bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of common acute respiratory infection case definitions for identification of hospitalized influenza cases at a population-based surveillance site in Egypt
Authors: Rowlinson Emily , Peters Lisa , Mansour Adel , Mansour Hoda , Azazzy Nahed , Said Mayar , Samy Sahar , Abbas Eman , Abu Elsood Hanaa , Fahim Manal , Eid Alaa , Reaves Erik , Van Beneden Chris , Hamid Sarah , Olsen Sonja , Fitzner Julia , Dueger Erica
Published: March 2021

Background

Multiple case definitions are used to identify hospitalized patients with community-acquired acute respiratory infections (ARI). We evaluated several commonly used hospitalized ARI case definitions to identify influenza cases.

Methods

The study included all patients from a population-based surveillance site in Damanhour, Egypt hospitalized for a broad set of criteria consistent with community acquired ARIs. Naso- and oropharyngeal (NP/OP) swabs were tested for influenza using RT-PCR. Sensitivity, specificity and PPV for influenza identification was compared between the 2014 WHO Severe Acute Respiratory Infection (SARI) definition (fever ≥38°C and cough with onset within 10 days), the 2011 WHO SARI definition (fever ≥38°C and cough with onset within 7 days), the 2006 PAHO SARI definition, the International Emerging Infections Program (IEIP) pneumonia case definition, and the International Management of Childhood Illness (IMCI) case definitions for moderate and severe pneumonia.

Results

From June 2009-December 2012, 5768 NP/OP swabs were obtained from 6113 hospitalized ARI patients; 799 (13.9%) were influenza positive. The 2014 WHO SARI case definition captured the greatest number of ARI patients, influenza positive patients and ARI deaths compared to the other case definitions examined. Sensitivity for influenza detection was highest for the 2014 WHO SARI definition with 88.6%, compared to the 2011 WHO SARI (78.2%) the 2006 PAHO SARI (15.8%) the IEIP pneumonia (61.0%) and the IMCI moderate and severe pneumonia (33.8% and 38.9%) case definitions (IMCI applies to <5 only).

Conclusions

Our results support use of the 2014 WHO SARI definition for identifying influenza positive hospitalized SARI cases as it captures the highest proportion of ARI deaths and influenza positive cases. Routine use of this case definition for hospital-based surveillance will provide a solid, globally comparable foundation on which to build needed response efforts for novel pandemic viruses.
Personality traits and academic performance: Correcting self-assessed traits with vignettes
Authors: Coenen Johan , Golsteyn Bart H. H. , Stolp Tom , Tempelaar Dirk
Published: March 2021

In this study, we investigate whether Conscientiousness, Emotional Stability and Risk Preference relate to student performance in higher education. We employ anchoring vignettes to correct for heterogeneous scale use in these non-cognitive skills. Our data are gathered among first-year students at a Dutch university. The results show that Conscientiousness is positively related to student performance, but the estimates are strongly biased upward if we use the uncorrected variables. We do not find significant relationships for Emotional Stability but find that the point estimates are larger when using the uncorrected variables. Measured Risk Preference is negatively related to student performance, yet this is fully explained by heterogeneous scale use. These results indicate the importance of using more objective measurements of personality traits.
Can fund shareholding inhibit insufficient R&D input?——Empirical evidence from Chinese listed companies
Authors: Li Xiao , Liu Gang
Published: March 2021

Based on the principal-agent theory and the financial management theory, this study analyzes the impact of fund shareholding on corporate insufficient R&D input, and explores the action mechanism of fund shareholding on corporate innovation activities. The results show that fund shareholding is helpful to inhibit the insufficient R&D input. Moreover, this inhibiting effect is mainly reflected in the case of higher risk of financial failure. The further analyses show that the higher level of marketization strengthens the inhibiting effect of fund shareholding on insufficient R&D input. Finally, it is suggested that fund companies should be encouraged to hold shares of listed companies, and the proposal power of fund companies in the shareholders’ meeting should be appropriately enhanced. And it is suggested that the regulators continue to promote the development of securities investment funds, and guide fund shareholding to play an active role in external governance. Also, it is suggested that the regulators promote the process of regional marketization, to strengthen the positive effect of fund shareholding on innovation activities.
HIV risk screening and HIV testing among orphans and vulnerable children in community settings in Tanzania: Acceptability and fidelity to lay-cadre administration of the screening tool
Authors: Gill Michelle M. , Jahanpour Ola , van de Ven Roland , Barankena Asheri , Urasa Peris , Antelman Gretchen
Published: March 2021

Introduction

HIV risk screening tool validation studies have not typically included process evaluations to understand tool implementation. The study aim was to assess the fidelity to which an HIV risk screening tool was administered by lay workers and acceptability of delivering home-based screening coupled with HIV testing to beneficiaries in an orphans and vulnerable children (OVC) program.

Methods

This cross-sectional study was conducted March-April 2019 in two regions of Tanzania. Community case workers (CCW) were observed conducting screenings with OVC 2–19 years and participated in focus group discussions. Research staff used structured observation checklists to capture if screening questions were asked or reworded by CCW. In-depth interviews were conducted with older adolescents and caregivers in their homes following screening and testing. A composite score was developed for the checklist. Qualitative data were thematically analyzed to address screening and testing perceptions and experiences.

