021

Introduction:

Empathy a cognitive phenomenon, with affective and behavioral components; helps improve clinical competence. It varies depending on physicians' gender and specialty. While some western studies reported significant fall in empathy levels when they progressed from non-clinical to clinical training years, Asian studies including Indian had varied results. We hypothesize that empathy will decrease among medical undergraduates over four years while they progress from non- clinical to clinical rotations and that female medical students and those opting for clinical specialties will have higher empathy than male medical students and those opting for non clinical specialty.

Methodology:

This study was carried out in a medical college from the year 2012 to 2015. Each year at the beginning of academic session all students were asked to complete Jefferson's -Scale for Physician's Empathy (JSPE student) student version. Over next three years similar assessments were repeated for all batches. The results were tabulated and analyzed using EpiInfo7 software.

Results:

Over four years 481, 416, 412 and 354 medical students in 1st, 2nd, 3rd and 4th year respectively from seven different batches were evaluated. Choice of specialty differed significantly in each year different batches. The empathy score had no relation to gender or choice of specialty. Empathy declines from first year onwards till third year but is not statistically significant.

Conclusion:

In this large multiple sample cross sectional study, it is evident empathy drops from 1st to 3rd year therefore there is an urgent need to evaluate why empathy falls.
IgA nephropathy superimposed on diabetic nephropathy
Authors: Lyngdoh Bifica Sofia , Baishya Pakesh , Mishra Jaya , Marbaniang Evarisalin , Dey Biswajit
Published: July 2021

Diabetes mellitus is one of the foremost diseases in the modern era and diabetic nephropathy contributes to a major percentage of end-stage kidney disease. Although diabetic nephropathy is difficult to revert back, detection of nondiabetic renal disease (NDRD) is important to detect as most of them are treatable. We describe a case of a 62-year-old female with long-standing diabetes mellitus presenting with massive proteinuria and clinical features of nephrotic syndrome. The kidney biopsy showed class III diabetic nephropathy along with focal proliferative glomerulonephritis with crescent formations. The immunofluorescence study showed strong mesangial IgA deposition with the predominance of lambda stain. This confirmed the diagnosis of diabetic nephropathy with superimposed IgA nephropathy. We reviewed eight Indian studies herewith to demonstrate NDRD spectrum in the Indian diabetic scenario.
When the head is big, think this too
Authors: Chandrasekar Shyam , John Joseph , Satapathy Amit K. , Mahapatro Samarendra
Published: July 2021

We present a one-year old, developmentally normal toddler from a non Agarwal community, who presented to us with only a large head. The examination findings were unremarkable except a large head circumference. Neuroimaging confirmed the diagnosis of megalencephalic leukoencephalopathy (MLC). Although developmental delay and seizures are common manifestations in MLC, we want to highlight the fact that many children like ours may have no neurological manifestations at all which makes it necessary to do neuroimaging to establish the diagnosis and offer genetic testing for confirmation of the same.
Population-based seropositivity for IgG antibodies against SARS-CoV-2 in Ahmedabad city
Authors: Prakash Om , Solanki Bhavin , Sheth Jay , Oza Divyang , Kadam Mina , Vyas Sheetal , Shukla Aparajita , Pethani Jayshri , Tiwari Hemant
Published: July 2021

Context:

Ahmedabad city with approximately 7 million population was one of the earliest cities to witness the high case load of COVID-19 pandemic in India. A population-based sero-survey was ideally suited in Ahmedabad to guide the public health response for managing COVID-19 pandemic.

Objectives:

To study the percentage sero-positivity for SARS-CoV-2 to understand the pandemic status and deriving conclusions for guiding the public health measures for managing the COVID-19 pandemic.

Settings and Design:

Population-based cross-sectional sero-surveillance.

Methods and Material:

Large scale sero-surveillance with population-based stratified sampling covering more than 10,000 samples from general population of Ahmedabad was carried out during second half of August 2020. The seropositivity was correlated and compared with various demographic factors and other parameters for valid and precise predictions on the immunity status of the population.

Results:

With 2,396 samples positive for IgG antibodies from a total of 10,310 samples, the seropositivity against COVID-19 in the general population of Ahmedabad is around 23.24%. The seropositivity has increasing trend with increasing age and is significantly higher among females (25.37%) than males (21.81%). The zone wise positivity ranged from 11.74% to 33.14%. This closely correlates with the cases recorded so far, higher for those zones with high current or past cases.

