bluuebunny/crossref_metadata_2025 huggingface dataset:
Percepção do Conselho acerca do Monitoramento Participativo da Biodiversidade para a Gestão das Unidades de Conservação da Amazônia
Authors: Freda Pereira Fernanda , Pellin Ângela , Dias Letícia , Lemos Pollyana , Silva Marcela , Lehmann Débora , Bernardes Virgínia , Lima Fernando , Prado Fabiana , Tófoli Cristina
Published: November 2022

O monitoramento participativo da biodiversidade consiste em uma das estratégias com o intuito de auxiliar a gestão de áreas protegidas com envolvimento dos atores locais residentes nessas áreas e seu entorno, criando uma cultura de questionamento e respeito da floresta, seus recursos e usos. Por meio do Programa Nacional de Monitoramento da Biodiversidade (Monitora), do Instituto Chico Mendes de Conservação da Biodiversidade (ICMBio), em parceria com o Instituto de Pesquisas Ecológicas (IPÊ), desenvolve o projeto de Monitoramento Participativo da Biodiversidade (MPB) em unidades de conservação (UCs) da Amazônia. Nesse sentido, analisamos a percepção dos conselheiros quanto ao significado e impacto do MPB tendo como objetivo compreender a interação entre o conselho gestor e o monitoramento participativo enquanto estratégia de participação social na gestão de UCs. O projeto MPB é desenvolvido em 16 UCs federais da Amazônia e em duas UCs estaduais. Para avaliação do projeto, foram aplicados questionários semi-estruturados junto aos participantes. Esses questionários foram respondidos durante as reuniões de conselho gestor e com lideranças das UCs, entre os meses de março a junho de 2019. Das 18 UCs abrangidas pelo projeto, 12 foram avaliadas, participando da pesquisa 205 conselheiros e lideranças de 10 conselhos (dois são compartilhados entre unidades), a maioria sendo representantes dos conselhos. Os resultados mostraram que o conhecimento e as percepções dos temas entre os conselheiros e lideranças variam, no entanto de forma geral todos têm a compreensão da importância do monitoramento para gestão e conservação da UC. Iniciativas participativas e espaços de diálogo como os conselhos de UCs criam um senso de pertencimento entre gestão, comunidades e instituições locais, promovem reconhecimento e contribuem com a conservação da biodiversidade e ações de manejo.
Penerapan Rapidminer menggunakan metode K-Means untuk Pengelompokkan Puskesmas pada Cakupan Imunisasi Dasar (Studi Kasus : Kota Bandung)
Authors: Ramadhan Raka Rizki , Saprudin Usep
Published: November 2022

Program Imunisasi sejak tahun 1974 merupakan komponen penting bagi pelayanan Kesehatan bayi. Imunisasi merupakan salah satu cara dalam mengurangi angka kematian bayi dan anak karena imunisasi berfungsi untuk memperbaiki resistansi tubuh dan mengatasi penyakit. Penelitian ini bertujuan  untuk pengelompokkan jumlah bayi yang dilayani oleh puskesmas dalam program imunisasi. Dalam penelitian ini metode yang digunakan ialah Algoritma K-Means . Data yang diambil dapat dikelompokkan ke dalam beberapa clustering, yaitu dari clustering tertinggi, clustering sedang dan clustering terendah. Data yang didapatkan bersumber dari open data di portal website bandung dengan portal website https://data.bandung.go.id . Data yang dipakai yaitu dari tahun 2019-2020 yang terdiri dari 80 UPT Puskesmas . Pada Penelitian ini atribut yang digunakan yaitu Jumlah total Bayi dan Jumlah total pelayanan Kesehatan bayi. Proses iterasi sebanyak 6 kali hingga memperoleh hasil pengelompokkan puskesmas yang memberikan pelayanan Imunisasi dasar. Hasil cluster yang didapatkan yaitu cluster tertinggi terdapat pada cluster 2 dengan 11 anggota, cluster sedang terdapat pada cluster 1 dengan 37 anggota , cluster terendah pada cluster 0 dengan 32 anggota. Dari 80 UPT Puskesmas yang terletak di Kota Bandung, dapat diketahui imunisasi tertinggi yaitu ada di Puskesmas Pasirkaliki dengan jumlah 2126 bayi dan terendah ada di Puskesmas Salam dengan Jumlah 37 Bayi.
Intestinal Malrotation with Midgut Volvulus Comorbidity with Bronchopneumonia: A Case Report
Authors: Sindi Fatmah , Yusri Dianne Jurnalis  , Jon Effendi
Published: November 2022

Background: Intestinal malrotation is a congenital anomaly resulting from abnormal rotation and fixation of an imperfect midgut during embryonic development. This study aims to describe the diagnosis and management of intestinal malrotation and its comorbid diseases in children.

Case presentation: A boy, aged 9 months, was referred from a regional hospital with complaints of repeated vomiting accompanied by a distended stomach and no bowel movements for 4 days. Based on the birth history, the patient was born with vacuum assistance for the indication of prolonged phase II. The results of the physical examination showed that the patient was seriously ill, with compos mentis, pulse rate 130 x/minute, respiratory rate 34x/minute, blood pressure 90/60 mmHg, temperature 37.6ºC, 99% saturation with the help of O2 nasal canule 2L/minute. There are increased bowel sounds on abdominal examination. Blood examination showed an increase in leukocytes (10.850/mm3). The chest X-ray showed lateral bronchopneumonia, and the abdominal X-ray showed low-lying obstructive ileus. The patient was diagnosed with obstructive ileus due to volvulus, moderate dehydration, comorbid with bronchopneumonia, and global developmental delay.