Results

CCW (n = 32) participated in 166 observations. Commonly skipped items were malnutrition (34% of all observed screenings) and sexual activity and pregnancy (20% and 45% of screenings for adolescents only). Items frequently re-worded included child abuse (22%) and malnutrition (15%). CCW had an average composite observation score of 42/50. CCW in focus groups (n = 34) found the screening process acceptable. However, they described rewording some questions viewed as harsh or socially inappropriate to ask. Overall, adolescent beneficiaries (n = 17) and caregivers (n = 25) were satisfied with home-based screening and testing and reported no negative consequences. Learning one’s HIV negative status was seen as an opportunity to discuss or recommit to healthy behaviors. While respondents identified multiple benefits of home testing, they noted the potential for privacy breaches in household settings.

Conclusions

We found sub-optimal fidelity to the administration of the screening tool by CCW in home environments to children and adolescents enrolled in an OVC program. Improvements to questions and their delivery and ongoing mentorship could strengthen tool performance and HIV case finding using a targeted testing approach. Overall, home-based HIV risk screening and testing were acceptable to beneficiaries and CCW, could improve testing uptake, and serve as a platform to promote healthy behaviors for those with limited health system interactions.
Superspreading of SARS-CoV-2 in the USA
Authors: Pozderac Calvin , Skinner Brian
Published: March 2021

A number of epidemics, including the SARS-CoV-1 epidemic of 2002-2004, have been known to exhibit superspreading, in which a small fraction of infected individuals is responsible for the majority of new infections. The existence of superspreading implies a fat-tailed distribution of infectiousness (new secondary infections caused per day) among different individuals. Here, we present a simple method to estimate the variation in infectiousness by examining the variation in early-time growth rates of new cases among different subpopulations. We use this method to estimate the mean and variance in the infectiousness, β, for SARS-CoV-2 transmission during the early stages of the pandemic within the United States. We find that σβ/μβ ≳ 3.2, where μβ is the mean infectiousness and σβ its standard deviation, which implies pervasive superspreading. This result allows us to estimate that in the early stages of the pandemic in the USA, over 81% of new cases were a result of the top 10% of most infectious individuals.
App-based symptom tracking to optimize SARS-CoV-2 testing strategy using machine learning
Authors: Dantas Leila F. , Peres Igor T. , Bastos Leonardo S. L. , Marchesi Janaina F. , de Souza Guilherme F. G. , Gelli João Gabriel M. , Baião Fernanda A. , Maçaira Paula , Hamacher Silvio , Bozza Fernando A.
Published: March 2021

Background

Tests are scarce resources, especially in low and middle-income countries, and the optimization of testing programs during a pandemic is critical for the effectiveness of the disease control. Hence, we aim to use the combination of symptoms to build a predictive model as a screening tool to identify people and areas with a higher risk of SARS-CoV-2 infection to be prioritized for testing.

Materials and methods

We performed a retrospective analysis of individuals registered in "Dados do Bem," a Brazilian app-based symptom tracker. We applied machine learning techniques and provided a SARS-CoV-2 infection risk map of Rio de Janeiro city.

Results

From April 28 to July 16, 2020, 337,435 individuals registered their symptoms through the app. Of these, 49,721 participants were tested for SARS-CoV-2 infection, being 5,888 (11.8%) positive. Among self-reported symptoms, loss of smell (OR[95%CI]: 4.6 [4.4–4.9]), fever (2.6 [2.5–2.8]), and shortness of breath (2.1 [1.6–2.7]) were independently associated with SARS-CoV-2 infection. Our final model obtained a competitive performance, with only 7% of false-negative users predicted as negatives (NPV = 0.93). The model was incorporated by the "Dados do Bem" app aiming to prioritize users for testing. We developed an external validation in the city of Rio de Janeiro. We found that the proportion of positive results increased significantly from 14.9% (before using our model) to 18.1% (after the model).

Conclusions

Our results showed that the combination of symptoms might predict SARS-Cov-2 infection and, therefore, can be used as a tool by decision-makers to refine testing and disease control strategies.
Impact of deceased donor with acute kidney injury on subsequent kidney transplant outcomes–an ANZDATA registry analysis
Authors: Pei Juan , Cho Yeoungjee , See Yong Pey , Pascoe Elaine M. , Viecelli Andrea K. , Francis Ross S. , van Eps Carolyn , Isbel Nicole M. , Campbell Scott B. , Clayton Philip A. , Chapman Jeremy , Collins Michael , Lim Wai , Tang Wen , Wong Germaine , Hawley Carmel M. , Johnson David W.
Published: March 2021

Background

The need for kidney transplantation drives efforts to expand organ donation. The decision to accept organs from donors with acute kidney injury (AKI) can result in a clinical dilemma in the context of conflicting reports from published literature.

Material and methods

This observational study included all deceased donor kidney transplants performed in Australia and New Zealand between 1997 and 2017. The association of donor-AKI, defined according to KDIGO criteria, with all-cause graft failure was evaluated by multivariable Cox regression. Secondary outcomes included death-censored graft failure, death, delayed graft function (DGF) and acute rejection.

Results

The study included 10,101 recipients of kidneys from 5,774 deceased donors, of whom 1182 (12%) recipients received kidneys from 662 (11%) donors with AKI. There were 3,259 (32%) all-cause graft failures, which included 1,509 deaths with functioning graft. After adjustment for donor, recipient and transplant characteristics, donor AKI was not associated with all-cause graft failure (adjusted hazard ratio [HR] 1.11, 95% CI 0.99–1.26), death-censored graft failure (HR 1.09, 95% CI 0.92–1.28), death (HR 1.15, 95% CI 0.98–1.35) or graft failure when death was evaluated as a competing event (sub-distribution hazard ratio [sHR] 1.07, 95% CI 0.91–1.26). Donor AKI was not associated with acute rejection but was associated with DGF (adjusted odds ratio [OR] 2.27, 95% CI 1.92–2.68).

