bluuebunny/crossref_metadata_2025 huggingface dataset:
Innovative Assistance System for Setting up a Mechatronic Straightening Machine
Authors: Bathelt Lukas , Bader Fabian , Djakow Eugen , Henke Christian , Trächtler Ansgar , Homberg Werner
Published: July 2022

High-strength wire materials are usually available as strip material which is further processed in a forming process (e.g. punch-bending). For storage and transport of the semi-finished wire to the customer, the material is wound onto coils. The manufacturing and coiling process introduces plastic deformations into the wire, which lead to undesirable residual stresses and wire curvature of the semi-finished product. These residual stresses and curvatures cause variations in the material properties of the semi-finished product, which have a negative impact on the subsequent product quality. Straightening machines are used to compensate the residual stresses and the curvature in the wire. At the beginning of the straightening process, the straightening machines must be set up in such a way that residual stresses and curvatures are optimally compensated. This setup process is usually a manual and iterative process, where a lot of material is wasted until the optimal settings for the straightening machine are found.In order to reduce the amount of material waste, the operator must be supported in the setup process. In this context, a new and innovative setup assistance system was developed to support the operator during the setup process. The setup assistant system automatically detects the wire curvature by means of an optical measuring system. Based on the optically detected measuring points, the wire curvature is determined by a robust calculation algorithm. Based on a database built up through the carried out experimental and numerical research work, the optimum setting parameters for the straightening machine are suggested to the operator without lengthy trial and error. After confirmation by the operator, the roller settings are automatically adjusted by the mechatronic straightening machine. With the presented method, the conventional iterative setup procedure can be made more resource-efficient and a high straightening quality can be reproducibly achieved.
Evaluation of Cold Roll Forming Strategies for the Production of a High-Strength Aluminum Hat Profile
Authors: Suckow Timon , Groche Peter
Published: July 2022

High-strength aluminum alloys, such as the AA7075 alloy, offer great potential for lightweight construction thanks to their high specific strength. However, high strength and low ductility are a challenge for processing these materials. In our study, three different process routes (T6, W-Temper, O) for roll forming of a hat profile are investigated experimentally and in an FE-simulation. Since the targeted production of the hat profile is hindered due to material failure in T6-condition, inline induction heating and subsequent water spray quenching is used to bring the material to the W-Temper state before roll forming. As a third option, a pre heat treatment is applied to a soft annealed (O) material state. The experimental results show fundamental differences of the forming processes, depending on the tempering condition. The FE-simulation involves the roll forming process for the production of a hat profile and shows a high agreement with the experiments. Finally, the experimental results demonstrate how inline solution annealing by induction heating for the W-Temper process affects the properties and the quality of the profiles produced.
Laser Powder Bed Fusion of Aluminium Alloy 6061 for Ultra-High Vacuum Applications
Authors: McCann Ronan , Hughes Cian , Brabazon Dermot
Published: July 2022

As additive techniques such as laser powder bed fusion find increasing adoption industry, the ability to adapt these processes to industrially relevant materials is paramount. This adaptation can represent a significant challenge when working with wrought alloy feedstocks, which often result in brittle or porous parts lacking the mechanical properties of their conventionally wrought counterparts. One such alloy, aluminium 6061, is a highly used alloy in the aerospace, automotive, and semiconductor manufacturing industries. The conventionally manufactured components can have complex morphologies and may be assemblies of multiple individual components. As such, the ability to use an additive approach, and produce these as single parts can lead to significant benefits.In this work, we examine laser powder bed fusion of aluminium alloy 6061. The effects of process parameters such as laser power, beam scan speed, hatching distance, spot size was examined with a view towards developing an optimised process for this traditionally wrought alloy. Parts were examined for porosity and microstructure, with an aim to develop greater than 95% relative densities. To aid in process optimisation, in-situ pyrometry was deployed to understand the effects of the process parameters and develop a robust and repeatable process for producing 6061 components.
Ingested (Oral) Adrenocorticotropic Hormone Inhibits IL-17 in the Central Nervous System in the Mouse Model of Multiple Sclerosis and Experimental Autoimmune Encephalomyelitis
Authors: Dittel Landon J , Dittel Bonnie N , Brod Staley A
Published: July 2022

Experimental autoimmune encephalomyelitis (EAE) is an inflammatory autoimmune disease of the CNS that resembles multiple sclerosis and provides a useful animal model for the evaluation of mechanisms of action for potential immunomodulatory therapies. We have previously shown that oral adrenocorticotropic hormone (ACTH) decreased IL-17 in the gut lamina propria and the spleen and increased CD4+ Foxp3+ T regulatory cells and IL-10 in the spleen during EAE in the C57BL/6 mouse. However, we did not investigate the specific cellular alterations of proinflammatory and anti-inflammatory factors in the CNS. The aim was to determine if oral ACTH would have a similar clinical effect on inflammatory cytokines in the gut and define specific cellular effects in the CNS in an alternative strain of mice. SJL/J mice were immunized with proteolipid protein peptide 138–151 and gavaged with scrambled ACTH (scrambled α-melanocyte-stimulating hormone) or ACTH 1–39 during ongoing disease. Ingested (oral) ACTH attenuated ongoing clinical EAE disease, decreased IL-6 production, and increased T regulatory cells in the lamina propria and decreased CD4+ and γδ IL-17 production in the CNS. Ingested ACTH attenuated EAE clinical disease by decreasing IL-6 in the gut-associated lymphoid tissue and decreasing IL-17 in the CNS.
Mechanism of Wuweijiangyasan in the Treatment of Spontaneous Hypertension based on Network Pharmacology
Authors: Chen Ai-Ping , Zhang Zi-Juan , Li Jing-Zhong , Zuo Ling , Cheng Ya-Xing , Deng Dong , Li Xue-Li , Ma Xiao-Yun , Man Da , Zheng Ming-Huang , Chen Jian , Wen Bo , Wang Juan , Zhou Jian-Guo , Zhao Hui-Hui
Published: July 2022