Conclusion: Management of intestinal malrotation with volvulus in this patient includes general improvement and rehydration, Ladd's procedure for definitive correction of the cause. Management of comorbid global developmental delay is carried out after the emergency is resolved.
LITERATUR REVIEW: PERAN CENDAWAN NEMATOFAGUS TERHADAP NEMATODA PARASIT
Authors: Erwin Nurul Hikmah , Furtuna Dewi Klarita , Toemon Agnes Immanuela , Jabal Arif Rahman
Published: November 2022

Latar Belakang: Cendawan nematofagus merupakan cendawan tanah yang dapat mereduksi cacing nematoda, cendawan ditemukan di berbagai tempat dan cendawan terbukti efektif sebagai agen biocontrol, Cendawan tergolong nematofagus seperti: Arthrobotrys spp., Catenaria anguillulae, Drechmeria spp., Duddingtonia flagrans., Geniculifera spp., Harposporium spp., Monacrosporium spp., Nematocnus spp., Pleurotus spp., Tridentaria implicans, Verticillium balanoides. Tujuan: mengetahui jenis cendawan nematofagus yang mempunyai efek terhadap cacing parasit nematoda pada hewan. Metode: Penelitian ini menggunakan pendekatan systematic review. Sumber data yang digunakan adalah data sekunder yang diperoleh dari Google Scholar, dan NCBI. Kata kunci yang digunakan adalah cendawan nematofagus dan nematoda, diperoleh 15 jurnal penelitian yang memenuhi kriteria inklusi dan analisis kualitas data. Hasil: 7 jurnal penelitian menyatakan cendawan dengan jenis Duddingtonia flagrans mampu membunuh cacing nematoda pada stadium L3, 3 jurnal penelitian menyatakan cendawan jenis Pochonia Chlamydosporia mampu mengontrol larva cacing parasit nematoda. 1 jurnal dengan penelitian cendawan Chysosporium spp, 2 jurnal penelitian dengan cendawan Trichoderma spp, 2 jurnal penelitian dengan cendawan jenis Purpureocillium lilacinum. Kesimpulan: Banyak jenis cendawan nematofagus yang baik dan mampu mereduksi cacing nematoda, tetapi banyaknya penelitian yang menggunakan cendawan Duddingtonia flagrans dan Pochonia Chlamydosporia, hal ini membuktikan jika kedua cendawan ini sangat bagus dalam mereduksi dan mengkontrol cacing parasit sehingga memiliki peran penting sebagai biocontrol pada lingkungan

Kata kunci: Cendawan nematofagus, nematoda, jenis, dan Peran
Factors Affecting Enforced Tax Compliance of Businesses in Vietnam
Authors: Hong Nguyen Thi Phuong
Published: November 2022

The objective of this study is to test 11 factors including Social Norms, Tax Education, Coercive Power of Tax Authority, Legitimate Power of Tax Authority, Tax Information, Tax Penalty, Tax Audit, Tax Rate, Tax Compliance Costs, Service Quality of Tax Authority, Public Governance Quality affecting the enforced tax compliance of businesses in Ho Chi Minh City, Vietnam. The study uses a data collection tool which is a questionnaire with survey subjects who are accountants, chief accountants, and financial directors of businesses in Ho Chi Minh City, Vietnam. The author uses Structural equation modeling to test the hypotheses in the research model. The research results found that there are 5 factors that have a significant influence on the enforced tax compliance of businesses in Ho Chi Minh City, Vietnam. They are Legitimate Power of Tax Authority, Service Quality of Tax Authority, Tax Information, Coercive Power of Tax Authority, and Tax Education, and the remaining 6 factors do not affect the enforced tax compliance of the businesses industry in Ho Chi Minh City, Vietnam. Policymakers, tax authorities, and other stakeholders based on this research can come up with more appropriate solutions to enhance the enforced tax compliance behavior of businesses.
PARAMETER IDENTIFICATION PROBLEM TO FIND THE CARDIAC POTENTIAL WAVE FORM IN IONIC MODELS
Authors: Pongui Ngoma D.V. , Mabonzo V.D. , Gomat L.J.P. , Nguimbi G. , Bamvi Madzou B.B.
Published: November 2022

In this paper, we have defined an optimization problem allowing to directly find the shape of the cardiac wave of some ionic models. This allowed us to compare some of these ionic models via a parameter identification problem instead of comparing them directly by plotting the graphs for given values of the parameters. Compared to the empirical methods used to adjust one or two parameters at a time encountered in electrophysiology, we believe that our parameter identification approach is reliable and able to simultaneously identify four to eleven parameters of an ionic model. Using this approach, we adjusted the parameters of the Mitchell-Schaeffer and Aliev-Panfilov models to recover the shape of the action potential obtained experimentally by fluorescence.
Allometric effect of body size and tegmen mirror area on sound generator characters in Euconocephalus pallidus (Orthoptera, Tettigoniidae, Copiphorini) from Singapore
Authors: Tan Ming Kai
Published: November 2022