Conclusion

Donor AKI stage was not associated with any kidney transplant outcome, except DGF. Use of kidneys with AKI for transplantation appears to be justified.
The odorant metabolizing enzyme UGT2A1: Immunolocalization and impact of the modulation of its activity on the olfactory response
Authors: Neiers Fabrice , Jarriault David , Menetrier Franck , Faure Philippe , Briand Loïc , Heydel Jean-Marie
Published: March 2021

Odorant metabolizing enzymes (OMEs) are expressed in the olfactory epithelium (OE) where they play a significant role in the peripheral olfactory process by catalyzing the fast biotransformation of odorants leading either to their elimination or to the synthesis of new odorant stimuli. The large family of OMEs gathers different classes which interact with a myriad of odorants alike and complementary to olfactory receptors. Thus, it is necessary to increase our knowledge on OMEs to better understand their function in the physiological process of olfaction. This study focused on a major olfactory UDP-glucuronosyltransferase (UGT): UGT2A1. Immunohistochemistry and immunogold electronic microscopy allowed to localize its expression in the apical part of the sustentacular cells and originally at the plasma membrane of the olfactory cilia of the olfactory sensory neurons, both locations in close vicinity with olfactory receptors. Moreover, using electroolfactogram, we showed that a treatment of the OE with beta-glucuronidase, an enzyme which counterbalance the UGTs activity, increased the response to eugenol which is a strong odorant UGT substrate. Altogether, the results supported the function of the olfactory UGTs in the vertebrate olfactory perireceptor process.
Osteopontin’s relationship with malnutrition and oxidative stress in adolescents. A pilot study
Authors: Aztatzi-Aguilar Octavio Gamaliel , Sierra-Vargas Martha Patricia , Ortega-Romero Manolo , Jiménez-Corona Azucena Eunice
Published: March 2021

Osteopontin (OPN) is a protein involved in inflammatory illnesses such as fibrosis and cancer; its overexpression in cardiovascular diseases promotes the biomineralization of blood vessels and other soft tissues. Moreover, there is an active component of oxidative stress related with those diseases. The present study relates serum OPN levels with nutritional condition and oxidative stress in a group of adolescents. Anthropometric measurements were performed, and fasting blood samples were analyzed to determine OPN concentrations, blood chemistry parameters (glucose, triglycerides, total cholesterol, urea, uric acid, and creatinine) and oxidative stress biomarkers (Paraoxonase-1, Glutathione S-Transferase, Catalase, NAD(P)H Quinone Oxidoreductase, free carbonyl groups and malondialdehyde). Adolescents were categorized according to body mass index (BMI) and metabolic syndrome (MetS) criteria. We found increased OPN serum concentrations in overweight and obese adolescents, as well as in adolescents with MetS. Rises in OPN correlated with arm circumference and biomarkers of lipid peroxidation; with regard to serum glucose there was a trend to positive correlation. Our results suggest that serum OPN is associated to nutritional status and could be considered as an early biomarker of low-grade inflammation and probably the early biomineralization of soft tissues in adolescence.
Machine learning models based on remote and proximal sensing as potential methods for in-season biomass yields prediction in commercial sorghum fields
Authors: Habyarimana Ephrem , Baloch Faheem S.
Published: March 2021

Crop yield monitoring demonstrated the potential to improve agricultural productivity through improved crop breeding, farm management and commodity planning. Remote and proximal sensing offer the possibility to cut crop monitoring costs traditionally associated with surveys and censuses. Fraction of absorbed photosynthetically active radiation (fAPAR), chlorophyll concentration (CI) and normalized difference vegetation (NDVI) indices were used in crop monitoring, but their comparative performances in sorghum monitoring is lacking. This work aimed therefore at closing this gap by evaluating the performance of machine learning modelling of in-season sorghum biomass yields based on Sentinel-2-derived fAPAR and simpler high-throughput optical handheld meters-derived NDVI and CI calculated from sorghum plants reflectance. Bayesian ridge regression showed good cross-validated performance, and high reliability (R2= 35%) and low bias (mean absolute prediction error, MAPE = 0.4%) during the validation step. Hand-held optical meter-derived CI and Sentinel-2-derived fAPAR showed comparable effects on machine learning performance, but CI outperformed NDVI and was therefore considered as a good alternative to Sentinel-2’s fAPAR. The best times to sample the vegetation indices were the months of June (second half) and July. The results obtained in this work will serve several purposes including improvements in plant breeding, farming management and sorghum biomass yield forecasting at extension services and policy making levels.
Comparison of 27-gauge and 25-gauge vitrectomy in the management of tractional retinal detachment secondary to proliferative diabetic retinopathy
Authors: Chen Po-Lin , Chen Yan-Ting , Chen San-Ni
Published: March 2021

Objective

To compare surgical outcomes between 27 and 25-gauge vitrectomy in proliferative diabetic retinopathy (PDR) with tractional retinal detachment (TRD)

Methods

This retrospective study was conducted to compare the intraoperative status, operation time, use of instruments, endotamponade substance, wound suture number, and iatrogenic break, between 27 and 25-gauge vitrectomy in 43 eyes afflicted by PDR with TRD. The post-surgical results, best-corrected visual acuity, intraocular pressure, recurrent vitreous haemorrhage, and re-operation rate were regularly followed up for 6 months.