Conclusions:

Seropositivity of 23.24% in general population indicate the overall current level of protection. Since effective vaccine is not yet available, it is required to continue emphasis on the public health preventive measures for controlling and managing the COVID-19 pandemic.
Diagnostic accuracy of screening tools for chronic obstructive pulmonary disease in primary health care
Authors: Tyagi Jyoti , Moola Sandeep , Bhaumik Soumyadeep
Published: July 2021

Background:

Chronic obstructive pulmonary disease (COPD) contributed significantly to burden of diseases in India, with missed, incorrect, and delayed diagnosis in primary care. We conducted a rapid evidence synthesis, to summarize the evidence on accuracy of the screening tests for COPD in primary health care on request form State Health Resource Centre, Chhattisgarh.

Methods:

Considering the rapid nature of decision making, our approach was to first search for existing systematic reviews. We identified one existing systematic review on the topic with the search conducted until 2014. We updated the review by searching in two major databases screened, title/abstracts, and full texts of studies as per eligibility criteria and extracted relevant data. A narrative synthesis was conducted.

Results:

We retrieved 7,007 and included five new studies, to add to 10 studies of the existing systematic review. Overall, 13 studies assessed diagnostic accuracy of screening questionnaires [e.g., COPD Diagnostic Questionnaire (CDQ)], five assessed handheld flow meters (COPD6 and PICO-6), and four assessed the combination of both the tests. The CDQ questionnaire using a score threshold ≥16.5 or >17 demonstrated comparatively a higher sensitivity both in pooled result for ever-smokers [87.5% (95% CI 83.1--90.9%)] and among the adults >35 years [73.8--93% (95% CI 69--98%)] when compared to a different score threshold of CDQ and other questionnaires. Handheld flow meters reported a pooled high sensitivity of 79.9% (95% CI 74.2--84.7%) in ever-smokers and 87.9% in adults with age >35 years.

Conclusions:

The need for better diagnosis of COPD in primary healthcare can be addressed by using of COPD Diagnostic Questionnaire alone or in combination with hand-held flow meters. There is scope for more implementation research on the domain.
Role of tenofovir and telbivudine in treatment of hepatitis B related acute on chronic liver failure
Authors: Malakar Debraj , Mahtab Mamun A , Manik Abul H , Alam Sheikh M Noor E , Das Dulal C , Mamun Ayub A , Khan Md. Sakirul Islam , Rahman Zakiur , Rahman Salimur , Akbar Sheikh Mohammad Fazle
Published: July 2021

Introduction:

ACLF is characterized by acute deterioration of liver function in patients with chronic liver disease. HBV is one of the most important causes of both acute insult and underlying chronic liver disease in ACLF. Reactivation of HBV is one of the common causes of ACLF in our region. ACLF requires multiple organ support and is associated with high short and medium term mortality. This is the reason why early, rapid reduction of HBV DNA is essential in treating ACLF-B.

Methods:

Consecutive patients of ACLF-B due to spontaneous reactivation of HBV (ALT> 5xULN or >2 x baseline and HBV DNA >20,000 IU/ml) were randomized into tenofovir group (300mg/day) and telbivudine group (600mg/day) along with standard medical treatment. Clinical and laboratory parameters were evaluated at baseline, day-7, day-14, day-30 and day-90. HBV DNA was evaluated at baseline and after three months of therapy. Primary end point was survival or death at three months. Secondary end point was improvement of liver function assessed by Child-Turcotte Pugh score and MELD score at three months.

Results:

30 patients were enrolled in the study and 15 of them received tenofovir and 15 patients received telbivudine. Most of the baseline parameters showed no difference except serum AST and serum creatinine level that showed statistically significant difference between two groups. After antiviral therapy both groups showed significant clinical improvement along with CTP and MELD scores. However statistically significant improvement between tenofovir and telbivudine groups was only seen with MELD score. Survival rate was 80% in tenofovir group and 60% in telbivudine group, but this was not statistically significant. Low serum albumin at baseline was predictor of mortality.