Acoustic communication, including allometry of secondary sexual traits and body size, can differ among katydid species from different parts of the world. However, Neotropical species tend to be better studied than their Southeast Asian relatives. This is true for the tribe Copiphorini (Orthoptera, Tettigoniidae). To allow for future comparative studies of Neotropical and Palaeotropical Copiphorini, the allometric relationships between sound generator characters and body size of Euconocephalus pallidus from Singapore were examined. Five sound generator characters–tegmen length, stridulatory file length, tooth width, teeth density, and mirror area–were correlated with pronotum length as the proxy for body size. Stridulatory file length, tooth width, and teeth density were also correlated with the mirror area. The relationships were subsequently tested for difference between scaling slope and isometry based on 29 male adults from a single population. All sound generator characters except teeth density exhibited significant positive correlations with pronotum length, whereas teeth density exhibited significant negative correlation with pronotum length. Among them, only tooth width and teeth density scaled hyperallometrically, while the other characters scaled isometrically. As males produce a continuous buzzing call over long durations, larger teeth (i.e., larger tooth width and lower teeth density to accommodate larger teeth) are probably more resistant to age-related abrasion. This may imply that males with larger teeth can produce calls recognized and/or favored by the females over a longer part of the males’ adult lifespan. File length and mirror area exhibited isometric scaling. This suggests a stabilizing selection driven by their function in dictating carrier frequency, which females tend to rely on to recognize conspecific males.
Management of Axial Disease in Patients With Psoriatic Arthritis: An Updated Literature Review Informing the 2021 GRAPPA Treatment Recommendations
Authors: Lubrano Ennio , Chan Jon , Queiro-Silva Ruben , Cauli Alberto , Goel Niti , Poddubnyy Denis , Nash Peter , Gladman Dafna D.
Published: November 2022

Objective

Axial involvement in patients with psoriatic arthritis (PsA) is a common subset of this condition, but a unanimous definition has yet to be established. It has been defined by using different criteria, ranging from the presence of at least unilateral grade 2 sacroiliitis to those used for ankylosing spondylitis (AS), or simply the presence of inflammatory low back pain (IBP). Our aim was to identify and evaluate the efficacy of therapeutic interventions for treatment of axial disease in PsA.

Methods

This systematic review is an update of the axial PsA (axPsA) domain of the treatment recommendations project by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA).

Results

The systematic review of the literature showed that new biologic and targeted synthetic disease-modifying antirheumatic drug classes, namely interleukin (IL)-17A and Janus kinase inhibitors, could be considered for the treatment of axPsA. This would be in addition to previously recommended treatments such as nonsteroidal antiinflammatory drugs, physiotherapy, simple analgesia, and tumor necrosis factor inhibitors. Conflicting evidence still remains regarding the use of IL-12/23 and IL-23 inhibitors.

Conclusion

Further studies are needed for a better understanding of the treatment of axPsA, as well as validated outcome measures.
Management of Dactylitis in Patients With Psoriatic Arthritis: An Updated Literature Review Informing the 2021 GRAPPA Treatment Recommendations
Authors: Palominos Penélope Esther , Fernández-Ávila Daniel G. , Coates Laura C. , Adebajo Adewale , Toukap Adrien Nzeusseu , Abogamal Ahmed , Polachek Ari , van Kuijk Arno W.R. , Caso Francesco , de Marco Gabriele , Kaeley Gurjit S. , Steinkoenig Ingrid , Chau Jeffrey , Feletar Marie , Vis Marijn , Elkayam Ori , Sewerin Philipp , d’Angelo Salvatore , Aydin Sibel Zehra , AlShehhi Waleed , Helliwell Philip S.
Published: November 2022

Objective

This literature review aimed to identify the most efficacious current interventions for dactylitis and provide up-to-date scientific evidence to support the 2021 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) recommendations on the management of psoriatic arthritis.

Methods

Original articles published from 2013 to 2020, registered in MEDLINE, Embase, and Cochrane Library, describing interventional trials and reporting dactylitis-related outcomes were included. The 20 members of the GRAPPA dactylitis group were divided into 9 subgroups according to treatment, and members of each group independently extracted data from articles/abstracts corresponding to their group by using a standardized data extraction form.

Results

Forty-nine publications were analyzed, representing 40 randomized clinical trials (RCTs) and including 16,752 patients. Dactylitis was assessed as a secondary outcome in 97.5% of these trials and more than 40% of RCTs did not employ a specific dactylitis measure or instrument.

Conclusion

The emergence of agents with novel mechanisms of action in recent years, such as interleukin 17 (IL-17), IL-12/23, IL-23, and Janus kinase inhibitors, has significantly expanded the available treatment options for dactylitis. This article points out the lack of consensus regarding dactylitis assessment and the paucity of data concerning the effect of local steroid injections, nonsteroidal antiinflammatory drugs, and conventional disease-modifying antirheumatic drugs. Clinical trials evaluating the effect of these traditional and low-cost medications used to treat dactylitis should be encouraged.
Management of Nail Disease in Patients With Psoriatic Arthritis: An Updated Literature Review Informing the 2021 GRAPPA Treatment Recommendations
Authors: Laheru Dhruvkumar , Antony Anna , Carneiro Sueli , Di Lernia Vito , Garg Amit , Love Thorvardur Jon , del Rocio Macias Garcia Karla , Mendonça José Alexandre , Mukherjee Sandeep , Olteanu Rodica , Perez-Chada Lourdes , Rosen Cheryl F. , Tannenbaum Rachel , Yazbek Michel Alexandre
Published: November 2022

Objective

Nail psoriasis is common, impairs fine motor finger functioning, affects cosmesis, and is associated with a lower quality of life. This review updates the previous Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) treatment recommendations for nail psoriasis.

Methods

This systematic literature review of the PubMed, MEDLINE, Embase, and Cochrane databases examined the updated evidence since the last GRAPPA nail psoriasis treatment recommendations published in 2014. Recommendations are based on preformed PICO (Patient/Population - Intervention - Comparison/Comparator - Outcome) questions formulated by an international group of dermatologists, rheumatologists, and patient panel members. Data from this literature review were evaluated in line with Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology.

Results

Overall, there is insufficient evidence to make any recommendation for the use of topical corticosteroids, topical calcipotriol, topical tazarotene, topical cyclosporine, dimethyl fumarates/fumaric acid esters, phototherapy, and alitretinoin. There is a low strength of evidence to support the use of calcipotriol and corticosteroid preparations, topical tacrolimus, oral cyclosporine, oral methotrexate, intralesional corticosteroids, pulsed dye laser, acitretin, Janus kinase inhibitors, and apremilast.