Results

Patients in the 25 and the 27-gauge groups did not differ significantly in terms of pre-surgical conditions, such as age, gender, pre-existing glaucoma, best-corrected visual acuity (BCVA) and the severity of their TRD. The mean operation time was 56.7 minutes in the 27-gauge group and 63.7 minutes in the 25-gauge group (p = 0.94). There is significantly less use of micro forceps in the 27-gauge group (p = 0.004). No difference between micro scissors and chandelier usage were noted; neither was their difference in iatrogenic retinal breaks. Significantly fewer wound sutures were noted in the 27-gauge group (p < 0.001). The post-operative results revealed no significant difference in ocular hypertension, hypotony, BCVA improvement, recurrent vitreous haemorrhage and re-operation rate.

Conclusions

The 27-gauge vitrectomy system offers comparable surgical outcomes in PDR with TRD. The 27-gauge vitrectomy system is suitable for complicated retinal surgery.
Development and performance of CUHAS-ROBUST application for pulmonary rifampicin-resistance tuberculosis screening in Indonesia
Authors: Herman Bumi , Sirichokchatchawan Wandee , Pongpanich Sathirakorn , Nantasenamat Chanin
Published: March 2021

Background and objectives

Diagnosis of Pulmonary Rifampicin Resistant Tuberculosis (RR-TB) with the Drug-Susceptibility Test (DST) is costly and time-consuming. Furthermore, GeneXpert for rapid diagnosis is not widely available in Indonesia. This study aims to develop and evaluate the CUHAS-ROBUST model performance, an artificial-intelligence-based RR-TB screening tool.

Methods

A cross-sectional study involved suspected all type of RR-TB patients with complete sputum Lowenstein Jensen DST (reference) and 19 clinical, laboratory, and radiology parameter results, retrieved from medical records in hospitals under the Faculty of Medicine, Hasanuddin University Indonesia, from January 2015-December 2019. The Artificial Neural Network (ANN) models were built along with other classifiers. The model was tested on participants recruited from January 2020-October 2020 and deployed into CUHAS-ROBUST (index test) application. Sensitivity, specificity, and accuracy were obtained for assessment.

Results

A total of 487 participants (32 Multidrug-Resistant/MDR 57 RR-TB, 398 drug-sensitive) were recruited for model building and 157 participants (23 MDR and 21 RR) in prospective testing. The ANN full model yields the highest values of accuracy (88% (95% CI 85–91)), and sensitivity (84% (95% CI 76–89)) compare to other models that show sensitivity below 80% (Logistic Regression 32%, Decision Tree 44%, Random Forest 25%, Extreme Gradient Boost 25%). However, this ANN has lower specificity among other models (90% (95% CI 86–93)) where Logistic Regression demonstrates the highest (99% (95% CI 97–99)). This ANN model was selected for the CUHAS-ROBUST application, although still lower than the sensitivity of global GeneXpert results (87.5%).

Conclusion

The ANN-CUHAS ROBUST outperforms other AI classifiers model in detecting all type of RR-TB, and by deploying into the application, the health staff can utilize the tool for screening purposes particularly at the primary care level where the GeneXpert examination is not available.

Trial registration

NCT04208789.
Minimal invasive surgery of the spleen
Authors: Nyilas Áron
Published: March 2021

A laparoszkópos splenectomia 1991-es bevezetése óta gold standarddá lépett elő a lép sebészetében, és a nyitott műtéttel szembeni előnyei vitathatatlanok. Habár a műtéti idő jellemzően hosszabb LS esetén, viszont a splenectomiával öszefüggő morbiditás ritkább, és a posztoperatív hospitalizáció rövidebb. Az irodalomban igen korlátozott számban állnak rendelkezésre magyar betegpopuláción végzett vizsgálatok eredményei. A laparoszkópos lépsebészet 1994-ben került bevezetésre a Szegedi Tudományegyetem Sebészeti Klinikáján, és az azóta eltelt időben munkacsoportunk szerezte meg az egyik legnagyobb tapasztalatot a témában Magyarországon. Habár a laparoszkópos technikát kezdetben splenomegalia esetén kontraindikáltnak tartották, idővel bebizonyosodott a módszer biztonságossága extrém méretű lépek esetében is. Ahogy a laparoszkópos eljárás az extrém nagy méretű lépek esetében is elterjedt, felmerül az olykor 2000 grammnál is nagyobb tömegű specimen eltávolításának nehézsége. A szokásos eljárás a specimen Endobagbe helyezése, és valamelyik port helyén morcellációval történő eltávolítása. A kézzel asszisztált laparoszkópos splenectomia (HALS) esetén kézenfekvő a specimen hand-port helyén történő eltávolítása. Ezen eljárások mellett ismert a specimen Pfannenstiel-metszésből történő eltávolítása is. Irodalmi adatok alapján a lépméret mellet a learning curve bír még kiemelt jelentőséggel a splenectomia eredményeire. A splenectomia leggyakoribb indikációja az idiopátiás thrombocytopéniás purpura (ITP). Tekintettel az ITP immunológiai mechanizmusára, az első vonalbeli standard terápia kortikoszteroidok, illetve iv. immunglobulinok adása. Amennyiben a betegek az elsődleges kezelésre nem reagálnak, vagy a betegség reagál ugyan, de folyamatos gyógyszerelést igényel, refrakter ITP-ről beszélünk, mely miatt második vonalbeli kezelés jön szóba. Ez lehet Rituximab, TPO receptor agonisták, valamint a splenectomia, melyek közül a splenectomia biztosítja a legjobb és legtartósabb eredményt (80% körüli válasz, 60% 5-10 évig). A laparoszkópos eljárás számos előnye miatt évtizedek óta elfogadott sebészi módszer az ITP kezelésében. A módszer hematológiai eredményessége a hagyományos splenectomiához hasonló. Mindezek mellett csak nagyon korlátozott számban állnak rendelkezésre standardizált definiciókat és kimeneteli kritériumokat figyelembe vevő közlemények a splenectomia hosszú távú eredményeiről. Tekintettel arra, hogy a splenectomizált betegek mintegy 15-25 %-ánál nem vezet azonnali eredményre, illetve a betegek 1/3-a a későbbiekben relapszusba kerül, fontos lenne prediktív faktorok meghatározása a felesleges műtétek elkerülése, a terápia tervezhetősége érdekében. A splenectomia sikerességének megjóslására számos hipotetikus prediktív faktort vizsgáltak. Irodalmi adatok szólnak az életkor, a szteroid terápiára adott válasz, a perioperatív thrombocyta érték, valamint a thrombocyta sequestratio jellegének prediktív értékéről.
Standardization and quality assurance in clinical electroencephalography
Authors: Craciun Laura
Published: March 2021