Background:

Hypertension affects over 1 billion people globally and is the top risk factor of cardiovascular morbidity and mortality. Wuweijiangyasan (WWJYS), as an empirical prescription, has stable depressurization effects. This study investigated the chemical composition and pharmacodynamic effects of WWJYS in regulating the blood pressure (BP), emotion, and blood lipid of spontaneous hypertensive rats, and further explored the depressurization mechanism of WWJYS.

Materials and Methods:

This study used network pharmacology to identify the origins and predict targets of WWJYS, and artificial intelligence-based molecular docking is used to further predict targets and mechanisms. The chemical constituents of WWJYS were analyzed and identified by ultra high-performance liquid chromatography–mass spectrometry (MS)/MS.

Results:

In the WWJYS group, the systolic BP level significantly was decreased, and the HR was stable. The irritability became stable after the 5-week treatment compared with the model group (P < 0.05). Rats' rotation tolerance time increased after 2-weeks stabilization. Compared with the model group, angiotensin-converting enzyme 2 protein and mRNA of the WWJYS group increased significantly (P < 0.05). Network pharmacology collected 64 compounds and identified 22 potential targets of WWJYS for antihypertensive activity. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis showed that WWJYS might regulate smooth muscle cells, affect inflammatory response and improve endothelial function through multiple pathways. The molecular docking study further supported that the target proteins have good combinations with the main active components of WWJYS.

Conclusions:

The data indicated that WWJYS had significant depressurization, analgesic, and sedative, as well as lipid-lowering effects, and the depressurization mechanism of WWJYS may function in multiple signal pathways, especially in improving blood vessel function and intervening inflammation.
Study of vitamin D3 level in Egyptian hemodialysis patients and the effect of replacement therapy
Authors: Sabry Alaa A.A. , Elazazy Mohamed , El Wahab Ahmed Abd
Published: July 2022

Background

The ability of extrarenal tissues to convert 25-hydroxyvitamin D into 1,25-hydroxyvitamin D and its dependence on substrate levels provide the rationale for supplementing vitamin D in dialysis patients who usually have severe depletion of both calcitriol and vitamin D. The primary aim of the study was to detect serum vitamin D3 levels in a cohort of Egyptian hemodialysis patients and to check the effect of 12-week therapy of cholecalciferol on serum calcium, phosphate, and parathyroid hormone (PTH) in vitamin D-naïve hemodialysis patients with vitamin D deficiency.

Patients and methods

A total of 40 patients (25 males and 15 females) with chronic kidney disease on regular hemodialysis, attending the Nephrology Unit of internal Medicine Department, Mansoura University Hospital, during the period from January to June 2017, were included. According to laboratory investigations and clinical examination, deficient patients were treated with Devarol-S (cholecalciferol) for 3 months and then revaluated. Deficient patients received intramuscular injection of 50 000 IU monthly for 3 consecutive months.

Results

The patient group included 40 persons, comprising 27 (73%) male patients and 13 (27%) female patients. Their mean age was 47.16 ± 14.92 years. The mean dialysis duration was 4.68 ± 2.42 years. At 3 months after vitamin D replacement, significant increase in serum calcium (8.33–8.89 mg/dl), phosphorous (4.99–5.85 mg/dl), and vitamin D3 (4.01–28.43 ng/ml) levels were observed compared with pretreatment levels. There was also significant decrease in PTH level (419.30–377.20 pg/ml). After 3 months of follow-up, there were no significant changes in the levels of hemoglobin, Kt/v, albumin, and alkaline phosphatase in the study group.

Conclusions

In most patients, treatment with cholecalciferol in a 50 000 IU/month dose permits safe correction of vitamin D deficiency and control of PTH level, yet serum phosphorus should be monitored.
Vascular access thrombosis among end-stage renal disease patients with acute COVID19 infection (a retrospective cohort study)
Authors: Elmahdi Ahmed M. , Gawish Rasha I. , Shalaan Wael E. , Eldin Marwa Gamal , Gamal Nahla A. , Mabrouk Moustafa H.
Published: July 2022

Background

According to studies, coronavirus disease 2019 (COVID19) infection is linked to an elevated risk of venous thromboembolism (TE). The frequencies of overall COVID19 thrombotic events and the influence of TE on COVID19 mortality, however, are unknown. Although respiratory symptoms are the most common symptom of the disease, evidence is growing suggesting that it is linked to coagulation system malfunction, which puts patients at risk for venous and arterial TE and higher mortality as well.

Materials and methods

A retrospective cohort study was conducted on 50 end-stage renal disease patients on maintenance hemodialysis (25 patients with confirmed COVID19 infection and 25 patients without COVID19 infection) to determine the incidence of vascular access thrombosis among patients with COVID19 during a 3-month period. Risk factors for mortality and severity were considered as secondary outcomes. Patients with previous history of vascular access dysfunction were excluded from the study.