Conclusion

The highest strength of supporting evidence is for the recommendation of biologic agents including tumor necrosis factor inhibitors, and interleukin 12/23, 17, and 23 inhibitors.
Boundedness criteria for the quasilinear attraction-repulsion chemotaxis system with nonlinear signal production and logistic source
Authors: Wang Chang-Jian , Yang Yu-Tao
Published: November 2022

This paper deals with the following quasilinear attraction-repulsion chemotaxis system

   \begin{document}$ \begin{equation*} \left\{ \begin{array}{ll} u_{t} = \nabla\cdot((u+1)^{m}\nabla u-\chi u(u+1)^{\theta-1}\nabla v+\xi u(u+1)^{l-1}\nabla w)+au-bu^{\kappa}, \ &\ \ x\in \Omega, \ t>0, \\ 0 = \Delta v+\alpha u^{\gamma_{1}}-\beta v, \ &\ \ x\in \Omega, \ t>0, \\ 0 = \Delta w+\gamma u^{\gamma_{2}}-\delta w, \ &\ \ x\in \Omega, \ t>0 , \end{array} \right. \end{equation*} $\end{document}

with homogeneous Neumann boundary conditions in a bounded, smooth domain $ \Omega\subset\mathbb{R}^{n} (n\geq 1), $ where $ m, \theta, l \in \mathbb{R} $ and $ \chi, \xi, a, b, \alpha, \beta, \gamma, \delta, \gamma_{1}, \gamma_{2} > 0, \kappa > 1. $ It is proved that if the nonlinear exponents of the system satisfy $ \theta+\gamma_{1} < \max\left\{l+\gamma_{2}, \kappa, m+\frac{2}{n}+1\right\}, $ then the system has globally bounded classical solutions. Furthermore, assume that $ \theta+\gamma_{1} = \max\{l+\gamma_{2}, \kappa\}\geq m+\frac{2}{n}+1, $ if one of the following conditions holds:

   \begin{document}$ \begin{align*} \mbox{(a)}\ \mbox{when}\ \theta+\gamma_{1} = l+\gamma_{2} = \kappa, & \ \mbox{if}\ \theta\geq l\geq 1 \ \mbox{and} \ \frac{[(\kappa-1-m)n-2](2\alpha \chi-\gamma\xi)}{2(l-1)+(\kappa-1-m)n}<b \\ \ &\mbox{or if}\ \ l \geq \theta\geq 1\ \mbox{and} \ \frac{2\alpha \chi[(\kappa-1-m)n-2]}{2(\theta-1)+(\kappa-1-m)n}\kappa, & \ \mbox{if}\ \theta\geq l\geq 1 \ \mbox{and} \ 2\alpha \chi\leq \gamma\xi; \\ \ \mbox{(c)}\ \mbox{when}\ \theta+\gamma_{1} = \kappa>l+\gamma_{2}, & \ \mbox{if}\ \theta\geq 1 \ \mbox{and} \ \frac{2\alpha \chi[(\kappa-1-m)n-2]}{2(\theta-1)+(\kappa-1-m)n}<b, \end{align*} $\end{document}

then the classical solutions of the system would be globally bounded. The global boundedness criteria generalize the results established by previous researchers.
Technological industry agglomeration, green innovation efficiency, and development quality of city cluster
Authors: Liu Pengzhen , Zhao Yanmin , Zhu Jianing , Yang Cunyi
Published: November 2022

Technological progress, especially green innovation, is a key factor in achieving sustainable development and promoting economic growth. In this study, based on innovation value chain theory, we employ the location entropy, super-efficiency SBM-DEA model, and the improved entropy TOPSIS method to measure the technological industry agglomeration, two-stage green innovation efficiency, and development quality index in Yangtze River Delta city cluster, respectively. We then build a spatial panel simultaneous cubic equation model, focusing on the interaction effects among the three factors. The findings indicate: (1) There are significant spatial links between the technological industry agglomeration, green innovation efficiency, and development quality in city cluster. (2) The development quality and technological industry agglomeration are mutually beneficial. In the R&D stage, green innovation efficiency, development quality, and technological industry agglomeration compete with each other, while there is a mutual promotion in the transformation stage. (3) The spatial interaction among the three factors reveals the heterogeneity of two innovation stages. The positive geographical spillover effects of technological industry agglomeration, green innovation efficiency, and development quality are all related to each other. This paper can provide a reference for the direction and path of improving the development quality of city clusters worldwide.
Depression, anxiety, stress and perceived mental healthcare need of Sri Lankan undergraduates studying in selected countries affected by COVID-19
Authors: Amarasingha A. A. D. S. , Peiris H. H. , Amarasingha A. A. B. N.
Published: November 2022

Introduction: The spread of COVID-19 pandemic has caused a considerable level of stress among the university students. The objective of this study was to determine depression, anxiety, stress and perceived mental healthcare needs of Sri Lankan undergraduates studying in countries affected by COVID-19.
Methods: A cross-sectional study was conducted with Sri Lankan undergraduates studying in Russia, India and Sri Lanka from 01st July 2020 to 31st December 2020. Snowball sampling technique was used. An online self-reported questionnaire designed based on published literature was used for data collection. Data were analysed using SPSS software version 21.
Results: A total of 187 Sri Lankan undergraduates studied in India (26.7%), Russia (39.6%) and Sri Lanka (33.7%) were enrolled. Of the total, 61.5% of participants were female. The prevalence of depression, anxiety and stress among participants were 11.58%, 11.58% and 3.16%, respectively. There was no statistically significant difference in depression, anxiety and stress among undergraduates with reference to gender, age, type of degree, marital status, status of living or studying country. The present study concludes that prevailing COVID-19 pandemic has caused considerable stress, depression and anxiety among undergraduates. However, reported depression, anxiety and stress were less compared to studies done on other Asian undergraduates.
Factors contributing to stress amongst adolescents in Colombo District, Sri Lanka: A cross sectional study
Authors: Kaththiriarachchi L. S. , Hewage D. C. , Wimalasekera S. W. , Rajan R. , Mendis A. L. S.
Published: November 2022