Objectives: Our objectives were to address some key issues- to determine the minimal efficient duration of the standard and sleep EEG recordings, to assess the diagnostic yield of hyperventilation (HV) and to assess whether injuries occur more often in an Epilepsy Monitoring Unit (EMU) where portable EEG amplifiers are used, and where patients can freely move within a large area during the monitoring. Methods: For the first part of the study, we have reviewed 1005 EEG recordings and determined the shortest recording duration necessary to identify interictal EEG abnormalities. In order to assess the diagnostic yield of 5 min HV compared to 3 min HV, data were evaluated from 1084 consecutive patients, from three European centers, referred to EEG on suspicion of epilepsy. Seizures and interictal EEG abnormalities precipitated during the first 3 min and during the last 2 min of the HV period (totally 5 min) were determined. For the last part of our study, patients were monitored at the Danish Epilepsy Center. Adverse events (AEs) including injuries, were prospectively noted, as part of the safety policy of the hospital. Other data were retrospectively extracted from the electronic database, for a 5-year period (Jan 2012–Dec 2016). Results: Standard, awake recordings shorter than 20 min yielded a significantly lower incidence of abnormal findings as compared to longer recordings. Although there was an increase in the diagnostic yield from 30 to 180 min recording duration, this failed to reach the level of significance. For sleep recordings, there was no significant increase in the diagnostic yield beyond 30 min. 877 (81%) completed 5 min HV. Seizures were precipitated during the first 3 min of HV in 21 patients, and during the last 2 min in four more patients. Interictal EEG abnormalities were precipitated in the first 3 min of HV in 16 patients, and during the last 2 min in 7 more patients. Psychogenic nonepileptic seizures occurred in eight patients during the first 3 min of HV and in two more patients during the last 2 min. No adverse events occurred during the last 2 min of HV. 976 patients were admitted to the EMU. Falls occurred in 19 patients (1.9%) but none of them resulted in injury. The rate of AEs were similar or lower than previously reported by other centers, where the mobility of the patients had been restricted during monitoring. Conclusions: Our results provide evidence for recommending at least 20 min recording duration for standard awake EEGs and 30 min for sleep EEG recordings. 16% of seizures and 30% of interictal EEG abnormalities triggered by HV occurred during the last 2 min of HV, suggesting the clinical usefulness of prolonged hyperventilation for 5 min. The vast majority of patients (99%) who are able to hyperventilate for 3 min can complete 5 min HV, without additional adverse events. In an EMU specially designed for this purpose, where patients are under continuous surveillance by personnel dedicated to the EMU, injuries can be avoided even when the mobility of the patients is not restricted.
Study of BISAP Scoring System, Ranson’s Scoring System and C-Reactive Protein Level as Predictors of Clinical Outcome in Acute Pancreatitis
Authors: Machindra Gaikwad Avinash , K.V. Rajeshwara
Published: March 2021

BACKGROUND This study was conducted to compare BISAP scoring system, Ranson’s score and CRP levels in predicting the clinical outcome in acute pancreatitis and for early detection of severity and organ failure in acute pancreatitis. METHODS This study was an observational longitudinal analytical study conducted among patients admitted with diagnosis of acute pancreatitis, in Father Muller Medical College Hospital, Mangalore, from November 2016 to March 2018. The study was started after obtaining ethical clearance from the institution’s ethical clearance committee. All patients diagnosed with acute pancreatitis between the age 20 and 60 years were included in the study. RESULTS Comparison of serum CRP levels between the Atlanta classified groups shows that severe group has the maximum value of 340.966 and mild has the minimum value of 55.38. This difference is statistically significant with a test value of 16.543 and a P value of < 0.001. On comparison of the test group, Ranson’s score with the BISAP score, the test group had a sensitivity of 89.3 % and specificity of 77.3 %. CONCLUSIONS The study has demonstrated the concordance between Ranson’s score, BISAP score and serum CRP level as predictors of clinical outcome in acute pancreatitis. KEY WORDS Acute Pancreatitis, Clinical Outcome, C Reactive Protein, Scoring Systems.
Comparative Evaluation of the Antimicrobial Efficacy of Different Irrigating Solutions on Endodontic Pathogens - An In Vivo Study
Authors: Shetty Suneeth , Tejaswi Sunil , U.K. Ambikathanya , Mittal Akanksha
Published: March 2021