Results

In all, 24% of COVID19-positive patients (n=6) developed vascular access thrombosis during 3 months of follow-up while no one of the COVID19-negative patient developed access thrombosis. The incidence of vascular access thrombosis was statistically higher in the COVID19 positive group (p value < 0.022). The incidence of vascular access thrombosis was significantly can u please add this part : increased in patients who had lymphopenia, elevated LDH, also it was more common in patients who needed mechanical ventilation and who had severe disease

Conclusion

The incidence of vascular access thrombosis was statistically higher in the COVID19 positive group (p value < 0.022). The incidence of vascular access thrombosis was significantly can u please add this part: increased in patients who had lymphopenia, elevated LDH, also it was more common in patients who needed mechanical ventilation and who had severe disease.
Safety and efficacy of low-dose glucocorticoid regimen in the induction phase treatment of class 4, 5 lupus nephritis
Authors: Vakrani Girish P. , Tanuja Nambakam , Saba Sania
Published: July 2022

Background

Renal involvement in systemic lupus erythematosus is known as lupus nephritis (LN). LN presents with varied renal features. Class 4 and 5 LN are traditionally treated with prolonged standard high doses of prednisolone with various immunosuppressants such as cyclophosphamide and mycophenolate. These high doses of prednisolone are associated with numerous side effects. There is deficient data on the dose, duration of glucocorticoid therapy, and also paucity of data on comparison between the standard dose versus low-dose glucocorticoid therapy. Hence, this study can help in evaluating the use of low-dose glucocorticoids, its impact on renal outcome, and looking at side effects.

Materials and methods

It was a retrospective observational study conducted to look at the safety and efficacy of low-dose glucocorticoid regimen in induction phase treatment of class 4, 5 LN.

Results

On treatment, it was found that the resolution of microscopic hematuria, and improvement of low C4, and hypoalbuminemia were statistically significant in the low-dose steroid group. The resolution of proteinuria was seen in both groups and the resolution of renal failure was noted in both groups but was statistically significant in the standard dose group. Increased incidence of steroid-related complications was seen in the standard dose steroid group.

Conclusions

These findings possibly indicate that low-dose steroid therapy is good enough to treat LN with proteinuria, but a standard dose steroid is required in the presence of renal failure in LN, though increased incidence of steroid-related complications was seen in the standard dose steroid group.
Expert Consensus on Triple Combination of Glimepiride, Metformin, and Voglibose Usage in Patients with Type 2 Diabetes Mellitus in Indian Settings
Authors: Das Ashok K. , Wangnoo Subhash K. , Chawla Rajeev , Shaikh Altamash , Bantwal Ganapathi , Kalra Pramila , Jaggi Shalini , Abhyankar Mahesh V. , Prasad Ashish , Sarda Prashant
Published: July 2022

Background:

Type 2 diabetes mellitus (T2DM) is a progressive disease affecting a huge chunk of the population globally.

Aim:

This study aimed to address the existing gaps in knowledge about the triple-drug combination and to provide guidance to the clinicians on the triple-drug combination in Indian settings.

Materials and Methods:

Doctors’ opinions (n = 2262) were recorded based on surveys and round table meetings. The National Expert Group approved a standard questionnaire that included 13 questions pertaining to T2DM management using a triple combination of glimepiride, metformin, and voglibose, which were prepared, discussed, and evaluated by the experts. After due discussions, the expert group analyzed the result and further recommendations were made and a consensus statement was derived.

Results:

Out of 2262, 1498 were consulting physicians, 358 were diabetologists, 93 were endocrinologists, 104 were cardiologists, and 209 were family physicians with focus on diabetes practice or had more than 10 years of experience from different regions from India. A strong consensus was observed for targeting postprandial hyperglycemia in the management of T2DM, which may reduce cardiovascular (CV) disease risk. The experts opined that meal pattern was the major factor affecting glycemic variability. The experts recommended early use of triple combination as it improves glycemic control (early aggressive control, beyond three oral drugs are on no benefit, ingrained). More than 90.0% of clinicians believed that this combination is cost-effective. Most agreed (32.0%) that this combination moderately reduces body weight. Additionally, it was felt that triple combination in patients with T2DM is also beneficial during Ramadan.

Conclusion:

In the present expert opinion-based consensus, most of the healthcare providers believed that triple-drug combination can potentially improve glycemic control and can delay/postpone the microvascular and CV complications. However, more multicentric studies are needed to support these recommendations.
A Case of Regression of Insulin Lipohypertrophy with Correct Injection Technique
Authors: Sharma Dewark
Published: July 2022

Lipohypertrophy of the injection site is a common and often-neglected complication of treatment with insulin. It causes unpredictable absorption of the drug, leading to higher glycemic variability. Using the correct injection technique, the lesion may be reversed. Here, we present the case of a patient with type 1 diabetes, whose lipohypertrophy regressed over time. Along with this, the patient also attained better glycemic control and freedom from diabetic ketoacidosis.
The Reversal Model for Metabolic Syndrome (RMMS) Study
Authors: Ghosh Subhajyoti , Saboo Banshi
Published: July 2022

Background:

Recently, attention is paid on strategies and policies to halt or reverse the forecast type 2 diabetes mellitus (T2DM) epidemic across the globe and in India. Metabolic syndrome (MetS) predisposed us to T2DM along with cardiovascular disease (CVD). Our study aims to develop a reversal model for people with MetS through an education program under observation. This paper will describe the design of the reversal model for metabolic syndrome (RMMS) study along with intervention strategies.