Introduction: In Sri Lanka, adolescents comprise 16.1% of the population. Stress during adolescence may impact maturation of emotional and cognitive capabilities. The objective of the study is to determine the psychosocial factors and other factors that contribute to stress amongst adolescents aged 14 to 16 years living in the Colombo District, Sri Lanka.
Methods: A descriptive cross-sectional study was conducted on adolescents aged 14 - 16 years (n = 331) from randomly selected schools in the Colombo District, Sri Lanka. A self-administered questionnaire was used to collect baseline socioeconomic data. Baseline anthropometric measurements of height and weight were measured and BMI was calculated. Adolescent stress was assessed by using the Adolescent Stress Questionnaire (ASQ).
Results: In the current study, 179 (54.1%) adolescents were males. The mean ages of male and female adolescents and their social characteristics were similar. There was a statistically significant increase in the mean height (p<0.001) and mean weight (p<0.001) of male adolescents when compared with female adolescents. The mean total stress scores of female and male adolescents were similar (p = 0.063). The mean score of stress of home life of female adolescents was significantly higher than male adolescents (p<0.001). The mean score of stress of school attendance was significantly higher among male adolescents than female adolescents (p = 0.012).
Conclusions & recommendations: Both male and female adolescents experience considerable stress. Measures to overcome preventable stressors should be implemented at school and at home by parents, teachers and education administrators.
Screening for obstructive sleep apnoea in overweight and obese children in Southern Sri Lanka
Authors: De Silva M. H. A. D. , Hewawasam R. P. , Chamika R. M. A.
Published: November 2022

Introduction: One of the main risk factors of obstructive sleep apnoea (OSA) is childhood obesity which account for about 60% incidence in obese children. Although polysomnography is the gold standard, it is costly and difficult to be used in children. The objective of this study was to use a prediction tool called a “Modified STOP bang tool” in the assessment of OSA in overweight and obese children in Southern Sri Lanka.
Methods: A descriptive cross-sectional study was conducted on ninety seven children (57 boys) aged 5 – 15 years with BMI >85th percentile for age and gender based on CDC 2000 growth charts recruited from the nutrition clinic at the Teaching Hospital, Karapitiya, Sri Lanka. Modified STOP bang questionnaire which assessed snoring, tiredness, observed apnea, blood pressure 95th percentile, BMI >95th percentile, academic problems, neck circumference >95th percentile for age, and male gender was considered on all study participants and a score was generated.
Results: Out of 97 children participated, 27.8% children had a higher risk of OSA and 49.5% had an intermediate risk of OSA. According to this study, significant risk factors for OSA in overweight and obese children included, being a male, BMI greater than 95th percentile for age, obesity for age and sex, circumference greater than 95th percentile for age, neck/ height ratio and waist/hip ratio.
Conclusion: In the community setting, modified STOP bang questionnaire is useful in the screening of overweight and obese children for OSA and for further follow-up.
Theme and variations in the human body; implications
Authors: Goonesinghe Satish K. , Waidyarathne Eisha I.
Published: November 2022

No abstract available
Childhood tuberculosis: Erythema nodosum as the only clinical manifestation
Authors: Sulakshi R. U. , Jayawardana P. P. , Gunathilaka G.
Published: November 2022

No abstract available
Utility of IQCODE (Informant Questionnaire on Cognitive Decline in the Elderly) in Diagnosing Dementia in Malayalam Speaking Population
Authors: Mathew Robert , Sheetal S , Sauda P , Lekha Chitra , Byju P
Published: November 2022

Background:

Among screening instruments used to diagnose dementia by interviewing the caregivers rather than the patients, Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) is widely used.

Objectives:

To adapt and validate IQCODE in a Malayalam-speaking population and to study the utility of IQCODE in diagnosing dementia.

Materials and Methods:

Cross-sectional study conducted as a two-phase survey on individuals aged ≥55 years availing dementia care services at three tertiary care hospitals and a dementia clinic in Kerala, India. In the first phase, modifications were made in the questionnaire (IQCODE) in accordance with local social and cultural practices. The questionnaire was then translated to Malayalam and back-translated to English. In the second phase, this was administered to healthy elderly subjects and close caretakers of dementia patients. These patients underwent neuropsychology evaluation consisting of mini-mental state examination (MMSE) and Addenbrooke's cognition examination-Malayalam (ACE-M), and the statistical correlation between mean IQCODE scores and ACE-M scores was assessed using ANOVA test.

Results:

A total of 396 patients with dementia were included in the study. The mean age group was 72.54 ± 7.11 years. The mean IQCODE score was 3.93 ± 0.68, and the mean ACE-M score was 39.96 ± 23.41. It has a statistically significant correlation with the total score of MMSE and ACE-M scales, confirming its utility as a good screening instrument.

Conclusion:

The IQCODE could be adapted and translated to Malayalam without making any major changes in its content and has good acceptance among this cohort of hospital-based subjects.
Streptococcus Agalactiae Meningitis Presented with Cerebral Infarction in Adult Patient – Clinical Case and Review
Authors: Tsalta-Mladenov Mihael Emilov , Dimitrova Vladina Miroslavova , Georgieva Darina K , Andonova Silva Peteva
Published: November 2022

Background:

Bacterial meningitis (BM) is an inflammation of the meninges, associated with the invasion of bacteria. The etiologic agents vary by age group. BM because of Group B streptococcus (GBS) is common for the neonatal period but considered as rare in adult patients. Acute BM can have various presentations and adverse effects, such as ischemic stroke in 10% to 29% of the cases.