BACKGROUND The key to a successful endodontic treatment is to ensure complete eradication of the infection present and to prevent reinfection. This depends on meticulous disinfection using intracanal irrigants. In dentistry the most commonly used irrigant is sodium hypochlorite which has the disadvantages of cytotoxicity and unpleasant taste. The extracts of neem have been used since ages for their medicinal values and used widely for health care. However, the potential use of such an agent for the success of endodontic procedures has not yet been investigated. Hence, if proved effective, such a natural agent will have a dominant hold against the chemical disinfectants in terms of biocompatibility and tissue response. This study aimed to evaluate the effectiveness of Q-MIX (2 in 1), 10 % neem (Azadirachta indica), and 2 % sodium hypochlorite on the growth and culture of Enterococcus faecalis and Mutant Streptococcus over a period of 4 weeks. METHODS This is a descriptive study conducted among samples collected from 30 healthy patients who were indicated for pulpectomy. The sample size was taken for convenience. Incisors of these individuals were selected on the basis that they had to undergo endodontic treatment due to primary endodontic infection. The zones of inhibition were measured by agar well diffusion method. Statistical analysis was done using independent T test & chi-square test. RESULTS Statistical analysis showed that the mean zones of inhibition in this study were 20.54 mm, 9.65 mm and 4.54 mm for Q-MIX (2 in 1), 10 % neem and 2 % sodium hypochlorite. The significance was greater between Q-MIX (2 in 1) and the other two agents as the P-value was < 0.001. CONCLUSIONS The result indicated Q-MIX (2 in 1) is a more effective root canal irrigant when compared to 10 % neem and 2 % sodium hypochlorite. KEY WORDS Q-MIX (2 in 1), Azadirachta indica, Apical Periodontitis, Enterococcus faecalis
Prevalence of NAFLD and Its Correlation with Diabetic Nephropathy in Type 2 Diabetes Mellitus Patients
Authors: Kaur Simran , Laxmareddygari Sushma , Gupta Nitin , Tabjula Akshith Rajgupta , Joshi Yavatesh , Dhaliwal Sargam
Published: March 2021

BACKGROUND Diabetes mellitus (DM) is a disease related to abnormality in metabolism of carbohydrates which is characterised by hyperglycemia that results from relative or absolute defect in insulin secretion, varying degrees of insulin resistance or both. Various researches have established the link between type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD). The present study was done for assessing the prevalence of NAFLD and its association with diabetic nephropathy in patients with type 2 diabetes mellitus. METHODS 75 patients of type 2 diabetes were included in this study. Clinical details and demographic data of all the patients were obtained. Samples were obtained from all the patients and all the routine investigations were carried out. Ultrasonography (USG) abdomen was performed in all patients after 12 hours fasting. Microsoft Excel was used for recording the results and were analysed by Statistical Package for the Social Sciences (SPSS) software. Level of significance was evaluated using chisquare test. RESULTS NAFLD was present in 57 patients. Therefore, the overall prevalence of NAFLD was see 76 %. The overall prevalence of diabetic nephropathy was 42 percent among diabetic patients. Out of 31 patients with diabetic nephropathy, NAFLD was present in 25 patients. Significant results were obtained while assessing the association of NAFLD with diabetic nephropathy in T2DM patients. CONCLUSIONS NAFLD was found to be a significant risk factor for the development of diabetic nephropathy in patients having type 2 diabetes mellitus. KEY WORDS Non-Alcoholic Fatty Liver, Diabetic Nephropathy, Type 2 Diabetes Mellitus, Nonalcoholic Steatohepatitis
Adenomatoid Odontogenic Tumour - The Master of Disguise
Authors: Shah Shreyas N. , Patel Falguni , Shah Vandana
Published: March 2021

Adenomatoid odontogenic tumour, truly coined as one of the masters of disguise of orofacial pathologies, was first reported in the literature by Steen Lands.1 Philipson and Brin used the terminology adenomatoid odontogenic tumour for this pathology with its commonly accepted abbreviation AOT.2 Later on, adenomatoid odontogenic tumour (AOT) name was accepted by the World Health Organization (WHO) in 1971. In 2005, WHO revealed the histological variants of the adenomatoid odontogenic tumour and classified it as a tumour comprised of odontogenic epithelium showing various patterns in histopathologic view within a mature connective tissue stroma.3 It is seldom noticed neoplasm which comprises only 3 % of all the odontogenic tumours. It was commonly found in the maxilla with female predilection and mostly in association with impacted canines.4-6 Adenomatoid odontogenic tumour is an odontogenic epithelial tumour usually seen in females in their second decade of life. The tumour is slow growing in nature which eventually results in painless expansion of jaw. The maxilla is commonly affected than mandible. Being benign in nature, most of the AOT cases usually got treated with conservative surgical enucleation but the greater size of tumour can leave behind an oro-facial defect. To prevent such type of incident, it is important to diagnose them early and treat accordingly. Herewith, we are presenting a case report of adenomatoid odontogenic tumour of mandible in a male patient.
Rare Presentation of Acute Lymphoblastic Leukemia – A Case Report
Authors: Chinde Nafe Navid , Kaur Simran , Reddygari Sushma Laxma
Published: March 2021

Acute lymphoblastic leukaemia / lymphoblastic lymphoma is the most common childhood malignancy. Leukaemia and lymphoma are clinical presentations of the same disease. It is estimated that approximately 2500 to 3500 new cases are diagnosed each year in the United States, with an incidence of approximately 3.4 cases per 100,000. Number of the cases vary all over the world which is due to diagnostic and reporting differences.1,2 Leukaemia, especially acute types, can lead to intracranial haemorrhage (ICH) with high morbidity and mortality. It was reported that ICH occurred in 2.8 % adult patients with haematological malignancies. 3,4 But majority of cases presented with intraparenchymal haemorrhage, only rare cases have been seen to present with sub dural haemorrhage.
Pulp Revascularisation of a Non-Vital Immature Young Permanent Tooth - A Case Report and Literature Review
Authors: Satpute Tanvi Sanjay , Verma Jayeeta Sidharth , Shah Jimish Rajiv , Shinde Aditya Kiran
Published: March 2021