Materials and Methods:

The RMMS study is a multi-center, parallel arm, quasi-experimental study. The study will be done in western (viz., Ahmedabad) and eastern (viz., Guwahati and Dibrugarh) parts compromising 707 patients from each part. The intervention arm will be part of the “observation cum self-management education program” for a period of 6 months. The non-intervention arm will be followed up to 6 months with routine care. The analysis for the outcome will be done at the end of 6 months. The primary outcome measures will be the reversal of MetS or the components of MetS. The piloting of the study has been done after the ethical clearance, and necessary changes are also done in a proforma.

Conclusion:

The RMMS is first of its kind among Indian population to study the effectiveness of the reversal model. The results will provide insights into changes in the prevalence of the components of MetS and hence can be used as primary prevention strategies for T2DM and CVD.
The role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in oral squamous cell carcinoma
Authors: Verma Simran Naresh , Das Deepa Achath
Published: July 2022

Objective:

The aim of this study was to systematically review the literature to assess the role of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in oral squamous cell carcinoma (OSCC).

Materials and Methods:

The literature was searched using MEDLINE and ScienceDirect databases. Studies comparing fusion imaging PET/CT with other imaging modalities in the staging, identifying secondary metastasis, treatment response assessment, and follow-up of OSCC, were deemed eligible.

Results:

Six studies met the inclusion criteria. The average mean was found to be 85.47%, 78.80%, 78.50%, and 89.22% for sensitivity, specificity, positive predictive value (PPV), and negative predictive value, respectively. The risk of bias graph shows that there was 50% low risk of bias in selection of patients, more than 25% low risk of bias in conduct/interpretation of the index test, and > 25% risk of bias in reference standard. 18F-FDG PET/CT is a good prognostic factor for overall and progression-free survival.

Conclusion:

FDG PET/CT has a good diagnostic accuracy for identifying metastatic nodes, especially subcentimeter metastatic nodes that appear morphologically normal on CT images. PET/CT is promising in the diagnosis and evaluation of distant metastases and for identifying unknown and second primary malignancies.

Advances in Knowledge:

Fusion imaging is gaining importance with its ability to identify tumor as small as 0.5 mm and provide early diagnosis, thereby increasing quality of life of patients. PET/CT provides valuable information for therapeutic planning, therapeutic assessment, follow-up, and surveillance in the care of patients with OSCC.
Diagnostic accuracy of ultrasonography verified with computed tomography for the diagnosis of maxillofacial fractures – A prospective study
Authors: Shah Abhishek Shailesh , Kale Tejraj , Hattiholi Virupaxi , Dhabaria Husain
Published: July 2022

Objectives:

The objective of this study was to evaluate the diagnostic accuracy of ultrasonography (USG) if it can be used as a primary diagnostic method for maxillofacial trauma and to determine the sensitivity and specificity of USG verified with a computed tomography (CT) scan.

Materials and Methods:

This study was a comparative prospective study that consisted of a total of 32 patients. Patients reported to the Trauma Care and Emergency Center of KLES Dr. Prabhakar Kore Hospital with maxillofacial trauma during October 2018–September 2020 were included in the study. Following a CT scan, based on the inclusion criterion, the patient underwent an ultrasonographic examination of any maxillofacial fracture that had been confirmed by a CT scan to verify it. Sensitivity and specificity were calculated to establish the accuracy of USG.

Results:

A total of14 sites were selected in the maxillofacial region. Out of all the 14 anatomical landmarks, nine were able to detect all the fractures on USG with 100% sensitivity and specificity. Intracapsular condyle fractures were not seen on USG. The region where all the fractures were not identified on USG was medial wall and floor of the orbit, one nondisplaced ramus fracture.

Conclusions:

The overall sensitivity observed for the diagnosis of maxillofacial fracture was 85.21% and specificity observed was 100%. In conclusion, USG can be a handy, diagnostic, additional, noninvasive, and inexpensive tool in the detection of maxillofacial fractures when compared to CT in the primary health-care center. Furthermore, studies should be conducted with a considerable amount of sample size as the literature mentions limited work regarding USG as a primary technique in maxillofacial fractures detection.
Examination for the factors contribute to joint effusion in patients with internal derangement on temporomandibular joint disorder
Authors: Mizuhashi Fumi , Ogura Ichiro , Watarai Yuko , Suzuki Tatsuhiro , Mizuhashi Ryo , Oohashi Makoto , Saegusa Hisato
Published: July 2022

Background/Aim:

The aim of this study was to investigate the factors contribute to the joint effusion in the patients with internal derangement on temporomandibular joint (TMJ) disorder.

Methods:

We reviewed the 83 TMJs that were diagnosed as internal derangement (anterior disc displacement with or without reduction) by magnetic resonance imaging. Joint effusion was diagnosed using T2-weighted images. The differences in the presence of joint effusion according to the gender, age, diagnosis, and TMJ pain were analyzed using cross-tabulation or Mann–Whitney test. The relationship between joint effusion and gender, age, diagnosis, and TMJ pain was analyzed by logistic multivariate regression analysis.