Conclusion:

In patients of ACLF-B, antiviral therapy with both tenofovir and telbivudine improve liver function, but there is no statistically significant difference in survival between tenofovir and telbivudine.
Strategies for COVID-19 control among migrant labourers in a developing country setting
Authors: Bava Nooh P. , Sreekumar S , Mathew Geethu , Sushan Abey , Sheeja A. L , Parvathy P
Published: July 2021

Background:

The ongoing pandemic of Covid-19 is a public health emergency with serious implications world-wide including India. Vulnerable population like migrants are often left out of epidemic preparedness planning and reaching out these marginalized population is a challenge.

Objective:

To describe different strategies implemented for control and prevention of Covid-19 among migrants in Pathanamthitta.

Results:

Strategies for Covid-19 control among migrant labourers were planned and implemented with intersectoral coordination and community participation. Line listing and risk stratification, mobilisation of community volunteers, contactless active symptomatic surveillance using technology, IEC activities for awareness generation in multiple languages, sample collection, testing and distribution of personal protective equipment's were initially implemented. Setting up of a call centre facility assisted with M health technology exclusively for addressing concerns of migrants was first and one of its kind in the country. In addition to that special measures were taken to improve adherence and wellbeing of migrants which included addressing medical needs of migrants including psychological needs, ensuring food security, migrant hostels for the providing shelter, basic health care, isolation facilities and arranging transportation facilities for more than 10,000 stranded migrants. The success of these strategies was evident from the fact that not even a single migrant labourer was tested positive in the district during this period

Conclusion:

Pathanamthitta district being in a resource constraint setting showed a very effective model by implementing technology assisted strategies tailored to the needs of population.The success of these highly effective and replicable strategy underlines the need to incorporate principles of primary health care in crisis management.
COVID-19 seropositivity among non-medical frontline office staff from two cities in Rajasthan, India
Authors: Jain Vidhi , Gupta Manoj Kumar , Grover Malika , Nare Tejashree , Srivastava Saumya , Bhardwaj Pankaj , Goel Akhil Dhanesh , Saurabh Suman , Dara Sanjeeta , Kumar Ashok , Sharma Praveen , Nag Vijaya Lakshmi , Misra Sanjeev
Published: July 2021

Aims:

The indigenously developed Indian Council of Medical Research (ICMR)-NIV COVID Kavach IgG enzyme linked immunosorbent assay (ELISA) has been recommended for seroprevalence among vulnerable populations in India, which provided essential services throughout the lockdown. The staff working in the High Court was one such group. We compared anti-SARS-CoV-2 IgG seropositivity among the staff of Jodhpur and Jaipur High Courts, Rajasthan, India.

Methods:

Asymptomatic judiciary staff of Jodhpur and Jaipur benches of High Courts were enrolled after informed written consent. A questionnaire was filled and 3–5 ml venous blood was collected from participants. The ICMR-NIV COVID Kavach IgG ELISA and EUROIMMUN IgG ELISA were used for detection of Anti-SARS-CoV-2 IgG antibodies.

Results:

A total of 63 samples (41 from Jodhpur and 22 from Jaipur) were collected between 28th July to 4th August 2020. The overall anti-SARS-CoV-2 IgG seroprevalence was found to be 6.35%. Seropositivity was higher among the staff from Jaipur (13.64%) as compared to Jodhpur (2.44%). The Kavach ELISA results were in complete agreement with EUROIMMUN ELISA. The infection control measures were deemed effective.

Conclusion:

Seroprevalence among the staff of Jodhpur High Court was found to be lower than Jaipur, reflecting higher susceptibility to COVID-19 in the former. Many offices worldwide are closed till mid 2020 but need to come up with pre-emptive policies eventually. This study may help to anticipate the possible challenges when other government/private offices start functioning. The infection control practices of one workplace may help formulate guidelines for other offices.
Serum vitamin B12 status of patients with type 2 diabetes mellitus on metformin
Authors: Alam Muhammad Shah , Kamrul-Hasan ABM , Kalam Syeda Tanzina
Published: July 2021

Background:

Metformin use is a known cause of B12 deficiency in patients with type 2 DM (T2DM). Diabetic peripheral neuropathy (DPN) often has clinically indistinguishable clinical features of B12 deficiency-induced peripheral neuropathy (PN).

Objective:

The present study aims to assess serum vitamin B12 levels in patients with T2DM on metformin.