Traumatic injuries to an immature permanent tooth may result in cessation of dentin deposition and root maturation. Novel revascularisation endodontic procedure (REP) has been considered as an option for treatment of immature teeth with damaged pulp tissue. The continuous development of the root and the root canal has been recognised as a major advantage of this technique over traditional apexification approach. Traditional apexification procedures may resolve pathology but have not been able to prove tooth survival due to absence of continued root development and risk of root fracture. A successful REP results in resolution of signs and symptoms of pathology, radiographic signs of healing, proof of continued root development as well as presence of pulp vitality due to the regeneration of pulp tissue in the root canal. Currently, repair rather than true regeneration of the ‘pulp-dentine complex’ is achieved and further root maturation is variable. According to Glossary of Endodontic terms published by American Association of Endodontists, REP’s are biologically based procedures designed to physiologically replace damaged tooth structures, including dentin and root structures, as well as cells of the pulp-dentin complex.1,2 Apexification treatment has been a routine procedure to treat and preserve such teeth for many decades.3 Apexification is the process by which a suitable environment is created within the root canal and periapical tissue to allow for the formation of a calcific barrier across the open apex. Calcium hydroxide [Ca(OH)2] has been the material of choice for apexification as Frank reported its capacity to induce physiological closure of immature pulpless teeth in 1966.4 However, this technique has several disadvantages, including the unpredictability of apical barrier formation and the long duration of treatment, which often requires multiple visits.5 A retrospective study by Jeruphuaan et al.6 has shown a higher survival rate with regenerative endodontic treatment when compared to both mineral trioxide aggregate (MTA) and Ca(OH)2 apexification. The first evidence of regeneration of dental tissues was in 1932 by G.L. Feldman, who showed evidence of regeneration of dental pulp under certain optimal biological conditions.7 In 1971, a pioneer study in regenerative endodontics conducted by Nygaard-Ostby concluded that bleeding induced within a vital or necrotic canal led to resolution of signs and symptoms of necrotic cases and in certain cases, apical closure.8 According to Windley et al. (2005), the successful revascularisation of immature teeth with apical periodontitis is mainly dependent upon: 1. Canal disinfection 2. Scaffold placement in the canal for the growing tissues 3. Bacteria-tight sealing of the access opening.9 The purpose of this case report is to illustrate the outcome of a revascularisation endodontic procedure in a non-vital immature young permanent central incisor.
Jelentések a frontvonalból – verseny és versenyképesség vállalati mélyinterjúk tükrében
Authors: Némethné Pál Katalin
Published: March 2021

A GKI Gazdaságkutató Zrt. 2007 folyamán a Gazdasági Versenyhivatal Versenykultúra Központja megbízásából végzett kutatást annak vizsgálatára, hogy kimutatható-e összefüggés a nemzetgazdasági ágazatokban folyó verseny erőssége és az ágazatok vállalatainak versenyképessége között. A cikk első részében (Vezetéstudomány, 2008. június) a GKI régebbi vállalati felméréseinek a kutatás szempontjait szolgáló átvizsgálását mutatta be. Ennek során azt találták, hogy gyenge kapcsolat van a válaszadó vállalatok versenyképessége és az általuk tapasztalt verseny erőssége között. A második részben a kutatás során folytatott empirikus kutatás tapasztalatait tárja a szerző az Olvasó elé.
The influence of speed of integration on M&A integration Success
Authors: Morag Omri , Barakonyi Károly
Published: March 2021

Despite the importance of the dimension of time in the world of competitive strategy, only a few researches have focused on the issue of the speed of the integration (SOI) in the process of merger/acquisition (M&A) and its impact on the deal-success. This article focused on the issue of speed of integration and its impact on the integration effectiveness and the success of the M&A. This impact changes depending on the combination of a number of variables such as the main reason of the acquisition, the type of acquisition, the characteristics of the companies involved in the acquisition, and the selected integration approach. Therefore, every acquirer has to pay attention to the SOI variable and to adjust the optimal speed to the specific acquisition scenario.
Quorsum hoc pertineo defectus? – A hibázás és a szervezeti viselkedés összekapcsolódása
Authors: Egri Miklós
Published: March 2021

A hiba egy elvárt állapottól való eltérést testesít meg, ami nem jó. Érthető módon a hibázás a teljesítményorientált szervezetek tagjai számára általában negatív. A cikkel a szerző kísérletet tesz a hibázás és a szervezeti viselkedés kapcsolatában rámutatni arra, hogy a hibázás elkerülhetetlen, sőt kívánatos. A hiba szociológiai értelemben kerül feldolgozásra „egy bizonyos elvárt eredményállapottól való eltérés megállapításaként”. A dolgozat részletesen végigviszi a hiba fogalmának dimenzióit és azok hatásait a szociológia főbb rendszereire. A fejlődés egyik alapvető elősegítőjén keresztül, a hibakultúrán keresztül jut el a hiba és a szervezeti viselkedés összekapcsolódásához. A modern társadalom tagjainak egymástól való függősége és a hibák hatása nőtt. A szociológiai rendszerek eredményessége és a hibákhoz való viszonya fontos aspektus a jövő alakításának szempontjából. Pre- és post-defectus stratégiákat mutat be a szerző, melyek a hiba pozitivitására és bennük rejlő lehetőségek kiaknázására épülnek.
Automatic headlight controlling of vehicle using ambient light sensor based on phototransistor
Authors: Shahriar Kazi Muhammad Fahim
Published: March 2021