Results:

The presence of joint effusion was larger on anterior disc displacement without reduction (χ2[1] = 7.47,P= 0.006) and the TMJ with pain (χ2[1] = 7.50,P= 0.006). The results of logistic multivariate regression analyses indicated that the diagnosis of anterior disc displacement without reduction was signiﬁcant in TMJ with joint effusion (odds ratio = 3.299,P= 0.036) and the TMJ with pain was also signiﬁcant in TMJ with joint effusion (odds ratio = 4.413,P= 0.007). The gender and age showed no relationships with joint effusion.

Conclusions:

The results of this study made it clear that joint effusion was easier to occur in the TMJ of anterior disc displacement without reduction and in the TMJ with pain. Anterior disc displacement without reduction and TMJ pain would be related to the higher risk of joint effusion.
Alveolar bone density based on image density of intraoral radiography using artificial intelligence software
Authors: Kobayashi Eizaburo , Minami Yoshiyuki , Ogawa Ruri , Tezuka Yasuhito , Ogura Ichiro
Published: July 2022

Background:

In recent years, an artificial intelligence (AI) software “DentalSCOPE” for alveolar bone density based on image density of intraoral radiography was developed.

Aims:

The purpose of this study was to evaluate the alveolar bone density of osteoporosis patients with antiresorptive medications administration before tooth extraction using DentalSCOPE.

Materials and Methods:

Five osteoporosis patients with antiresorptive medications administration before tooth extraction were analyzed using a computer program “DentalSCOPE” for alveolar bone density based on image density of intraoral radiography. The alveolar bone density around extraction tooth was compared to lytic and sclerotic bone reaction with the opposite side as normal region. Statistical analyses of alveolar bone density were performed with Wilcoxon rank-sum test. P < 0.05 was considered statistically significant.

Results:

The alveolar bone density of the opposite side as normal region (972.9 ± 74.3 mg/cm2) was significantly higher than those of lytic bone reaction (633.9 ± 114.2 mg/cm2, P = 0.043) and lower than those of sclerotic bone reaction (1144.0 ± 99.4 mg/cm2, P = 0.043).

Conclusions:

This study evaluated the alveolar bone density of osteoporosis patients with antiresorptive medications administration before tooth extraction using DentalSCOPE and indicated that the computer program could be useful for the evaluation of osteoporosis patients.
A microbiologist managing COVID-19 patients
Authors: Gupta Neha , Gur Renu , Makhijani Shrishti
Published: July 2022

In April 2021, amidst rising COVID-19 cases in Delhi with negativity all around, we all faced challenges. However, a microbiologist working on the forefront as a clinician with COVID-19 patients was scary as well, more so for patients. Starting a banquet hall as COVID care facility was full of hurdles which were gradually overcome with each other's cooperation and support. Variety of experiences during that duty made me a better version of myself both as a person and as a doctor.
Surveillance of device-associated infections at a tertiary care hospital of Punjab
Authors: Gupta Veenu , Sharma Sarit , Chaudhary Ashwani , Chaudhary Jyoti , Gautam P. L.
Published: July 2022

Background:

Surveillance of health-care-associated infections (HAIs) plays a key role in the hospital infection control programme and reduction of HAIs. Device-associated infections (DAIs) are an important cause of excessive stay and mortality. The prevalence of HAIs is underreported from developing nations due to a lack of systematic surveillance.

Aims and Objectives:

The aim of the study was to know the rate and microbiological profile of DAIs.

Materials and Methods:

This surveillance study was conducted over a period of 2 years. Patients with indwelling devices were included. The data were collected and analysed by infection control team and labelled DAIs as per the CDC guidelines. The rates of HAIs and the profile of pathogens isolated were analysed.

Results:

A total of 294 patients developed DAIs, of which 181 were male and 113 were female. A total of 239 device-associated infections were reported in 2019 and 55 in 2020 and overall rate of DAIs was 1.81 and 0.58/1000 device days, respectively. Among DAIs, 50 were ventilator-associated pneumonia (VAP), 71 central line-associated bloodstream infections (CLABSI) and 173 catheter-associated urinary tract infection (CAUTI) cases. Overall, the rate was 2.02,1.21,1.21/1000 device days for VAP, CLABSI and CAUTI, respectively. In DAI's, majority were males and maximum cases developed after 6–10 days, 15 days and 11–15 days of device use in VAP/CAUTI and CLABSI, respectively. Gram-negative isolates (85.1%) were predominant, and among these, most common were Klebsiella spp, Acinetobacter spp and Escherichia coli. A high rate of multidrug resistance was observed.

Conclusions:

The present surveillance shows high resistance pattern of Gram-negative organisms causing DAIs. To reduce the risk of infection in hospitalised patients, DA-HAI surveillance is of primary importance as it helps in implementing preventive measures.
Outbreak investigation of Elizabethkingia meningoseptica at a tertiary care hospital
Authors: Kottapalli Pragathi , Deepika Chintha , Jyothi S. , Mol Rincy , Sadhana Y. V. , Chander Reddy P. Naveen
Published: July 2022

Aim and Objective of the Study:

The aim and objective of this study were to do a prospective study on patients with Elizabethkingia meningoseptica infection at AIG Hospitals and to identify the possible source of E. meningoseptica in our hospital.