Subjects and Methods:

This cross-sectional study was conducted at a specialized endocrine outpatient clinic in Cumilla, Bangladesh, over six months from January 2020 to June 2020. Non-pregnant adults (≥18 years age) receiving metformin for T2DM for at least six months were evaluated for PN and assessed for serum B12 levels.

Results:

Among 90 subjects evaluated, 28 (31.1%) had B12 deficiency and 6 (6.7%) had borderline B12 deficiency; 56 (62.2%) had normal B12 levels. Study subjects with subnormal B12 used metformin for a longer duration [8.5 (7.0-14.0) vs. 5.0 (2.25-10.0) years, median (IQR), P = 0.006], gram-years of metformin use was higher in them [12.0 (7.9-14.0) vs. 5.75 (2.0-13.6) years, median (IQR), P = 0.005] and they had a higher mean corpuscular volume [85.9±7.2 vs. 82.4±6.4 fL, mean±SD, P = 0.020] compared to those having normal B12 levels. Serum B12 levels had a strong negative correlation with duration of metformin use and gram-years of metformin use. B12 status did not influence the presence and severity of PN.

Conclusions:

A considerable number of patients with T2DM have subnormal B12 levels. Periodic screening for serum vitamin B12 level may be of clinical benefit in such patients.
Perception of safety from workplace violence affects job satisfaction among doctors practicing modern medicine in India
Authors: Ahamed Farhad , Kaur Amandeep , Sengupta Paramita , Ghosh Tandra
Published: July 2021

Background:

Doctors are often been judged negatively as a consequence of high expectation and demand from their job and face violence at workplace. Continuous worry of facing aggression at workplace may seriously affect job satisfaction and intention to job turnover. However, the association between workplace safety and job satisfaction had not been studied earlier in India.

Methods:

A cross-sectional survey was conducted among doctors from November 2019 to April 2020 using a pre-tested, semi-structured, anonymous “Google forms” based questionnaire among doctors working in private and/or public healthcare settings across India. Perception of safety was assessed by scoring in a scale. Cronbach's coefficient of the scale was calculated to be 0.88. Job satisfaction was assessed using the 5-item Brayfield and Rothe measure of job satisfaction. Cronbach's coefficient of the scale was 0.76. The data was coded and analyzed with the help of STATA-12.

Results:

617 doctors practicing modern medicine participated in this study from all over India. 262 (42.5%) doctors were found to be satisfied at their job. Perception of safety at workplace was found to have 2.5 times greater influence on job satisfaction of doctors. 23.2% of the doctors expressed job turnover intention which was positively correlated with job satisfaction and perception of safety.

Conclusion:

Perception of safety from workplace violence was found to have significant effect on job satisfaction and turnover intention than actual violence. Appropriate strategy may be undertaken to address this apprehension at workplace.
Prevalence and clinical presentation of sinusitis in pediatric age group in Aseer, Saudi Arabia
Authors: Alshehri Ali M. S. , Assiri Ohood A. , Alqarni Afnan M. S. , Alkhairi Muhammed A. Y. , Alzahrani Mohammed A. A. , Alshehri Sarah H. A. , Alshehri Nada A. A. , Abouelyazid Ahmed Y.
Published: July 2021

Background:

Paediatric rhinosinusitis is mostly different than that in adults. More frequently, children presented with cough, bad breath, crankiness, low energy, and swelling around the eyes, besides a thick yellow-green nasal or post-nasal discharge. About 5- 13% of childhood viral upper respiratory tract infections may advance to acute rhinosinusitis, with some of them developing a chronic condition.

Aim:

To assess prevalence and clinical presentation of sinusitis in the paediatric age group in Aseer, Saudi Arabia.

Methodology:

A retrospective record-based study was conducted in Abha Maternity and Children Hospital in Abha city, Saudi Arabia between January 2015 and January 2018. All medical records during the study period for children whose from to 15 years old attended the hospital and diagnosed as having sinusitis were included.

Results:

The study included 100 children with complete files whose ages ranged from less than 1 year to up to 13 years old with a mean age of 5.3 4.2 years. Nearly 51% of the children aged 4 years or less and male were 53 (53%). Past history for chronic rhinosinusitis (CRS) was positive among 30 children. Regarding clinical presentations of rhinosinusitis (RS) as reported by the children caregivers, fever was the most reported complaint (50%) followed by red eye (44%), ringing nose (42%), cough (41%) and headache (36%). Mucous culture was positive among 58 cases. The most isolated pathogens were streptococcus pneumoniae (45.6%), Haemophilis influenza (24.6%).