Objective:

This study aimed to present a rare case of GBS meningitis presented with cerebral infarction (CI) in an adult patient and to make a brief review of the etiology and incidence of GBS infections in adults.

Case Report:

We present a case of a 62-year-old female who presented with acute onset of central lesion of the right facial nerve, mild hemiparesis on the right, and partial sensorimotor aphasia. There were no signs of meningoradicular irritation. The pupils were equal, with slow reaction to light, and unaffected eye movements. There was a central lesion of the right facial nerve and mild hemiparesis on the right. Tendon reflexes were unremarkable and Babinski's sign was negative bilaterally.

Discussion:

This review shows an increasing incidence of cases in elderly patients. A higher risk of GBS is found in adults with more medical comorbidities. CI, as a rare adverse effect in BM, is both a sign for severity and a predictor of a poor clinical outcome with a high lethal rate. GBS infections are a growing problem in older adults and those with chronic medical conditions. The involvement of the central nervous system as meningitis is a less common manifestation with a high lethal rate.

Conclusions:

CI is a rare adverse effect of neuro infections leading to an even worse clinical outcome. Early recognition of the infection and appropriate antimicrobial therapy are the crucial moments of successful management of GBS disease.
Mental and Psychosocial Health
Authors: Ray Suman
Published: November 2022

Background:

India, with a total population of 1,309,053,980, has 0.29 psychiatrists, 0.00 child psychiatrists, and 0.80 mental health nurses per 100,000 population. The mental health expenditure per person is just 4 INR as per Mental Health ATLAS 2017 (World Health Organization). The treatment gap for mental disorders still remains very high. These raise issues to our mental health status post coronavirus disease 2019 (COVID-19). Higher levels of anxiety, stress, and depression after the stay-at-home order post COVID-19 could lead to further psychological trauma besides mental health. A younger age, the female gender, and the caregiver status have a greater degree of stressfulness because of the pandemic.

Objective:

To assess the mental health status of the general population post COVID-19 in India.

Material and Methods:

An online survey was conducted using Depression Anxiety Stress Scale (DASS) 21 in the month of July, 2020.

Results:

The results of the online survey using DASS 21 conducted in the month of July, 2020, in India support the mental distress in the general population too.

Conclusions:

Systematic and regular surveys need to be conducted to allow for monitoring of the mental health impact of COVID-19 from time to time and prepare ourselves so as to prevent the second wave of mental health crises post the COVID-19 pandemic.
Pituitary Dysfunction Following Snakebite Envenomation
Authors: Roy Ayan , Suryadevara Varun , Nagarajan Krishnan , Sahoo Jayaprakash , Naik Dukhabandhu , Perumal Nandhini Lakshmana , Narayanan Niya , Merugu Chandhana , Patel Deepika , Patil Milind , Kamalanathan Sadishkumar
Published: November 2022

Background:

Snakebite envenomation (SE) is an important tropical disease in India, causing significant morbidity and mortality among patients. The hormonal deficiencies due to the involvement of the pituitary in case of SE can present in either acute or delayed setting. Hypopituitarism (HP) is often an underrecognized and relatively rarely reported complication of this neglected disease.

Methods:

We present here the data of 15 patients diagnosed to have HP following systemic SE and are being currently followed-up in the Endocrinology outpatient department of a tertiary care hospital of South India. The study was approved by the Institute ethics committee, and informed onsent was taken from all the study patients. The study was a record-based retrospective analysis of the patients with HP following SE. Clinical data including lag time in diagnosis and type of snake were determined. Further, hormonal data including all the anterior pituitary functions (thyroid stimulating hormone, free T4, cortisol, insulin-like growth factor (IGF-1) luteinizing hormone, follicular-stimulating hormone, testosterone; prolactin) and water deprivation test to determine diabetes insipidus (DI) in patients with polyuria on follow-up were extracted from the records and the hospital information system. An experienced neuroradiologist examined the magnetic resonance imaging (MRI) findings of the pituitary.

Results:

The mean age of the patients was 43 ± 9 years and 80% were male. Around 90% of patients belonged to upper–lower socioeconomic status according to the modified Kuppuswamy scale. The commonest snake species reported was Russell's viper. Thirteen patients had delayed HP. The median duration from snakebite to onset of HP symptoms was 1 year (range 0.33–10 years). However, the median time from snakebite to the diagnosis of HP was 7 years (range 1–13 years). Central hypothyroidism and hypogonadism were present in all subjects. However, central hypocortisolism was noted in 93% of patients. Low IGF-1 was noted in all the six patients where data were available. One patient had partial central DI. Thirteen out of 15 patients had reduction of pituitary volume in MRI.

Conclusion:

HP in patients with SE can appear slowly and the diagnosis is frequently delayed for years. Following snakebite, multiple pituitary hormone deficiencies associated with radiological abnormalities like a significant reduction in the pituitary volume are common.
A New Practical Method Based on MRI to Individually Localize the Transverse-Sigmoid Sinus Junction in Retrosigmoid Craniotomy
Authors: Zhao Tian-Zhi , Shi Wei , Feng Lang-Lang , Ge Shun-Nan , Yang Zi-Jian , Li Zhi-Hong , Guo Wei , Wu Ying-Xi , Zhang Yun-Ze , Xue Ya-Fei , Xue Feng , Wang Bao , Qu Yan
Published: November 2022

Background:

Although the asterion has long been used as a skeletal surface marker of the transverse-sigmoid sinuses junction (TSSJ) point in the retrosigmoid approach, abundant evidence shows that the relationship between asterion and TSSJ point varies greatly. In recent years, new technologies have been developed, such as neuronavigation and three-dimensional volume rendering imaging, that can guide in exposing the TSSJ point individually. However, they are not only expensive but also difficult to apply in emergency surgery.