Materials and Methods:

Outbreak of infection with E. meningoseptica was identified in intensive care units (ICUs) in February 2021. A prospective study was taken up and environmental surveillance swab cultures were collected along with clinical data from case sheets using a pro forma to identify the possible risk factors associated with E. meningoseptica infection. Interventional strategies were planned by infection control team along with hospital administration.

Results:

A total of 10 E. meningoseptica bacteraemia and pneumonia cases were documented between March 2021 and May 2021. It was more common among patients with COVID-19, with prolonged ICU stay, and on multiple antibiotics and was associated with poor outcomes. Surveillance swab cultures collected from various sources showed growth of E. meningoseptica in the tap water of some ICUs.

Conclusion:

Considering that E. meningoseptica are usually resistant to multiple antibiotics and that inappropriate antimicrobial therapy is an independent risk factor for mortality, early diagnosis and adequate antibiotic treatment are vital for patients with E. meningoseptica infection.
Prevalence of Hepatitis A in and around the Aligarh region
Authors: Kumari Arti , Raza Adil , Khan Haris Manzoor , Sami Hiba
Published: July 2022

Background:

Hepatitis A virus (HAV) most commonly affects children, is transmitted by faecal–oral route and is prevalent worldwide. It is usually present in the highest concentration in the stool of the infected individuals, with the greatest viral load occurring near the end of the incubation period.

Aim:

The aim of the present study was to study the prevalence of hepatitis A in and around the Aligarh region.

Methodology:

A total of 524 samples were collected from all age groups, who were suspected of having viral hepatitis. The serum was separated and processed for performing the enzyme-linked immunosorbent assay (DIA. PRO, Italy).

Results:

Out of 524 samples tested, 229 (43.7%) were positive for anti-HAV immunoglobulin M, most of which (82.53%) were from the 10 years' age group.

Conclusions:

The predominance of hepatitis A was found in under 10-year-old children, with mast case occurrences between June and September.
Quackery as a Cause of Maxillofacial Infections and its Implications
Authors: BI Akhiwu , HO Akhiwu , TO Mudashiru , B Ijehon , AA Aderemi , LZ Bwala , E Ambrose , MI Sani , AM Dauda , EU Okafor , E Chimbueze , AL Ladeinde
Published: July 2022

Background:

In recent times, the prevalence of quackery in oral and maxillofacial practice has become rampant with complications, one of which is odontogenic infections. This study was aimed to identify how common quackery is among our patients with odontogenic infections and the outcome of the patients.

Materials and Methods:

The study was a descriptive cross-sectional study of all patients presenting with odontogenic infections seen at the accident and emergency unit and the oral and maxillofacial surgery clinics of a tertiary hospital in North Central Nigeria from January 2017 to December 2021. Information obtained included sociodemographic characteristics, presenting complaints, duration of illness, prehospital care, diagnosis, duration of hospital stay, where the patient was first managed, what is the “doctor/dentist” status, and outcome.

Results:

A total of 237 patients were recruited with a male to female ratio of 1:1.3. The commonest presenting complaints were toothache and jaw swelling with patients been ill for up to 2 weeks before presenting. About 41.8% of the patients have a co-existing health condition, and 46.4% of the patients had tooth extraction by a quack, with 82.7% taking antibiotics prescribed by a chemist before presentation. About 11.0% of the patients died; 96.2% of those that died had their tooth extracted by quacks. Patients with preexisting health conditions and preadmission tooth extraction were more likely to die with odds ratio (OR) = 2.230; 95% confidence interval (CI) = 1.06–4.71 and OR = 28.9; 95% CI = 3.97–209.6, respectively.

Conclusion:

Quackery is very common in our society. The odds of death are increased in patients with odontogenic infection if the patient has a preexisting health condition and even more significant if they had their tooth extracted by quacks.
Retinopathy of Prematurity in the University of Calabar Teaching Hospital, Calabar, Nigeria
Authors: Nkanga Elizabeth D. , Agweye Chineze Thelma , Etim Bassey Archibong , Ochigbo Sunny Oteikwu , Udoh Martha-Mary Ekong , Nkanga Dennis George , Udoh Jacob Jackson , Asam-Utiin Kelly Olalekan
Published: July 2022

Background:

Retinopathy of prematurity (ROP) is an important cause of childhood blindness worldwide. This blindness is avoidable through regular screening of preterm infants and prompt intervention for those with the condition.

Aims/Objectives:

This study aimed to determine the pattern of presentation of ROP and the risk factors for its development among preterm infants in the Neonatal Unit of the University of Calabar Teaching Hospital, Calabar, Nigeria.

Design of Study:

This study is a prospective, longitudinal study.

Settings:

The study was carried out in the Special Care Baby Unit, Sick Baby Unit, and Neonatal Clinic of the Department of Paediatrics and Child Health, University of Calabar Teaching Hospital, Calabar, Nigeria.

Materials and Methods:

All preterm infants whose mothers had given informed consent to participate were enrolled. Ocular examination was performed by a trained ophthalmologist. ROP was staged and documented using the revised version of the International Classification of ROP. Data were entered into a questionnaire and analysed using IBM SPSS version 22.

Results:

Of the 53 neonates recruited into the study, ROP was detected in 11 (21%) neonates, of which 9 (82%) had stage 1 disease, 2 (18%) had stage 2, and none had stage 3. ROP was more common in females, 7 (63.6%), than their male counterparts 4 (36.4%). ROP was higher among those with gestational age (GA) ≤30 weeks [9 (81.8%)] when compared with those with GA >30 weeks [2 (18.2%)] (P = 0.016). Other risk factors for ROP assessed by this study were found not to be significantly associated with the occurrence of ROP.