This paper proposes an efficient method to control the headlight intensity of the vehicle using ambient light sensor (ALS) based on phototransistor with the principle of pulse width modulation. The main responsibility of this automatic headlight control is to control the intensity of the headlight based on the ambient light. The intensity of the headlight will be low when the ambient light intensity is high and vice versa.
Cadaveric Study of the Neurovascular Bundle in Tarsal Tunnel Region among Sudanese - 2020
Authors: seddeg yasser , Ismail Elfarazdag
Published: March 2021

Abstract Background: Tarsal tunnel is situated medial to the ankle lying deep to the flexor retinaculum. Within which lies the neurovascular bundle in separate compartments. This study examines the level of bifurcation points of tibial nerve and posterior tibial artery, and the location of medial and lateral plantar nerves in the tarsal tunnel. As well as the origin of the medial calcaneal nerves. Methods: This study was a descriptive observational cross sectional study. Step by step dissections of the tarsal tunnel were performed on 30 Sudanese cadavers, the contents of the tarsal tunnel were explored. Results: The tibial nerve was found to bifurcate before the the medial malleolus calcaneal axis (MMCA) in (n=4/30, 13.3%) specimens , and inside the tunnel (n=26/30, 86.7%). The branching point of the posterior tibialartery was found before the MMCA in (n=10/28, 35.7%) of specimens, at the MMCA in (n=16/28, 57.1%), and after the MMCA in (n= 2/28, 7.1%). Medial calcaneal nerves were found to be derived from the LPN plus the TN in (n=13/30, 43.3%), while in (n=6/30, 20%) were derived from LPN plus MPN plus TN. only (n=5/30, 16.7 %) were derived from LPN alone. Conclusion: anatomical knowledge of the bifurcation points of tibial nerve and posterior tibial artery is of great importance in many medical procedures like external fixation of medial malleolus fractures, medial displacement osteotomy and nerve blocks in podiatric medicine.
Identification of CYP2D6 allelic mutations in a sub-set of Karachi population
Authors: Fatima Tamkeen
Published: March 2021

CYP2D6 gene polymorphism is considered a main obstacle in the process of drug metabolism under clinical diseases that affect pharmacokinetics of ~25% of antidepressants and other drugs. Inter-individual variation occurs in the amount and functional activity of CYP2D6 enzyme produce undesirable side effects. The primary aim of current research is to evaluate gene and genotypic frequencies of CYP2D6 *1 extensive metabolizer, *4 poor metabolizer and *10 intermediate metabolizer allelic variants among depressed patients and compared with normal subjects and other populations. Human genomic DNA was isolated. Genotyping was performed by Polymerase chain reaction followed by restriction endonucleases digestion for variants analysis. The results indicated gene frequency of CYP2D6*1 was 59% (CI 49.6,68.3%) in normal subjects whereas, CYP2D6*4 was 13% (CI 3.7, 22.3%) and CYP2D6*10 was 54% (44.7, 63.3%) predominantly found in depressed patients. The results demonstrate pronounced association of CYP2D6 *4 and *10 allelic variants with patient’s drug response activity.
A Multicenter, Open-Label, Single-Arm Study to Evaluate the Efficacy and Safety of Saroglitazar in Patients With Primary Biliary Cholangitis
Authors: Vuppalanchi Raj , González-Huezo Ma Saraí , Payan-Olivas Ramon , Muñoz-Espinosa Linda E. , Shaikh Farheen , Pio Cruz-Lopez Jose L. , Parmar Deven
Published: March 2021

INTRODUCTION:

Patients with primary biliary cholangitis (PBC) without biochemical response to ursodeoxycholic acid (UDCA) are at increased risk of liver-related mortality. Saroglitazar is a novel peroxisome proliferator-activated receptor (PPAR) agonist with dual PPAR agonistic properties (α/γ). There is a strong mechanistic rationale for studying saroglitazar in PBC because PPARα is a molecular target of fibrates that showed improvements in liver tests in patients with PBC.

METHODS:

In this 16-week, open-label, phase 3 study, 37 patients were screened across 3 clinical centers to enroll 7 patients. All patients received daily dose of saroglitazar 4 mg for 16 weeks in addition to their ongoing treatment with UDCA. The primary efficacy endpoint was the reduction in alkaline phosphatase (ALP) level at week 16 as compared to baseline.

RESULTS:

Mean age of the study population was 51.1 ± 10.0 years, all patients were female of Mexican descent, and mean body mass index was 25.5± = 4.8 kg/m2. Six (85.7%) patients reported taking ursodiol at baseline and continued throughout the study with a mean daily dosage of 417 mg. Among these, the daily dosage of UDCA 500 mg in 4 and 250 mg in 2 subjects, respectively. The mean baseline ALP level was 230 ± 103 U/L. The primary efficacy endpoint, mean change (reduction) from baseline in ALP concentration at week 16 based on the modified intent-to-treat population was −94 ± 53 U/L (P = 0.003), corresponding to a reduction of 48 ± 23%. Treatment with saroglitazar 4 mg resulted in a rapid and sustained decrease of ALP levels at week 4 (−84 ± 47 U/L, P = 0.003). Six patients who completed the study achieved mean ALP reduction of at least 40% at week 4 and all subsequent visits.

DISCUSSION:

Although the study was terminated because of lack of enrollment, saroglitazar daily for 16 weeks resulted in rapid and sustained improvements in ALP with an acceptable safety profile in patients with PBC.