Conclusions:

In conclusion, the study revealed that CRS is a common disease in children at different ages, especially, maxillary and frontal sinuses. In most of the cases, medical treatment is highly appreciated; though, surgical intervention may be needed in a small percentage.
Assessment of the knowledge, preferences and concern regarding the prospective COVID-19 vaccine among adults residing in New Delhi, India – A cross-sectional study
Authors: Islam Farzana , Agarwalla Rashmi , Panda Meely , Alvi Yasir , Singh Vishal , Debroy Arup , Ray Arindam , Vadnerkar Amruta , Uttekar Shraddha
Published: July 2021

Background:

Understanding the perception and concerns of people about COVID-19 vaccine in developing and populous country like India will help in understanding demand for the vaccine and further tailoring out public health information and education activities. The study was carried out to assess the present state of knowledge people have about the probable vaccine for COVID-19, to know the preferences of respondents about this vaccine and to learn the expectations and apprehensions of people about features of this prospective COVID-19 vaccine residing in the capital city of India.

Methods:

This cross-sectional study was conducted amongst the residents of Delhi, India from July to October 2020. Both offline and online interview method was used to collect date from 513 participants representing various occupational strata. Data were collected on sociodemographic variable, vaccine acceptance and concerns regarding COVID-19 vaccine.

Results:

Among the study population, 79.5% said they will take the vaccine while 8.8% said they were not going to take the vaccine and remaining 11.7% had not yet decided about it. More than 50% were willing to pay for the vaccine and 72% felt vaccine should first be given to health workers and high-risk group.

Conclusion:

The following study has helped to understand the percentage of people who are hesitant to take the vaccine and also the concerns regarding the vaccine. Also since half of the population is willing to pay for the vaccine, a strategic approach considering the various economical classes of people could be applied in a developing country like India.
Diagnostic tools for evaluating the effectiveness of COVID 19 vaccines
Authors: Yadav Dinesh
Published: July 2021

Evaluation of potential immunity due to SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) infection or vaccination is essential for health as well as social and economic recovery. Two vaccines (Covishield and Covaxin) produced in India have been authorized for emergency use in India. Which vaccine to prefer if the choices given to the recipients is a matter of general curiosity and public health interest. Different types of testing methodologies are being carried out in various laboratories around the world. There is no standardized measurement process and definitive set of values to know the protective immune response. A suitable antibody test which can be used as a tool to check whether the vaccine has triggered a sufficient immune response is required. The method needs to have the ability to measure the true quantity of antibody generated and it should be traceable to the international unit.
Non-traditional stable isotope signatures in geological matrices as a tool for interpreting environmental changes – a review
Authors: Fiket Željka , Furdek Turk Martina , Ivanić Maja , Kniewald Goran
Published: July 2021

The development of new analytical techniques enabled the precise determination of the expanded set of stable isotopes and provided new insight into the existing geological issues. This review outlines recent studies of non-traditional isotope signatures in geological matrices, summarizing in one place new data for stable isotopes of Ca, Mg, Sr, Li, Ni, Cr, and Cu and their application in the interpretation of environmental processes. Although some of them, such as δ44Ca and δ26Mg, have been previously used to track changes in seawater chemistry throughout geological history, recent studies report their application as geochemical proxies of post-depositional processes. Similarly, isotopic signatures of strontium, previously used in radioactive isotope chronology, and δ7Li, used in tracing plate subduction and crust/mantle material cycling, found a new application in studies of weathering patterns. The use of δ53Cr and δ 65Cu isotope signatures, on the other hand, reflects their fractionation under different redox conditions, whereas δ60Ni, due to its co-precipitation with sulfide species and Fe-Mn phases, is used in interpreting the contributions of different material sources. And while the isotopic signatures of all these elements indicate certain environmental conditions and processes (e.g., post-depositional processes, redox conditions, organic matter input, the contribution of sources, etc.), combining them a more comprehensive insight into the investigated environment can be achieved.
Larvicidal potency of Dioscorea sansibarensis leaf extract against vector mosquitoes: Anopheles gambiae s.s. and Culex quinquefasciatus
Authors: Philbert Anitha
Published: July 2021