Conclusion:

ROP was present in 21% of the neonates, and the majority had stage 1 disease. This finding emphasizes the need for screening of all preterm neonates for ROP in order to forestall avoidable blindness which could result from this condition.
Physiotherapeutic management of hirayama disease
Authors: Patel Lilima , Sarkar Bibhuti , Oraon Anil Kumar
Published: July 2022

Hirayama disease (HD) is a rare condition which is also known as juvenile muscular atrophy of distal upper extremities (JMADUE). The case study of a 22-year-old man is presented who reported weakness in his distal upper extremities and many of his clinical presentation, electrophysiological, and neuroimaging findings were consistent with HD. The purpose of this case study was to present a detailed assessment and evaluation of this rare disease and also to formulate a general physiotherapeutic intervention. Neurological examination demonstrated moderate-to-severe atrophy of distal muscles, preserved reflexes, and normal sensation in his both upper limbs. Electrophysiological studies revealed neurogenic changes in the muscles innervated by the lower cervical spinal cord. Magnetic resonance imaging showed atrophy of the midcervical cord with high signal intensity in the anterior horn cell region. These examination and investigation findings were compatible with the diagnosis of JMADUE also known as HD. A physiotherapeutic regimen of 6 weeks, consisting of strengthening exercises for the upper limbs and neck muscles, and the postural correction was carried out. Grip strength was measured by Jamar handheld dynamometer and functional disability by the disabilities of arm, shoulder, and hand (DASH) questionnaire. After 6 weeks of intervention, improvement in grip strength (left side 20.2 lbs to 25.6 lbs and right side 35.7 to 38.6 lbs) and many of his activities of daily life were noted along with DASH score (left side 90/125 to 76/125 and right side 55/125 to 30/125). HD is a self-limiting disorder and there is no definitive treatment. Physiotherapy helps in preventing complications resulting from immobility such as joint stiffness and muscle wasting. A general strengthening exercise program can limit the disorder and improves the quality of life.
Effectiveness of neck flexors and extensors muscle strengthening exercises on pain and function in migraine patients
Authors: Priya S. , Abhilash P. V. , Sivasankaran M. Gopika
Published: July 2022

CONTEXT:

Migraine is a primary episodic headache disorder, characterized by combinations of neurological, gastrointestinal, and autonomic changes in the body. Migraine patients are more likely to self-report neck pain, to have more cervical trigger points and tenderness over cervical muscles. Neck flexor and extensor muscles have shown decreased strength in migraine patients.

AIMS:

To determine the effectiveness of neck flexors and extensors muscles strengthening exercises on pain and function in migraine patients.

SETTING AND DESIGN:

A case–control study was conducted among 14 individuals of ages 20–30 years with Migraine in a Tertiary Care Hospital, India.

SUBJECTS AND METHODS:

Fourteen migraine patients were selected for the study and neck flexor and extensor strengthening exercises were administered for 4 weeks. The pain, cervical range of motion, and disability were measured using visual analog scale (VAS), universal goniometer, migraine disability assessment score (MIDAS) before and after the intervention.

STATISTICAL ANALYSIS USED:

Data were analyzed using SPSS v. 26.0. Values are expressed in terms of mean and standard deviation (X[Combining Macron] ± SD). Statistical analysis to compare pre and post group was done using paired t-test.

RESULTS:

Paired t-test was used to compare the interventions within the group. Statistical analysis showed significant improvement in pain and function on migraine patients after 4 weeks of treatment. VAS (t = 6.358, P < 0.05), MIDAS (t = 3.798, P < 0.05), ROM (t = 5.014, 2.851, P < 0.05).

CONCLUSION:

The present study concluded that strengthening exercises of both neck flexors and extensors muscles reduced pain and improved function in migraine patients.
Association of foot arch types with chronic low back pain among selected adults in Sri Lanka
Authors: Marikkar Shanaz F. , Fernando Desha Rajni , Deepani Siriwardana H. V. Yamuna
Published: July 2022

BACKGROUND:

Abnormal foot posture has been extensively discussed as a risk factor for chronic low back pain (CLBP). The present study aimed at assessing the association of foot arch types with CLBP in a selected population.

METHODOLOGY:

A descriptive study was conducted at the Department of Rheumatology and Rehabilitation Clinic of National Hospital of Sri Lanka with employing a 100 of patients diagnosed with CLBP (50 cases and 50 controls). The data were collected during December 1, 2019, and February 28, 2020. Foot arch type was detected using the arch index method. The modified Oswestry low back pain disability questionnaire was used to measure the disability level and Numerical Rating Scale (NRS) for pain. Chi-square test and Pearson's correlation tests were used for data analysis.

RESULTS:

Out of the patients with CLBP, 82% (n = 41) were with normal foot arch (NFA), 16% (n = 8) with low foot arch (LFA), and 2% (n = 1) with high foot arch (HFA). In the control group, there were 94% (n = 47) with NFA, 4% (n = 2) with LFA, and 2% (n = 1) with HFA. Sample size was small to extract a significant P value for the observed difference between cases and controls with regard to the presence of LFA. The majority (66%) of the patients had severe disability followed with moderate disability (28%), minimal disability (4%), and crippled (2%). A positive correlation was found between disability level and the pain scale (P < 0.01).