Objective:

To introduce a quick, practical, and low-cost new method for locating the TSSJ point precisely.

Methods:

In this retrospective before-after study, the test group located the TSSJ point with our new method during a 6-month period, while the control group used asterion as a surface landmark to estimate the TSSJ during the preceding 6 months. The primary outcome is the immediate exposure rate of the TSSJ point by the initial burr hole.

Results:

There were 60 patients in both control and test groups as no significant difference in the general clinical characteristics of both groups were observed. The new three-step method significantly increased the TSSJ exposure rate by initial burr hole compared with the control group (96.67% vs. 53.33%,P= 0.0002). Moreover, the total bone loss and craniotomy duration were significantly reduced by the new method. Incidence of sinus injury (10% vs. 6.6%), post-operation infection (3.33% vs. 3.33%), and CSF leakage (3.33% vs. 0%) were similar.

Conclusions:

The novel three-step approach accurately locates TSSJ points in retrosigmoid craniotomy, reduces bone defects, saves time, and does not increase the risk of sinus injury, infection, and CSF leakage.
Spectrum of Neurological Manifestations of COVID-19 Data from a Tertiary Care Hospital
Authors: Dias Akshay Louis , Raghavendra BS , Ahmed Safwan , Arunachalam R
Published: November 2022

Background:

Coronavirus is a novel virus which has disrupted life in the past year. While it involves the lungs in the majority and this has been extensively studied, it involves other organ systems. More number of studies need to be focused on the extrapulmonary manifestations of the disease.

Objective:

To delineate the clinical manifestations of coronavirus disease 2019 (COVID-19) virus on the central and peripheral nervous systems and to assess the risk factors and the outcome of COVID-19 patients with neurological manifestations.

Materials and Methods:

All patients who were SARS-CoV-2 RNA polymerase chain reaction (PCR) positive were assessed, and detailed clinical history and laboratory findings were collected. Data was analyzed using percentage, mean, and frequency.

Results:

Out of 864 patients, 17 (N= 17, 1.96%) had neurological manifestations. Twelve out of 17 had comorbid conditions. Patients had diverse presentations ranging from acute cerebrovascular accident to paraplegia and encephalopathy. Ten (58.8%) patients presented with acute cerebrovascular accidents. Of the patients who developed stroke, five (50%) died.

Conclusions:

COVID-19 usually presents as a respiratory disease. The neurological manifestations of COVID-19 are not uncommon. One should be aware of a wide spectrum of neurological signs and symptoms of COVID-19 for early diagnosis and treatment for preventing mortality and morbidity.
A Prospective Study Comparing the Three-Dimensional Rotational Angiography and Two-Dimensional Digital Subtraction Angiography in Evaluation of Brain Arteriovenous Malformations
Authors: Pan Somnath , Kannath Santhosh K , Singh Gurpreet , Rajan Jayadevan E
Published: November 2022

Background:

Complex angioarchitecture of brain arteriovenous malformations (BAVM) are often difficult to evaluate with standard imaging technique of digital subtraction angiography (DSA). These details are better provided by 3D rotational angiography (3D-RA).

Objective:

The aim of the study is to compare two-dimensional digital subtraction angiography (2D-DSA) and 3D rotational angiography in the evaluation of BAVM angiographic architecture.

Materials and Methods:

2D-DSA and 3D-RA of 167 consecutive patients with BAVM were analyzed for arterial feeders, nidal patterns, and detection of flow-related aneurysms, arteriovenous fistulous components, venous drainage, and draining vein stenosis.

Results:

3D-RA detected a significantly higher number of aneurysms and draining venous stenoses (P< 0.001). The detected number of true intranidal aneurysms was significantly higher with 3D-RA (n= 94) vs 2D-DSA (n= 34) (P< 0.001). 2D-DSA has low sensitivity (43.1%) and specificity (73.4%) for detecting intranidal aneurysms. 3D-RA detected a significantly higher number (12.6%) of BAVM patients with feeding artery aneurysms as compared to 2D-DSA (8.4%),Pvalue of 0.004. 3D-RA accurately depicted the distal course of dominant arterial feeders and fistulous sites in BAVMs. Direct arteriovenous communications were evident in 31.1% with 3D-RA, as compared to 2D-DSA (15%) withPvalue < 0.0001. A significantly higher number of draining vein stenosis was detected with 3D-RA (21.6%) as compared to 2D-DSA (13.2%),Pvalue < 0.001.

Conclusion:

3D-RA is better than 2D-DSA for detecting BAVM-associated flow-related aneurysms, distal course of the dominant arterial feeders, direct visualization of the fistulous components, deep venous drainage, and draining venous stenosis; findings imperative for making a prudent therapeutic decision.
Meningeal Melanocytoma- A Clinicohistological Masquerader
Authors: Chhabra Raaja , Misra Shagun , Prasad Pallavi , Khati Shikha
Published: November 2022

Meningeal melanocytoma is a rare benign tumor, most frequently located in the posterior fossa and spinal canal. Localized tumors present as leptomeningeal masses and range from well-differentiated melanocytomas to lesions of intermediate malignancy and overtly malignant melanomas. Spinal meningeal melanocytoma has a benign course and is amenable for gross total resection. The outcome is favorable following complete resection. Meningeal melanocytoma may occasionally be associated with histological benign leptomeningeal spread and aggressive clinical course in spite of the absence of malignant transformation. We report a case of intraspinal melanocytoma in a 57-year-old female, which clinically as well as radiologically mimicked other spinal lesions. The final diagnosis was confirmed on histopathology.
Orbital Chordoid Meningioma
Authors: Jadhav Nithin Kumar , Alugol Rajesh , Mudumba Vijayasaradhi , Uppin Megha
Published: November 2022