Mosquitoes are responsible for transmission of illnesses of public health importance including malaria, lymphatic filariasis, dengue, chikungunya, and many other diseases caused by viruses. Vector control using synthetic insecticides has been the cornerstone for management of vector-borne diseases. However, the chemical based interventions have not been sustainable due to emergency of resistance against insecticides among disease vectors. Plant based mosquitocidal products can be potential alternative tools in vector control. Therefore, the present study aimed at exploring the larvicidal properties of Dioscorea sansibarensis leaf extract against malaria and lymphatic filariasis vectors; Anopheles gambiae s.s. and Culex quinquefasciatus. The larvicidal activities of Dioscorea sansibarensis were assessed following WHO test procedures. Ethanol leaf extract of Dioscorea sansibarensis was evaluated against all the four instar larvae stages of An. gambiae s.s and Cx. quinquefasciatus susceptible laboratory colonies. The highest larvicidal potency was shown against the 4th instar stages of both species with the LC50 values of 60.915 ppm and 80.700 ppm for Cx. quinquefasciatus and An. gambiae s.s., respectively. The respective LC95 values for Cx. quinquefasciatus and An. gambiae s.s. were 168.898 ppm and 249.295 ppm. This implies that the extract can be applied as mosquito larvicide should its impact on non-targeted species be established.

Keywords: Dioscorea sansibarensis; vectors, mosquitoes, Zanzibar yams, Dar es Salaam, Tanzania
Assessment of natural radioactivity and radiation hazards of building materials in Kinondoni District, Dar es Salaam, Tanzania
Authors: Mammba Huruma P , Balobegwa Vitus A , Muhulo Alex P , Pantaleo Peter A , Kawala Remigius A
Published: July 2021

Natural radionuclides from building materials are one of the potential sources of external as well as internal radiation exposure to the human body. Currently, this exposure has been increasing since people spend more than 80% of their time indoors (ICRP 1991). Commonly used building materials from Kinondoni District were investigated using γ-spectrometry; their activity concentrations of 226Ra, 232Th and 40K in Bq/kg were measured. The results showed that average values of activity concentrations of 226Ra, 232Th and 40K were 15.62, 21.51 and 237.99 Bq/kg, respectively. All the activity concentrations in the studied samples were lower than the world average values of 35 Bq/kg for 226Ra, 30 Bq/kg for 232Th and 400 Bq/kg for 40K. The radium equivalent activity ( 𝑅𝑎𝑒𝑞), external ( 𝐻𝑒𝑥), internal hazard index ( 𝐻𝑖𝑛) and gamma activity concentration index (𝐼𝛾) were calculated to assess the radiological hazards due to presence of natural radionuclides in the building materials. The results showed that the average values of Raeq, Hex, and Iγ were 64.7 Bq/kg, 0.17, 0.21 and 0.24, respectively. These values were lower than the world criteria values 370 for Raeq, ≤ 1 for Hex, ≤ 1 for Hin and ≤ 1 for Iγ, respectively. The obtained results indicated that all the investigated building materials were safe for inhabitants.

Keywords: Building materials, Natural radionuclides, Radiation hazards, Gamma ray spectrometry, Activity concentration
Mathematical analysis of harvested predator-prey system with prey refuge and intraspecific competition
Authors: Mapunda Alanus , Sagamiko Thadei
Published: July 2021

In this paper, a predator-prey relationship in the presence of prey refuge was studied. The analysis of the dependence of locally stable equilibrium points on the parameters of the problem was carried out. Bifurcation and limit cycles for the model were analyzed to show the dynamical behaviour of the system. The results showed that the system is stable at a constant prey refuge m = 0.3 and prey harvesting rate H = 0.3. However, increasing m and decreasing H or vice versa, the predator-prey system remains stable. It was further observed that for a constant prey refuge m ≥ 0.78, the predator population undergoes extinction. Therefore, m was found to be a bifurcation parameter and m = 0.78 is a bifurcation value.