CONCLUSIONS:

Further research with large sample size is necessary to make firm conclusions on association of LFA type with low back pain. However, the pain and the disability level among the patients with CLBP seems to be highly correlated.
Doctor-patient communication in thyroid conditions
Authors: Lathia Tejal , Selvan Chitra , Namjoshi Shraddha , Badhe Satyendra
Published: July 2022

Thyroid disorders are common conditions in the population that have repercussions on health, fertility, quality of life (QoL), and overall well-being. A literature search was conducted using PubMed database, using the key search words “thyroid disorders,” “QoL,” and “doctor[FIGURE DASH]patient communication.” The impact of thyroid disorders on patients' QoL, overall well-being, and the patients' outlook toward their prognosis necessitates better and more detailed communication between patient and provider. Thyroid disorders can have lasting psychological impacts and patient coping depends on effective management of these. An empathetic clinician can play a major role in boosting patient confidence and improving patient satisfaction, well-being, and adherence to treatment, resulting in improved outcomes. Physicians must identify the unmet needs of their patients and potential areas where their patients may need greater support and bridge the gap between the information that they are providing and patient-expected information.
Exact lower and upper bounds for shifts of Gaussian measures
Authors: Pinelis Iosif F
Published: July 2022

Получены точные верхние и нижние грани для отношения $\operatorname{\mathbf E}w(\mathbf X-\mathbf v)/\operatorname{\mathbf E}w(\mathbf X)$ для центрированного гауссовского случайного вектора $\mathbf X$ в $\mathbf R^n$, а также оценки скорости изменения $\operatorname{\mathbf E}w(\mathbf X-t\mathbf v)$ по отношению к $t$, где $w\colon\mathbf R^n\to[0,\infty)$ - произвольная одновершинная функция и $\mathbf v$ - произвольный вектор в $\mathbf R^n$. В качестве следствия таких результатов даны точные верхние и нижние грани для функции мощности статистических критериев для математического ожидания многомерного нормального распределения.
Generalized Marcinkiewicz laws for weighted dependent random vectors in Hilbert spaces
Authors: Son Ta Cong , Dung Le Van , Dat Do Trong , Trang Ta Thi
Published: July 2022

Целью статьи является применение теории правильно меняющихся функций для изучения слабого и усиленного законов больших чисел Марцинкевича для взвешенных сумм $S_n=\sum_{j=1}^{m_n}c_{nj}X_j$, где $\{X_n, n\geq 1\}$ - последовательность зависимых случайных векторов в гильбертовом пространстве и $(c_{nj})$ - вещественные числа. Полученные результаты далее применяются для вывода некоторых утверждений о сходимости многомерных распределений Парето-Ципфа и многомерных логарифмических гамма-распределений.
A note on the Berry-Esseen bounds for $\rho$-mixing random variables and their applications
Authors: Lu Chao , Yu Wei , Ji Rong Lin , Zhou Houlin , Wang Xuejun J
Published: July 2022

В 2019 г. Ван и Ху, используя мартингальный метод, для случайных величин с $\rho$-перемешиванием установили неравенства Берри-Эссеена со скоростью нормальной аппроксимации $O(n^{-1/6}\log n)$, где $\log x=\ln\max\{x,e\}$. В настоящей статье мы устанавливаем некоторые общие результаты о скорости нормальной аппроксимации, которые включают соответствующие результаты Вана-Ху 2019 г. При некоторых подходящих условиях скорость может достигать $O(n^{-1/5})$ или $O(n^{-1/4}\log^{1/2} n)$. В качестве применения мы получаем неравенства Берри-Эссеена для выборочных квантилей, построенных по случайным выборкам с $\rho$-перемешиванием. Наконец, мы приводим результаты численного моделирования, чтобы продемонстрировать на конечных выборках эффективность теоретического результата.
Большие уклонения суммы независимых случайных величин, распределения которых имеют быстро убывающие хвосты
Authors: Rozovskii Leonid Victorovich
Published: July 2022

В работе исследуется асимптотическое поведение на бесконечности распределений и плотностей суммы конечного числа независимых случайных величин в случае, когда плотности или хвосты распределений самих случайных величин убывают быстрее, чем плотности или хвосты гамма-распределения.
Mallows distance convergence for extremes: regeneration approach
Authors: Mousavinasr Somayeh , Gonzalves Catia , Dorea Chang C.Y.
Published: July 2022

Исследуется сходимость в смысле расстояния Маллоуса, чтобы охарактеризовать область притяжения для распределений экстремальных величин. При умеренных допущениях выводятся необходимые и достаточные условия. В случае независимых одинаково распределенных случайных величин наши результаты применимы к регенеративным процессам.
Предельный спектр выборочных ковариационных матриц растущей размерности с граф-зависимыми элементами
Authors: Yaskov Pavel Andreevich
Published: July 2022

Для выборочных ковариационных матриц, отвечающих случайным векторам с граф-зависимыми элементами и размерностью, растущей пропорционально объему выборки $n$, найдены условия, при которых предельный спектр матриц имеет ту же форму, что и в случае гауссовских векторов с аналогичной ковариационной структурой. Полученные условия точны. В частности, они являются необходимыми и достаточными в теореме Марченко-Пастура для выборочных ковариационных матриц, отвечающих случайным векторам с $m$-зависимыми ортонормированными элементами при $m=o(n)$.