Chordoid meningioma, classified as WHO grade II, are rare tumors comprising only 0.5% of all meningiomas. Chordoid meningioma is an aggressive tumor with high local recurrence. Orbital chordoid meningioma is a much rare entity with very few cases reported in the literature. We report a case of a 77-year-old male who presented with a painless progressive swelling over the right lateral orbital wall.
Acute Isolated External Ophthalmoplegia
Authors: Badal Sachendra , Jauhari Prashant , Singh Sonali , Kamilla Gautam , Chakrabarty Biswaroop , Gulati Sheffali
Published: November 2022

Acute-onset ophthalmoplegia is a perplexing diagnosis in a young child. When the full-blown picture of ophthalmoplegia, ataxia, and areflexia is evident, the diagnosis of Miller–Fisher syndrome (MFS), a variant of Guillain–Barre syndrome (GBS), is almost certain. However, the same is not true for isolated external ophthalmoplegia as it is etiologically heterogeneous. Only anecdotal case reports of childhood-onset acute ophthalmoplegia exist in the literature. Adult series suggest that acute onset external ophthalmoplegia is often immune-mediated and is secondary to anti-GQ1b antibodies. We present a 30-month-old boy with acute-onset bilateral external ophthalmoplegia with highly elevated serum anti-GQ1b antibodies. The child had a rapid and complete recovery with intravenous immunoglobulin. A review of all published cases of childhood anti-GQ1b antibody syndrome was performed. The case highlights that anti-GQ1b antibody syndrome should be considered even in young children with acute-onset external ophthalmoplegia. The disease has a favorable prognosis. The majority improve on conservative management. Treatment with steroids or IVIG may be considered in some after weighing the risks and benefits.
Association of HLA Alleles with Antiepileptic Drug-Induced Mild Cutaneous Reactions
Authors: Zhang Wuqiong , Ye Xiaojuan , Meng Hongmei
Published: November 2022

Background:

Human leukocyte antigen (HLA) is associated with drug-induced cutaneous adverse reactions, including antiepileptic drugs (AEDs). HLA gene polymorphism has a regional discrepancy, and it is therefore important to study it in different populations.

Objective:

To investigate the role of HLA in AED-induced mild cutaneous adverse drug reactions (cADRs) in a Northeast Han Chinese population.

Methods:

A case-control study was performed in the First Hospital of Jilin University between August 2016 and March 2017. In total, 26 patients with mild cADRs induced by AEDs and 23 AED-tolerant control patients were included. Sequence-based typing (SBT) was used to detect HLA-A and HLA-B genotypes. Differences in genotype frequencies between groups were assessed using Fisher's exact test.

Results:

In the mild cADRs group, 22 patients (84.6%) presented with maculopapular exanthema (MPE) and four patients (15.4%) presented with an isolated itch. The median duration between the AED exposure and cADRs was 7.5 days (IQR, 3 − 14 days). We failed to find statistically significant differences in HLA alleles between the cADRs group and the control group when considering all the drugs included in our study together or when considering oxcarbazepine (OXC), carbamazepine (CBZ), and levetiracetam (LEV) alone (P > 0.05).

Conclusions:

Our findings indicated that there was no correlation between HLA alleles and AED-induced mild cADRs in the Northeast Han Chinese population.
F-18 PSMA Uptake in Male Breast Cancer During Restaging Evaluation of Carcinoma Prostate
Authors: Zade Anand , Shetty Shishir , Ambekar Asawari , Karpe Makarand
Published: November 2022

Fluorine-18 prostate-specific membrane antigen (PSMA) positron emission tomography-computed tomography scan is widely used for restaging of prostate cancer. We present a case where false-positive PSMA uptake was seen in metachronous carcinoma breast during restaging workup of carcinoma prostate.
Fluorodeoxyglucose Positron Emission Tomography-Computerized Tomography Scan in LGI A1-Positive Limbic Encephalitis and Concordance with MRI in a Known Case of Carcinoma Breast
Authors: Rathore Hemant , Rajnath Jaiswar
Published: November 2022

The limbic encephalitis is an autoimmune disorder which characterized by inflammation of the brain with rapidly progressing dementia either due to paraneoplastic or nonparaneoplastic etiology which requires definitive neurological and whole-body evaluation. We describe both clinical and nuclear medicine imaging and radiological findings in a case of limbic encephalitis using positron emission tomography and magnetic resonance imaging.
Ga-68 Chemokine Receptor-4 PET/CT Imaging in Schminke Type of Nasopharyngeal Carcinoma
Authors: Ramachandran Arivan , Krishnaraju Venkata Subramanian , Kumar Rajender , Shukla Jaya , Laroya Ishita
Published: November 2022

Nasopharyngeal carcinoma is a rare malignancy of the head-and-neck region. It is associated with Epstein–Barr virus infection and smoking. Its association with breast cancer is also infrequent. Chemokine receptor (CXCR)-4 imaging is a newer agent for imaging many malignancies with a good diagnostic value. We present a case of a young female diagnosed with left breast carcinoma in whom Ga-68 CXCR-4 PET/CT demonstrated tracer avid lesion in the nasopharynx. Biopsy of the nasopharyngeal lesion revealed Schminke type of lymphoepithelial cancer, indicating CXCR-4 PET/CT as a potential imaging modality for lymphoepithelial malignancy.