Keywords: Prey refuge, bifurcation, harvesting, intraspecific competition, phase portrait
Sign language recognition using Kinect sensor based on color stream and skeleton points
Authors: Bulugu Isack
Published: July 2021

This paper presents a sign language recognition system based on color stream and skeleton points. Several approaches have been established to address sign language recognition problems. However, most of the previous approaches still have poor recognition accuracy. The proposed approach uses Kinect sensor based on color stream and skeleton points from the depth stream to improved recognition accuracy. Techniques within this approach use hand trajectories and hand shapes in combating sign recognition challenges. Therefore, for a particular sign a representative feature vector is extracted, which consists of hand trajectories and hand shapes. A sparse dictionary learning algorithm, Label Consistent K-SVD (LC-KSVD) is applied to obtain a discriminative dictionary. Based on that, the system was further developed to a new classification approach for better results. The proposed system was fairly evaluated based on 21 sign words including one-handed signs and two-handed signs. It was observed that the proposed system gets high recognition accuracy of 98.25%, and obtained an average accuracy of 95.34% for signer independent recognition.

Keywords: Sign language, Color stream, Skeleton points, Kinect sensor, Discriminative dictionary.
Several Methods to Teach Reading to Early Childhood
Authors: Wahyuni Vera Sri
Published: July 2021

One of the challenges now faced by the parents of young children, especially at the early childhood level of education is to teach reading. This paper aims to find out some more effective ways to teach reading to the children. The method discussed in this paper include: using children’s songs and books, using game card , through guessing game, using variety of study applications, and the parent’s patience. The results of the study show that in order to teach reading to early childhood, the parent or teacher must be able to choose a method that suits the child's situation, abilities and interests. Thus, it will able to increase children's ability and interest in reading and avoid boredom.
Estimation of the Extreme Distribution Model of Economic Losses Due to Outbreaks Using the POT Method with Newton Raphson Iteration
Authors: Ibrahim Riza Adrian , Sukono Sukono , Riaman Riaman
Published: July 2021

Extreme distribution is the distribution of a random variable that focuses on determining the probability of small values in the tail areaof the distribution. This distribution is widely used in various fields, one of which is reinsurance. An outbreak catastrophe is non-natural disaster that can pose an extreme risk of economic loss to a country that is exposed to it. To anticipate this risk, the government of a country can insure it to a reinsurance company which is then linkedto bonds in the capital market so that new securities are issued, namely outbreakcatastrophe bonds. In pricing, knowledge of the extreme distribution of economic losses due to outbreak catastrophe is indispensable. Therefore, this study aims to determine the extreme distribution model of economic losses due to outbreak catastrophe whose models will be determined by the approaches and methods of Extreme Value Theory and Peaks Over Threshold, respectively. The threshold value parameter of the model will be estimated by Kurtosis Method, while the other parameters will be estimated with Maximum Likelihood Estimation Method based on Newton-Raphson Iteration. The result of the research obtained is the resulting model of extreme value distribution of economic losses due to outbreak catastrophe that can be used by reinsurance companies as a tool in determining the value of risk in the outbreak catastrophe bonds.
DSC and Dielectric Properties of Epoxy Resin Reinforced with (ZrO2, CuO) Nanoparticles
Authors: M. Hassan Haneen , A. Salman Sabah
Published: July 2021

In this research the additive effect of Zirconium Oxide (ZrO2), Copper oxide (CuO)
nanoparticles to epoxy resin as a matrix have been studied, in addition to
manufacturing hybrid composites from the same nanoparticles which are (CuO/ZrO2)
to epoxy resin as a matrix too. The hand lay-up method is using to manufacturing the
composites from the epoxy resin and the nanoparticles with different weight ratios
((0, 0.3, 0.6, 0.9) wt%), the thermal and dielectric tests have been done of all prepared
composites. The effect of the weight ratio of the reinforcement materials on the
thermal properties of all-polymer composites has been studied also. The practical
results have shown that the differential scanning calorimetric (DSC) test has shown
that the glass transition temperature of all-polymer composites increases at all weight
ratios of reinforcement materials compared with pure epoxy and the highest value of
glass transition temperature is to the composite (EP-ZrO2) which equal (89.97 °C),
also the crystalline melting temperature of all-polymer composites has shown irregular
behavior compared with pure epoxy by increasing the weight ratio of reinforcement
materials. The effect of the weight ratio of the reinforcement materials on the
dielectric properties of all-polymer composites have been studied, the practical results
have shown a decrease in dielectric constant with increase the frequency for all weight
ratios of reinforcement materials, and also increasing the dielectric constant with
increasing the weight ratio of the reinforcement materials at the same frequency.